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the shizzle => diet, training and injuries => Topic started by: Monolith on January 27, 2014, 04:35:20 pm
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For the past 10 years (most episodes occurring in latter years) I've been plagued by bouts of excruciating lower back hell.
After pulling on during the warmup phase on very easy ground at the wall yesterday, I stepped through, reached left and tumbled groundward in absolute agony. Last night was a hellish night with painkillers and ibruprofen doing very little to ease things.
Just now, I managed to bite my lip and get painfully into the shower. Whilst in there, I looked down and noticed my abdominal muscles seem to slant quite drastically out of line with my centreline. Looking in a full length mirror this seems quite drastic to me and upon doing a google search for 'twisted spine' being something of a drama queen, I discovered the topic of Scoliosis. It has often been commented by people walking behind me that it appears as if I'm limping (possibly hip related?) and I notice this can be a feature of said condition.
Is there a chance that as my lower back muscles appear pretty damn inflamed, my posture is 'seized up' on one side and hence giving the current postural appearance? I do have bad posture, am just over 6ft 2ins and despite my best recent attempts to begin drastically improving my core and lower back strength, this does seem to be a reoccurring (and very very painful) episode for me.
Any useful advice is hugely appreciated. I'm guessing going to the doctor might be a good place to start once I can move out of bed properly.
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Yes, get to the bloody physio as soon as possible mate. I had some problems a while back with lower back pain (nothing as bad as yours by the sound of it) and it turned out it was 100% down to bad posture. Mainly from sitting at a desk but also from other normal day to day activities where I just wasn't moving properly and exacerbating the situation.
Could be this, could be something else but either way you need a proper diagnosis to make sure whatever you're doing / not doing is making it better rather than worse.
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Go and see a physio.
There are lots of potential causes, some of which may be separate or inter related.
4 years ago I could only walk leaning over to one side and with a pronounced limp. Full strength prescription codeine just to move. 3-4 weeks of lots of exercises and being careful I was back to near enough normal.
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Mines just flared up this last week.. :( not as bad as yours Mono - but causing me some discomfort at night and makes it hard to bend down for things. Used to have lots of lower back probs, but climbing seemed to really help (stretching and core work)..
This seems to be linked to trying the Pit Problem at Trowbarrow (powerful body tension move pulling hard on a high right heel)....
Sorry - just realised that my moaning doesnt help much!
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Thanks guys. Ordinarily I'd speak to my main man and physio par excellence Matt Donnelly but he's safe from the grasps of injured climbers in Asia at present.
The confusing thing is that I've been paying attention to core conditioning and this happens warming up for it!
It's hard to admit this but the pain was so bad I was in tears on the floor at 4am this morning. Really not liking the look of this postural image and hoping to high heaven it can be easily fixed. Will sort act out asap.
Tom, get better soon mate! It's hell I know.
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And us tall guys get all that crap from the hobbits about being able to reach holds blah blah...
They never see the downsides.. What do they know... ;)
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Tell me about it! ;)
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Monolith you've said despite drastic recent attempts to train core and lower back. Could this be the cause of the recent spate? You need to go and see someone in the know asap
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It's usually one of two possibilities or a mixture of both: a lumbar shift due to a disc problem and / or muscle spasm will make your hips out of line with your shoulders and give you a limp. A Physio should recognise that and a good self help book which explains it well and gives you appropriate exercises is : Treat your own back by Robin McKenzie - about £8 from amazon or a book shop. Good luck with it.
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Monolith you've said despite drastic recent attempts to train core and lower back. Could this be the cause of the recent spate? You need to go and see someone in the know asap
My initial thought too. I get lower back problems on and off, I think most people of normal stature (6ftish or more) Have problems at some point. I know I have and my brother gets it a lot too. I have been to a physio about it and know the exercises I need to do should I feel it coming on. Get a book especially the one recommended, but I would also see a professional physio too.
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Monolith you've said despite drastic recent attempts to train core and lower back. Could this be the cause of the recent spate? You need to go and see someone in the know asap
My initial thought too. I get lower back problems on and off, I think most people of normal stature (6ftish or more) Have problems at some point. I know I have and my brother gets it a lot too. I have been to a physio about it and know the exercises I need to do should I feel it coming on. Get a book especially the one recommended, but I would also see a professional physio too.
I find hanging (as in straight arm deadhanging) - relaxing the back really helps. Kind of streches everything out...
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Sorry to hear Tom. I found the progressive lumbar/pelvic tilt exercises and tips on posture joe shows on his videos really helpful for sorting mine out when it crept back last year after going a couple years back.
http://climbingphysio.blogspot.co.uk (http://climbingphysio.blogspot.co.uk)
Check his post from 8th march. Hope it gets better but definitely go and go see a physio!
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Get to a physio.
My somewhat arthritic left knee is nowhere near as debilitating as a back problem, but it was getting pretty painful and limiting after a few Xmas-New Year weeks of visiting family and neglecting the exercises my physio prescribed for it. Got back on the wagon and did the exercises five days out of seven last week, and I'm already miraculously fully mobile again.
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I have long term lower back problems and I'm not tall. I do a routine of lower back stretches including Mckenzie exs and exs shown to be by various physios and osteos. I also see the osteo about once a month for a tune up or to sort out any issues.
