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  1. #1
    Join Date
    Dec 2003
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    Washington, D.C.
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    2,343

    Question Low back pain - from 'fragile' to skiing shape?

    I have a history of low back pain - first had that awful 'pop' circa 2009. Had it happen periodically till it popped really bad in 2015 and did not get better, while I was deployed to Australia. Finally got an MRI, had both a bad herniation at L5-S1 and a tumor in my spinal canal (schwannoma, benign). Tumor resection + microdiskectomy in 2015, full recovery for the remainder of my time on active duty (deployed again as an infantry officer, to Syria).

    Had my next 'pop' early in 2018, in the gym. Since then, it's been every six or so months. I have tried to be proactive - I workout regularly (4+ times / week), get acupuncture through the VA, just had my first steroid shot. A follow-up MRI has shown a bulging L4-L5, some reherniation at L5-S1, and spinal stenosis (narrowing), as well as generalized degenerative disc disease.

    I've tried a number of PT regimens - the regular PT (feels too easy), Mountain Tactical's lower back pain (was good for awhile), Foundation Training - in hopes of getting that strong/confident feeling back. I wake up feeling like an old man (I'm 32), and I have that persistent 'fragile' feeling. I can lift/workout/do controlled things (road cycling) fine most of the time - including still being an infantryman in the reserves - but I'd love to get back to a place where I can be athletic in a dynamic environment. Last time I tried to ski (January of last year), it twinged hard on my 3rd turn, putting me flat on my back for about a week with big painkillers and muscle relaxants.

    I want to ski again, and I want to get ahead of this in a manageable way so it doesn't prevent me from being an athlete. Any recommendations as to building back that stability/confidence/ability?

  2. #2
    Join Date
    Sep 2008
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    Not Brooklyn
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    7,291
    I've had similar issues and have made great progress. L4-L5 smashed up and arthritis for 2.5 decades and wrestling and coaching. I doubt the exact same things that have worked for me will work for you, but I think some of it will apply.

    -Stop doing exercises that occasionally hurt your back. Even if it only aggravates things twice a year, quit it. I don't squat any more, and I don't deadlift heavy, and I don't ride a road bike. And I sure as hell don't wrestle. Even if the lifts I replace them with aren't as effective, I stay stronger in general by avoiding injuries.

    -Do core and glute exercises (and whatever else your PT recommends to protect your back) at the beginning of your workout, not at the end. This switch was big for me. Managing a lifelong injury that takes precedent over max strength. At the start of a workout you're more fresh, more focused.

    -Don't lift to failure. No more 1 rep max. Not worth it.

    -But yes, you need to lift because...

    -Core and glute exercises- these are what keep my back feeling good. My lower back, despite the arthritis and general smashed-upiness, is plenty strong. But when things aren't lined up right it hurts like hell. Working on my glutes (especially glute med) and core keeps me limber and straight. I've tried cutting back on lifting and running more at times, and I get faster, and have more endurance, but I eventually have more back pain. Maintaining baseline strength is key with core and glutes 1a and 1b.

    -When you add new exercises, do it very cautiously. If you take a week or two off from lifting, reduce the weight more than you want to.

    -Stretch your whole fucking body. Deeply. 2-3 times a week. I like to smoke a bowl first. Helps me relax through the pain without over-stretching. Then I go to bed.

    -Figure out sleep positions that are better for your back. If I sleep the wrong way I wake up with my hips out of alignment. I often sleep on a couch because the fact that it is narrow makes it harder for me to get into a position that I find comfortable, but leads to back pain. It's weird, but it works.

    -When your back does get fucked up: dry needling/ acupuncture isn't always pleasant, but it can be miraculous. A massage is far more pleasant, but nothing can relieve knots and get me back to normal faster than a needle.

    -Lose weight if you need to. Extra weight just adds stress on your back.

    -Try another PT. Then another. Then another until you are happy with where you are. I've seen a bunch of good ones that I've learned from. Now nobody understands my body better than me, but I couldn't have done it without their help. Try to find someone who works with athletes. Better yet find someone who was/is an athlete. Best I've worked with was a former pro bike racer. She understood me, not just physiologically, but psychologically.

    5 years ago I thought I was going to need surgery or just lead a less active life. No I feel pretty fucking good.

    Good luck.

  3. #3
    Join Date
    Dec 2004
    Location
    SoOre
    Posts
    706
    Quote Originally Posted by I've seen black diamonds! View Post
    I've had similar issues and have made great progress. L4-L5 smashed up and arthritis for 2.5 decades and wrestling and coaching. I doubt the exact same things that have worked for me will work for you, but I think some of it will apply.

