Shoreline

Hi Yall, Although most docs will tell us the most important thing is to keep moving, there is a difference between keeping moving and excercising. Anyone in PM that has a bad back should have been through at least one or two rounds of PT. The feel good stuf is nice and we learn the right way to stretch and excercise without causing more damage. Eventually people will meet max medical benefit from PT where insurance won't pay for more to simply maintain muscle tone. Although the Pt's are teaching us the right excercises, the right stretches and how to do them properly, Pt's don't push people beyond their own comfort limits. They aren't personal trainers, their job really isn't to undue years of living sedentary or going from surgery to surgery. They give us guidence and the rest is really up to us. If you have been doing this long enough, seen enough PT's and been through enough PM and work hardeneing clinics and programs, We have been tought what to do. It's just a mater of taking that info and putting it to use.

The bulk of what we learn is core strengthening. I have found phsysio balls to be great tools and I'm on my 4th or 5th in 15 years. A good way to check your core strength is try anything that requires balance. Without core strength, standing on one leg is impossible, sitting on a ball and doing a leg lift makes you roll off or even walking without bumping into wals becomes difficult.

Whatever form of activity you find that actually is excercise, if you focus on your core muscles and excercise daily, it becomes second nature to tighten those mucles when you do anything that causes pain. So if walking or standing cause pain, your training your muslces to support you when you wakor stand. If I'm walking or standing my posture is correct and my abs are tight. If I'm on an elyptical or the gazelle, they have to be or I would fall off when I let go of the handels. I've gotton to the point of using treadmills and elypticals without holding on and with dumbells in my hands to force my core to work.

Excersice for us is no different than anyone else as far as most peole over do it, hurt too much from the first few times and give up. Gyms sell thousands of lifetime memeberships for decades for club that holds 1200 people. They know that the majority of people get motivated, start and then give up. How many of us know someone with a treadmill or bike in their house that hasn't been used in years? We don't have that option unless you want things to stay the same as they are now, which really means getting worse as we become more and more tolerant to the meds.

The key is to not hurt yourself in the beginning. Find what works best for you, whether it's treadmill, elyptical, biking, seated bilking or my own personal favorite that changed my life was a Gazelle. That thing you might have seen Tony Little selling on an infomercial a few years ago. Basically your legs swing back and forth in a cross country sking type motion, There is absolutely no impact or pounding down on my spine, Just continous movement with the option of leaning forward and using your arms or leaning back and using your arms. You can do it with legs straight or bent or use it hands free with dumbells and develop some balance and core strength. The big thing for me was no impact or coming down on broken hardware. No amount of premedication with Bt meds is going to mask that pain for me and although it may help some , The problem with taking meds before you excercise, is what do you do after you excercise, take twice as much?

I think it's a reasonable idea at first when you first start out and the worst thing you can do is create pain you can't manage. But if your going to hurt whether you sit on the couch all day, pace around, lay down, sit, stand or walk, what do you have to loose by starting slow, wherever your pain allows. I started at 5 minutes a day on the Gazelle on Valentines day 2 years ago. I walked after surgeries and walked daily, but the problem is, that's not excercise. The farther and longer I went the slower I would end up going and the harder it was to drag my butt back home. So I always had to save enough just to get home. It's a start, but if it doesn't raise your heart rate, you don't break a swseat, if it isn't making your stronger more flexable and increasing your endurance, it's not excercise.

We have to be honest with ourself and realize that throwing cards in a hat, or walking in a gorcery store or vacuming the floor isn't excercise. Just like going to work and walking all day at a job isn't excercise. It doesn't raise your heart rate too peak level for 20 minutes, you don't break a sweat, it isn't building muscle, so lets not fool ourselves by calling card throwing into a waste bin excercise or activity.

The video game thing like a Wi may be helpful with some of it's games, but that game "dance dance whatever" that I've seen the kids do, leaves them sweating and huffing for air. That's excercise.

I'm not saying that anything that keeps you moving and distracted isn't a good thing, it's just not what anyone that understands physical conditioning would call excercise.

No Pt would have ever pushed me as hard as I push myself. I'm not saying doing leg presses 6 weeks post fusion wasn't painful or walking around the block 5 days post fusion wasn't painful, But getting home in extreme pain still isn't the type of excercise that book, an in patient rehab faclity or any phsyiologist is going to call excercise. It's not rebuilding what years of living in pain and being sedentary to avoid additional pain has done to our bodies, mind and health.

It may take a year to rebuild what 2 years of being sedaentary after a failed surgery or onset of a disease has taken from you, but you can rebuild if you find the right way to get real excercise. The kind that makes you sweat, the kind we were tought in PT to strengthen our abs and back or totla body. Everyone has heard of Pilates and people pay hundreds of bucks for an hour with a trainer. All they are doing is different versions of the strengthening and stretching we learned in PT. The superman is right out of the Mckenzie method of treating low back pain and also part of every Pilates workout. "The fun one, where your lay on your belly and alternate lifting one leg and and opposite arm." However if you can only do it 3 times this week and can do it 5 times next, that's progress. Going from 5 minutes to 7 minutes is progress.

