Well, I fianally got the answer to what has been causing my back to hurt all summer. I had an MRI and just got the report. I have two herniated discs (posterior midline herniation L4-5 and L5-S1 ). I'm calling a disc specialist at the Hospital for Special Surgery in NYC today. Has anyone been through this? I've hardly ran since June, hardly biked in the last month, mostly just swimming and right now only with the pull bouy.
What do you think? Will I recover from this? Run again? Bike? Do I need a Softride? Does anyone know anything about damaged discs?
Hold it right there!
Dont just run off and expect surgery to fix your back.
Get a second opinion.
Have you tried some traction? This may work for some people, certainly worked for me.
Sorry to hear you joined the club. Good basic information can be obtained from webMD or mayoclinic.com.
I’m still living a no-training-since-June 4-because-of-a-herniated L5-S1 hell. PT has consisted only of traction because she is concerned about the amount of leg pain I have and doesn’t want to make it worse. While supine, I can’t lift my straight leg more than 30 degrees from the table. Traction for 20-30 min 3x/wk has not helped. The pain management and physical medicine guys won’t see me until September. Nice huh? The only thing that takes enough of the pain away that I can concentrate at work is prednisone which they’ll only give me for weekly bursts and only after the preceding burst has “worn off”. Ibuprofen helps a little, but not much by itself without the prednisone.
I’m taking the no-surgery route for as long as possible. With time and/or better inflammation/pain management I can receive more effective PT. Unfortunately, 2004 is shot. I cancelled out of Half MAX, Muncie, and IM Wisconsin, and won’t be doing a few other races I planned to do.
Best wishes for a quick recovery. I’m sure you’re not taking this any better than I. I’m told I can’t start biking or running again until they can lift my leg close to 90 degrees without pain. Funny, since I don’t think I could do that before the disk herniated. THAT (i.e. tight hamstrings), said the PT, is PART of the problem! She has a Cat2 client who has the same problem and is back to racing at his previous high level so I don’t think we have to consider a Softride.
Sorry to hear about your disc problem. The first thing you need to understand about disc problems is that they are not like other injuries - they don’t go away with a little PT, rest and recovery. They can be withy you a very long time and require a significant change in lifestyle. I know, I have a L4-L5 herniated disc myself. I discovered this 2 years ago after escalting back problems over the preceeding two years. Ironically the back problems started when I shut down serious tri training and racing. For 25+ years of running and triathlon racing up to the year 2000, I had never had any back problems.
Don’t rush into the surgery. I have heard that it is only a last resort. Main reason is that it’s a 50/50 shot at improving the situation.
I have delt with my situation with significant changes in my lifestyle( no running, no xc- skiing, no heavy lifting and always being very cautious of my body movements to protect my back). Using pain-killers and anti-inflamatories when needed. Finding the core strengthing exercises that help( many don’t help and can make my condition worse) A few of the key Pilates moves I have found to be really helpful - almost like natural pain killers. And finally doing things that I can do and focussing on them. Surprisingly, cycling does not bother my back if I keep the gears easy and stretch well, before and after cycling.
Best wishes.
“What do you think?”
I think you have a herniated disk whose treatment options should include therapy. It can and does work… but, it can take a significant period of time to recover. Surgery is typically considered after therapy has been attempted. Surgery is not considered an immediate solution for herniated disks. I would definately give proper therapy and lots of recovery time a shot… long before any surgery is attempted.
“Will I recover from this?” Most likely…provided you stop training and start recovery… Then, re-evaluate your training method and redefine your training progress. It’s about start over with one small step at a time. There will nothing fast about recovery… and, you sure as hell can’t try to race or train at your current level (or past level) and expect to recover.
Run again?
Most likely, but you may have to change your training method and level of intensity.
Bike?
Very likely, but (again) you should have your fitting done by a those who specifically deal with medical conditions associated with bike riding… Boulder Medical Sports Center comes to mind.
Do I need a Softride? Maybe-Maybe not… but that’s getting the cart in front of the horse… what you need is proper physical therapy at this point. …Then you get a proper re-fit (see above)… then find a bike that matches the new fit. It’s not much different than when you first started biking… only, the repercussions for a poor bike fit are much more severe.
