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Re: Tip to manage and looking for spine friendly workouts for L5-S1 Disc her iation [runner15] [ In reply to ]
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some of these hurt to read... dont brace... thats going to make things worse, decompression might help and literature shows that. Current research is pointing more to a total joint complex issue rather than a disc specific. I would find someone well versed in mckenzie technique. they have a website you might be able to find a doctor on. Surgery can work wonders for some but outcomes are usually not very good for these cases because imaging does not diagnose...

If you’re curious send me a PM and I am more than willing to try and help you find the right conservative care or send you research on all sides.

https://www.mckenzieinstituteusa.org/

ART, MDT, DNS, MPI, FST
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Re: Tip to manage and looking for spine friendly workouts for L5-S1 Disc her iation [runner15] [ In reply to ]
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Didn't want to start a new thread, and really don't want to derail this one... But I'm dealing with similar. Basically a little over a year ago I slipped on some ice, felt like I'd pulled my left hamstring. It didn't heal, and all through the summer slowly got worse to the point where it was chronically tight. I could still ride (my primary form of exercise, having given up running years ago due to foot issues). End of August last year, in a taekwondo class, doing some sprints, it let go. Pain through back of leg all the way down, significant strength loss. Started with chiro, then MRI on 9/30 (shows "Moderate to large left subarticular disc extrusion migrates inferiorly, and displaces the traversing left S1 nerve root in the subarticular recess. Severe left and moderate right neural foraminal stenosis."), then PT that didn't do much. Well after the PT I did get some "centralizing", but still can't bend over to do so much as put on my shoes without severe pain upon rising.

Appointment with pain management clinic in November leads to cortisone injection on 2/25 after over two months of scheduling debacle. I'm now 6 days post injection and it basically feels like they did nothing. I was told that I wouldn't know the full effects of the injection for 7-10 days, but I'm not hopeful given that it's been getting worse over the last 4.

The unfortunate thing is that this is the trail that insurance makes you take, and yes if I'd had surgery right away I'd already be recovered. I just don't have the option to pay out-of-pocket for surgery.


The interesting thing is that every resource I've seen that addresses non-surgical recovery basically doesn't even want to touch this level of injury -- they just say you need surgery.

So yeah, I'm kinda venting, kinda empathizing.


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Last edited by: brider: Mar 2, 20 7:53
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Re: Tip to manage and looking for spine friendly workouts for L5-S1 Disc her iation [linkslefty] [ In reply to ]
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Reassuring to hear that there are other young people that have had this misfortune and have come out of it.

What is foundation training?
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Re: Tip to manage and looking for spine friendly workouts for L5-S1 Disc her iation [runner15] [ In reply to ]
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Thank you all for your responses.

Going to keep on keeping on.

Hopefully if this simmers down, Ill be able to add in some pilates.

If this does come back or gets worse, leaning towards the surgery route.
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Re: Tip to manage and looking for spine friendly workouts for L5-S1 Disc her iation [brider] [ In reply to ]
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I feel your pain (literally). Im sorry.

From what I read, weakness is a big indicator for surgery so I am surprised they wouldnt cover it :(

Re the injection- I had sharp shooting intense pain with sit<>stand and a dull persistent butt ache. My pain got slightly better the day of, but that night i had horrible burning pain down my leg and worse pain in my butt and back for the next two days. By the second night, I was able to sit<>stand without pain ann things got better through the week. I think i felt better about a week out. I am a little more than 2 weeks out post injection and I have some pain with the slump test and some intermittent butt ache. I occasionally get an aching/tightening in my lower hamstring. My doc told me to repeat the injection if the butt pain isnt gone in one month.

After the injection, I took total rest for 48hours and restarted swimming and PT exercises 3 days after.
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Re: Tip to manage and looking for spine friendly workouts for L5-S1 Disc her iation [runner15] [ In reply to ]
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I'm getting PTSD reading this thread. I had sciatic nerve pain for 16 months which didn't allow me to stand up without intense pain in my glutes and numb foot for more than 10 minutes. I'd have to bend down to relieve the pain. I trained/raced through the pain for the first 6 months of the injury and then just hobbled along for the next 10 moths. I did intense PT for 8 months and steroid injections in order to avoid surgery and it was a waste of time for me. I had L4/5 microdiscectomy in August '19 and walked out the hospital to my car, nerve pain gone. The nerve pain came and went for the next 3/4 months and I took my recovery very seriously. I only did daily walks for the following 3 months and started to run back with 10 second intervals. I hit 40 miles this past week running. If you are intense pain, don't put off the surgery.
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Re: Tip to manage and looking for spine friendly workouts for L5-S1 Disc her iation [runner15] [ In reply to ]
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runner15 wrote:

This is the MRI:

L5-S1: Large disc protrusion (2.0 x 0.6 x 1.0 cm) dissecting below the disc level, eccentric to the left where it contacts descending left S1 nerve root in the lateral recess and approaches the right-sided S1 nerve. No foraminal stenosis.

