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Lower back problem
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Im in awe Captain Nugget,Triathlon is the route i am intending to take once ive got myself sorted,have you been doing triathlon long?
Congrats though,anyone that completes an ironman in my book deserves all the credit in the world,the distance and the training involved takes some dedication,no matter what.!!
So your core routine is pilates and what else?
What tri did you do UK?,Ive noticed that this years venue has changed to Bolton this year!
Beany, it's not that costly, about the same as physio or chiro but you won't be needing as many appointment.
RunningKate, if you see the Bowen person, I'd love to hear how you get on.
beany, I did germany last year. Unforgettable experience from start to finish. I'm doing austria this year. I may do UK one year but I'm not sure it could live up to the european one's. I'll certainly be going to support this year in Bolton. I've been doing it 4/5 years. I started in pool based sprints and progressed from there. I'm even a club coach now!
Re the core routine- I do pilates once a week. From that I cherry pick the exercise that best suit my "issues" and do them for 10-15 minutes at the end of every gym based session. I was born with a slightly curved spine and now i lack a lot of flexibility in my bottom 5 vertabrae. I've also been working on funcional training recently so time permitting I'll be doing one of these sessions a week. If you youtube "functional Training" you'll get an idea of what i'm talking about. In a few years everybody will be at it.
Brilliant achievement,you must be well proud of your achivements thus far,hard work and dedication has obviously been a key factor for you getting to such a high peak of fitness.
Ive heard that the european tri,s are second to none both in organisation,and overall crowd participation etc,so like you say UK will not be the same having completed european ones.
I was going to make my first tri a standard distance event,would you reccomend this or would you reccomend shorter distances to begin?
The functional training method is something that i am going to start straight away, i am never going to have this problem happen to me again with my back,hopefully!!!
Its funny because i thought that my core was really strong,obviously not,or i spent to much time on ab work and not enough on back exercises,?although my running gait did have a large part to play in the injury i think.??
There is a lot of talk about chiropractors and no actual input from one so here goes. Just so you know my background i initially qualified in sports massage 10 yrs ago and went on to chiropractic. i also do triathlon and this year ironman also.
firstly, most chiropractors do a 4 year full time degree at either glamorgan or AECC in bournemouth unless you opt for the McTimmoney style chiropractic which is slightly more subtle to the other 2 methods.
Our focus is not to realign or "put things back". what happens is that joints generally get tight either due to overload or overuse injuries. Therefore you have involvent of muscles and ligaments also which can eithere get weak, lax or tight. A good chiropractor should use muscular as well as manipulation to treat all areas involved. You should also get some rehab exercises to either mobilise, stretch or strengthen the affected area.
In regard to back and leg pain (or sciatica) a term chiropractors dont use as means nothing as is non specific. Any low back issues either the discs, sacro-iliac joints or even gluteal or lumbar muscles can cause leg or buttock pain. Generally from runing the sacro-iliac joints will be involved due to the amount of leg extension as part of your running gait. you may find your leg on one side doesnt raise as well if you lay on your belly and lift the leg straight up without bending the knee. Disc or nerve pain is usually caused by a low back twisting and bending injury and usually pain refers down the leg to the knee and also pins / needles or numbenss is felt in leg or foot but it can present symptomless also.
n regard to manipulation, there is a chance that in the early days you will feel sore 24hrs post but this should lessen as the sessions go on. In regard to you having 18months pain, this may have been the 1st time you felt pain but the injury may have been building longer than this but been painless. even at 18 months you cant expect things to change overnight as lots of other factors will influence the chronicity. I would expect that if chiro treatment was going to work for you then you shoul notice a difference within 2-3 session but to get the injury fully correct may take a lot longer due to the chronicity.
Pilates based exercises are the best you can do as they focus on the core muscles which will stabilize your spine once healed and functioning correctly again. I am aware of the bowen technique and i feel this should be something you could benefit from also. Use a multi dimensional approach and you should get what you want.
Good Luck getting back to it!
feel free to comment, i have thick skin!
Kelvin
I'm team chiro!
My chiro has done more for my disk/sciatic/muscle related problems in 2 months than a bunch of physios did for me in a whole year! Not slating physios at all, as they are great and have their place but in my case, the chiro approach has worked better and the best news of all is that i am back doing a little running 2 - 3 times per week for 20mins....after over a year of being told don't run!
Kelvin, do you practise Active Release Technique? This has done the most to ease a lot of the symptoms of my disk problems. I can't recommend it enough!
Beany, i went sprint distance first partly because of the cost of a wetsuit if I didn't like the open water (though they can be hired). I was a late starter in the swimming and thus not over confident. OLY distance is fine for starters. Some people even go straight to Ironman believe it or not.
