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Guhhh... Skiing with a slipped / herniated disc. Help?

post #1 of 20
Thread Starter 
So 6 or so years ago I probably herniated a disc while lifting something. I recovered and it went away. 3 years ago I was doing Crossfit and it slipped again while doing deadlifts. That did NOT go away. Pain down the left leg, couldn't stand up straight.

The regular medical doctor just prescribed me pain meds and charged me $120 for the 10 minute visit. So I went directly to a chiropractor who did an x-ray and found that my lower spine was way too straight, so he adjusted it back to the natural curvature and I felt a lot better after many sessions. I didn't do PT or an MRI because my health insurance didn't cover it.

So after 3 years the pain went away. If I focused I could still feel some lingering pain down the left leg, but for the most part I was OK.

Then skiing this year. A couple of weeks ago I decided I wanted to learn how to ski switch. The falls while learning switch twist me and I landed on my lower back once on the hardpack after catching an edge and now I'm back in pain - sort of.

After I fell I could hardly ski back down even on the groomers because every little bump would send a wave of pain to my back. I do a backwards back stretch and sleep with a towel roll under my lower back and it seems to push the disc back into place.

Today I did Beaver Creek and the first run of the day was on a groomer. I had some speed going and I hit a bit of a bump. I guess my knees where not loose enough and the shock got transferred directly to the weakest point of my spine. So again, I'm in pain.

I did a backwards stretch on the slopes and became ultra, ultra cognizant of my skiing form afterwards. I basically ski now like I would do a deadlift - butt sticking out, hips forward, lower back rounded down instead of rounded up, chest up.

(Like the middle image)

http://www.wannabebig.com/wp-content/themes/mimboPro_single/images/article_images/training/deadlift_2.jpg

I realized that I've been skiing with improper form all this time. I skiid with my weight forward, but my back was rounded out, so any shock that my knees didn't absorb my lower back did, in a squeeze-your-disc-outwards kind of way.

Anyone else go through this? What did you do?

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post #2 of 20

Definitely not trying to be a smarta$$, but my screen name would suggest one good option (if your insurance allows that is).  With situations such as yours, chances are you have positional dysfunction(s) in the spine, hip mobility deficits, and poor activation of lumbar stabilizers.  These problems have solutions, but are difficult to address via the WebMD method.  There is no one cookbook answer to your question unfortunately.  Ask around and find a reputable PT.  Best of luck!

post #3 of 20
Quote:
Originally Posted by PTski View Post
 

These problems have solutions, but are difficult to address via the WebMD method.  There is no one cookbook answer to your question unfortunately.  Ask around and find a reputable PT. 

 

I've had back issues since my 20's.  Last year at age 47, my L5/S1 disc blew out while I was shoveling dirt.  Did dope, PT, acupuncture, chiro, ESI's, and finally had to have it cut it out (micro-discectomy/laminectomy) in July due to numbness in left leg, which can result in permanent nerve damage.  The back pain is gone, but the weakness/numbness in my left leg is often still there (can take up to a year to go away...IF it does), so my skiing this winter will be...uh...conservative.  

 

If you have pain in your leg from a disc issue, my understanding is that is when it becomes a much greater concern...but I'm not a Doctor.  I agree with PTski, though.  Find a reputable PT and pay-out-of pocket if need be.  If money is tight, they may be able to develop a "home program" for you after a few visits.  Non-surgical approaches work for a LOT of people, and the several hundred bucks you spend on a few PT appointments now beats what may be a $25,000 surgery later if left unaddressed.  

 

Check out Epidural Steroid Injections also.  It's a low-cost and minimally invasive method that also works for a lot of people...although you may need 2 or 3 over a 6-month period for it to "take."

