T Nation

Advice On Girlfriend's Back Injury


#1

Hi T-Folk,

I'll ask the question at the end, but give you the details first:

Nearly three years ago my GF had a pretty bad work accident, and was eventually diagnosed with a bulging/herniated disk (L5/S1). Last November she had a discectomy to remove part of the bulging disk, thereby stopping pressure on the nerve running down the spine.

This showed initial promise, although she's now unfortunately reverted back to her pre-op state with regards to pain, range of motion and general quality of life.

Before the accident we would train together, play sports together, we had awesome sex (and still do!), piles of motivation for life, etc.

In contrast after the injury, she now has permanent sciatic pain down both legs to the ankles, very little range of motion in the hips, she cannot sleep due to pain unless she uses strong sedatives, the ONLY exercise she can do is normal walking and even that makes her pain temporarily worse, and due to drug sensitivity she's virtually precluded from taking any pain-killing medicine at all and lives in 24 pain with no relief whatsoever.

Her motivation in life is vanishing (especially after the failed operation), and I'm hoping like crazy that she won't surcumb(sp) to depression as her quality of life now is literally 10% of what it was.

Guys, this is absolutely tearing me to pieces!!!

My question: does anyone have any experience similar to this, any advice, knowledge, tips, ANYTHING that they can pass on to me and my GF that may help her either heal, or live a life without permanent pain???

I just can't sit by and watch her slide into further despair, but I'm coming to the end of my ideas and knowledge. Physio's aren't helping, the specialist can only offer surgery options and he's hesitant to go in again... I think my lack of being able to do more is really getting to me now.

I mean, it's midnight as I type this, I've been unable to sleep due to worrying for her. She's trying as hard as she can, but I really feel like I should be motivating her in any way possible that's helpful.

Guys, if you can offer ANYTHING, it will be more appreciated than you could know..

Many thanks in advance.
Mark
AUSTRALIA


#2

sorry to hear about your girl. But maybe i can help. I too have herniated s1-l5. did it spotting someone sideways while they were benching, bent at my side not directly over and boom, hernated and pinched nerve.

Well that was 8 years ago and at first it sucks i mean the first year is miserable, especially getting out of cars that are low to the ground. So I made adjustments to my workouts and life.

I bought a VW vanagon, no more acura sports car too low. And I walked in a pool and worked up to running, no more pavement pounding. I know that sounds dumb but it works trust me, I also took up swimming and of course still surfed.

As far as the injury it will flare up now and again and her back will spasm real bad and knock her out of all activity for at least a week, but it will pass.

 I still lift but I am a strict form trap bar enthusiast and with a renewed focus on hamstring and core training.  i stick to basic lifts, avoid lifts like barbell curls or bent over rows, trust me some will say oh they are fine, but they will catch up with you.

And finally stretch! i don't have picks but I do a Yoga video every morning and night called AM yoga and PM yoga. It is very very very basic but the stretches are exactly what my PT guy told me to do. focus on bridges and also a core flex where you lie on your back feet together but stretched out and suck in you navel and hold for a couple seconds and repeat. It works, you will feel your lower back muscles flex.

 And about her lack of pain killing meds that is a mixed blessing.  I was getting percocet and man is that stuff addictive, it was scary i almost went in and lied to the Doc that i needed more when i realized I was becoming a junkie I quit taking them and flushed them donw the toilet.

tell your girl to stretch and stretch and not give up. She is not alone believe me. hope this helps. CYA


#3

Sorry to hear of this. Backs are no fun when they don't work. Has she tried a TENS unit for pain relief? While they don't work for everyone, it's not drug based and should not trigger her allergies.

You might use a different name in Oz. They are electrical stimilation devices, used at low levels, not enough to cause muscle contraction, but enough to interfere with the nerves' ability to transmit pain. (Simple explination for on-line use, your physio or doctor will have a more complete one.)


#4

That article made me gringe!!! I had the L5-S1 inward herniation on the Siatic nerve- You are correct....Here's me - 35 Y/O 200 lb powerlifter in Great shape and having great sex, but that wasnt the way it was for years.

In high school I was speared by a guy with a helmet, major back problems lost total feeling in leg, started spasming, body started to get out of alliagnment. I saw the best doctors who all wanted to chop into me , put in rods, fuse shit together... I held off for 11 years, dealing with the pain, doing everything from chiro, to injections(dont continue) , accupuncture even hypnosis...

