Health/Fitness

My story of a back injury and how I’m learning to live with it in my 40’s.

The plan this week was for Dave and I to follow-up from our last video, and to finish talking about hormones in our 40’s, and most importantly “what can we do about them?” (the million dollar question.)  The plan, however, has changed due to Dave going back to a busy week at work, and simultaneously getting a man-cold.  (seriously. and we thought menopause was bad.)

I promise we’ll get to that video after Dave gets off work one day soon, or at the very latest in two weeks when he comes up for air.  Thanks for grace.

Meanwhile, let’s talk about me.  Haha. Just kidding.  I honestly have wanted to share this story with you for a long time, but cringe at the thought of coming across as complaining or wanting attention.  I am only sharing this with you because I’m pretty sure many of you will relate, and for those who don’t — I’d love to save you some pain by sharing my story along with some helpful steps you can take to avoid it becoming your story.

HISTORY:  I grew up doing competitive gymnastics (and then all of the team sports in my high school years) so I don’t know when I initially hurt my back.  My guess is that landing on my skinny-kid-butt from the uneven bars or balance beam one too many times might have done some damage.  (I can still feel the bruised tailbone when I think about it, ouch!) Regardless, somewhere in my 20’s I began to have pain off and on in my low back, which occasionally would shoot into my left gluts and leg.  As a fitness instructor at a gym, doing a lot of aerobic and strength conditioning classes, most of the time the pain was manageable.

PROBLEMS: Since we moved to the country (and far from a gym) over 6 years ago, my main workout has been running and walking, along with some basic hand weights for resistance work.  I have rarely done any abdominal or strength work.  Though I preach core work (remember my abdominals post?) I really neglected to do much of it. #guilty

Two years ago, my back pain increased and this time it did not go away.  It began to affect sitting, bending, standing for any length of time, and would even wake me up, aching in the night.  Eventually, the pain was going into my left leg more and more, and for a time I had tingling and numbness in my left foot.  I continued to run off and on, unsure if running actually made my pain worse.  Other things seemed to affect it more than running (like the day I sat, bent over doing puzzles with Levi for many hours; the next day I could hardly move.)  I went to a Physical therapist, but the therapist wasn’t sure what she was working on, so we didn’t have a clear game plan and my pain did not improve.

Finally, about a year ago, Dave suggested I get an MRI of my spine.  Dave and the orthopedic surgeon took one look at the results and could see it plainly;  A full disc herniation in L5-S1.  But of more concern was that the bright white semi-circle pattern running through both L5 and at the top of the S1 vertebra, which signals inflammation in the bones.  This is likely a sign of degeneration.  The simple explanation for this would be that due to the disc herniating (which could have happened any time in the past, and would explain the pain down the legs and the tingling toes) there was no longer cushion between L5 and S1, and now I was bone-on-bone…This can exasperate degeneration, and begin the process of arthritis.

**You can see ^^ the disc between the L5 and S1 is really small.  This was taken while lying down, so as you can imagine when I am standing up (or running) that tiny bit of disc doesn’t do any cushioning.  (I should also note here that a disc herniation itself is not super uncommon; some people have herniated discs and don’t even know it! The problem is if nerves are impinged, or bones begin to degenerate, as in my case.)

The orthopedic surgeon did not have much to offer.  He said that surgery is one option; he could fuse my two vertebrae (L5 and S1) together, which would decrease the bone-on-bone issue.  He said that for women of my age and fitness level, this is highly successful; in fact there is an 80% decrease in pain for 80% of women like me facing these issues.  However, to do this surgery, he would have to go in through my stomach, try to avoid my aorta (yikes!) and fuse the vertebra together.

I’d really rather not.

I’ve definitely been torn on this issue:  On one hand, I can walk fine, I can drive a car, and sleep most of the time without pain.  Basically, I can live with this.  However, my pain affects things like: putting on shoes, picking things up off the floor (any mom knows how much we do that!) and any quick movements, like catching a ball, or playing with my boys.  (Also if you see me getting up from the ground, you’ll agree I move like a 90 year-old.) (waah.)

But weighing out the pros and cons, I haven’t felt like my pain is bad enough to get surgery.  So I have lived with this for the last year, waiting to see what happens.  Things have not changed much, and though I can do almost everything I need to do, it’s been a bit depressing to consider this may be how I feel for the rest of my life.  Chronic pain?  I never thought I’d face it in my 40’s!