 

Good Luck with it.  Back pain sucks!    

post #4 of 20

I had huge problems with a herniated disc that caused sciatica.  I did it shoveling snow and it was misery every day for a year.  I was even having trouble farting, sneezing, and crapping.  I tried drugs, chiropractors, and acupuncture.  What finally worked was working with a therapist on a strengthening and stretching program.  I ski for a living and that was the season that I broke through and started getting regular assignments to teach upper level lessons.  It sucked to be teaching mogul skiing five days a week with shooting pains, numbness, and a measurable loss of strength in the affected leg.  I had to keep skiing because I needed the paycheck.  It was good for my skiing, I got a lot smoother, but I can't recommend that method for improvement.  Good Luck with your problem.  I am careful with my posture and movements to avoid a return to the misery I left behind.  Every time I even think I feel some tightness in my left buttock I get onto some extra core work.  Get with a good PT and pay out of pocket if you have to.  The guy that fixed me wasn't covered by my insurance.  Surgery is permanent and can go badly.  I would avoid it if at all possible.

post #5 of 20

My story: I  jumped off a parked work truck 20 years ago and felt something happen in my lower back when I hit the ground. Since then, at least 2 or 3 times a year, my back would “go out” and my upper body would shift over several inches.

 

Snow shoveling, vacuuming, yard work, bad jiu jitsu form, bad skiing form and even pushing it too hard mt. biking would put me into misery for a few weeks. Sitting at a computer all day became unbearable.

 

Last spring things flared up again and my ski pass had to sit unused for two months. At times it was impossible to feel relief even with a steady diet of Lortab. I couldn’t even put my socks on. One day I noticed that my left foot was flopping. This “drop foot” was a big wake-up call that something needed to change.

 

I had seen an orthopedist several times who thought I had sacroiliac dysfunction. This time, the drop foot made him think it was time for an MRI. As I suspected I had herniated discs. I went ahead and had him do an injection. My body nearly leapt off the table when the needle touched something it was supposed to. Anyway, I did manage to sleep better the next night but during the daytime I experienced no further relief. Things did settle down after a few more weeks and then I decided it was time to make some physical changes to my body.

 

I’m a tall skinny guy and have never really targeted my posterior chain in the gym very much.

Nowadays I focus a lot more on developing my hamstrings, glutes and lower back. 

The following stretch (in the most upright position)

 http://www.youtube.com/watch?v=ED_T6hFoc4E  has been absolutely crucial to my recovery as well. I do it for 5 or 10 slow reps every day. It’s also a great way to gauge how out of place or tight things are back there. I still flat out avoid any sort of deep flexion in my lower back while exercising and always try to maintain an arch. I always sleep with a shirt or towel rolled up under my lumbar region.

 

My drop foot has gone away thankfully and I’m steadily building up my shin strength.

Another huge part of my comeback has been setting up a sit down/ stand up workstation. I mix it up all day long and probably stand about 50% of the time. Now I feel great when I leave work.

 

Just four days on the slopes so far this year and my back feels great.

Like you I think I tended to slouch. My new equipment (Lange RS 130’s and Moment Bibby Pro’s) helps this by demanding a more upright posture.

 

Purchasing a snow blower has also been a big back saver.

 

There were times that I thought I was done for as far as athletics go but clearly this is not the case. I’m 43 years old and feel stronger than ever, at least on my backside.

 

In my opinion if you keep focusing on good postural habits and backside fitness you will be fine.

Good luck!

post #6 of 20

Ha, ha.  Medical advice on the Internet?   PTski was pretty straight forward.  My suggestion?  Stop skiing and go swimming.  And get some professional help till it don't hurt no more.

post #7 of 20

Lots of good advice in this thread, and as PTski said, it's a complex problem and the solution will vary by individual. Some brief notes on my story:

 

- Partial bulge of L5/S1 due to deadlifting/squatting with heavy weight 3x a week and questionable form (tight hips from sitting at a desk)

- 10 month recovery period of doing PT work

- 3 years later I have zero symptoms and am lifting relatively heavy again but I never sacrifice form ever (training on my own and at CrossFit boxes)

 

What helped me during the recovery:

- McKenzie/cobra stretches

- Working on hip mobility

- Standing at work for at least part of the day

 

