Started by Bryce Warren, February 9, 2012 · 7 Replies · 4,009 Views
I've got a friend that has this issue with her spine, and was curious what anyone could tell me about this type of problem. How you can slow this process down, strengthening exercises, etc. Basically anything that can help. I've heard about this from a few people so I'd like to know everything I can. Always nice to be able to give people some useful information. Thanks guys.
"Blew it out on the job 18 years ago. It's been degenerating ever since (discs breaking down from the sacrum up)"
As always, this is not medical advice. Not all professionals are up to speed with all the research, but it is important to see them because in general they do good things for people. And they have liability insurance, which I do not. Anything you do as a result of this post is at your own risk. This is for informational purposes only.
That is an excellent question for a licensed athletic trainer or a physiatrist. No one can give actual advice on this without being licensed and seeing her in person to get a full history and perform proper examinations.
Suggestions to run by a qualified professional:
In general, there are two things she can do: One, keep her spinal endurance up. 58s or better in a back extension position (NOT hyperextending, just maintaining a normal spinal posture) horizontal with the ground is associated with a significantly decreased amount of pain regardless of degenerative status according to a study from Norway or Sweden. Fairly large sample size, good statistical power, and this should also make for common sense.
For her in particular, this will probably be safer than arch holds on the ground as they will require full lumbar extension and that may be painful or contra-indicated. A neutral position, which is possible with a bench and something to lock her heels or calves under, will almost certainly be safer for her. Hollow holds should be excellent prehab for her, but she will have to be extra careful about form. NO arching of the back! It is more important for her to have 60s endurance in an easier position than 15s of strength in a hard position.
Two: Do everything she can to attain and maintain proper posture.
Three: Avoid excessive spinal loading. Some seated bounces, performed gently, on a swiss ball can actually help nourish the discs by squeezing them like sponges, which is how they get their nutrition from the surrounding fluids. So can limited prone flexion + extension on a swiss ball.
As always, this is not medical advice. Not all professionals are up to speed with all the research, but it is important to see them because in general they do good things for people. And they have liability insurance, which I do not. Anything you do as a result of this post is at your own risk. This is for informational purposes only.
What do you think of using an inversion chair?
Oh boy this is a tough one.
One would really need more info, there are some degenerative diseases, but my understanding is that it is fairly rare, however with that in mind, Slizz's caveat goes here as well.
In general disk degeneration is actually completely normal. In fact there are many people out there with 'herniated' disks, disk degeneration etc that have no problems at all. Yes i know this may come as a surprise but it's true.
Posture can have some effect, but everything i've been studying of late tells me it also being exaggerated. I personally find sitting in chairs miserable, but that's because you are stuck in a position that does put some strain on the back. It's not the posture, it's being there for extended periods of time without moving much.
The problem with doctors and this issue is often the solution is radical surgery, which as often as not does not help the pain, after the many months recovery can take. It's really a last resort.
The best solution is movement.
The fear of disk degeneration, and more importantly pain, will cause people to stop moving, then they are taught not to flex or not to do this or that. This is also being exaggerated, yes a strong core is good, knowing what an upright posture is is good. But we need to move, and break through the bodies defense mechanisms. The body, via the mind, learns to guard itself, which creates a sort of negative pain feedback loop.
One needs to very slowly get moving in various ways, finding what feels good and what doesn't and over some time expanding the what feels good so it all does. This can not be done with force. One can't push through the pain, it will only strengthen the feedback loop. Rather it's like working with a pet that's been abused, it has to be carefully nurtured back into trusting its new master.
Here is a nice site, and i can endorse the series he presents to help with low back pain. Try it, it's money well spent. Also have your friend read through the site and others it may lead her to.
http://www.bettermovement.org/products/
If you want you can PM me with your location and i can see if i know of someone who may be able to help.
Again the above is a very brief and general overview of the current understanding of pain. It's not a replacement for a doctor or good therapist, but may help her frame the problem in a new and more productive way.
This is great, and instead of trying to come up with my own way of saying this it'll be easier just to send her directly to this discussion. Always good to get different advice from people that may know something new whether it's professional or not. These forums never seem to fail when it comes to excellent discussion and information. Thanks again.
Nice, Feldenkrais DVDs! That is excellent!
Cole is right, there is no correlation between pain and the level of disc degeneration. That is what I was saying when referring to the Nordic study. They found that the only factor that had a statistically significant impact on the likelihood of a person experiencing pain was the endurance of the spinal musculature. 58 seconds was what was determined to be the threshold, after which there is a sharply reduced risk of lower back pain (by FAR the most common back pain).
Posture is more influential in the progression of degeneration than it is in the actual acute pain sensations, but to some degree it does affect this by simply putting muscles in a position where they have to work harder to maintain posture, which leads to fatigue and sometimes pain. Again, even with bad posture good endurance protects you against the pain.
With nearly all movements, slowly working into them is important and good. Spinal extension is the one you have to be careful of, because when you extend the spine you push the gel in the center of the discs towards the spinal cord. This is totally ok when you do not have a ruptured disc, but IF you actually have a herniated disc you do NOT want to go past normal postural extension for any reason except for an emergency where there is just no good alternative. Why? SImple: when the disc is herniated it is nearly always herniated on the side of the spinal cord (posterior surface, against the posterior longitudinal ligament. This means you're squirting a very dense gel (the nucleus pulposa, in the center of every disc) against your nerve roots. The more it pushes out, the more it starts impinging on the nerves, and that is where you can start getting some serious issues going on. Moving from a flexed position back to normal posture is fine, and does count as extension, but extending beyond that is a bad idea.
That's what you have to be careful of. It is possible to take a minor herniation that is causing little to no symptoms and turn it into an excruciating condition by extending far enough to force more gel into the spinal cavity.
Curling around a swiss ball and then extending back to a flat back is probably fine, but actually arching backwards is a no-no for safety reasons. It is totally unnecessary for total body conditioning and in the herniated disc population it has a far greater chance of negative effects than positive. Not a good gamble in my book.
There is no need for added weight either, and like Cole has already said you really have to pay attention to your body... if it hurts, don't do that yet.
Necroposting, but I believe for correctness the above post should be referencing lumbar flexion, not extension. Extension is more likely to give facet problems, or "spondylolisthesis".
http://apps.washingtonpost.com/g/page/national/the-health-hazards-of-sitting/750/?tid=sm_fb
Just for general interest, guys! The "What can you do about it?" section is a bit underwhelming for people who have Foundation to the rescue, but anyways!