Despite all this my back will go in spasm sometimes for no obvious reason, however when I ask the osteo why this might be he just laughs and points out my body is not really designed to do what I try and make it do.
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I had lower back issues for years. Weeks off work, loads of sodium dicloflenac. I solved/massively improved things by a few month visiting a chiropractor. In the last decade I have managed to keep my back pretty sweet with a daily routine of 5 mins stretching in.the morning and evening. I
Ok if I forget to do it for a few days then I start to tighten up, and then I just get back to stretching and it sorts it out quickly. I have not missed a day off work in 10 years due to back issues.
So daily stretching _lieing down- left knee to chest, right knee to chest, both knees to chest, side to side with knees, roll over- probe cobra stretch, stand up - a couple of attempts to touch toes. Done. Works for me and my misses.
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I've been too slack with frequency of doing these stretches. Absolutely must readdress my weekly training schedule for things other than just board and fingerboard training. I'll go with the mass consensus to see a physio!
Thanks for the link too Rich. When the initial inflammatory pain subsides I'll get straight onto stretches. Tried earlier but was simply too painful to do even the most basic leg lift.
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Desk jockey job doesn't help either.
I've been recommended by my physio to get one of these
http://www.amazon.co.uk/Mckenzie-Original-Airback-Lumbar-Roll/dp/B0056PTVNQ/ref=pd_sim_d_4 (http://www.amazon.co.uk/Mckenzie-Original-Airback-Lumbar-Roll/dp/B0056PTVNQ/ref=pd_sim_d_4)
but never bothered.
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Mine was much better after sleepign in my own bed last night.. but still stiff..
Went to Logport wall over lunchtime to see if that would ease things off.. it feels a bit better after a very gentle hour.. but was jarring when I jumped off problems - which is the first time I've ever had that :( Ho Hum...
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Bad times Mono/TT. I know how it feels.
I get a mild version of this every time I go to Font as I throw myself at overhang after overhang. Last time for some reason (the 12 hour drive back) it was so bad I had to have a day off work as I could barely get out of bed and I couldn't reach my feet to put socks on or tie my shoes. The pain almost unbearable.
Sphinx and cat stretches helped a lot to fix it. Underlying cause is posture I reckon.
TT - I suspect the jarring thing is due to 'forgetting' to bend the knees to aborb the fall and bending the back instead. At least that's what I've noticed.
I'm doing an hour an half of yoga a week and sitting up straight at work when I remember.
Sent from an office desk sat as posturally correct as possible.
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i always avoid jumping off as much as possible, downclimb a ways if I can, my knees and back have limited shelflife. Good at falling off though.
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I've had various bouts of back pain, debilitating spasms and sciatica over the last ten years. Had lots of physio, which can give short term relief (acupuncture recommended), but long term back health has come from doing yoga regularly. An hour a week is enough. Climbing will give you bad posture, and hence back problems, if you don't balance things out with something.
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There's no excuse for me not to head to the yoga class next door to my office at least once or twice a week. It's become apparent that this should become a top priority. Good shout JB.
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And a boot up the arse as a reminder I should get to the one next door to me once every week or two for our (subsidised) classes. No excuses other than I'm a lazy cnt.
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Three days in bed is killing me. Don't get in this boat Chris - attend a class tonight I urge you mate!
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What did the doctor say?
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It's been taking me about five minutes to sit upright so I've not left the house yet. I'll have to try getting one around. Feeling marginally looser today which is a start I suppose.
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Mate, not moving it is the worst thing you can do. Get up lie on the floor with your knees up and move your legs side to side, do some cat stretches, or just some child pose stuff, anything to get it moving.
As it is now the pain is making you tense up your back all the time, making the muscles spasm, and going into a vicious circle.
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Monolith you've said despite drastic recent attempts to train core and lower back. Could this be the cause of the recent spate? You need to go and see someone in the know asap
My initial thought too. I get lower back problems on and off, I think most people of normal stature (6ftish or more) Have problems at some point. I know I have and my brother gets it a lot too. I have been to a physio about it and know the exercises I need to do should I feel it coming on. Get a book especially the one recommended, but I would also see a professional physio too.
I find hanging (as in straight arm deadhanging) - relaxing the back really helps. Kind of streches everything out...
I find that too. Plus, very gentle rocking side to side from the hips while doing it.
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Mate, not moving it is the worst thing you can do. Get up lie on the floor with your knees up and move your legs side to side, do some cat stretches, or just some child pose stuff, anything to get it moving.
As it is now the pain is making you tense up your back all the time, making the muscles spasm, and going into a vicious circle.
Be careful with, gentle exercise is fine, but your back will spasm to protect the spine if your body thinks you're going to damage it.
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Tall people often have difficulties around L5 / S1, hard so say as 1. I'm not a quack and 2. even if I were haven't examined you but you may have a bulging disc which occasionally compresses a nerve.
