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Monday, 26 August 2013
Look After your Back
I seem to have a bit of time
on my hands as my back symptoms are troubling me again so bike time has become
computer time for a little while. Back pain is so common yet so
debilitating. Like a lot of folk reading
this I have had back problems for years. Some fair wear and tear, a lot from
poor lifting and handling, and a bit from direct injury.
My “story” goes back to my
early 20’s before Fiona made me use my brain and do some studying and follow
through with something medical related.
Stacking 3 metre pulp as chainsaw feller (lumberjack) up to my arse in
brash I soon developed chronic back stiffness. A particular injury was trying
to turn a 2 ton 4.5m log with a “cant hook” to get at the branches that were
embedded in the ground. The lever
snapped and I went back downhill landing on rocks and got knocked out. I woke up with the rain on my face unable to
walk. A crawl to the road where
workmates found me lying I was heaped in a van and taken home to the forest
house we rented as part of the job.
Crawling up the path and into the house where Fiona found me lying on
the floor a few hours later when she came back from teaching skiing. I lay in bed for days and the local GP
examined me and thought I had a pelvic #.
I couldn’t walk without pain for weeks and was on “Fortral” and
“Temgesic” (spew in pill form!) Later I
was diagnosed with crushed lumbar vertebrae.
At this time I was well into climbing and windsurfing so within a year my
core was strong but always a simple thing like getting up out of bed too fast
and I would be locked up in pain from muscle spasm for days.
Next drama was mountain
biking at Learnie Red Rocks where I jumped a berm at about 30mph and then woke
up in Raigmore. Helmet smashed to smithereens and Ko’d the spinal X Ray was
clear so I was let out that night. Fish
n’ Chips at Drumnadrocht and I couldn’t swallow as my throat had closed
up. A poor sleep and slowly progressing
numbness up both arms I asked Henry Methold one of my work colleagues to take
me to the Belford where good old BT sorted me out for an MRI scan back up the
road and a Philadelphia collar to wear until the results were known. Seems I had fluid around a cervical disc. That still bothers me as on the TT bike I
struggle to look up, and any bump to my head causing neck flexion my arms go
numb and my throat gets sore. That makes me hold back a bit on the MTB as it
affects my thinking and I get flashbacks at speed and this has major
psychological effect i.e. fecks with my head. Waking up fully packaged
wondering how it’s going to play out isn’t easy to forget. Maybe these injuries are why I used to fight
for the packaging of injured skiers and climbers to be good and would get in
trouble for arguing with aircrews doing a snatch rescue of someone that might
have a spinal injury.
The Learnie Helmet
There will be a # under there then ?
I am not trying to be a
pussy here as I still give it a go on the bike and don’t let it hold me back
much. It’s just that its fekin scary and
sore beyond belief being on a spine board. I should add that at Learnie the
Helicopter and ambulance staff were very, very careful when moving me.
This last back injury has
probably been a long time coming. Folk
talk about having a slipped disc when they have back pain but let me assure you
a prolapsed disc if you have one is amongst the worst possible injuries for
pain. Having broken ankles, collar bones, fingers and toes a true slipped disc
was/is a true 10/10 in the ouch scale for me.
For the last few years I have had transient nerve jabs down my legs so
probably a lumbar disc has been bulging.
Ironically I have always worked hard on my core stability and
flexibility but maybe it was left too late to make a difference. Start lifting correctly when you’re young and
do core workouts before you get injured folks!
January 1st this
year Ski Patrolling up at Glencoe doing avlx control work I got taken out by a
small slide that buried me up to my waist and pulled me down 50 meters. My bindings didn’t release and I got out just
fine if humbled, but my back definitely took a hit as for the next six days I couldn’t get
my socks on without help, and each day started face down on the floor. In my
wisdom(?) I decided to do the Barcaldine XC Race which those who did it will
know involved ducking under and over fallen trees, bog mashing, getting tree’d
and was general anaerobic hell. It hurt
but by God it cleared the lungs.
Next day I woke up with my
right leg having a workout of its own. A
walk with Fiona and I noticed I couldn’t lift my leg as easily, but we kept
walking up the woods to look at a new trail we were going to make. Above Glencoe Lake/Lochan my right foot got
caught under a branch and I went to step forward and it was like being shot or
stabbed in the back. Instant pain at level ten unbearable and writhing on the
ground. After 15mins of this Fiona
mentioned calling out the rescue team and I got on my feet but couldn’t
walk. Freddie Gatting was called and
came up and between them in an hour or so they got me to the car. The passing
walkers were all pretty alarmed at this screeching nutter between two women.