Finally after some martial arts ( which I took for flexibilty and worked I just started competeting and worked up to the state level in competetion), then I get slammed by some Judo Manaic and BAMM- my back in totallly fucked, I couldnt work for 3 months, eating pain pills and muscle relaxers like candy literally 30/day, then I got into a SEVERE depression, almost suicidal-no shit and I am the happiest person you ever met-single in south florida, great life, but this destroyed me and as you stated you arent even the person who you were before.

3 AM on morning I was awake , as always (didnt sleep for shit for 3 months)I was standing in my living room with a knee wrap tied around my ass hoping to decrease inflammation on Iscial Tuberocity. I started crying and the next day went looking for surgeons , found the best and had the same operation as your GF.

I immed. went to rehab and started moving around like crazy, the DAY AFTER surgey I rode a stationary bike, the next day HIP FLEXION - I couldnt belive it, I just had my spine opened and 48 hours later Im doing GOOD MORNINGS. MY THERAPIST ALL TOLD ME TAT THE LOW BACK DOESNT HEAL WELL DUE TO THE DENSENESS OF THE TISSUE SO BLOODFLOW IS MUCH LOWER THAN OTHER PARTS OF THE BODY.

With that being the premise of my aggressive rehab, I had to pump the shit out of my lower back and stretch it all the time or I will have problem forever.

I learned that antinflammatorys worked great but need to be take over a long period. The obvious was Chondrodtin/Gluecosimine, which I think worked a little, but the HUGE DIFFERENCE came ith me talking to a VETENARIAN who explain that HORSE who are worth a million dollars, have joint OR back problems, the FIRST thing they do is ADD MOLLASSES to its food, now I know that this sounds like total bullshit, so I started asking my best friends who are doctors and health pros, and they ALL AGREED.

Heres how it works, mollasses with SULPHUR, must have SULPHUR, decreases joint inflammation, the most prominent product on the market today is MSM which stands for MetholSULPHURm....., The component that makes it work is SULPHUR, I started to take 2 tbsps 3 X day, gulping down that nasty tar like shit,( easy to chase with milk ) and inside the next week I started feeling better, much better.
CHRISTIAN33 is dead on about the other stuff so I wont repeat- hes right.

Now thats my little supplement "trick" now heres what helps the swelling go down , take the pressure off the nerves, open up the Energy Meridian, allows pelvic rotation and the ABILITY TO START SCREWING AGAIN!!!!

HANGING PELVIC ROTATION THROUGH TRACTION- what the hell is that? basically hang inside a squat rack from those arm supports(those black loops you put your arms through all the way up to armpit). You stand on a box and control the ammt. of traction on your back, from no hang to full bdwt hang- then you rotate your hips FULL movement from side to side, back and forth, circles.

DO THIS for at least 3 sets of 3 minutes EVERYDAY!!!!this will allow better bloodflow to get nutrients into injured area. ALSO if you can utilize a reverse hyper ext. machine or duplicate position, that is a great STRETCH for area, DONT start doing rev. hyper ext. just hang over a couch and take pressure off back.

The problem is the injured area on goes from bearing weight and compression to NO weight bearing like laying down, there is NEVER any DECOMPRESSING which will undue a compression problem.

A great site is also the elite fitness site the openly discuss injury, also very knowledgable.
I just woke up here in Florida USA to a sunny day and after reading your post I had to respond. This is the longest post I have ever made but it really hit a cord with me because I feel for her and hope this information is well recieved.

I remember that people who didnt have spinal problems couldnt understand the pain or lifestyle affecting problems caused by injury. Since my spine problem I had a root canal and didnt want to be numb, cause I hate that drooling feelin) the Dentist said it would hurt more that anything before- I laughed, the root canal was a joke compared to spinal pain.

PS through aggressive rehab I got into powerlifting always strengthing the area, now I am Competetive with a great lifestyle, hope the same results for her.


#5

I can feel your pain. I really can. I am so sorry for her. My mom broke her back while leaving work she slipped and fell on the way out.

It has been over 10 years and I have watched my mom go through several surgeries and even doctors. Even one that was prescribing her bucket's full of vicodin & claiming she had a mental problem which pissed me off. Because she ended up with a nasty vicodin addiction & still in unmeasurable amounts of pain because of the quack.

My mom has had the tens unit. Now she has a Metronics Spinal Cord Stimulator implant in her spine to control the pain. It has remote that she puts on her back where she can adjust it to manage the intensity of the pain.

The only draw is that you have to get the battery replaced every few years via surgery. I have to say since the stimulator was implanted her pain has decreased immensley. She even works out now as well.

She does have times when it gets really bad. She has a few disks that are bulging and then they did site injections (steroids) into her facet joints to take the inflammation away from the bulging disks.

