Ok, I just had a consult with my ortho after having an MRI. I have two herniated disks at L4 and L5. That news was like being slapped in the face with a dead fish. I was so surprised that I wasn’t able to come up with very intelligent questions at the time. What can I expect athletically from this injury? Anyone out there have the same injury or are there any Doc’s listening? I am going through PT right now and I seem to be responding positively to the treatment which is why I was so surprised when I got the news. Any help or stories about your experiences would be appreciated.
Wanna,
Lumbar disc herniations can be asymptomatic, can cause localized back pain, or can cause shooting pains down the leg (aka radiculopathy or sciatica). The type of symptoms produced by the herniation usually depends on its size and location. While surgery is sometimes necessary, conservative treatment with a combination of physical therapy, reduced back strain, and anti-inflammatories is all that is needed for the majority of patients (90%). When surgery is needed, it can usually be of the minimally invasive type, frequently requiring less than a full day stay in the hospital.
When I see patients for this problem, I usually okay them to participate in non impact activites as limited by pain. For a triathlete, that means you could swim and bike as long as doing so didn’t aggravate your pain. I usually recommend against running for 2-3 months to allow the disc tear to heal over. Similarly, I would restrict weight lifting for the same amount of time. I give similar recommendations for my post-op patients. Two good examples of well known athletes with this same problem are Cal Ripken and Mario Lemieux. Like these two, even if your disc herniation heals, you may still have flare ups of back problems from time to time and will always need to be conscious of proper lifting technique, stresses, strains, etc. That being said, recovery from this type of problem is generally complete and I have patients who are marathoners and triathletes who are back competing.
Medico-Legal disclaimer: As a member of the medical specialty with the highest malpractice insurance rates, I feel compelled to point out the obvious. A 2-minute cyberspace posting does not substitute for the care and expertise of a real live physician. Please consult with your orthopedist and follow his/her guidelines!!!
Kevin A. Walter, M.D., Faculty, Department of Neurosurgery, University of Pittsburgh
wannatri,
I like the advice by Dr. Walter… If you’re looking for some inspirational comback stories. Jurgen Zack came from some disc herniations to compete at a very high level. He basically just took a few months of lying on the beach (probably not the approach your looking for) But when he felt better, he started running immediately. I think he went to see a bunch of doctors to get numerous opinions (a few even wanted to operate) He decided to wait and see and it worked out for him.
I believe Chris Legh had some serious disc issues as well. He had a nice year as well
As someone who has multilevel herniations and bulges, my first advice would be to attempt to avoid surgery at any cost. Obviously your activity level is going to be affected by your symptoms. I had a completely extruded disk at L3-4 and could hardly walk b/c of the radicular leg pain. I needed the surgery and it got rid of the leg pain. That being said, any long rides in aero position now results in incredible back pain. Try the PT, try the injections. I have a friend who swears by VAX-D, which is essentially putting you on a modern rack-like device and attempting to stretch the vertebras. I still do tris, but no more ironman’s, and bike training is limited.
My wife had this problem. Hers happened last July. She’s just now starting to run again. Just three miles a week. Its been tough. She still doesnt know if she will be able to race again.
Dave
Thank you kwaltermd! I have been doing more research on medical web sights and now feel a lot better about the situation. I guess i’ll not try to run until april or so. Another question if you dont mind. If I “heal” from this injury, would it preclude me from being on the SWAT team?
Wannatri-
I was diagnosed with a herniated disk and a bulging disk last spring. I rowed competitively in high school and college and have always had a balky back, but the shooting pain down my leg and severe pain in my lower back told me something wasn’t right. In 12 hours I went from walking around normally to not being able to get out of bed.
I was told that surgery wasn’t necessary yet and was instructed not to run, lift, and preferably bike for 6-8 weeks. I did as directed and swam like a madman with no ill effects. Over time, my pain decreased and after 5 weeks I had no pain at all. Just to be safe, I waited a further five weeks before resuming my running, biking, and lifting. I had no problems resuming my training, and on the plus side I became a better swimmer. I was doing a ton of volume, enough that I started focusing on drilling for the first time. Wow, big difference.
Anyway, I haven’t had any major problems but there aren’t many days when my back isn’t a little stiff for a few minutes after waking up. I need to lift with good form now–if I don’t I get a flare up–and doing core and back strengthening activities are a better idea now than they’ve ever been in the past. I’ve found that when I’m diligent about my exercises, I can row on an ergometer or in a boat up to five times a week with no ill effects. The second I let my exercises slip, I’m in the hurt locker.
