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July 23, 2009 - 12:29pm
Picking up swimming after a herniated disc
Hi everyone,
I have a 'moderate' disc herniation at L5/S1 (though it's more like L5/L6 - I have an extra vertebra in my lumbar), confirmed by an MRI at the beginning of june this year. I've had it since the beginning of March 09 and so have been recovering for nearly 5 months. I'm 19 years old.
I'm happy with my condition right now and most of my symptoms are gone. No leg pain (I had sciatica in left), occassional a little tingling in toe, and when it gets sore or hurts, it's just right at the top of my buttock. Overall I think I've come quite a way and I have improved.
I do some exercises given to me by my chiropractor and walk between 3-6 miles everyday depending on how it feels. I ice everyday. I've been told I can't run or play sport yet since the disc herniation is quite sizeable. I have an appointment to see an orthopedic surgeon in late August - though my symptoms strongly suggest I don't need surgery of any kind, my chiropractor thinks it prudent to get an opinion from a surgeon as my problem has gone on longer than expected.
I really want to pick up swimming, because all the exercise I do currently is good, but doesn't get my heart rate up, and I realise I may still have many more months to go before I can start building up with jogging and towards sport. All the sports I used to play were high-impact and involved running. I've been attemtping swimming but I am really bad and the crawl and have been advised to avoid the breaststroke. I really want to swim because it's great exercise, fun, and will help keep me fit and aid in my recovery.
However I've been told that if you weren't a swimmer before, and I wasn't (I haven't swam for abou 4 years - and only used to swim casually) then swimming won't help and might make it worse. I'm somewhat inclined to belive this (though regretfully, because I don't want to give up on it), and I've gone a couple of times already and I've struggled to get going at all with the crawl and just end up stopping and starting and flailing in the water. I'm really worried about making it worse and don't want to do anything to aggravate it. I'm not very confident at all in the water and don't think my technique is anywhere near good enough, and it's very difficult to learn when you've got a serious injury hanging over you.
What do you guys think? Should I continue with my attempts to start swimming regularly (I want to build up to 3x a week) r just continue with brisk walking and core exercises? This is not an injury I want to mess about with, but there's so many benefits from swimming I don't want to miss out on them!
Thanks for reading
_____________
Male, 19yrs old, UK
First injured back in December '08 - completely misdiagnosed as a 'back strain'
Pain continues for 3 months - deflected to physiotherapy. Assured there was no serious underlying problem.
March 4 2009 - wake up with sharp pains down my left leg
Diagnosed as a herniated disc by chiropractor day later, confirmed as L5/S1: 'moderate central and paracentral protrusion' (technically L5/L6, extra lumbar vertebra) by MRI June 5 09
7 months post-injury. 'Does not require surgery right now'.
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I recently underwent an ALIF of L5/S1. At first my surgeon told me to only walk in the pool. Now, 6 weeks out, I can use a float board (child's styrafoam surf board is the cheapest), and flutter kick around the pool. I'm certain that would get my heart rate up, but if you're young and fit, it might not be enough for you. Maybe you could position the board under your body and "swim" and kick from there. Best of luck.
Rusty
I have two hernaited lumbar discs. I was in pain for over a year, and during that time kept swimming in the belief that this would aid recovery. In fact, it turns out that it was the swimming that was preventing my hernia from healing properly. SInce then I have been to see a doctor who prescribed Voltarin SR - which I can only describe a a miracle drug - pain was gone within 48 hours.
He also advised me that swimming is OK provided I stick to backstroke and don't swim on my front. Since then I have been swimming backstroke 3 or 4 times a week and so far remain pain free. Obviously, every hernia is different and you should check with your doctor first, but backstroke has been the way back into the water for me. Good luck.
My situation is a bit different, as I swam a mile a day for years on end, until I developed a c-spine issue...with arthritis, slipped vertebrae, kyphosis..oh..and now I'm told I'll need a four level fusion..
Quit swimming for four years and just resumed, even with these issues. I swim with a snorkel so I do not turn my head and it feels like heaven to be back in the water. My body feels stronger and lighter..the down side is that sometimes I feel a tad woozy afterwards,but it passes soon.
Perhaps you could take some lessons to help you with your stroke..I would not recommend using a float board...try for some lessons...they can be quite inexpensive and you'll be surprised how quickly you pick up the strokes. See if your doctor okays all of these before you continue..
Best of luck to you...
I am an army physio greatly interested in backs. Contrary to widespread belief, it is not bending activities which degrade discs but sustained and repeated hyper-extension postures. These compress the rear disc walls causing them to endure a "wrung-out" state for long periods. Consequently circulation and nourishment suffer to the extent that the matrix breaks down and radial fissures appear. A bending motion merely induces the nucleus to push through finally, but is not to blame for the cumulative degeneration. Swimming in small doses is fine but do not perform vigorous breast-stroke with the head out of the water, nor butterfly! Furthermore avoid the McKenzie spinal extension exercise routinely given out by most physios as these only compound the compression of the lumbar discs. If you routinely perform these you are lining yourself up for a subsequent prolapse. If anything, Western man needs to slump more (dirty-word) or foot-flat squat like he evolved to. Chair sitting offers little respite to lumbar discs as the extension lordosis is largely maintained. Adopting a C-shaped spine for periods of the day relieves the compression on the rear disc walls and permits a bellow effect which pumps circulation and nutrients around the disc.