As a sufferer of back sporadic and at times spasmodic back pain over the years I would offer the following advise:
1. Rest, (but not immobilise) when you're back even feels a bit iffy (I normally get some warning signs of an eposide) just don't climb, don't do your stretches, just have a warm bath, massage & etc
2. Do not take lots of diclofenace or other NSAI drugs, these can cause real problems with the gut and in extreme cases lead to significant gastirc bleeds (fat doc should be able to say how much is too much)
3. Do not listen to quacks, i.e. alternative medical practitioners a.k.a. charlatans, frauds and liars.
4. Do not risk 'manipulation' you only have one spine and if you really injure it it's a long way back if at all.
5. Go see a qualified orthopaedic surgeon. Listen to what they say and act on it.
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I have a bulging disc in my lower back (confirmed by x-ray) and this flares up sometimes (like on NYE - awesome night :'(). Despite what Sloper says, I have had it regularly treated by an Osteopath who has done a very good job in fixing me up. To give you an example, on NYE I couldn't even stand up straight or walk very well but after one session, I was standing straight and walking much better with less pain. The risks are relatively minimal so you make the choice.
One thing - If you are training core etc - Never do any exercises which involve straightening both legs at the same time (L-sits, levers, lifts etc). These are extremely bad for anyone with lower back issues (me doing these always seems to be lead to another 'episode'- I think I've learned my lesson now). Straightening one leg at time is ok tho if you must do them.
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2. Do not take lots of diclofenac
Is diclofenac actually good for anything? That stuff turned my urine into Iron Bru and made me feel nauseous the second I went near food.
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Monolith, commiserations.
Broadly speaking, I think spines (and people) need a balance of 'stability' and 'mobility'. More stability is not the answer to everyone with back pains. It is plausible that stability exercises are not for you. It's also possible that stability exercises might be helpful but you are currently doing them in an unhelpful fashion. Leg lifts - which you describe as a stretch - could be a ‘stability’ or ‘mobility’ exercise depending on what you do exactly.
The same goes with dealing with flare-ups. Complete rest or pressing on regardless are both usually unhelpful.
Seeing a surgeon is not appropriate for 99% of people with back problems.
I'm fairly positive about manipulation as a short-term help. Manipulation for back pain has been around for at least 3 500 years (references in ancient Egyptian documents). Lay manipulators practiced in the UK for millenia and are still common in developing countries as climbing in Thailand will reveal. In the late nineteenth century this lay knowledge was professionalised, analogous to Swiss shepherds becoming climbing guides, and Chiropractic, Osteopathy and Physiotherapy came into existence.
There is no great difference between the techniques of spinal manipulation used by Chiropractors, Osteopaths, and Physiotherapist. They are all codified versions of what had been done by lay manipulators for thousands of years. It does not matter who does the manipulation, Chiropractic, Osteopathy, or Physiotherapy has exactly the same effect on pain and disability (UK BEAM 2004) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC535455/. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC535455/.) I have some issues with the training and professionalism of some alternative practitioners.
Manipulation is probably effective in the short and medium term compared to doing nothing or seeing your GP. There are some risks from manipulation, mainly to the neck, but any treatment having an effect can have a side-effect and the benefits probably outweigh the risks. Far more people are killed by stomach ulcers due to anti-inflammatory drugs than by strokes due to manipulation. NICE (2009) recommends manipulation as a treatment for back pain. Edzard Ernst disagrees: http://171.66.127.115/content/99/4/192.full (http://171.66.127.115/content/99/4/192.full)
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Is diclofenac actually good for anything?
On the last day of a two week font trip I was disappointed to find I couldn't even warm up without screaming elbows. Pickles slipped me a couple of pills and ten minutes later I did the first and only one-armer of my life, and then climbed all day pain free. However it is killing vultures in India.
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I had your symptoms Monolith, in my early twenties.
The sudden onset of pain and visible spine misalignment that were diagnosed as scoliosis.
The important thing for treatment was to discover and treat the cause: in my case it was (unknowingly) having a limp for about three years due to a R ankle sprain and then later a partial dislocation of the L knee.
All the while I'd been climbing and cycling as normal but with weakened ligaments in my various leg joints. Eventually it dramatically effected my back.
Apart from yoga and core work etc only when fully recovering from the leg problems did the scoliosis 'attacks' stop. This took several years.
Do you have any outstanding problems?
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Monolith, commiserations.
Broadly speaking, I think spines (and people) need a balance of 'stability' and 'mobility'. More stability is not the answer to everyone with back pains. It is plausible that stability exercises are not for you. It's also possible that stability exercises might be helpful but you are currently doing them in an unhelpful fashion. Leg lifts - which you describe as a stretch - could be a ‘stability’ or ‘mobility’ exercise depending on what you do exactly.
The same goes with dealing with flare-ups. Complete rest or pressing on regardless are both usually unhelpful.
Seeing a surgeon is not appropriate for 99% of people with back problems.
I'm fairly positive about manipulation as a short-term help. Manipulation for back pain has been around for at least 3 500 years (references in ancient Egyptian documents). Lay manipulators practiced in the UK for millenia and are still common in developing countries as climbing in Thailand will reveal. In the late nineteenth century this lay knowledge was professionalised, analogous to Swiss shepherds becoming climbing guides, and Chiropractic, Osteopathy and Physiotherapy came into existence.