When you mention ab work for core, thats exactly what most people think it is. A few crunches at the end of a session, job done. It really needs its own session.Its such and important but amazingly undertrained area. If you look at your goals and your back pain is stopping you achieving them then fixing your back pain jumps right to the top of the list.
I can reccommend a book called "functional training for sports", i forget who its by. And "How to eat move and be healthy" by Paul Chek.
Kelvin, its nice to have your input (where were you earlier when I was calling you guys). I tried it, the guy promised to fix me, he didn't so I tried something else and it turned out that worked much better
i do on occasions use ART on the neck muscles as it works well in that area as the pt can turn their head whilst you hold pressure on the muscles etc. along with PIR (contract /relax) type techniques which anybody can add to their stretching regime by stretching 10sec then gently contracting against the resistance for 10secs, then stretching again, you will find the muscle will stretch further . There was a big piece on this in 220 the tri magazine last month. There are a lot of good applications out there that the lay person can use to help themselves, u don t need to be a therapist. Is just a little difficult in some areas as is difficult to massage or manipulate yourself.
I try to use a lot of different techniques depending on the patient and condition they present with. generally i manipulate, massage, and use acupuncture or ultrasound if appropriate and then try to get the patient to either stretch or mobilize and then strengthen the appropriate area. A lot of chiros will get hung up on one routine or way of treating and they then dont get people better as they focus so much on that one routine that they miss the obvious.
Agreed with whats wrote above core stuff isnt a six pack, that doesnt stabilize anything, the key muscles are Longus colli in the neck, Serratus anterior in upper body and transverse abdominus in lower body along with multifidus for the spine. I am aware of the paul chek book but not sure where i have seen it. You need pilates type exercises for core, not many other exercises work the appropriate areas
ART has worked very well on my hip and glute muscles which just kept getting contracted. Foam rollers, spikey balls and stretches just weren't quite doing the trick.
Seems every practitioner has their own way of doing things and uses different techniques - it's just a case of finding one that works for you as an individual. The problem with this approach is that it can take ages to stumble across the right one and can consequently it can cost big bucks also, you have to hope you don't stumble on one who does more harm than good!
I think one of the reasons my issues have dragged on for so long is that physios kept telling me to strengthen my glutes by doing bridging type exercises etc and strengthen my core using pilates type exercises, the problem was that all of these were winding up my disk as my back was getting flexed and extended, only I didn't get pain at the time, only hours after or the following day. I just wished one of them had cottoned on earlier that this may be what was preventing the area from healing and suggested maybe stopping all that for a bit but none of them ever did! Maybe I should have realised myself, but when you're being told, do this it will help you, well then i guess you believe what you are told!
TBH i do usually manipulate whilst a patient has leg pain (in relation to a disc). Its safer to wait till the leg symptoms centralise (pain is only in the back not in the leg) Then it should generally be safe to either manipulate or in your case do the exercises. the key thing with the disc is to see whether you tolerate flexion of extension of the low back. all exercises should then be done with that in mind, ie if it hurts with extension, dont do extension rehab. The other key is to constantly use ice. keep the low back cool down wear the disc is, granted not all cold will penetrate to the disc but in many cases its not always the disc that presses the nerve, its the inflammation (unless MRI suggests different of course)
as you say there are many ways of doing things and every practitioner will do it there way depending on their experiences. A general rule of thumb is to remove pain (ice, heat, Nsaids) / restore function (manipulation, mobilise, other) and then prevention (stretch, strengthen)
Kelvin, as you're here it'd be interesting to know what you think of my friends belief that 90% of back pain could be cured/ prevented without the help of a therapist? He's a biomechanics expert, his wife is a therapist.
Also who's remit does self miafacial release fall under? Is it physio's? Chiro's? Do you think it has any benefit?
Kelvin
I'm so pleased to hear you say ice! Physios have told me use heat! My chiro nearly cried when I told him this!!
Interestingly, i can flex and extend without any pain at the time. It is only hours or the next day that the lower back soreness/leg pain starts up. Then i apply ice and that does the trick.
I have had an MRI and have a mildly prolapsed L5/S1 disk which is not impinging the nerve root so it would seem most of my issues are caused by inflammation around the disk.
This all very inconveniently kicked off from all the stretching i was doing for an ITBS flare up i had in 07. I was doing all manner of horrendously unfriendly to disk stretches like sitting on the floor with both legs stretched out in front of me and putting nose to thighs, and standing, crossing one ankle over the other, bending over and twisting to side (idea to stretch ITB) - these make me shudder now!
I had had an acute lower back pain episode about 5 years ago (lifting and chucking a bale of hay) which had me on the floor for day's so i imagine this is when i initially did the disk some damage, but I recovered from that quickly and never had a problem with it again until i started all the stretches for my ITB. Reckon i must have disturbed it.
