Anatomy of a flare up... and recovery...

After my last post I returned to training in surf lifesaving on a surf ski.  This involves sitting pulling a paddle through the water with flexion and rotation of the back.  Not great for a recovering disc but I was going well.  And then... I fell of my bike landing on the sore side.  As our research shows discs are often worse the next day and sure enough the day after this fall I had severe left leg pain.  I thought this was a flare up that would recover quickly (like I explain to my patients) and so after 3 days rest I rode my bike (remember it helped my leg pain before) 300m.  This caused significant worsening and the onset of calf weakness (I couldn't stand on my toes) as well as foot numbness.  The next 4-6 weeks was a dark a place as I think I've ever been.  After recovering well, my injury deteriorated further than I thought possible and all I could do was rest (mostly on my stomach over a bean bag) and take Panadol Osteo, Lyrica and Voltaren.  A 2 week trip to Noosa (after a very very long drive taking breaks every hour to lie down) proved the circuit breaker and through swimming, core training, very gentle yoga and eventually some bike riding I began to regain some function.  However I still struggled to walk more than 100m.

But that was only the beginning.  I had booked a 50th celebration in New Zealand and Fiji with friends and family... a once in a lifetime experience of surfing, fishing and mountain hiking.  I had to set a plan to get myself right by December.  This period taught me so much about the pain and distress my patients go through as well as the value of a carefully managed rehabilitation program.  Almost incredibly I achieved my goal and had the best time of my life celebrating my 50th even though I'd lost so much fitness and had put on 10kg.

Bella, Nick and me at Cloudbreak, Fiji

Bella, Nick and me at Cloudbreak, Fiji

The mackerel that didn't get away!

The mackerel that didn't get away!

I am now back in full training and did pretty well at the recent state titles.  The year of my back injury placed an enormous burden on my friends and family; resulting in strains that only now are being rectified.  I am still frightened of my back recurring but have learned so much about how to manage my problem long term.  I'm optimistic!

Hopefully my story can help give hope to the patients I see every day.  If nothing else it has helped me to understand the difficulties they face with severe persistent pain.  For that I am grateful.

Cycling and radiculopathy

For those of you who don't understand what radiculopathy is... when a disc bulges (or herniates) in backwards direction it can press on the nerves that form the sciatic nerve.  See the picture and arrow... ouch... this causes leg symptoms including numbness and weakness.  Sadly I experienced this after over training (its common in males of my age).  It took 2 weeks of virtual bed rest, anti-inflammatory medication and anti-nerve pain (neuropathic pain) medication to start things settling.  For many physios the idea of cycling  (where your back is flexed) is not a good thing for disc problems.  But I've found in clinical practice that cycling can be really helpful for radiculopathy as it gently get the nerve moving and sliding in the spine and the leg.  Nerves need to move too!

MRI scan of a disc herniation causing radiculopathy

MRI scan of a disc herniation causing radiculopathy

Sure enough after a gradual build up of cycling my leg symptoms have gone (much quicker than if I'd had surgery).  After every session on the bike my leg felt better.  I'm up to 20km moderate rides now and hope to start increasing walking (which is still a problem), kayaking and surfing soon!  Stay tuned...

Jon experiences back pain

One of the main reasons I became interested in back pain was because of an injury I sustained as a physiotherapy student.  After lifting a patient I was astounded that the experienced physiotherapists I saw couldn't help me.  I managed to rehabilitate myself from a moderate severity disc injury over a period of 12 months.

I have been relatively pain free, and fully functional until recently.  My surf lifesaving interest has seen me return to paddling (which I did a lot of as a young adult) and over the past 4 years I have become more and more serious in my training regime.  Unfortunately a combination of marked increased training volume/intensity, a larger blade size and poor recognition of symptoms (my initial pain was a hamstring pull) has led to a serious disc herniation with radiculopathy.

Its been quite an amazing experience to rehabilitate myself with a more severe

 

Me at the Australian titles back in the day...

Me at the Australian titles back in the day...

problem and I plan to document the detail in the coming months as my recovery continues.  Needless to say I've learnt a lot including a serious dose of empathy for my patients!

I guess the lesson is careful monitoring of training parameters and athlete response, particularly as you nudge into middle age!

Cheers

Jon