What I do now to avoid injury/symptoms:

- Squat/deadlift/posterior chain work with PERFECT form (never sacrifice form for weight), it is important (to me) to do these exercises with a challenging weight as that is how your body will adapt and build the muscle you need to keep your knees/hips/back healthy

- Continuous effort on hip mobility - I sit at a desk 40-60 hours a week, and sit in the car 3 hours every ski day, this is HORRIBLE for my hips/back so every time I am in the gym I spend 10 minutes on the foam roller beating the crap out of my posterior chain/quads and also another 15 minutes stretching my hips after my workout

 

The foam roller (I use a travel roller) helps immensely in loosening up the hips, use one every day.

 

With this approach I've been able to be pain free and continuing training (including Olympic weightlifting, which I think is good for mobility) and skiing/backcountry touring 5-6 days in a row without issue.

 

Basically, you have to maintain your body continuously and forever.

post #8 of 20
Thread Starter 
Thanks for all the advice! Since I've had this problem for a number of years I've been pretty well versed on how to deal with it through all the ready and videos I've done.

My primary concerns are this:

- my insurance doesn't cover PT and the rate of $60 a session or thereabouts can get prohibitively expensive really fast. That's why I decided to just try learning on my own.

- I know and employ all the McKenzie stretches. Extremely basic stuff, really. Too basic. And there're all backwards stretches. You either bend the back backwards on the floor, against a wall, or standing.

- how do I safely bring back forwards range of motion? Life requires you to bend forward. Putting on ski boots. Bending down to clamp them. Pulling them off. Putting on pants. All of these things strain my back and worry me because I don't want to bulge that disk out again by bending forwards.

- I had a chiropractor for about 3 months. 2-3 adjustments a week. At the end I told him that I was still feeling residual pain and he recommended that I go get an MRI done and that I had reached the limit of the chiropractic effect.

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post #9 of 20
Quote:
Originally Posted by fuzzybabybunny View Post

My primary concerns are this:

- my insurance doesn't cover PT and the rate of $60 a session or thereabouts can get prohibitively expensive really fast. That's why I decided to just try learning on my own.

 

60 bucks isn't that expensive for a PT session...unless the session is 15 minutes or something!

 

I paid out of pocket far more than that, but I went just enough to get instructions on what exercises I should be doing, how to do them correctly, and how often.  It was worth the cost.

Unless your PT person is trying to rip you off, they should be able to put together an effective "Home Program" (that's what mine called it) for you pretty quickly...after only a couple of visits...if they know you can't or won't manage more visits than that.

 

Think of this way, you would spend 200 bucks for a piece of ski garb with nary a thought, so how is 2-300 bucks to help ensure your continued healthy ability to ski not worth what you would pay for an inexpensive jacket???

post #10 of 20

Sorry to hear you are in pain.

 

I've found good low back mobility improvements from kettebell work.  If you are not familiar, its the cannonball with a handle looking weight you may see at newer gyms.

 

Kettlebell swings are great for strengthening posterior chain and for improving range of motion in the hips.

 

Here's one stretch I do that really targets the low back:

 

 

 

Be honest with your level of pain and mobility.  This guy is very strong and mobile so don't try anything that heavy.

 

Also:

 

 

 

 

Try some of these strength and mobility exercises and see if they dont get you on the right track.


Edited by dmourati - 12/20/13 at 10:00am
post #11 of 20
Thread Starter 
What is that green thing?

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post #12 of 20
Quote:
Originally Posted by fuzzybabybunny View Post

So 6 or so years ago I probably herniated a disc while lifting something. I recovered and it went away. 3 years ago I was doing Crossfit and it slipped again while doing deadlifts. That did NOT go away. Pain down the left leg, couldn't stand up straight.

The regular medical doctor just prescribed me pain meds and charged me $120 for the 10 minute visit. So I went directly to a chiropractor who did an x-ray and found that my lower spine was way too straight, so he adjusted it back to the natural curvature and I felt a lot better after many sessions. I didn't do PT or an MRI because my health insurance didn't cover it.