Does anyone know anything about damaged discs? Yea… they hurt!
The only problem with herniated disks is not treating it properly… and treating it properly means doing the things that will make it better. Unfortunately, doing triathlons or training for triathlons will not typically fit into that equation - at least for now. Good Luck.
FWIW Joe Moya
I’ve been dealing with this (same discs) for the last year plus. Every case is different, but there are options short of real surgery. Sometimes a cortisone shot will help, sometimes time off will be enough. There are also some less-invasive surgical procedures, such as inserting a substance into the disc area that almost creates an artificial disc. In the long run, stretching and strengthening core muscles will be key. For me, Pilates made an immediate and big difference.
FWIW, after losing all of my 2003 races to the injury, I have done a bunch of events this season, including two half-Ironmans and a marathon, and am planning on being at IM Wisconsin. I ride a Cervelo P3, but I had it professionally refit to put less stress on my lower back. It’s not as aero, but it’s rideable. Sometimes I have back pain, but usually not for long.
You can come back from this. It’s just a matter of taking your time and really working at the rehab, working as hard at it as if it is a race, even if the rehab requires time off. Finding some experts you trust, who are familiar with disc injuries in an athletic context, whether they are from conventional or alternative medicine, helps.
[ Has anyone been through this?
No, I have not had a herniated disc, but do have a Harrington Rod as a result of childhood scoliosis. Which means that my spine is fused from T5 to L3. This means only a few discs in the lumbar region taking all the brunt of the work. (You should see my x-rays - not pretty) This causes daily discomfort which can sometimes be pain in the lower back, buttocks and even numbness into the foot and lower leg, but daily trunk and back exercises keep the pain under control and manageable.
What do you think? Will I recover from this? Run again? Bike?
Yes, you will do all of the above again, but in due time. Do your therapy first. It sometimes seems to take an excrutiatingly long time, especially for active people. But, please take the non surgery route. I have been able to keep things under control and train and lead an active life style with appropriate therapeutic exercises.
Follow your PT’s advice and do as instructed. Try to avoid surgery at all costs. Imagine that your spine is a well designed spring. If you have a laminectomy or a discotomy, etc., then you are removing one of those very important parts of the machine. This causes undue stressors on the other parts. Most people that I have treated in the past with these problems will return with more problems as a result of this.
Also take a look at how you do things. Lifting, moving, etc. Are your trunk muscles able to stabilize the spine in its biomechanical optimum positioning for movement or not. Ask your PT if she has heard of “functional lumbar stabilization” exercises. I use these daily. They are exercises that work on the ‘smaller’ stabilizing muscles of the trunk and spine to strengthen them. These muscles need to be trained to stabilize the spine in various functional positions. It is one awesome workout too! Once these muscles begin to do their job again, you will find a change in your discomfort. When I neglect my exercises for this region of the body, my back lets me know!
Do I need a Softride?
No, you just need a bike that fits you well. I ride a P2K in races and TT’s and a titanium road bike at other times. I have found that the ti bike is easier on my than the aluminum.
Does anyone know anything about damaged discs?
Please, try to avoid surgery. I know that it is hard to be off and missing the season. It has happened to me and it is incredibly frustrating. However, I did volunteer at all of the local races that year and it did give me some satisfaction to be there and give to my sport on the other end of the race chute.
Good luck with your recovery. Don’t rush things. With the spine, it takes time, but the time you take now and the avoiding of surgery will be worth it in the end.
Hi Guys,
Don't worry I'm not running off to the surgeon. The doctor I'm seeing tomorrow isn't a surgeon. He is a physiatrist who specializes in lower back injuries and treats without surgery. I'll see him tomorrow and see what he has in mind. The pain that I have is not that bad. It's only bad in the middle of the night. It wakes me up every night like a hot knife in the back, then I'm up for the rest of the night and when I get up it's like Frankenstein getting out of bed. As the day goes on it gets better and I usually feel almost fine in the afternoon.