    -Stop doing exercises that occasionally hurt your back. Even if it only aggravates things twice a year, quit it. I don't squat any more, and I don't deadlift heavy, and I don't ride a road bike. And I sure as hell don't wrestle. Even if the lifts I replace them with aren't as effective, I stay stronger in general by avoiding injuries.

    -Do core and glute exercises (and whatever else your PT recommends to protect your back) at the beginning of your workout, not at the end. This switch was big for me. Managing a lifelong injury that takes precedent over max strength. At the start of a workout you're more fresh, more focused.

    -Don't lift to failure. No more 1 rep max. Not worth it.

    -But yes, you need to lift because...

    -Core and glute exercises- these are what keep my back feeling good. My lower back, despite the arthritis and general smashed-upiness, is plenty strong. But when things aren't lined up right it hurts like hell. Working on my glutes (especially glute med) and core keeps me limber and straight. I've tried cutting back on lifting and running more at times, and I get faster, and have more endurance, but I eventually have more back pain. Maintaining baseline strength is key with core and glutes 1a and 1b.

    -When you add new exercises, do it very cautiously. If you take a week or two off from lifting, reduce the weight more than you want to.

    -Stretch your whole fucking body. Deeply. 2-3 times a week. I like to smoke a bowl first. Helps me relax through the pain without over-stretching. Then I go to bed.

    -Figure out sleep positions that are better for your back. If I sleep the wrong way I wake up with my hips out of alignment. I often sleep on a couch because the fact that it is narrow makes it harder for me to get into a position that I find comfortable, but leads to back pain. It's weird, but it works.

    -When your back does get fucked up: dry needling/ acupuncture isn't always pleasant, but it can be miraculous. A massage is far more pleasant, but nothing can relieve knots and get me back to normal faster than a needle.

    -Lose weight if you need to. Extra weight just adds stress on your back.

    -Try another PT. Then another. Then another until you are happy with where you are. I've seen a bunch of good ones that I've learned from. Now nobody understands my body better than me, but I couldn't have done it without their help. Try to find someone who works with athletes. Better yet find someone who was/is an athlete. Best I've worked with was a former pro bike racer. She understood me, not just physiologically, but psychologically.

    5 years ago I thought I was going to need surgery or just lead a less active life. No I feel pretty fucking good.

    Good luck.
    Good stuff ^^

    I've found that front squats do not aggrevate the l5s1 issues I deal with, whereas back squats give me nerve / leg pains at night...

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    I love my family. Kids are the best.
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  4. #4
    Join Date
    Mar 2008
    Location
    northern BC
    Posts
    23,191
    ever try any yoga ?

    they now have have yoga classes in the oil & gas camps up in narthern Alberta

    My yogini looked at a ski bro and said out of the blue wow that guy looks hurt,

    i said buddy got hit by a tree how did you know he was injured ?

    she can tell by looking
    Lee Lau - xxx-er is the laziest Asian canuck I know

  5. #5
    Join Date
    Mar 2005
    Location
    Vinyl Valley
    Posts
    1,426
    I've got a bad back with spondylolisthesis and a variety of other commotion. Yoga has allowed me to get back to playing hockey, golf, tennis, skiing... all types of dynamic twisting motions feel fine. I have more energy now than I did before I started my practice ~17 years ago. Plus, I lost ~25lbs

  6. #6
    Join Date
    Dec 2003
    Location
    Washington, D.C.
    Posts
    2,343
    I've seen black diamonds - much of what you say is very much on point for me, especially the tension between NEEDING to lift (otherwise your back will *definitely* twinge) and the fact that lifting can sometimes be the trigger for a twinge/spasm. I had hoped that COVID (and it's transition to much more bodyweight/my 45lb kettlebell/40# ruck based workouts) would be a good push in the higher volume, lower risk (vs the old favorites of deadlights and hang cleans) workout department, but where I've ended up is a back I can lift with, yet never really feels 100%. I would echo the dry needling/acupuncture bit as well - can take days/weeks off the recovery time when the back is feeling bad.

    What I'm really trying to wrap my head around is - do you have any good programming that builds to that sort of generalized strength/confidence/etc?

    There are definitely things I need to do more of - and know it - i.e., bikram (pre-COVID) used to be a huge help, regular massage, really need to get my hip flexors and IT bands working/lengthened to reverse my anterior pelvic tilt / stop overtensioning my hamstrings and over-pressuring my back.

    In the foundation training (which is good, but not enough) free video, he promises "do this 12 minute routine everyday and you'll have no back pain, ever again." I tried that for about 4 months - before my back spasmed again as bad as it's been post-surgery. If there's *something* I can do - consistently and regularly - to get that sort of effect...