So after 3 years the pain went away. If I focused I could still feel some lingering pain down the left leg, but for the most part I was OK.

Then skiing this year. A couple of weeks ago I decided I wanted to learn how to ski switch. The falls while learning switch twist me and I landed on my lower back once on the hardpack after catching an edge and now I'm back in pain - sort of.

After I fell I could hardly ski back down even on the groomers because every little bump would send a wave of pain to my back. I do a backwards back stretch and sleep with a towel roll under my lower back and it seems to push the disc back into place.

Today I did Beaver Creek and the first run of the day was on a groomer. I had some speed going and I hit a bit of a bump. I guess my knees where not loose enough and the shock got transferred directly to the weakest point of my spine. So again, I'm in pain.

I did a backwards stretch on the slopes and became ultra, ultra cognizant of my skiing form afterwards. I basically ski now like I would do a deadlift - butt sticking out, hips forward, lower back rounded down instead of rounded up, chest up.

(Like the middle image)

http://www.wannabebig.com/wp-content/themes/mimboPro_single/images/article_images/training/deadlift_2.jpg

I realized that I've been skiing with improper form all this time. I skiid with my weight forward, but my back was rounded out, so any shock that my knees didn't absorb my lower back did, in a squeeze-your-disc-outwards kind of way.

Anyone else go through this? What did you do?

Sent from my SGH-M919 using Tapatalk

Sorry to hear about your issues. I'm a practicing spine surgeon. Your new issues sound more like an annular tear in the disc as much as anything. Your disc is a two part structure. If you aren't having pain down the leg like in the past, chances are its not actually herniated at this point. Annular tears will heal, but to be honest skiing on it will slow that healing.

Also if you do have a tear in the annulus you could eventually squeeze out the inner nucleus and then you have a full fledged herniation. Be careful
Edited by Kardinal - 12/20/13 at 12:58pm
post #13 of 20
Thread Starter 
Quote:
Originally Posted by Kardinal View Post


Sorry to hear about your issues. I'm a practicing spine surgeon. Your new issues sound more like an annular tear in the disc as much as anything. Your disc is a two part structure. If you aren't having pain down the leg like in the past, chances are its not actually herniated at this point. Annular tears will heal, but to be honest skiing on it will slow that healing.

Also if you do have a tear in the annulus you could eventually squeeze out the inner nucleus and then you have a full fledged herniation. Be careful

 

What makes you think that it's an actual tear versus a simple bulge versus my deep muscles mis-aligning my back for me?

post #14 of 20
Just my opinion based on your mechanism of injury and your symptoms. A disc bulge actually means nothing. Literally everyone has bulging discs if they are over 30 and have not spent their life living in a bubble. Discs bulge out when they lose vertical height secondary to loss of water content which happens to everyone over time. Obviously, I can't say for sure whether you have a muscular injury or a tear in the annulus without actually evaluating you in person. Just offering another possibility based on seeing roughly 80 spine patients a week. Hope you get well soon. Be safe.

Also for any of the things that this may likely be, PT would be the preferred initial treatment
post #15 of 20
Thread Starter 

Right, anything that is not 100% solid that is caught in the middle of two heavy objects is going to bulge. 

 

What I meant by "bulge" is "bulging out a greater distance than what is normal."

 

So why do you think that an actual tear is the cause of my symptoms (which symptoms exactly?) instead of just a "greater than normal bulge?" Is it because discs, simply due to their material composition, never actually "bulge out greater than they normally do?" If they ever become wider than normal (with a person's weight and age being the same) it necessitates some kind of a tear in the annulus? 

post #16 of 20
Quote:
Originally Posted by fuzzybabybunny View Post

Right, anything that is not 100% solid that is caught in the middle of two heavy objects is going to bulge. 

What I meant by "bulge" is "bulging out a greater distance than what is normal."

