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Old 01-12-2004, 12:24 AM   #1
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Exercise advice please - annular tear L4-L5

Hi All,

Great site and great information. I have an "early annular tear" - L4 and L5 with sciatic symtoms (pain in the butt and legs) & supposedly no disk herniation noted (from MRI report). Unfortunately I work long hours and don't have the benefit of real Physiotherapy where I live - in Korea, neither have I been able to see a doctor about it either but have been try to educate myself and have spoken with a physiotherapist in my home country. It happened due to repeat mountain bike crashes and now I have to try to get a set of exercises together to begin rehab. Any ideas how I should go about rehab exercise? Is swimming OK and if so presumably gently and no tumble turns.

Good to see that such a support community exists and there is such useful information sharing.

Thanks

 
Old 01-12-2004, 10:18 AM   #2
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Re: Exercise advice please - annular tear L4-L5

Hi Biker'sback,

You need to make sure you are stabilized well before swimming (so you can get out of the pool when you are done without hurting you back!). Swimming is one of the best exercises for the back. But it is much more than (no tumbling and such). Your first things to do is to put your back against the pool wall and raise one leg at a time with knee bent. Do up to 10 reps each. Then the arms. Then the opposite arm/leg for the same reps. Once you have mastered this, then get off the wall. Do the same thing while balancing in the water. You can balance in the water by holding one leg up (about 10 inches) and arms level with the water line. Stand for as long as you can comfortably and switch legs. You can also hold onto the side of the pool (standing sideways) and do leg lifts and leg circles, etc.

Walking in water is your warm up. This is a must. Walking forwards AND backwards. Making sure your arms swing opposite and help to keep your balance. As you get stronger, you walk faster and faster until you can cause a wake as you for from forward to backward, etc. Only do 2-4 laps of walking and then go to the stabilization exercises.

Only after you have done all of these types of exercises should you attempt any swimming. When you are ready for that, then get a water buoy for your legs and place it between your knees. Swim laps that way. May I also suggest a mask and snorkle so you don't have to turn you back to breath. I was an olympic hopeful in swimming...I know how to swim well. Even I had to go through all of this and wasn't ready for swimming laps until prolly a month after all these other things were mastered. You shouldn't swim for more than 40 min. and you should ALWAYS take a nap after a swimming session. This will allow your back to reap the benefits of your wonderful swim. Resting it just won't do because we all will still get up to answer the phone or the door, turn to get a drink of water....whatever. In sleep, you aren't moving at all. Your body can concentrate on healing instead of keeping you up and functioning.

You should also ice your back after any exercise. I hope this all helps. Talk to people...you will be shocked as to just how many people have bad backs and what they do to relieve their pain. There may also be some good websites to get water therapy exercises. Problem is......water therapy is specialized -- to each individual person. What works for me may not work for you. Anything you try, please do so with caution and if it hurts....STOP. Good luck to you.

 
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Old 01-12-2004, 05:36 PM   #3
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Re: Exercise advice please - annular tear L4-L5

Hi Successstory,

Thanks for the advice - without it I most certainly would have gone overboard. I hear what you say on the exercises, stop anything causing pain and the rest and icing after exercise makes a lot of sense.

Yup, I too was an eager swimmer, fastest in my country over 100m fly in age group at one stage - long long time ago... started cycling - did that for years, then cross country mtb, then downhill and freeride mtb... then this :-( Now giving the big FR bikes away, hoping will be able to ride road again.

What was your race/stroke?

Great to see you are on the way to recovery. Congrats - what is new career?

Last question - any suggestions for exercises for a mat?

Best,

Biker'sback

 
Old 01-12-2004, 07:39 PM   #4
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rmurf HB User
Re: Exercise advice please - annular tear L4-L5

I have an annular tear at L5-S1 w/out herniation much like yours. Be careful, I did too much too soon and I am paying for it 6 months later. My doc told me to order 4 Safe Back Exercise Videos with a gym ball and to progress at my own pace. I ordered online through [url]www.gymball.com[/url]. So far, I'm still on tape 1 and haven't flared up yet!!! Much of what they do there is what my PT had me doing, so we don't repeat it in sessions.

Good luck! It's a long slow grind having a tear. I also love being in the pool, tho I am not a good swimmer, and they are referring me to AquaTherapy in 2 weeks. Many people find that helpful. You may try to find one in your area.

 
Old 01-13-2004, 05:47 PM   #5
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Re: Exercise advice please - annular tear L4-L5

Just a quick word on pool exercise (probably obvious, but wasn't to me!). The warmer the pool, the better. Unfortunately, the pool that is most convenient to me is also pretty frigid--which adds a fair amoun of tightness to what I'm trying to relax. Of course, once moving, that settles down, but not as easily as in a warmer pool.