  7. #7
    Join Date
    Aug 2006
    Posts
    6,680
    I've been in the same boat for the past 16 months or so.

    My PT gal finally broke her facade and said "AR, you are 35...", before quickly putting the facade back on.

    Honestly, I'm glad she did. Chasing the dragon of how you felt 10 years ago as some young buck is a fool's errand. Stretch religiously, work out your core, and quit lifting any substantial weight. Seriously, it isn't helping.

    Take up swimming, its worked the best so far for me.
    Live Free or Die

  8. #8
    Join Date
    Jan 2009
    Location
    Squaw valley
    Posts
    3,315
    Every once in a while my lower back hurts out of a adjustment, and a visit to the chiropractor does it.

    But it only happens if i slack on my core routine, which is 5 times a week of planks, 60 seconds and crunches, 400.

    To keep my lower body strong, i do ťlectro stimulation for quads, hamstrings, butt and calves. This is pretty intense, can't watch tv while you're doing it.

    Sent from my Redmi Note 8 Pro using Tapatalk

  9. #9
    Join Date
    Sep 2006
    Location
    Rossland BC
    Posts
    1,406
    I went through this in my 20s following a serious car crash. Whatever path you find works best, the fundamentals are gradually and determinedly exploring your limits of both strength and flexibility, without aggravating your underlying condition. Initially youíll inevitably focus on your limitations, but the habits youíll acquire will pay dividends as you age.

  10. #10
    Join Date
    May 2002
    Posts
    32,865
    I've posted it here a few times, seldon, and I don't think anyone has ever bothered trying it - St. John's Wort oil on your spine everyday for a year. I had a litany of shit it seems to have cured.

  11. #11
    Join Date
    Feb 2015
    Location
    MA
    Posts
    3,782

    Low back pain - from 'fragile' to skiing shape?

    Quote Originally Posted by kootenayskier View Post
    (snip)Whatever path you find works best, the fundamentals are gradually and determinedly exploring your limits of both strength and flexibility, without aggravating your underlying condition. Initially youíll inevitably focus on your limitations, but the habits youíll acquire will pay dividends as you age.
    This sums up my experience over the past ~ 8 years and echoes the advice I usually give to people who are having similar problems. Initially I was too afraid of activity, I wasnít doing enough and now I believe I didnít get better as quickly as I could have.

    Iím not totally out of the weeds yet, and may never be. I still have acute episodes, maybe 1Ė3 / year, but they are further and farther between. It tends to really act up in December, for whatever reason. But I donít feel fragile anymore and Iíll push my skiing if I feel right on a given day. A handful of years ago I was in so much pain and so discouraged that I didnít think that would possible.

    The upside, as other posters have mentioned is that I had to make changes that have positively affected my life and fitness pursuits. Iím down ~25lbs from when the incident occurred (down 45lbs if you include the weight I put on after the injury) and I donít think Iíve ever been this flexible. I have a seasonal routine that works for me. My core feels as strong as when I was got to ski Squaw every. I believe my body works in better harmony than ever before because Iíve been forced to think about it.

  12. #12
    Join Date
    Mar 2008
    Posts
    382
    Agree with the critical importance of core strengthening, but other things to consider is changing how you ski. The combination of twisting and high impact is to be avoided. Things to consider, some of which are intuitive:

    1. You can ski bumps, but stick to softer ones and use your legs to absorb rather than your low back.
    2. Avoid jumps - the landings will be hard on you
    3. Avoid skis stiffened with metal - they are popular on this forum, but you need the ski to absorb some of the terrain; if you'd like a ski for firmer conditions, choose one with a bit of carbon fiber (it's more forgiving)
    4. Consider a twin tip ski - it lets you control the turn shape so that you can protect yourself (you don't want the tail locking you in)
    5. Avoid some of the modern skis that have TOO small a turn radius - you don't need a charger, but a more low to mid-20s turn radius can help. You can always skid a turn to make it smaller when need be, but you don't want the ski controlling the twisting motion as the radius gets smaller.

    Best of luck!
    Originally Posted by jm2e:
    To be a JONG is no curse in these unfortunate times. 'Tis better that than to be alone.

  13. #13
    Join Date
    Feb 2015
    Location
    MA
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    3,782

    Low back pain - from 'fragile' to skiing shape?

    I was actually about to circle back here to add that I didnít touch anything but damn-near-perfect moguls for 3-4 years and I changed my preference from metal laminate, rear-mounted Stockli-style skis to twin tips / reverse camber to accommodate a more upright centered stance. Now I donít think Iíd go back to skiing those skis even if I could, I donít miss having all that tip out in front of me in anything but the firmest snow.

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