Gymnasts, competitive breast-stroke and butterfly swimmers, fast bowlers and weight-lifters beware. Pity those poor kids made to swim every day for the club also. The medical advice on backs is in bad need of an overhaul and many myths abound.
Some interesting comments Hunch.
My current neurosurgeon would agree with you. My previous orthosurgeon would not. Funny how different surgeons view this.
My ortho who did my microd sent me to PT prior to surgery. He was hoping to avoid surgery. That PT was all about McKenzie this, McKenzie that. Gave me 2 books. 1 on lower back and 1 on neck. Told me to make a lifetime use out of them. He is trained and certified in it. I was doing press ups until the cows came home. It never really helped other than a few minutes of relief.
The neuro who just did my fusion. He told me not to ever see that PT again. Along with throw those books away and don't do that anymore. He sent me to the PTs he uses. I am doing a lot of pool therapy followed by massage and land therapy. Mainly real basic core stuff derived from Pilates. They are all about core strength and Transverse Abdominus.
You mention "fast bowlers". Are you referring to 10-pin bowling (not candelpin or outdoor lawn stuff)??? I have bowled most of my life up until the back went out. Started with DDD at L5-S1, followed by herniation and tear. My IT band on my left leg was in a permanent state of locked. I had to quit bowling and haven't touched a ball since. I threw a 15lb ball with a fair amount of hook. Would take a high back swing followed by a deep bend and twist to get under the ball and gain leverage. It really wrenches your body.
On the swimming part. I've been told no swimming in the pool at all. Makes being in a pool a tease when you are not supposed to swim... I'm 2 months post-op on the fusion. I've been told it will be many months before I am allowed to swim.
Graham
Sorry, I meant cricket bowling. Not really familiar with the 10 pin bowling style but sounds like you get a bit carried away with it. To be honest, I reckon core stability is a load of hogwash also. It has become the default explanation for all manner of back aches and is essentially what a clinician replies with when they are unable to diagnose you accurately. Any benefit from it is probably due to the movement which the exercises demand of your spine and pelvic region. Besides, most Westerners Have the opposite problem- rather than weakness of the paravertebral muscles, they have become shortened and overloaded. In other words they are now hypertonic and need stretched and relaxed, not strengthened. The 4 point kneeling, dorsal raises and sitting erect on a gymball merely fatigue the muscles further and exacerbate the problem. If I had my way, everyone would be sleeping in hammocks. I now reckon McKenzie is positively harmful in most cases. Problem is 10 different physios will give 10 different answers and the usual scripts are played out. Very few are capable of thinking outside the box- sorry to be so critical of my own profession.
Interesting. I have recently starting having problems with my lower back and having taken ages to get better from one problem 2 years ago, I have it all over again. I am now pretty sure that it is a prolapsed disc somewhere in the L/S region, although it's hard to get to the bottom of it when my GP isn't interested in a diagnosis, and I'm pretty much in the hands of an osteopath. I am a powerful breaststroke swimmer and, although I swim it correctly, I am aware of the pressure it puts on the lower back. I've noticed that the last 2 times I have developed problems are when I've upped my swim workouts somewhat. Much as I have always loved my swimming, I don't love this pain and it's having an impact on my work. I'm on the verge of stopping swimming and opting for low impact workouts at the gym (once I'm better, because I'm incapable of any significant exercise at the moment). The problem is people are always telling you how good swimming is for your back, but I instinctively feel that swimming breaststroke is screwing up my back - and searching on the internet there just isn't that much info on the risks of breaststroke to the back.
Flip...I seem to have a disclaimer now attached to all my advice. Oh well.
Hunchback,
The only advice I see you giving is sleep in a hammock, flat foot squat, swim in small doses, and no McKenzie exercises. Since you've already been targeted with a disclaimer, in your expert opinion, what should someone do with an L5/S1 herniated disc compressing S1 nerve root?
I'm trying to avoid surgery at all costs! Would love to hear back.
Thanks in advance.
Kathryn
July/August 2009 - Lumbar back pain.
Sept 2009 - Mild butt/leg pain proceeded to get worse.
January 2010 - Dx with L5/S1 herniated disc with 7mm fragment compressing S1 nerve root.
Feb 2010 - Caudal ESI. Took 10 days to work, but so far, so good.
May 2010 - Started lowering my meds to see if I can come stop altogether. Only take Lyrica 75Mg once a day and Meloxicam every other day.
Yeah you come on here and announce you are a "physio" then start giving advice. That doesn't go over well without a disclaimer. ie, it is your "opinion" about the current state of PT and exercises.
I find your approach interesting. I don't buy it all but some of it makes sense. You were doing ok until you threw Western medicine and therapy under the bus
LOL.
I'll continue to do Core Strength work thanks. I know my core is weak from sitting around. Only doing walking for exercise was not enough. However, my surgeon goes against McKenzie. Many think it is just the cats meow. So I won't do McKenzie because has asked me not too. However I won't come on here and preach it is the evil of Western PT's. It is simply another opinion on a form of PT that my surgeon disagrees with.