There is no great difference between the techniques of spinal manipulation used by Chiropractors, Osteopaths, and Physiotherapist. They are all codified versions of what had been done by lay manipulators for thousands of years. It does not matter who does the manipulation, Chiropractic, Osteopathy, or Physiotherapy has exactly the same effect on pain and disability (UK BEAM 2004) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC535455/. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC535455/.) I have some issues with the training and professionalism of some alternative practitioners.
Manipulation is probably effective in the short and medium term compared to doing nothing or seeing your GP. There are some risks from manipulation, mainly to the neck, but any treatment having an effect can have a side-effect and the benefits probably outweigh the risks. Far more people are killed by stomach ulcers due to anti-inflammatory drugs than by strokes due to manipulation. NICE (2009) recommends manipulation as a treatment for back pain. Edzard Ernst disagrees: http://171.66.127.115/content/99/4/192.full (http://171.66.127.115/content/99/4/192.full)
I wouldn't put much store in the evidence based on historical practice, after all medicine now is unrecognisable from medicine 200 years ago let alone 3500 years ago.
The point about manipulation is, it is not wholly supported by a proper evidence base and the degree to which it is recommended does not have an impact on the evidence or lack thereof fc TEETH, thousands use homeopathy and other types of alternative medicine which are nothing more than placebo.
That more people die from gastric bleeds associated with NSAI than strokes caused by manipulation is again a failure to understand the concept of evidence and risk; the number of people taking NSAI's is vastly greater than the number's having manipulation and further the benefits of NSAIs are well documented as are the side effects and contra indications. None of this can be said for manipulation.
Having a spinal maipulation without investigations to determine whether there's an underlying bony or STI is quite literally putting your life in the hands of someone who is neither medically qualified nor possessed of what would be critical information.
Treatment with >85% DBRCT evidence based response with 10-4 risk of serious untowards outcomes = rational. Treatment with <0% DBRCT evidence based response with 10-5 risk of serious untoward outcomes does not equal rational.
Yes of course a lot of people swear by manipulation, as do others for magnetic copper bracelets, trips to Mecca and so on.
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Is diclofenac actually good for anything?
On the last day of a two week font trip I was disappointed to find I couldn't even warm up without screaming elbows. Pickles slipped me a couple of pills and ten minutes later I did the first and only one-armer of my life, and then climbed all day pain free. However it is killing vultures in India.
maybe I should slip TomTom my leftovers?
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I have had these issues since my mid 20's. In '96 it was so bad I lost the use and sensation in my left leg entirely.
I've had four Epidurals and shit loads of Physio.
It's a CT confirmed herniated disc a L4/5.
I had an episode four years ago and that was the first in almost ten years.
It was because I'd forgotten the only thing that actually helps.
Exercise.
Specifically maintaining lower back strength and muscle mass and flexibility.
Aka... Tons of Dorsal raises.
And stretches.
Best to get a Physio to give you the programme though.
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I had your symptoms Monolith, in my early twenties.
The sudden onset of pain and visible spine misalignment that were diagnosed as scoliosis.
The important thing for treatment was to discover and treat the cause: in my case it was (unknowingly) having a limp for about three years due to a R ankle sprain and then later a partial dislocation of the L knee.
All the while I'd been climbing and cycling as normal but with weakened ligaments in my various leg joints. Eventually it dramatically effected my back.
Apart from yoga and core work etc only when fully recovering from the leg problems did the scoliosis 'attacks' stop. This took several years.
Do you have any outstanding problems?
This is interesting cowboy. I do have poor posture as mentioned but whether the limp people observe me to have is partially responsible I don't know. I managed to stand up and walk a little today with a day in the office sat in a chair. This was especially uncomfortable and I only really went in as I had to. It's basically locked up now unlike ever before and I'm convinced even some gentle manipulation (despite some potentially credible assertions to the contrary) might assist me. I'm basically 'C' shaped when standing.
Many others experiences here seem particularly severe and I'm keen to prevent this condition ever returning where possible. Opinions on differing treatment methods aside, I'm now convinced of the merits of yoga and/or pilates. I dread to cite Ryan Giggs as an example but his career and still existing abilities seem to attest to the usefulness of ongoing yoga practice.
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Like I said in my earlier post - I couldn't stand up straight or walk properly until I had manipulation.
I see Sloper's post and question, if not for manipulation - what would I have done to improve? I was incapable of stretching. It wasn't just going to miraculously get better on its own. What would a GP have done in that situation? Or a surgeon?
Find and Osteo you can trust (preferably recommended by someone) and give it a go.
***Anecdotal advice warning*** I work in insurance liability claims and we cover Osteopaths, Chiro's and physios. I've yet to see a stroke caused by an Osteo or Chiro. The only one I ever saw was caused by a physio who did a manipulation to someone's neck when they were not qualified to do it.
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Mine felt fine yesterday - then after a 70 min drive back from Sheffield it felt like shit. This morning it took 5 min to put my socks on. Rubbish.
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Like I said in my earlier post - I couldn't stand up straight or walk properly until I had manipulation.
I see Sloper's post and question, if not for manipulation - what would I have done to improve? I was incapable of stretching. It wasn't just going to miraculously get better on its own. What would a GP have done in that situation? Or a surgeon?