I am talking to my mother right now and she said for you to find a Pain Management Specialist because if you have tried everything to fix it and it's not working it might not be fixable but the pain can be managed.

I read your post to her and she said it sounds like your GF would be a good candidate for the spinal cord simulator. It's just finding a good Doctor for this that is the hard part. A good anesthesiologist and Pain Mngmt Doctor. One that is focused on managing her pain instead of looking for several ways to fix her. And yes you can do that without tons of drugs.

I know how you are feeling. I guess thats why I called my mom :wink: It is extremely difficult to watch someone you love go through that amount of pain. It just rips my heart out to see my mom who was a very active woman etc... in the amount of pain she has been in over the years.

After the Spinal Cord Stimulator her life GREATLY improved. She does not have to take many drugs to manage the pain only sometimes when the other disks start giving her problems. Heck she was even jogging before and she lifts weights. Like I said she has flare ups but thats when the site injections take place.

I wish her & you the best of luck and I hope this has helped some. :wink:

Take care!
T


#6

Man, that's sad to hear. I went though something similar, though clearly not as bad as your girlfriend. I'm just now starting to feel back to normal, and its been 8 months since the injury. Backs take a very, very, long time.

There are many physical things I could tell you that have helped me. Actually the Cool Tip of the day today is one of the best:

"Today's training tip comes from Dr. Ryan Smith:

Sitting Sucks

Sitting causes an increase in disc pressure. With prolonged sitting without low back support, this increased pressure is coupled with sustained low back flexion. This results in further increased disc loading forces, which can lead to injury. So, try to stand up and move around every 20 to 30 minutes to reduce this "tissue creep."

Also, use a towel roll to support the lumbar curve. Just roll up a towel, secure it with rubber bands, and place it at your low back. Make sure your butt is far back in your chair too. "

In my experience, get her a very nice chair - a computer chair that can swivel around, and one with an adjustable seat. Grab a small pillow or a towel, sit her far back in the chair, and shove the pillow down around the lower back, giving nice support.

Sitting may suck, but when you're stuck at home for months and it hurts to walk, either you're sitting in a bad position and watching tv/on the computer....or lying down with nothing but your thoughts. A bad chair to sit in will reverse progress. Get a good one.

The first thing I do in the morning is sit in that chair for a few minutes and my back actually relaxes into a proper lumbar curve... when I get up to walk around, I'm ready to go!

Another important thing is MAKE SURE she tries ALL the time to keep good posture!!!! Check out the articles on this site called Neanderthal No More 1-2or3 for an anatomy lesson in good posture. Learn it inside out!

Sleeping can be hard... you may have to force her to stop trying to cuddle with you when she sleeps and get her to sleep with her legs elevated (i will try to explain this, but i suck) so that the angle at her knee joint is 90 degrees and the angle at her hip joint is 90 degrees. --|__o How's that for an awesome picture?

If that is uncomfortable, get her to sleep on her side in a similar position with a pillow between her knees to keep stability in her hips.

Also, do you have an amazing bed? When I had my injury, I did all these things but they didn't help too much, cause my bed was a kids bed made for 14 and under. I am a cheapass and never bothered to get a new one as beds are expensive. Well I eventually decided that my body was deservedly the most expensive thing I own, and bought a very nice new bed. My symptoms started going away very quickly.

Christian33's advice is great about the pool! Being in water (as you know) makes you feel weightless and takes a LOT of pressure off the spine. Get her to start swimming a lot. Maybe take some classes just for fun and something to do!

Yoga is incredible, although many positions are probably bad for her at this point. Stretch the HELL out of the hip flexors, hamstrings, and calves. I've read that people with her specific injury tend to have weakness in the achilles tendon and surrounding area, so watch out for stretching the calves too hard or far.

Another stretch that has helped me so much but impossible for me to explain is called the Pigeon stretch in yoga...

imagine sitting in a chair. Take your right leg over your left as if you were crossing your legs. Not woman crossing, but man crossing... with your right foot/ankle over your left knee. Keep the back STRAIGHT! Bend forward with the goal of touching your stomach to your right shin. You should feel this basically in your right asscheek or so. You COULD do this lying with your back on the ground and your legs in the air, but I found that version to aggravate my hip flexors.

The best version for me is the next one. Imagine doing something similar on the ground. This time you arent on your back but facing the ground, like in a pushup position. Your left leg is straight back and your right leg is at about a 30 degree or less angle so your knee is pointing straight ahead of you... it looks somewhat like an arrow (---> long part = left leg, arrowhead = right leg). When you bend forward your goal is to touch your stomach to your right knee. STRAIGHT BACK!