Excercise is activity above and beyond what the average person would do in daily life. Going for a walk is great, but it's not excercise, its staying moving. The book your reading is about excercise, not just sustained movement.

I got my Gazele at JC Pennies, although I've seen them at Dicks sporting goods, It cost 100 bucks and I'm on my second one of those. It's real sweat dripping, ardio and exndurance ewxcercise. Letting go of the handles and using dumbells forces me to tighten my abs and use core strength to balance and keep from falling off. Physio balls should be a must have for anyone with a bad back and we have to realizer that it's our job to rebuild what pain, surgery or illness has taken away. We may never get back to the way we were before, but I can gaurentee you won't even get close if you do nothing.

The only difference betwen a profesional athlete and us as far as recovering after injury or surgery is the amount of effort we put into it. Anyone that's played any sport knows that a PT will never ask what a coach asks of their people. Someone mention good pain Vs Bad pain. Well chronic pain isn't a warning signal that something is wrong and muscle pain from muscles we haven't used in years isn't a sign of something going wrong. Unles the excercise or pain causes new neuro problems like loss of bowel or bladder control or loss of reflexes or sensation, we have to expect it. But aren't we going to hurt and be miseable tonight anyway? I sn't that why we take the most potent pain meds ever available.

So find what causes the least amount of pain or impact and move very slowly and gradually up as far as how hard you push yourself, how long you excercise or what type of excercise you do. Pick what method causes the least pain but still alows you to break a sweat. If you need another round of PT to kick start an excercise program, I would bet most docs would be more than happy to get any of us who could benefit from excercise into a work hardening program or into PT for another round.

Thay make 1,2,3,4 and 5lb dumbelss which sell for couple bucks. Adding dumbells to a movement program whether it's strethching, balance, or yoga, only forces you to strengthen your core or you tip over, so our bodies learn to tighten your abs and back if you lift one arm out in front of you with a 2lb dumbell and eventually we learn to keep them tight the entire time we stand or walk if that causes pain.

Simple muscle pain from using muscles we haven't in years is going to increase pain. The thing is, that pain will get better in a day or two and more excercise is exactly what those muslces need to work painful lactic acid out of them.

Between PT, availability of physio bals, dumbells and inexpensive machines or gym memberships, The only thing stopping us from excercising is fear of pain. Once you realize your going to have pain regardless of what you do and you only have things to gain from excercising and pushing yourself, can you actually see how different your life can be.

I actually feel guilty If I don't do somethign every day to improve my situation. I know my back isn't going to get better or fuse from excercsing, but I also know I could be in beter shape and better able to handle the small stuff like standing in front of the sink for 20 minutes or walking through a grocery store for a half hour. For some reason it's harder to stand in the check out for 5 minutes than to roam the store for 20. With a strong core and some real endurance I can tolerate a whole lot more and feel a whole lot better about every aspect of my life. I lost 30 lbs, went from 5 minutes to 30 minutes twice a day with dumbelss and returned to work part time. It took 8 months of daily excercise where I soaked through my shorts with sweat to get to the point of any kind of work being something I even saw as a possible. Without the daily effort, I wouldn't reap the benefit.

The proof only comes from doing it yourself. I know it sounds crazy to excercise when you can barely walk, but trust me, it's not going to paralyze you to excercise if your don't have paralisis now. I remeber the first surgeon I saw back in 93 for 2 ruptured discs. I was 28 and the doc said you don't want surgery, you just need to get to the gym and work out at least 3 days a weak. I was 6 ft and weighed 160 at the time and thought working 55 hours a week had kept me in shape. So of course I thought the doc was a jerk and didn't know what he was talking about. But knowing what I do now, I should have bought a gym membership that day and hired a personal trainer to help me with my back.

You wanted specifics Dr. P... Try a Gazelle, a phsyio ball and buy a couple 1lb and 2lb dumbells. Lots of light weight repetition is going to do more than trying to bulk up with heavy weights whether your'e a guy or a girl with a bad back. You can easily spend a half hour a day on a physio ball with a couple light dumbells or salowly increase your time on the Gazelle and notice a diference in a matter of weeks. Or, do nothing at all and plan on your next increase in a couple months. BTW, I Have'nt had a med increase since I stared working out 2 years ago. Do you have something better to do with your time? I'm not trying to be a smart a##, I just know how incrediably boreing and worthlees doing nothing can make you feel.

If you don't know what I'm talking about as far as core strength and excercise, get back into PT and kick start your workout. How you spend the rest of your life and how much effort you put into your own recovery is entirely up to you.

Good luck, Dave