Hoping someone out there has some ideas of what I can do to kick this thing once and for all. Since about mid-April (and all through IMCDA and post-IM into July) I’ve been plagued with Facet Joint syndrome in my low back. Multiple tests (X-ray, MRI), dx from trusted MDs, etc has confirmed that this is the issue. PT program is abdominal (TVA) and multifidus muscle conditioning/strengthening and is helping. Swimming is the big culprit and I’ve arrived at that conclusion via a lot of trial and error and discussions with PTs, docs, etc. Cut my swimming down to 1 day per week with minimal yardage (20-30 mins). All of this has helped. Need/want to ramp it back up for IMAZ (yes, I am late) but I believe I am making technical mistakes in the water (lack of rotation perhaps) that is causing the Facet Joints to be heavily loaded and mad again.
Any advice from those who have suffered similar issues?
Guessing it’s a weak core (which you are already addressing), work on holding your core tight, suck your bellybutton toward your spine and roll the top of your hips back, and keep your lower back from collapsing, It should be as close to straight as possible.
Don’t use a big pull boy, which tends to raise your legs and compress the lower back and don’t push off the wall hard, which compresses the back. Make sure your head is down. On the side you breath out focus on keeping your lower eye lens in the water. Swimming hard when I haven’t been swimming tends to tighten my hamis, which leads to a tight back. Take lots of breaks and concentrate on maintaining form and staying relaxed. When I get tired, I lose the streamline and start collapsing my stroke and get the side to side “wobble”.
Can you start building your swimming by going a few more times a week, even if it’s only 500 meters. I would think swimming only once per week may be causing more problems than helping. You may be better off swimming 500 meters 3-4 times a week than 1000-1500 meters once a week. More swims but keep volume down and slowly build until you get more comfortable and don’t have any irritation. Just a thought.
Have you changed anything on your bike or run, where the swimming causes the symptoms to increase? Don’t run on too soft a surface. This tends to bother my lower back. Avoid treadmills. The bounce and flex causes my lower back to tighten.
I missed one year at IMCDA with the dreaded back spams that came on after a long swim. But the true problem was I raced the weekend before and raised my seat about a mm or two and never lowered it back. Went on a long ride then did a long swim the next day. The swim did me in but I still believe it was caused by the suttle change in my seat height combined with the swim.
I agree with Summit. Maybe you have excessive arch in your lower back while swimming? You can test this possibility by allowing your legs to drop, thereby increasing hip flexion. In other words, do you have less low-back pain if your legs don’t float as high as usual?
Thanks to all who responded. I appreciate any and all input at this point. These are good ideas to consider.
Hey Jim – I got diagnosed with the same thing as you and trying to wrap my head around how to improve this situation. Any advice for someone who got diagnosed with a minor version of this?
Yes. 4 X 800mg ibuprofen daily for 14 days straight. Put the fire out for good. Felt great 3-4 days into it and PA told me to go all the way for a full two weeks no matter what. It worked. Gut was fine. That was 12 years ago…
Yes. 4 X 800mg ibuprofen daily for 14 days straight. Put the fire out for good. Felt great 3-4 days into it and PA told me to go all the way for a full two weeks no matter what. It worked. Gut was fine. That was 12 years ago…
Thanks I tried this regiment for 4-5 days but may need to take it to the extreme and see what happens. Appreciate it.
Yes. 4 X 800mg ibuprofen daily for 14 days straight. Put the fire out for good. Felt great 3-4 days into it and PA told me to go all the way for a full two weeks no matter what. It worked. Gut was fine. That was 12 years ago…
Thanks I tried this regiment for 4-5 days but may need to take it to the extreme and see what happens. Appreciate it.
Be careful with this regimen. As an MD who also works in pain related areas you need to be careful taking such high dose NSAIDs for this period of time. Consider taking them with some gastric protection (eg drugs like pantoprazole, ranitidine etc) and be very very careful re hydration.
I can’t say I would recommend this approach.
I’m a pain MD, huge swimmer. Could be facets but only 100% way to test that is medial branch blocks under flouro and then get into the water and swim.
Even if it is, I would advocate for 98% of people to focus on multifidus control exercises vs RFA, and working to ensure that you are not in huge lumbar lordosis/hips tilted forward, which would exacerbate the stress. I would probably work on stretching out your hip flexors and then strengthening your back/glutes muscles re-establish a fairly neutral pelvic tilt. Would probably avoid flip turns for awhile to let things quiet down and before every swim do some isometric core work (I’m a big fan of the mcgill stuff just cause its the most accessible thing for patients to grasp, acknowledging that its utility is highly debated in the back pain world!)
I’m a pain MD, huge swimmer. Could be facets but only 100% way to test that is medial branch blocks under flouro and then get into the water and swim.
Even if it is, I would advocate for 98% of people to focus on multifidus control exercises vs RFA, and working to ensure that you are not in huge lumbar lordosis/hips tilted forward, which would exacerbate the stress. I would probably work on stretching out your hip flexors and then strengthening your back/glutes muscles re-establish a fairly neutral pelvic tilt. Would probably avoid flip turns for awhile to let things quiet down and before every swim do some isometric core work (I’m a big fan of the mcgill stuff just cause its the most accessible thing for patients to grasp, acknowledging that its utility is highly debated in the back pain world!)
Thank you Dave. From your experience – If I have a minor onset of facet joint arthritis and its been nagging at me for the last 6 weeks (still able to train through it given pain is minimum but never had an injury linger this long) – is it normal for something like this to drag so long and is the best remedy here to stop until pain is down to 0 or continue training?