Make sense? Look it up if it doesnt, its a great stretch... so is the chair version. Also, if the chair version hurts, she can try to do it dynamically from standing... just swing one leg up at a time into that position.

As for exercises, anything that doesn't bend the back or put any pressure on the spine... DO THEM. The faster she gets active the faster she will heal. Get the blood flowing and nutrients into the area.

Check out bodyweight exercises and joint exercises from Pavel Tsatsouline. Superjoints, Naked Warrior, and Relax into Stretch will show you some good exercises to use, and also the ultra important techniques for increasing intra-abdominal pressure.

Get her to try Janda situps (they were designed with back rehab in mind), and One-Legged Deadlifts, One-Legged Squats, Lunges. Glute and ham strength should be improved if it is a weak link. STREGTHEN her core muscles! Read up on abdominal strength and its relation to back health.

As for mobility exercises, if she can handle it, try dynamic stretching of the hip flexors by swinging one leg at a time to the back... kind of like kicking someone behind you while facing forward. Again i suck at describing things, sorry.

Obviously, if any of these exercises hurt (and I am talking about with good form) then don't do them! Just get her to do SOMETHING that gets the blood moving.

Also, what does she eat? Throw out all the garbage in the house, buy meat, vegetables, fruit. Eat food. Repeat. Eating a good diet will help the healing process along very much, and many foods have anti-inflammitory effects. Get her on FLAMEOUT, or at least GNC fish oil pills. I hope that you are knowledgable about nutrition, if not, read everything by Lowery and Berardi a few times.

Better yet, read it with your girlfriend.

Drug-wise... and I hate drugs... Celebrex seems to be the drug of choice for healing inflammation. Ask your doctor about it. Other than that, I don't know much about drugs. As I hate them!

moonjumper's hanging decompression exercises... they sound promising! I will try those out myself as well!

But I will tell you, all this stuff means nothing IF she is depressed and has no hope. You sound like a good man, sticking around for 3 years with almost no sex! Hahaha... but seriously, you probably already do this, but make her feel USEFUL!

When you cant work, have no income, cant have sex, cant go anywhere, cant do the things you are passionate about... for over a YEAR... you feel like "what the fuck is the FUCKING point?" Know what I mean? It sounds like your girlfriend sure does.

You need to get her MOTIVATED as hell to get this over with. The only way that can happen is if she knows she can BEAT IT. She can! Show her examples of people who have had horrible back problems and returned stronger than ever.

A few examples are the people responding to this thread, Frank Shamrock (frankshamrock.com), Bruce Lee (you better know him!).... actually while I'm talking about Bruce, rent the movie Dragon: The Bruce Lee story. A big part of it is (although exaggerated) the story of him almost being paralyzed and his wife forcing him to stop being a bitch and fight through it.

Rent movies that show people coming back from bad injuries, ANYTHING to light the proverbial fire under her ass and make her determined to beat this fucking back problem!

After that it will be your job to slow her down!

A long read yes, but I feel her pain... seems to be a common feeling here! Hopefully there is something in my post that will help. I wish her and you the best of luck!


#7

Mark,
You're getting so many long responses because those of us who have been through long-term back injuries know it's awful, but we also know that it can get better with work.

I agree that the reason her rehab takes so long is that there is a lack of blood flow. The best thing she can do is move as much as possible -- this gets blood flowing to the area.

She needs to know that if she allows this to immobilize her, the situation will only deteriorate. I have no scientific studies to back up that statement. I only say it based on my experience and that of a few friends -- take it for what it's worth. But it seems that other long-term sufferers of back pain on this site agree.

When I hurt my back, I spent time trying to let it heal through rest. It only got worse. My back only got better when I began moving. A friend of mine hurt his back pretty badly recently, and he pursued the same strategy -- move whenever possible, strengthen the core.

Finally, let me say this: I would not go for any more surgery. That approach to fixing back problems has a VERY POOR track record. The fact of the matter is that the theory that damaged disks causes psiatic pain hasn't even been proved -- since certain nerves connect at certain points of the back, they should be able to predict, based on the site of disk damage, where pain will be felt. But predictions of where a patient will experience pain based on the location of disk problems are often wrong. Don't take my word for it -- the one thing you can do for your girlfriend is educate yourself and her -- find out where to read the latest studies, and go read them, even if you have to drive to a library.

My heart goes out to you and her. I hope she is healed. You have my respect and are a great example of how a man should act -- standing by his woman despite adversity, seeking help for her.