Hate to break the news to you but with a large protrusion the damage is already done and it will not get better with time. The disc will not move back into place no matter what you do. It a matter of how much pain are your willing to take.

The definitive cure is surgery. You have to have the nerve decompressed which means a hemi-discectomy (just part of the disc is removed), a laminotomy (a piece of bone is removed) or a laminectomy (a larger chunk of bone is removed) is usually indicated to decompress the nerve.

Right now there is no stenosis which is good but if the disc takes more damage (it can flatten out) and stenosis occurs the problems get worse as well as the pain.

Good luck.
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Re: Spine friendly workouts for L5-S1 Disc herniation [ericMPro] [ In reply to ]
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Hanging from a pull up bar also has a similar effect - or doing dips with a weighted belt. Anything that has a traction effect using bodyweight. I see a lot of people mentioning yoga/pilates. If it worked for them that's great. But generally you have to avoid all flexion - and unless your instructor understands what you are dealing with I would avoid all group classes that are structured towards the group and not the individual.

Also, re: PT/rest/other therapies remember there are 2 opposing forces here: the need to "decrease" inflammation to allow the disc to "heal" on its own - reduce to the point that the nerve impact is lessened. And second, strengthening the core/hips/glutes and stability muscles in order to prevent whatever caused it in the first place happening again. That is where PT comes in. So don't write off PT as it's part of the equation. You have to work on the inflammation as well as the strengthening. Just avoid all flexion and like me, spend a lot of time on the floor on your stomach watching Netflix. Someone mentioned Foundation Training which I love, but avoid the moves in the program that involve too much flexion.

Like most on this thread I have a L5/S1 12mm herniation impacting my S1 nerve root the last 4 months. 3 epidurals, PT, etc etc etc - I'm on this thread as I think it's time for surgery. With COVID it's probably the best time to do it even though exercise is my therapy and not sure how I will handle being out of action even if at the moment I am only swimming and walking.
Last edited by: newportcoaster: Aug 10, 20 21:32
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Re: Tip to manage and looking for spine friendly workouts for L5-S1 Disc her iation [runner15] [ In reply to ]
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You can see the basics here: https://www.youtube.com/watch?v=4BOTvaRaDjI.
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Re: Tip to manage and looking for spine friendly workouts for L5-S1 Disc her iation [runner15] [ In reply to ]
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Been there, done that (at 46). Considered surgery, thought running and racing career was over. Raced IM Canada 70.3 six months later. Being fit pays dividends in recovery and healing.
Rest (until sciatica subsides)
Take the meds for inflammation
Inversion table relieves pressure
Stretching and yoga
Walking when no sciatica
Swimming
Light cycling
Walk/Run on grass
Progress all of the above slowly and conservatively
Supplement with callogen and a high quality diet
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Re: Tip to manage and looking for spine friendly workouts for L5-S1 Disc her iation [brider] [ In reply to ]
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Replying to me own post in this thread.

I'm now two weeks post surgery on TWO herniations. The L5-S1 from 2019, and a new one al L3-L4 that showed up initially in the 9/30/2019 MRI as a minor bulge but turned into a full-on herniation with displacement at the end of May when I sneezed while sitting in my wife's (horrible) desk chair. Yeah, a sneeze. But fortunately I was able to chase down the whole approval track in short order so that it could be taken care of at the same time as my initial herniation.

I'm curious about the recco to spend as much time on the floor on the stomach... The sciatic pain from the L5-S1 doesn't seem to be triggered by bending over now (as little as I am bending over at this point), but starts a long slow burn whenever I do lay on my stomach. Which is a bummer because that is my preferred "falling asleep" position.

I've been able to do walks of about 1.5 miles over the last few days. My post-op appointment is on Wednesday, and they'll take out the stitches... Going to be getting one of those accessory mount bars to attach to the trainer (bringing a second flat handlebar up about 3 inches). We'll see what the doc says about when I could get back on the bike... I've gained some visible weight just in the last two weeks.

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http://www.mjolnircycles.com/
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Re: Tip to manage and looking for spine friendly workouts for L5-S1 Disc her iation [brider] [ In reply to ]
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Tolerance for being on the floor on your stomach depends on whether your pain is activated by flexion or not. Being on the floor in the “McKenzie” position can be a big relief if you are flexion intolerant. Just resting on your elbows in gentle extension can help a lot towards relieving the pain.
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