UP TO DATE:  Recently I went to another Physical Therapist.  I found a place that specializes in sports injuries and I really love it there.  (If you’re in Hawaii, it’s JACO Rehab.)  Since we now have the MRI and a better understanding of what I am dealing with, I hoped the PT might be able to educate me on the best way to strengthen, stretch, and basically learn to live with my problem.

After five sessions of PT, I am truly encouraged.  My therapist gave me a set of exercises and stretches; these are both for strengthening my core and gluteus (butt) muscles, and for stretching the areas that are super tight around my injury.  What she taught me would be safe and effective and helpful for anyone.  (As always, if you have back problems, see your own doctor to get help and advice.)  I’ll share what I’m doing below.

MY THEORY:  I am pretty sure that I have had back issues, and likely a bulging (if not herniated) disc for many years.  However, I believe that during the years in which I taught fitness, I was doing so much core and gluteal work that to a large extent it supported and even protected my spine.  It was only after moving to the country and all but quitting my core work that things started to fall apart.  Pair that with being in my mid-forties and in general losing some muscle tone, and the combination put me in a very vulnerable place.

MY CURRENT WORKOUTS:  My physical therapist suggested that I need not quit running entirely, unless it was increasing my pain, so the happy news is, I am continuing to run some.  I only run short distances (3-4 miles, max) and I take a day or two in between each run.  Then as many days a week as I can, this is what I do:

CORE:  I am doing pilates-style abdominal work, with a  focus on strengthening my deepest abdominal muscles (the rectus abdominus). I am working on slow, controlled movements and I have a routine of about 4 different ways I work the abs: a basic plank, side planks, and pilates-style crunches done a few different ways using a band.

GLUTS:  For my gluts I do a simple bridge:  lying on my back with bent knees, I press my feet into the ground, lift my hips up off the floor, then lift each foot for a count of five.  Taking a break between sets, I try to do 5-10 sets of these.  I also am working on some variations of lunges, with an intentional focus on working the gluts (instead of letting my quads and hamstrings do the work.)  I am working towards using a band around my ankles to do side steps, though at this point this seems to irritate my back, so I’m building up to that.  Starting slow, simple and consistent is hard for me, but I think it is the key to getting me where I need to go.

STRETCHING:  I am stretching my piriformis (one of the deep gluteal muscles, often tight in runners) by sitting down on the ground, and crossing one foot over the other knee, and gently lifting the bottom leg.  I also roll out my piriformis on a foam roller or small fitness ball.  I am also rolling out my entire back on a foam roller.  (apparently my thoracic spine is super rigid, which is likely contributing to my issues.)  I have Dave massage my para-spinal muscles (the tiny muscles all along my spine, at and above my area of pain) which is really helpful.  These tend to get tight as they are trying to “protect” my area of injury.

FINALLY:  Though I am not pain-free at this point, I feel like my core is stronger than it’s been in years, and I have a game plan — which in itself makes me feel more in control.  The PT said that I can get back to doing some yoga, but certain movements (forward flexion) would not be wise, so I need to modify what I do.  Pilates is excellent and I hope to learn more ways to incorporate pilates into my routine.

My story is not necessarily isolated to life in our 40’s, but I am pretty sure that any injury that has begun in our body will start talking to us when we hit this season of life…It’s part of the aging process. (ugh.)  I really want to encourage everyone (man, woman and child–seriously, I’m making my boys do this stuff!) to take their core strength seriously.  I read somewhere that a legit test for someone’s overall fitness level is their core strength!  That is heavy!

Whether you have back issues or not, I suggest you make core training a part of your regular fitness routine.  A Pilates instructor friend of mine suggested this site where you can take pilates classes from home, though a private pilates instructor is always the best way to get started.  Also, here are two online articles outlining basic pilates movements for back problems (many of them I described above!)

5 Pilates Exercises to Ease and Prevent Back Pain (Prevention.com.)
9 Pilates Exercises for Back Pain (VeryWell)

Comment below!?  Weigh in on your own back story, if you have one…Share if you do Pilates, or other core work.  If you are managing chronic pain, back injuries or anything else, feel free to tell us about it.  Hopefully we can encourage each other to grow older with grace, and strength!

Aloha and see you soon (hopefully with a handsome doctor by my side.)

XO
Monica

Hopefully it goes without saying that I realize that my back problems are SO SMALL in the bigger picture of life.  Like I said before, I reeeealy am not into drama, and promise I don’t share any of this for attention.  I have so much to be grateful for.  I do hope to live a long and healthy life, however, so learning to manage chronic pain is super important to me, and I’m sure it is to you, too. 🙂