Bottom line: doesn’t have to be a huge deal. Yes, you’ll need time off, which can be frustrating. And yeah, it would be a good idea to dedicate a little more time to preventative stuff. But you might become a better swimmer because of this, and your lifting will probably improve too since the proper form that your back now mandates will give your muscles a better workout.
Good luck.
I will pretty much echo with what Dr. Walter said in his post and add some real world experience of my own.
The first thing you need to do is realize that you have a semi-permanant to permanant condition with the disc herniation. This is not something that will turn itself around in 2 - 3 weeks, even with aggressive physio and other treatment like many other soft tissue injuries. It may take a VERY long time to heal/correct itself or it may just stay that way. If it’s the latter, you will have to do a bit of soul searching to comer up with a real-life solution(s) as certain things will need to be eliminated permantly from your life.
I have an L4-L5 herniation myself. It was positivly diagnosed via MRI two years ago. Escalating back pain over a two year period led to this diagnosis. Prior to the onset of pain, I had, had no back problems what so ever, for 20+ years of high level running and triathlon competition. I have tried just about every one of the conservitive treatment methodologies and, nothing has really had any impact. The only thing that has helped me is doing the basic Pilates routine and focusing on Tranverse Abdominus and Mutifidus strengthing. I have had to give up a number of activites - running, swimming, xc skiing, heavy lifting( anything over 5 pounds) of any kind. Cycling, thankfully I can do and have ridden up to 100K at times, as long as there is not any big climbs and I keep the gearing easy and RPM’s up.
Unfortunately, there currently is no happy ending to this. I keep hoping that the condition may spontaeneously resolve, as I have heard that this can happen as you get older. For the time being I focus on core strength, not doing anything stupid, and pain managment via OTC NSAID’s.
Fleck
I had a herniated disk about four years ago. PT was very effective. I think It was called McKenzie treatment. I Lost about a month of training. I did the exercises faithfully as prescribed. Started back swimming after about two weeks. Cycling on a mountain bike (on road) about a week later. Running last.Mine was in July and I had some good races by September. Good luck.
I agree with all the previous posts and would add that, in my experience, it was a lot of trial and error in figuring out what I could and couldn’t do. Swimming is supposed to be okay but it caused me a lot of pain. However, running didn’t bother me too much. Mine got better after a couple of years to the point where I didn’t think about it every second. I found that cross-training was better for me than just running, for example, and I actually kept up with weight training (being very careful about form) to keep things strong. I would tweak it every now or then (usually doing stupid things like picking up a sock) but after a day or two it would be fine. However, I tweaked it bad last year and I’m still recovering. Hope the best for you.
Like I said, I was freaked out at first, thinking that I was going to be a cripple. Thanks to everyone who responded. There more research I do, the more I come to the conclusion that this is a common injury with a good chance of recovery.
Been there done that last year… exact same herniation…
Last year was the only year I competed in 1 triathlon (before the diagnosis) since doing tris for 20 yrs.
I think the hardest part was transferring my conviction from training to recovery. Mentally it was tough… but, I was able to transfer the disciplined and consistency that I use to train for triathlon to therapy. That is what I contribute my successful recovery. In fact, One year later (yes, I said 1 whole year later) I’m a much healthier person and (for the first time in many years) working out WITHOUT a nagging pain.
The key to my success was multi-faceted but not cheap.
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I started PT and stayed with it religiously. Did ABSOLUTELY NOTHING to cause injury… I did not want to take one step forward and two steps back. I quite doing what I was doing in order to getting what I was getting - Injured.
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I got my bike fit and running form re-evaluated by medical professionals at Sports Medicine Clinic at Boulder Co. They comunicated to my PT’s that I used at my home town… Who I might add are also athletes. I intentionally chose athletes or medical professionals that deal specifically with athletes. I think this is crucial to a success level that matches your lifestyle.
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Finally, I stuck with it… I never gave up… and never let myself get down. Mentally it was tough… but, then what isn’t tough that isn’t worth working for?
After all that money, effort, time and therapy… I finally got a coach that worked with me from the basis of my limitations. I found a coach that had a medical background.
A combination of the things I listed above have made a HUGE difference… so big, in fact… I’m better now that before I was injured. However, it was both expensive in both time and money… but, in hindsight it was the best investment of my life.
Good Luck… And, if there is one thing I could recommend…remember, Patience and Perserverance is key.