I was taken to A/E and
straight for examination by a junior doc with a really shitty attitude as when
he examined me I had no sciatic symptoms but really, really sore legs. The level ten pain was in my knees in which
men with hammers were trying to break out and all the muscles in my right leg
were break dancing on their own. A spine
X ray was inconclusive but showed a big synovial sack and impingement on my femoral
head which might be causing the leg pain (the avlx?). I was referred for a hip
MRI, given Diazepam and Diclofenic.
Best decision I made at this
time was to see a good local physio who said my symptoms were definitely from a
prolapsed disc. After three of the worst weeks of my life, not sleeping,
sleeping curled in a ball, and unable to walk I booked to see a consultant privately at the Nuffield hospital in
Glasgow. I saw him two days later and was in such a state (some bladder
symptoms) that he had the MRI scanner opened up (it was closed for servicing)
and I had an MRI. That got looked at and
the anaesthetic registrar was called so I got a second MRI with contrast die.
Within twenty mins I was looking at my spine in 3D and told I needed emergency
surgery (private £4,000). The consultation was £160 the MRI £350 but I had a
diagnosis of an extruded L4/5 with sequestration and a DVD of the scan to take
to the NHS who I was then referred to. An emergency appointment was made at the
Southern General neuro). Emergency appointment time waiting list two months or
more! So what to do? Well I have to say Lochaber Sports Physio
sorted me out. A tailored programme of rehab
for my back and hip.
My local GP practice was really helpful and the epilepsy med
“Gabapentin” which gave me fantastic dreams reduced the muscle spasms in my
legs, and lots of Tramadol and Diclofenic helped.
All that gunk is toxic and presses on nerves
I saw the neurosurgeon in May and he commented
that based on the MRI he should operate but based on me as I had been on my
bike, tried a TT, skied gently and been walking said that we should hold off as I
was doing very well indeed. I then saw
an orthopaedic surgeon and found that I have an impingement in my right femur
and a synovial sack and like most outdoor folk will require a new hip at some
point, If I run then maybe 5 years, if I
stick with the bike and skiing maybe ten. It’s all a question of wear and tear
and if you X ray most folk I know they will all be the same.
I am going fine on the bike
but can’t do over a couple of hours yet as my back hurts. I have slightly smaller right leg quads and
that probably won’t change, but working hard on single leg pedal drills on the
turbo I seem to be only about 10 watts different and can’t last quite as
long. I can’t do aero well on the TT
bike so need to be more upright but I am within 10% of some PB’s and improving.
I still suffer back pain and leg tremors, I am another few mm’s shorter (I lost
a cm when I crushed my lumbar vertebrae) but overall consider myself very
lucky. I know many folk with back problems who are both less mobile and in more
chronic pain. Despite doing ok this has undoubtedly been the most painful and debilitating
injury I have had, and having researched all the options only surgery might
have done anything and even then it’s 50/50 with some folk worse off after
surgery due to scar tissue on the cord. Rehab is hard work but it pays off if
you treat it like training.
Something’s I learned from the experience:
Over the years I have seen
an Osteopath and physios. The physios take a softer more gentle approach.
Osteopaths have diagnosed everything from facet joint problems to piriformis
syndrome and manipulated my back in various quite alarming ways all to the
detriment of my wallet. If I had gone to
one of them with my recent back injury I don’t think I would ever have cycled
again. Mucking about with someone’s back blind, with no detailed imagery seems
so wrong. The £500 quid I shoved out
privately was a lot but got me a diagnosis and despite the NHS waiting list shortened
my time to see a neurosurgeon by about 4 months. Well worth it IMHO.
I got cycling this summer out of it and my
physio new exactly what we had to work on based on the diagnosis. Tom Danielson’s Core workout
for Cyclists is an excellent resource when you know what you’re dealing with. A
wobble board teaches the fecked nerves to your legs how to reconnect and
without one I doubt I could turn the pedal over the 12 o’clock as for 3 months
my brain and leg didn’t know how to do that, but the wobble board repathed these
broken connections I feel. Get physio bands and
work all the accessory muscles to compensate for major muscle loss. Despite a smaller right leg I am nearly back
as strong on it by compensating. Work
hard! I am seven months post prolapse and
reckon it will take the full year to get back back to 98% of what I had. The
new 100% is different but still damn fast and the full 100 might be possible if
you keep at it. I will tell you next