I wonder about my bike fit. I ride a Kestrel Talon and I don't feel any pressure on my back. I rode a century in July on lots of ibuprofen and chose the Kestrel over my road bike because I feel less pressure when I'm aero. The biggest mistake I made this summer was a ten mile run. I really suffered that night. I'm just swimming right now and I guess I'll start planning for next year. I'm really going to miss Lake Tahoe Marathon Festival, seven days of racing. I was planning the 1 mile swim thursday, 77 mile bike TT friday and marathon saturday. Oh well, maybe I'll just go and while my wife races I can go real estate shopping.
which Pilates moves did you find helpful?
I found many of the basic Pilates mat moves to be very helpful. Particularly the ones that involve sustained contraction of the transverse abdominus muscle. I could go into a Pilates session with a sore lower back and after 30 minutes, the pain would be gone and the next day I would have a “good back day”!
What about riding the Computrainer. I just rode for 45 min and feel fine but I should most of my problem is when I should be sleeping. Saturday I rode outside and WOW did I have a bad night. Do you think the problem is the leg motion of the jolting?
I went to a pain specalist (MD) and PT to try to beat the problem without surgery.
After 6 months of misery, a MD friend of mine got me an appointment with a leading brain and spinal surgeon.
Based on his reading of the MRI, I was risking severe and permanent nerve damage: the disk was impinging the spinal cord. I had the discectomy (L5) within a week. In the post-op visit, the surgeon said “I have done the easy part, you must do the hard part and make yourself stronger than ever before. Go and RUN”.
I couldn’t have hoped for a better outcome.
If I had listened to the pain specialist and physical therapists, today I would be in a wheelchair.
Don’t just get a second opinion, get an expert opinion.
Jeff
I have the same herniated discs you do as a result of an old rugby. It got really bad from August through January of last year. The 3-part solution =
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ART therapy (active release technique) =IT WORKS. Dr Marc Bochner in NYC is great. 10-12 sessions through January + February, 1x a month since then
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Pilates exercises + yoga stretching 5-6x a week (20 minutes). Need to be religious about this -either after you train (especially if its a little tight) or before going to sleep at night
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Professional bike fit. Paul Levine in NY is who I went to -He made my bike sooo much more comfortable for long rides
So far this year I’ve done 1 ironman, 1 half ironman, 2 olympic, 2 spints, 2 duathlons with NO PROBLEMS. Strengthen and stretch the core daily, that was the key for me.
Your spinal cord ends at L2. You don’t get spinal cord damage / paraplegia from an L5 disc - maybe nerve damage though. Not slagging your surgeon or the story of your recovery, it’s just that judging when to operate on a disc is very rarely a black or white decision.
Deke
I find it interesting that people find that the thought of surgery unacceptable, but taking intermittent weeks of prednisone acceptable (I’m assuming that we’re talking oral prednisone here). Prednisone is a scary drug, which has some significant side effects - avascular necrosis of the hip, for example. Not saying that surgery is a cure all, or that it even applies to you, just that some non-surgical treatments are associated with significant risks too.
Deke
Thanks Doc. Well put. When he said “nerve damage” I immediately thought “spinal cord”.
Jeff
I’m certainly no expert and am only offering you ‘IMO’ info based on my experience–but it is similar to your current condition. After trying PT, epidural steriod injections, rest, etc etc I was faced with a total rupture of the L4/L5 disk. Had surgery at Walter Reed and went through the obligatory rest and PT recovery period. Started running in the pool one month after surgery and got on my brand new softride a month after that for my first tentative ride. I went from a cannondale to a softride because the beam bike was more forgiving on MY frame and it was more adjustable as I regained flexibility and confidence. I believe surgery and recovery results are completely situationaly depended–so I wish you the very best of luck. My right calf is a little smaller than the left now but I’ve no noticable leg strength difference or numbness. Have completed IMF, several halfs, Honolulu Marathon, inumerable road marches with full kit and I believe 12 or 14 combat equipped night parachute assaults since the operation–I’d have to check my jump log. The surgery worked for me–hope it works for you if ya gotta go down that road. Do you have to get a softride? NO–but the two major beam bike brands do seem to be easier on the back than traditional framed bikes. Just MO 