FWIW Joe Moya
I have a herniated disk at L5- S1. Horrible pain and no decent sleep for a month now, going back to dr today for different (non coedine) pain relief. Pain managmeent specialist suggested epidural injection of steroid/anesthetic- does anyone have experience with that as at least temp relief from the pain?
I can ride a bike in small chainring, high cadence, but hardly walk. Have not tried to swim. HAving traction with DRX machine similar to one described above. Last go around with this 6 months ago it helped a lot.
I spend many hrs a day on my feet as a restaurant manager, i am sure that does not help.
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I have a disc hernation at L5-S1. I was fine on September 3, 2004. I woke up on September 4, 2004 and couldn’t get out of bed. Crazy. Anyway, I didn’t go to the doctor, thinking it was just a muscle strain, which I had done plenty of times before. Well, several weeks later I’m still hurting. It eventually gets a little better, but still sore and hurts when I wake up. I started running a little again and lifting relatively light weights, doing squats as well with about 30 pounds to strengthen my back (I thought this would be good). Well, all I did was re-aggravate the herniation and was back to square 1 (this was in December or so). This time I went to the doctor and had an MRI, which confirmed the herniated disc. My doctor sent me to a specialist. He sent me to physical therapy, which I started a month ago. I have just given my back rest and done the exercises the physical therapist has given me to do. My back feels great now…not 100%, but better than it has at any point since the original onset of pain in September.
I’m running again and going to try to ride again. I’m not going to push it too hard. Right now I’m just absolutely ecstatic that I can move without much pain again. It really is somewhat emotional, actually. It is so frustrating not being able to do anything physical for so long. I honestly thought that life as I knew it was over. Feeling this good again has given me new inspiration to train (sensibly, considering my back condition).
There is hope, so don’t get too down. Just give it time and it will get better. Mine has taken 6 months, and it will get you down. However, the high that I have (and you will have) from being able to move again is incredible.
Good luck!
I would think with so many replies to this posting, someone would mention seeing a chiropractor. I have found there are two camps when it comes to these practioners - people think they are quacks or people swear by them.
I woke up with one morning with the same type of pain in my back. The night before I was fine, the next morning it felt like my disk slipped out. I started to see a chiropractor who helped adjust my spine back into shape. I train over 17 hours per week and I know my regular visits to the chiropractor has kept my relatively pain free and training.
I have herniations of the L4, L5. It reared it's head last June when I slipped at work. I didn't fall, just slipped like you would on ice. My doctor first suggested PT. Three times a week for a month. Then I tried to run again, wham, the pain was back. Then I had one epidural steroid injection, two days later I was like a new man. Started running again and had a great race in Lake Tahoe running all those wicked downhills with no ill effects on the back. The steroid injection is not a cure. I just clears up the inflamation and lets the body do it's work faster. The most important thing for you to do right now is to start strengthening your core muscles. I got a list of excercises from the PT and I also got some great core exercises form Gordo's websight. All of these I do 3 or 4 times a week. Work on your core strength. Let your muscles suport you and take the pressure off your spine.
MTB accident in 97 – 2 surgieries to repair separated shoulder; then in 98, discovered herniated/ruptured disk in L4-L5 (I think from the same accident). Post-surgery i was in a deep depression – thought my running days were gone for good (quite a disappointment as I had run 2 marathons in 97 pre-accident). Instead, i swam, lifted weights, and did pull-ups until I thought my arms would fall off.
Every time I tried to run, it would hurt. Then, in 2003, I decided to give running another shot. I told myself that I wouldn’t run 2 days in a row, and if it hurt my back, I would stop. I worked up to a marathon in June 2003, ran Mardi Gras Mathon, Boston Marathon (on a charity # - no, I am NOT fast, never was!), Gulf Coast Tri and IM Florida in 2004.
My point is, you CAN come back from this injury, even if you have to have the surgery, which I hope you don’t. That being said, if 1 doc + a second opinion says you need it, get it.
I do take care of my back, am careful when I lift heavy things. I am glad I had the surgery.
By the way, i credit the pull-up regimen for strengthening my upper back and stretching out my spine – I need to re-incorporate one of those workouts (120-200 pull ups) back into my regime – it did wonders for me!
Charles
I think that pasrt of the reason is that back injuries are very complex and don’t really follow any set pattern. Therefore, there IS no one best way to treat them.
There are people who will have an MRI and are diagnosed with a herniated disc and they are completely asymtomatic( ie no symptoms) there are others who will have similar results on an MRI and be in agony! Few other injury situations are like that.
Chiropractic treatment is just one option or one component of treatment for people who suffer from back pain - I believe a good chiropracter would tell you that.
Fleck