Find and Osteo you can trust (preferably recommended by someone) and give it a go.
***Anecdotal advice warning*** I work in insurance liability claims and we cover Osteopaths, Chiro's and physios. I've yet to see a stroke caused by an Osteo or Chiro. The only one I ever saw was caused by a physio who did a manipulation to someone's neck when they were not qualified to do it.
I've found a local practice who appear to be quite reputable. What you say Carnage appears to make sense with regard to an inability to stretch, hence needing to loosen up somehow. In any event, I can at least leave the house to get a verdict now.
Tom, I hear you on the sock issue. Hope you start to mend fast champ!
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after a 70 min drive back from Sheffield it felt like shit
After 4 plus hours to Aviemore in the van (not the best seat) last week my back was so sore I couldn't sleep. Was lying in the back in my winter sleeping bag doing stretches to try and free it up, not the best.
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What stretches do you do to loosen it up?
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child pose, cat stretches, curling knees up to chin and rocking it, on back with knees up, lock knees together and take down to floor either side a few times.
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Thanks Chris.
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Thanks Again Chris - the Child pose seems to gently stretch my back. But a couple of idiot questions to the regular back sufferers if you dont mind..
Whats the best way of sitting down! Sofa schlumping - or even upright with a supportive lower back cushion - is not comfortable.. So I've been sitting bolt upright in a normal chair (ie desk or dining chair).. this best?
Second - will deadhanging do it any harm.. I suspect pull ups (esp assisted one armers) will twist things a little but just regular deadhanging? I'm going to have to drop climbing for a few days as I think thats not going to happen easily now :(
Third - Driving. I'm going to have to drive to Hull on Monday - car is modern (11 plate golf) and pretty comfy with lumbar support - should I add to this with an additional pad (used a rolled up scarf yesterday) or leave it? Yesterdays padding felt great in the morning, but I felt really bad after it later on..
Fourth - Standing up. This feels the most comfy.. but is this doing me any harm? Should I be lying, sitting standing? crouching tiger hidden dragoning?
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Like I said in my earlier post - I couldn't stand up straight or walk properly until I had manipulation.
I see Sloper's post and question, if not for manipulation - what would I have done to improve? I was incapable of stretching. It wasn't just going to miraculously get better on its own. What would a GP have done in that situation? Or a surgeon?
Find and Osteo you can trust (preferably recommended by someone) and give it a go.
***Anecdotal advice warning*** I work in insurance liability claims and we cover Osteopaths, Chiro's and physios. I've yet to see a stroke caused by an Osteo or Chiro. The only one I ever saw was caused by a physio who did a manipulation to someone's neck when they were not qualified to do it.
My point is that you should see a surgeon before you have manipulation. The manipulation may well still be placebo, but the risk of serious adverse consequences will be singificantly reduced.
PS Do you remember John Howell from the SIF days?
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I wonder why you think that you need to see a surgeon? Without an MRI what are they likely to tell you or do you think that everyone with a bad back should get an MRI and visit a surgeon?
Cheers Dave
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:agree:
I'm glad someone said it!
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And how the fuck are you going to get to see a surgeon when as you said you can' t even get in to see your G.P. As even if you go private you still need a referral from you G.P.
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It's good to have Sloper back isn't it.
Utter conviction in every post, backed up by... Utter conviction in every post (ignoring his previous one or what anyone else has said).
:-)
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I'm not a physio/doctor or anything medical, but I've been through the whole typical 15-20 year life-cycle of a back problem. I have/had terrible posture (slouched back and shoulders) and I'm naturally a 'tight' person (:greed:).
My initial back problems were similar to yours Monolith. It started with years of muscle twinges/lock-ups, progressed through 2 episodes of herniated discs resulting in sciatica into the foot, separated by 2 years between. Both of which resolved with rest, time and targeted exercise. Via a 3rd herniated disc resulting in sciatica into the foot which didn't resolve through rest, time and exercise and which required an epidural injection to 'fix'. Finally to a 4th herniated disc in autumn 2012 (while hanging on ab taking an action pic for the NW lime guide) which caused sciatica again into the foot and went on for 10 months into summer last year when things came to a head as I lost all muscle strength in the big toe and my leg went numb every time I sat down or bent over.
This resulted in surgery in September last year, the surgeon said if I didn't have surgery asap I'd have permanent loss of muscle strength in the foot. He shaved off part of a large disc bulge at L4/5 which was impacting the nerve root, and at the level below shaved off a bone spur (osteophyte) which was also snagging the nerve root. I'd had 4 or 5 mri's over the years, all private. The bone spur wasn't picked up on them, just the very large disc bulge, but the surgeon thought it worth investigating at that level as well, seeing as he was opening me up anyway for the very large disc bulge (was masssive - glooped all over the nerve). I'm glad he did. My back/leg doesn't give me pain anymore since the surgery although I'm aware of it when I get fatigued or stressed.
BTW the majority of people reading this, starting in late teens, will have bulging discs but most don't have symptoms.