#8

Wow! So many detailed replies!
Thankyou!!!

christian33: that water walking sounds like a good plan, I imagine the body weight is essentially lessened due to the bouyancy effect in water. Tell me, what depth of water were you in when you did this??? She has tried swimming, but the heavy use of the posterior chain muscles in keeping her body rigid and kicking her legs brought on too much pain... so water walking it will be.
Also copy on the stretching and core stability strengthening. Unfortunately it's at the point where virtually any stretching or activity will bring lasting pain, but if we start slowly we will hopefully have some success.

Ladyjaine: I have read about TENS actually. I'll have to look into a little more however. Thanks for the lead!

moonjumper: wow, what a story! Interesting point about the bloodflow restriction around that area of the back - I'll see what I can do to keep my GF active in lightly working the effected area. She's already on Glucosamine/MSM actually, and has been for months. I made her start with it about a month before the op, and I think it has helped a little. You've also touched on something I've been considering for some time, traction. I've got an inversion table, but she's not real keen on using it, so perhaps your idea of just hanging on a reverse hyper machine (or similar) will give us some little breakthrough. How long did you generally hold the traction of this kind for???

TX T.: did you actually get your mum on the phone just to ask her about this stuff! hehe cheers! Did the TENS work for your mum??? Or was it mostly the other treatment? I've also heard very mixed reports about the anti-inflamatory site injections - did she get any relief from this, and do you know if she recommends it? Thanks for the lead on the pain management doc, and spinal cord stimulator. And say thanks to your mum for us too!

enterthedojo: interesting about the sitting tips. She has a good chair, and wonderful posture still. Although we've never tried the trick of using the towel to get a better lumbar curve at the days start. I'll get her to give it a go. We do also have a great bed, and it has definitely helped take an edge of her pain. (Awesome pic you did by the way... hehe) I do understand the pigeon stretch you mentioned, and can see the benefit of stretching. I think the problem is that ANY stretch of the posterior chain muscles from the mid-back down, results in very acute pain. Hence her very limited range of motion in that regard. Did you (or anyone else reading this) have trouble like this where your ability to stretch was extemely limited? Were you able to overcome it through continued stretching? A lot of the exercises you mention will be a bit much for her, but I understand that getting general blood flow to the area is the key initially. Oh, and we DO have sex... hehe It's great actually, but I do worry that I'm going to hurt her sometimes. Copy on the motivational aspect as well - she's doing ok there, but I can see the pain blunts her energy levels big time.

Drew45: as with the others, glad you're on the road to recovery! Copy again on the need to get bloodflow to the area, it really seems such an important point. Now that I think of it, I can't quite understand how greater bloodflow will stop the disk from pushing on the spinal chord, but if it works, it works. And no worry about us not remaining educated, I'm going to keep searching for a fix until my time on this earth is done!

Thanks again all, it means a lot to me that you've all taken so much time to write detailed responses. I've left a couple of questions for you all in your separate responses, but of course no pressure.
Take care,
Mark


#9

Well this thread has been dead for a while I see, so hopefully that means there has been much improvement.

As to the questions you left me (sorry for the few month delay haha)...

Yes I did have huge problems stretching. I couldn't do any major stretch without pain for a few months after my injury. Then again I couldn't even sit or lie down without pain either.

If the stretch hurts her back very badly... well I guess she can't do it. But it may help to just get into a position where she can stretch either her calves, hamstrings, butt, ITB, TFL, and the ilio-psoas i think its called. Just have her sit there. Breathe deeply through the lower stomach, long exhale, dont try to stretch, just try to relax. I remember sometimes hurting like a bitch, but just keep breathing and eventually the muscles will relax.

One last thing I wanted to mention is myofascial release. Not sure if it was mentioned previously, but I strongly urge you to look into it. If you cant afford a specialist to do this with her, you can get one for about 50 cents. Its called a baseball.

Yes, this baseball is sometimes even better than a specialist because it is controlled entirely by its user.

She will have to get into some really weird positions to do this, and feel like an idiot, but what you can try is to put the baseball up against the wall, and get her to angle herself so the baseball is pressing into the muscles I mentioned earlier -- although doing this on your calves or hamstrings doesn't work too well in my experience. You know you're doing it right when it hurts like freaking crazy. Just slowly start rolling the ball around the muscles, keeping good pressure.

There is an article by Mike Robertson and Eric Cressey about foam rollers... I think its called Feel Better for 10 Bucks... that outlines some other techniques for myofascial release.

Hope that helps... if you check this thread again!