With some semen in my sack and some problems in the back
And a life that’s fill with crap,
Semen resides in the “sack” (the testicles). Tyler has problems that crush him like a weight on his back. These might refer to a knapsack, which is carried on the back
If the sack is the front, the back is the ass. This makes sense since Tyler’s life is filled with “crap.” The problems in the back probably also refer to his past.
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