In short Monolith it's very likely you'll be fine very soon. Your muscles have gone into over-protective mode because your system has detected a threat to the structures in your lower spine. Whether the threat is real - as in you've a bulging disc irritating the nerve root, facet joints rubbing into each other, a bone spur irritating the nerve, or something else mechanical which shouldn't be there and which is causing mechanical damage; or whether it's the result of an over-reaction perhaps due to stress, fatigue and an unfortunate combination of a minor pulled muscle setting off a more major reaction than usual - you'll only ever know if the pain doesn't go away and you end up seeing people who'll investigate via physical tests combined with your pain patterns and as a last resort imaging if necessary. Or... letting a surgeon open you up on a hunch, for a look inside to investigate and fix something which may end up not being there (and none would do this anyway). And you'll go to see someone about it becasue it' obviously not clearing up. But it's very likely to clear up as long as you get mobile as early as you can and don't try to do a marathon next week.
You'll only know it's going to be a long-term problem if you go on to develop chronic back ache or sciatica - this is due to chronic inflammation resulting from an original mechanical issue. However you can do a lot to make it much less probable that you'll ever get to the stage of chronic pain by getting yourself checked out by someone reputable and following their program.
If you want to avoid long-term issues with your back it would be a very smart thing - (for anyone who suffers lots of back lock-ups) to find a reputable spinal specialist who can go through a program of correcting poor movement habits and posture, neuro-muscular stabilisation (balance exercises) and core strength training. All of this is very subtle when done correctly - it isn't sit-ups or leg raises! They require a swiss-ball but not much else.
I personally find occasional manipulation useful, but not all chiro/osteo/physios are equal - the good ones are worth their weight in gold while the bad ones are dangerous. I had a bad experience with a bad chiro years ago and have been dubious since, but the chiro at NW spine clinic is excellent. If ever in North Wales I recommend the north wales spine clinic, who are a husband wife team - one a chiro the other a very well-qualified and experienced personal trainer who specialises in corrective exercises for the whole kinetic chain to get you moving optimally.
But seeing a surgeon is really unnecessary in the early stages of back pain unless you start to develop neurological signs like loss of muscle strength in the leg or foot/ numbness around the groin area (there are lots more signs, and it's critical to get medical help urgently if you develop any of them).
Tomtom: Sitting is not good - lying or standing is better for your back. I type standing at a desk and I lie on the floor rather than sit in the comfy chairs at home. Not because I'm in any discomfort, just because sitting for extended periods, especially in soft chairs, is terrible for your back.
If I get the time I can put the surgeon's back care notes up - he's one of the most highly-regarded in Britain (Peter Hamlyn: http://www.theprincessgracehospital.co.uk/specialist-search/mr-peter-hamlyn/ (http://www.theprincessgracehospital.co.uk/specialist-search/mr-peter-hamlyn/)). They're basic sense but I didn't do any of it (except token gestures) until my back problems were well down the line of chronic injury.
(edit: I also got diagnosed with an infection in the vertebrae which may have caused some of the back pain I experienced last year which resulted in a long spell on antibiotics (Amoxycilin) to treat. It was the thing which came out in the guardian around March last year 'miracle cure' etc etc.)
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Whats the best way of sitting down!
Might not work for everyone (probably doesn't!) but if my back is at all sore, i often sit on the floor if watching telly with my back against the arm of the sofa. I don't think standing does any harm provided your posture is good. Did you see my earlier link to the mckenzie lumbar roll? Might be good for the car instead of a scarf.
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Thanks Pete & Chris..
Yes I often sit 'under' the sofa leaning back on it...
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Pete, that's a mammoth of a post and really interesting reading. I have no grounds for complaint reading what you've had to endure and I'm very grateful for you giving your account. I'm away from home now at my girlfriends and trying to book an appointent with a local osteo before we have to go elsewhere. I'll be certain to digest your post more fully when back an the computer. Thanks agan for taking the time to share your story.
Thanks to all for their accounts ad advice too. Massive props.
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Brother, really sorry to read it's not sorted out.
I've been dedicating some time to fix my posterior tilt, ten minutes of the warm up, boring as hell despite my trying to make it an extreme full body effort.
I think it could be useful to also have your teeth checked: an incorrect occlusion can cause a lot of neck/shoulders/spine problems.
Also, I'd check the way you walk and possible ankle problems.
Get well soon animale.
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How did the Osteo go mono?
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I'll add this to a list of good back exercises:- Bird dogs. I find these really helpful, especially when leg raises hurts.
Bird Dog Core Exercise (http://www.youtube.com/watch?v=wgOuR7YrwtM#ws)
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Brother, really sorry to read it's not sorted out.
I've been dedicating some time to fix my posterior tilt, ten minutes of the warm up, boring as hell despite my trying to make it an extreme full body effort.
I think it could be useful to also have your teeth checked: an incorrect occlusion can cause a lot of neck/shoulders/spine problems.
Also, I'd check the way you walk and possible ankle problems.
Get well soon animale.
Thanks beast. That's precisely what I want to do - make it self competitive. Little and often from here on!
How did the Osteo go mono?
The Osteo was good Tom. The lady was an ex-gymnast/Circque du Soleil performer who had gone on to train as an Osteo once she could no longer backflip. She seemed to grasp pretty well what I had been trying to do with my core exercise regime but observed that there were plenty of others that didn't need to place such strain on my lower back (similar to what fried has linked to here - thanks for that!). She did a lot of manipulation and I was able to leave the practice standing up almost straight and in a lot less pain than when I had gone in.