So why do you think that an actual tear is the cause of my symptoms (which symptoms exactly?) instead of just a "greater than normal bulge?" Is it because discs, simply due to their material composition, never actually "bulge out greater than they normally do?" If they ever become wider than normal (with a person's weight and age being the same) it necessitates some kind of a tear in the annulus? 

If a bulging disc is symptomatic, it's going to cause leg pain. Like I tell people all the time, even tho I'm a "back" surgeon, I operate for leg pain not back pain. True discogenic back pain is actually extremely rare. Like I said before, your mechanism of injury and the exacerbation of your symptoms with an axial load( bumps) is just characteristic for annular tear type pain. Think of your disc as a jelly doughnut. The annulus is the doughnut part and its made of tough ligament. The jelly is your nucleus which you don't want to escape. When that happens you have a herniation. Once again, how much your discs bulge is irrelevant unless the protrude enough to contact a nerve in which case you feel the symptoms in your legs not your back. Annular tears however you do feel in your back.

That's pretty much the best I can do on an Internet consult smile.gif. The good news is I think you will get better with conservative treatment. Someone before made a good suggestion re PT. go for a few visits and get a home therapy regimen. If you actually call a good PT center and explain your insurance issues, most will work with you on cost. I know ours does all the time.

If you are not having leg symptoms I would hold off on epidural injection as I think the benefit is limited in that case. A short one week course of oral steroids would probably work better and your primary care doc would likely be glad to prescribe that for you. And, you may not want to hear this, but whether its disc or muscular, you really should take a short break from skiing. It could prevent you from having to take a much longer one
post #17 of 20
I have a bulging disc and I had a ambulatory tear. My back and leg loved powder skiing but not the ruts that arrived later and I had less numbness in my leg during winter, I skied a lot of backcounty. Two winters later I am just getting to the point I can ski inbounds and across ruts, patience tough to practice but worth it.
post #18 of 20

I hurt my back quite bad last year.  I've had back pain for six years or so, but had a bad event last year.  I was moving a large object, stressed it out, then picked up something I thought was light and felt something bad.  Next morning I couldn't walk and was getting absolutely terrible back spasms so i had to go to the ER.  If you can get an MRI, it's the best picture.  The physical therapist gave me a lot of good information, but didn't seem to think getting in shape would make it better (because body builders have the same problem).  Personally I think making the muscles a little stronger helps.  Keep the lower back straight with good posture, and discs do heal.  You have to be careful I guess.  Oddly enough bumps don't bother me, but getting off lifts real close to the ground do.  Anyways, when doing anything i always have the lower back in the back of my mind, because that is ridiculously painful.  At least I "wounded" the area, then messed with it, then the disc goes back into the nerve and spasms the muscles on that area. 

post #19 of 20
Quote:
Originally Posted by fuzzybabybunny View Post

What is that green thing?

It's called a theracane. There's a similar product out there called a back buddy. You use your body weight and the lever prying action to do self myofascial release. Its intense!
post #20 of 20
Thread Starter 

So, uh, I think skiing lately has made my back *better*. If anything, the lift rides hurt more than the actual skiing but a quick back arch when I get off the lift fixes it.

 

I think it has to do with my having the proper form - like I said in the OP, I now ski with the same form that I use to deadlift, which is to stick my butt out, straighten my back, and basically do everything I can to NOT round it. I also do my best to keep my core solid and flexed, although this is pretty automatic during skiing as I'm continually bracing for bumps.

 

So basically:

 

- I ski in the deadlift position.

- I keep my core solid and flexed and this in effect also exercises my core

- I keep my legs loose for bump absorption but also firm enough for control.

- Whenever I get thrown out of my deadlift form, I immediately go back to it.

- I take it easy and don't do any jumps in the park

 

So far I've been able to ski moguls and trees just fine and without any kind of pain. Whenever I stop to rest I do a back arch for good measure.

 

Honestly, the only part of my day right now that has some aching is sitting on the lift, working at a desk, and driving.  I feel great after skiing. 

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