Captain Nugget -my two cents worth... i think if the general public were educated on the importance of posture (when sitting, driving, bending, lifting etc and also the importance of core strength and having a moderately active lifestyle and keeping to a healthy weight, then yes i think your mate could be right about the prevention part anyway.
lumbar discs are usually a bending twisting injury as you suggested throwing a hay bale is enough to traumatise as is similar motion. I became a chiropractor as a result of a lumbar disc injury, since then i didnt follow my own advice and screwed my disc in my neck as well only last tyear as a resulf of some long duratiuon cycling with my head in crap position whilt on tri bars. the neck disk was more mpainful than the lumbar disc for what its worth. But coming back to the lumbar disc if im not careful and i lift things or bend awkwardly i often get a tingly foot to remind me which can last for days. generally if you injure a disc once it rearely injures a second time. is usually inflammation in the same area or the disck above. strange things happen though.
I would go as far as to say most back pain can be prevented by education but in this country how many people will listen to self help before they have been injured. not many so, your biomechanics friend is correct to an extent, but unfortunately its usually a case of the therapists intervention to help then re-educate to prevent further damage.
Myofascial release is just another way of releasing muscles, we all use it. Look up travell and simons trigger point charts to understand this better!
Kelvin
Thanks very much for the useful info,everything you said rings true to what i have been experiencing since my sessions at the chiros,i must admit that i am walking pain free for these last couple of days and have even managed two short runs,so i think i am getting somewhere.
Unfortunately another thing has arisen that is posssibly going to set me back if i want to do high mileage training in the future,that being that my chiro has told me that my right leg is 2cm shorter than my left, which has also led to my recent injury along with my, overpronation problem,what is your advice on this,my chiros advice is to have my running shoes adapted each time i buy a new pair to counteract the leg difference ,as putting heel inserts inside my shoes will not work as they will be to high with my orthotics in place as well?
What ironman are you doing?
Glad you are feeling some benefit. When chiros talk leg length they quite often refer to the way the pelvis can become mildly distorted through the sacroiliac jonts which gives the appearance of a short leg. 2cm is quite a lot. a true leg length difference ie from birth (actual shorter leg bone in the leg on one side) can occur but also a combination of overpronation, tight quad muscles or the aforementioned pelvic torsion can equally achieve that effect. You may well do best to follow his advice with regard to the shoes as he has obviously assessed you and can see what is going on whereas im just bouncing idears around for you.
Am doing Wimbleball 70.3 on 14th june. normally only do sprints due to work and family limitations on training so this is a big step up for me. Am doing it for the national Autistic Society so will be worth it!
Sezz
My right leg is actually shorter than my left,from birth,which is why he has come up with some methods if i want to carry on with marathon length running of ways to help overcome the problem,could be quite costly though,buying good trainers and then spending more to have them modified for me,to be honest when he told me i couldnt beleive it.
Kelvin
He did state that this is a birth thing and that most of his patients that come in thinking that they have one leg longer than the other 99% of them infact have not,but i have!!
He also said that if i wanted to be 100% sure that i could have my legs x-rayed to just back up what he is almost 100% positive that i have got a leg difference of 2cm.(freaky),splitting the difference on my leg length to 1cm though when i have shoes modified should correct me,and also not put to much pressure on me ,as my body has obviously over the years adapted to the leg difference.
I wish you the best of luck for your ironman,and like you say as its for charity it makes it all the more worthwhile.
Strong spinal column muscles is the best support for your back .
Try to find the Spine Exerciser and make your core stronger.
Something like shown in this article:
http://www.girlracer.co.uk/lifestyle/21-news/372-spinex-a-new-concept-fitness-machine.htmlRegards, Azbars
Dear Kelvina,
I did not mind before, but, thank you - now I know how much pilates classes cost, they cost much more than "very little". Have a look how much you can spend for one year of membership: Membership FeesOne class a week per month: £49 per month
Two classes a week per month: £89 per month
It is about £600-1080 per year. Plus you have to spend time and money to get there and back.
You can check prices yourself:
http://www.tenpilates.com/prices.html
http://www.se3pilates.com/fees.html
Any fitness machine at your home you have more than for one year and for whole your family. And you can use it from comfort of your home any day and any time suitable for you. It appears to be much convenient and cheaper then to visit pilates classes.
Concerning fitness machine effectiveness – you can find additional information at website: www.freespine.com
Please take a look this original fitness machines as well, you can find there useful information about experts:
http://www.fastexercise.com/LeapofFaith.asp
www.balancemaster.co.uk
Concerning exercising in general, couple years ago Nigel Graham, President of the British Osteopathic Association admitted: “The body has a natural ability to self-regulate and self-repair and osteopaths rely on this innate healing ability to treat their patients.Recent independent research suggests that a combination of spinal manipulation, general exercise and active management may produce most relief for back pain sufferers, helping them return to their normal activities".So without exercising you can not strengthen your core muscles and get rid of your lower back problems.
Regards,
azbars