As usual, I'm impressed by how many athletes are on this board, as well as very smart and very compassionate people. As said on another thread,
Go Lumbar Jocks!

Standingman

 
Old 01-13-2004, 10:32 PM   #6
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successtory HB User
Re: Exercise advice please - annular tear L4-L5

Hi Biker'sback,

You ask my race/stroke. Freestyle was my fastest....I could swim 25 meters in 8 seconds. My butterfly was at 14 seconds for 25 meters....not as good, but not bad either. My coach used to like me as the backstroker in medleys, I'm not sure why except I was the only one who could swim in a straight line and had an awesome fling to my start...my flips forward or backward were quite fast. I created a way to streamline turn and push off...funny thing, I noticed pushoffs in the Olympics were strangely becoming like mine (flipping one arm back and one forward during the flip--then doing the dolphin kick right after pushing off the wall)--it wasn't done until after the late 70's or early 80's I think....after my career was "no more". hehe I got into horses instead. Ah well.

My new career is as an acupressurist. Trying to help people in pain...after my own experience and what doctors couldn't (and could) do for me, I realized people need more than what is conventionally offered. I have good hands--always have. I haven't had a dissatisfied customer yet (and I'm not even in official practice yet!) hehe. I practice a lot. My kids are my favorite customers, hey....if my 5 & 7 year old insist on treatments, there's gotta be something to them.

Exercises for the mat. With tears you need to be careful. Land exercise can be the harshest. I say this because a tear leaks the gel-like substance inside our disks. That stuff is caustic to the nerves in the surrounding areas (the sciatic being the largest). It causes major burning pain around the injured area and will then cause sciatic pain running down the leg. So...might I suggest you use a double mat until there is no more pain? The exercises I suggest you may try but please do so very carefully and slowly. Stop if anything sharp hurts and don't do more than 6 repetitions of ANYTHING. Don't do more than 3 sets of any one thing either. At least until you are strong and can do them "no problem".

Pelvic Tilts: Lay on your back with knees up. Make sure spine is aligned and level and balanced. Now, imagine yourself taking your belly button and bringing it down to your spine. Don't move your hips or anything...just concentrate on touching your belly button to your spine. Do this 6 times in 3 sets. Between each set, gently bring one knee up (use your hands on the back of your leg if need be) for a really eeeeaaazy stretch. Preferrably, your knee shouldn't pass your hips, this is a super basic, as easy as we can get stretch for your injured area. This is the key, you have an injured area and you must treat it with care. You aren't in the same shape you were in before your injury and you've got to keep that in mind when exercising or anything. Tears are a very fragile thing....and your back is only as strong as it's weakest link (or disk).

Another exercise is laying flat on your back, pillow under your calves...but still horizontal. Bring up one leg so the calf is parallel with the ground, hold for 6 seconds. Bring up the other leg and do the same. Do 3 sets. Do the same with the arms but bring up arm like you are pointing to the ceiling (keep wrists and hands relaxed but not limp). Once you've done all these limbs by themselves...start combining and mixing like left arm, right leg, etc. A harder note to this one is bringing up both knees (one at a time) and holding them in the (calf parallel to floor) position for 10 seconds--drop one foot then the other. I wouldn't do this one often at first...it will put a lot of stress on your L4/L5 and L5/S1--something you don't need unless it's been fixed and doesn't leak anymore or you have worked you way up to this (with the other exercises).

Another exercise is called a bridge. Laying on your back with knees up and feet on the floor, raise your pelvis an inch or less off the ground and hold for 10 seconds. Don't be disturbed if you can't do this one (either)...I am giving you a gammet of exercises at different stages only because I just don't know what you can and cannot handle. Again, please follow your body messages carefully.

You should also work on your arm strength. Laying on your back (yeah, still) with pillow under knees--bring both arms up so like you are pointing to the ceiling (arms and wrists are relaxed not limp). Then bring both elbows down parallel with your ears (your hands are still pointing to the ceiling) and back up. Do 10 times per set.

Another arm exercise is basically doing the backstroke on land (except it's a pendulum swing instead of a full-arc swing). On back bring one arm over head and one along your side then switch. Keep switching to the count of 20. Do this slowly and with concentration. That will give your muscles a better workout.

A piece of advise if I may...stay away from all stairs and such. Anything going "up" is most aggravating to tears and would put me DOWN for 3 days after doing those types of things.

I hope this is helpful, maybe others have some good ideas.

 
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