It appears (and it has been observed before by Matt D) that I have very tight hamstrings and quadriceps/glutes that are causing problems. It's really very simple, I have to learn a lesson and do these daily now.
Thanks all for advice, well wishes etc.
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Thanks Mono - Mines eased off to the point where I was able to put on my strides without wincing this morning..
I've found that lying down as much as possible has really helped. I've been working lying flat on my back with my head propped up and laptop balanced on me - and at home been assuming the same position to watch the idiot lamp etc.. on a thermarest..
I also found that hip raises - from flat back, legs bent - lift the hips gently and hold - seems the best back warm up for me - and I can do them in bed before getting up which helps...
Intersting about tight hamstrings.. I had these a few years back and streching them out was a regular part of my warm up for years..
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I know it's a tired old drum, but yoga can really help with loads of tightness issues. I've got my shit in gear and signed up for 6 sessiosnat work, starting tomorrow. Looking forward to geting back into it.
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I agree about the yoga, I've seen a phyiso twice for my lower back and once for my knees in the last year, plus a biomechanics guy to deal with my feet issues which were / are contributing to my knee and back issues and the thing that has helped me the most with all of my ahces, pain and stiffness has been yoga.
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An update.
Its recovering nicely 5-6 days after it was really bad. I've been very careful of how I've sat at work - and in the car (raised seat and moved it forward a little so not leaning) - and been lying down on the floor instead of sitting on the Sofa. Its now at the point where it just aches and feels a bit sore rather than spasming and making me shout out in pain...
I was going to give it a try at the wall last night, but decided to continue with the rest and have a gentle work out on Friday...
Tom
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Did my first yoga for a year last night. Didn't realise how bad my back felt until it feels better!
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Hi Mono,
Sorry to hear about you episode. I read your local physio is away, I know to REALLY good physios that you could try?
I know that they would be happy to help over email initially if that is preferred and if travel is a big issue (which I am assuming it is)?
PM me if you want their details and I will gladly pass them on.
Glad it is improving and hope your recovery goes well.
Robin
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Ach - backs going again... just the left hand side now...
It was back to normal and on Sunday I gave it some beans on the fingerboard and gave myself a little crick in the neck (LHS) and woke up this morning and its bastard tweaked again :(
grr....
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Did you go to see a physio TT ?
Honestly its worth it
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deadlifting
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deadlifting
Deadlift the Physio?
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deadlifting
Deadlift the Physio?
to start, work up to the physio and assistant.
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Did you go to see a physio TT ?
Honestly its worth it
I really don't know where to start...
With my split life existence I dont know whether to look for one in Hull or in Manchester - online/yellow pages has loads in both places - and most talk about back problems..
MrsTT had a load (6-9 months worth) of osteopath sessions down the road from her - but that seemed to make things a bit worse and as someone said to her - if it wasnt working after a couple of months he was either bad or osteo was the wrong option. This contributes to my distrust/concern/uncertainty...
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Just try one and go from there. Don't get stuck with the same one either... if no improvement four-six weeks get another.
Also, I find that some (not all) can get stuck with their initial assessment of problem and treatment and then fail to do an objective secondary diagnosis once the primary problems are fixed and then continue hammering away with the same, possibly ineffective, treatment.
Backs, necks and elbows are complex things and when they're fucked it's usually one major and several minor contributing factors.
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deadlifting
Deadlift the Physio?
No, no, no!
Live Lift FFS,
'Cos that's only assault.
The other one's Murder....
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Just try one and go from there. Don't get stuck with the same one either... if no improvement four-six weeks get another.
Backs, necks and elbows are complex things and when they're fucked it's usually one major and several minor contributing factors.
+1. Any physio is better than fuck all. I'm sure there are people on here who can recommend one in either Hull or Manchester, as good a starting place as any.
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I really don't know where to start...
With my split life existence I dont know whether to look for one in Hull or in Manchester - online/yellow pages has loads in both places - and most talk about back problems..
Tom, my wife rates Didsbury physio, http://didsburyphysio.co.uk/, (http://didsburyphysio.co.uk/,) though she does play hockey with a few of them (half her team are physios). She has regular sports massages there and has had teatment for piriformis syndrome and various other bits and bobs. Drop me a text if you need anymore info.
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I have had good experieces of Sportsmed in stockport. Tim the gaffer there is more money than everybody else in the practise but worth it in my experience.
http://www.sport-med.co.uk/ (http://www.sport-med.co.uk/)
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Thanks Sam & Galpinos.. I'll have a look at both of them...
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With my split life existence I dont know whether to look for one in Hull or in Manchester - online/yellow pages has loads in both places - and most talk about back problems..
MrsTT had a load (6-9 months worth) of osteopath sessions down the road from her - but that seemed to make things a bit worse and as someone said to her - if it wasnt working after a couple of months he was either bad or osteo was the wrong option. This contributes to my distrust/concern/uncertainty...
I'm not anything medical etc.
Physio/Osteo/Chiro etc. for the sort of acute back pain you're suffering is a patch not a cure, but a good physio should help with getting relief from acute back pain. Seeing a substandard one is like throwing £30 - £45 in the bin. The important bit is learning what needs doing to avoid further flare-ups like you're now experiencing.
I've been through the whole unresolved back pain process - from suffering years of flare-ups, seeing physios/chiros/osteos/acupunctures/podiatrists, numerous disc issues and sciatica, mri's; to epidural injection; further disc issues/sciatica, to spinal surgery; followed by recovery/change of poor long-term movement habits. All via about 25 different physio's, chiro's and osteo's, a podiatrist and 3 different surgeons.
If I could change anything it would be to have found good advice about doing corrective stabilisation exercises, described below, and to have done them at the beginning of symptoms!
I'm guessing that you, being an academic with climbing as a hobby, do a lot of sitting and possibly a lot of driving, probably have some 'head forward'/slumped posture from using a PC, are fairly active outside of work and therefore have some muscle imbalances at play which add stress to an already stressed structure (your spine). Unknowns like predispositions to injury in the spinal area you may have been born with and you can't do much about.
Your back needs movement/flexibility i.e. not being in one position (sitting or standing) for too long, and it needs stability from the large back muscles and from the various small stabiliser muscles that protect the spine during movement. It's likely your large back muscles are more than strong enough (and probably over-active, like now) and some of your back's stabilser muscles are imbalanced/turned off.
Working the stabiliser muscles is a lot more subtle and counter-intuitive (was for me) than working the abs and large back muscles i.e. the 'movement muscles' worked by deadlifting, sit-ups, lat pull-downs etc. Targeting these involves doing some very specific combined balance and endurance exercises which you won't learn how to properly do from a physio handout or off a website. You need to be led through them, the best (but most expensive) way is 1-to-1 coaching rather than a class. Then you need to keep doing them over a sustained period of time. Together with an adjustment of poor movement habits and lifestyle stuff like sitting for too long, screen height etc. etc.
The stabilisation exercises are similar to pilates in that they're designed to train/improve the co-ordination and endurance of the whole kinetic chain but with, I believe, more of an emphasis on the endurance and switching on of the stabiliser muscles through the movements whereas pilates has more of an emphasis on flexibility through the movement - that could be wrong I'm no pilates expert.
As far as physio's, ones with MACP accreditation have a higher level of training than standard physio's in the sort of manipulation that can be effective for relieving acute back pain : https://www.macpweb.org/home/index.php?p=1 (https://www.macpweb.org/home/index.php?p=1)
I saw this person years ago in Sale who was very good, (gave short-term relief from a back flare-up in one visit): https://www.macpweb.org/home/index.php?p=18&id=714&page=1 (https://www.macpweb.org/home/index.php?p=18&id=714&page=1)
For the corrective exercises/movement mechanics (the important bit) you'll have to dyor. I'm lucky to have found a very good person in north wales.
I sent Monolith some useful notes on general back care given to me by my surgeon, I'll pm them to you.
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I sent Monolith some useful notes on general back care given to me by my surgeon, I'll pm them to you.
Would you mind posting them please ? (understand that they may be personal so you might not want to)
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Quite some time on but a distillation of the MRI I (finally) received recently. I had been admitted through the NHS physio system but it really didn't seem to be helping greatly. That said, one year on I'm managing to fell run with only moderate discomfort and even managed to climb two boulder problems at Ysgo recently.
"Conclusion: L5 pars defect with grade 1 spondylolistthesis. Inferiorly migrating right paracentral disc extrusion at L4/5 level which impinges on the right L5 nerve root."
Thankfully Matt Donnelly is firmly qualified in this area and has been advising me on the condition/s much better than my GP was able to. A referral to the spinal specialists is available if I want it. For now, carry on conditioning I suppose.
Hill running has really seemed to help by strengthening my quads/calf muscles and core. I have to be a bit granny-like on descents for now but hopefully this will change in time.
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"Conclusion: L5 pars defect with grade 1 spondylolistthesis. Inferiorly migrating right paracentral disc extrusion at L4/5 level which impinges on the right L5 nerve root."
What does this translate to; compressed vertebra, herniation or what?
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I understand it to be a bit of a mish mash down there! It's such a complex part of the body my tiny mind can't comprehend it very well. Matt's explanation was good and I now know what to avoid (leg lifts, feet on kickboard etc.).
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Any idea how you did it? I've apparently got a compressed vertebra caused by an impact at some point, but not sure which of many "incidents" caused it either individually or cumulatively.
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Once you get further down the road to recovery with a professional physio (or whoever), I'd suggest Pilates as a great - and cost effextive - transition out of 1-on-1 physio. After my worst back pain episode i did an 8 week pilates thing and was amazed how similar the exs were to the physio ones. I know a number of sufferers who swear by it too.
Personally I love yoga, but with no background in it and poor flexibility it's easy to overdo it in the heat of a class (and the inevitable hot chicks make that more likely for most too!). Sticking to beginners classes, staying at the back, and listening to your own body all mitigate this risk somewhat. Some would also say avoiding ashtanga/vinyasa/ flow types and sticking to hatha or iyengar given your history (can of worms...).