Too much exercise?

Discussions relating to Lower Back Pain.
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EngineerDoug
Posts: 10
Joined: Sun Feb 07, 2010 11:42 am

Too much exercise?

Post by EngineerDoug » Thu Dec 09, 2010 9:52 pm

Hello all,

I've been battling a minor/modest back injury since the beginning of the year. In a nutshell, my injury is a protruding L5 disc. I have intermittent low back pain, sometimes with faint shin/foot twinges. No weakness, no numbness. I am in the care of a physiatrist and have done physical therapy. The short story is that I have regressed a bit since the summer. At that time, I felt I had reached a level where the injury was just a source of discomfort now and again, and that I had done a lot of healing. I was not taking any meds, and it seemed I just needed more time for the discomfort to fade. I have been religious about my rehab, and work my core for >1 hr every other day. But these days my doctor is puzzled that I am doing a bit worse than I was a few months ago.
Sometimes I have to resort to Celebrex, and it definitely seems that inflammation of the L5 nerve is my problem.

I have a theory about all of this, or perhaps a question. Could it be that I am working out too hard? Generally I feel a little discomfort when I am doing my core work, and often later in the day I can tell the nerve seems a bit irritated. I don't do the Cobra, because I am not ready for extension exercises. Here is my routine:


Front plank, 3 sets 1:30 min each
Side plank, 1 set each side, 1:20 min each
Bird dogs, 2 sets for 4:30 min each
Pilates Reformer, 3 sets 20 reps each
Leg kicks on plyo ball, 3 sets 20 reps each
Stretching
Exercise bike

This workout typically leaves me feeling wiped out, so it is pretty intense. I just have the feeling that the nerve and whatever other tissues are inflamed are getting re-irritated with this routine. I can't think of anything else that I could be doing wrong, but as I said I feel I have slid backwards a bit. Could I be working too hard, and continually irritating myself, rather than encouraging healing?

Note that I tried a single epidural a couple of months ago. My doctor was surprised that it did nothing for me. Given my injury, and the fact it has been mild by comparison to many of you folks, I really thought it would be all I need to get past the last barrier.

My physical therapist - who I still consult with - thinks that I just need more time, and that the irritated nerve could take another year to settle down. I would be very interested to hear from any of you who have wrestled with a similar situation.

Doug

renob99
Posts: 3
Joined: Wed Dec 01, 2010 8:44 am

Post by renob99 » Tue Dec 14, 2010 9:11 am

Hey Doug,

I see no one replied to your message. What you're going through is what I think I'm having an issue with too. If you really think its a nerve issue, try looking up neurography and see if you can set up a time to have the "MR neurography" procedure done. This is the best thing I've seen that looks like they can really understand if its a nerve problem verses a back issue.

I would add the link to the site, but I can't on this forum. Send me your e-mail address if you want me to send you the site.
Good luck.

Adrian

nth_dimension
Posts: 8
Joined: Thu Jul 08, 2010 7:00 am

Post by nth_dimension » Wed Dec 15, 2010 6:52 am

Hi Doug,

Your situation sounds similar to mine. I gurt my back at the start of 2010 shovelling snow. The firrst 1-2 months were the worst, and I was/am making good progress, but lately things seem to have slid back a little. I have more general lower back pain, but no real restrictions on range of motion or anything like that. Just sore... day in and day out. Not enough to slow me down, but just enough to be a constant irritant and reminder.

My Dr doesn't really have a lot of advice either. Just exercise and wait it out!

Honestly, I really think that ~10 months on, 90% of the problem is mental. I can't prove this, or completely convince myself of it, but stress and anxiety sure seem to play a significant role.

EngineerDoug
Posts: 10
Joined: Sun Feb 07, 2010 11:42 am

Post by EngineerDoug » Wed Dec 15, 2010 2:29 pm

Gents,

Thanks for the suggestion about MR neurography. I'll ask my Dr about it when I see him again.

I am still optimistic about my recovery because my symptoms are relatively modest/minor. Add to that the fact that the symptoms are predominantely confined to the low back, and it seems there can't be too much nerve damage - or maybe just irritation.

I've thought about the mind/body connection. I can tell when I am under stress that I seem to hurt more. As a matter of fact, I am playing with some hypnosis to see how that could help me. I won't plug the "hypnotist" here, but there is a world-known hypnotist that offers CD's on the web (or MP3 downloads) that purportedly address many issues - such as PTSD, pain management, etc. If anybody is interested contact me about this source. Note that I am in no way associated with this hypnotist, nor am I inclined to believe it will help...so I maintain a healthy scepticism.

I've also done some reading that suggests once a pattern of pain gets locked into an area, the nervous system has a hard time breaking out of that pattern. Kind of a chronic pain thing. Here again I don't know if this holds any water.

So I have cut back on the intensity of my workouts, and will go in for a series of 1-3 epidurals in January. My physiatrist still thinks this is the way to go, so we'll see.

For those of you who are in a similar situation, we can be thankful the pain is not worse or ever-present. Nevertheless, it does grind you down some days and you wish it would just go away.

It looks like there the forums are picking up a bit; the last few months have seen very little traffic. Nice to know there are others out there these days.

Doug

nth_dimension
Posts: 8
Joined: Thu Jul 08, 2010 7:00 am

Post by nth_dimension » Thu Dec 16, 2010 8:16 am

I am still optimistic about my recovery because my symptoms are relatively modest/minor. Add to that the fact that the symptoms are predominantely confined to the low back, and it seems there can't be too much nerve damage - or maybe just irritation.
Exactly the same. Some days it'll drop down into my leg for a while, but that normally doesn't last long.

I also find that the lower back symptoms fluctuate. Sometimes it'l be over to the right, sometimes on the left side a little higher up, sometimes in a band the whole way accross. They really vary quite a bit. The main thing as that nothing seems to be constant. An exacerbation eventually subsides.... and then a good period eventually ends.

The reason i think its mental at this point is, in part, because of this. I even had a period through october and most of November where I have virtually ZERO lower back and leg symptoms. They went away when I had a problem with my neck and shoulders. The symptoms alternate and fluctuate are are constantly on the move. In speaking to a PT about this, they indicate it as a good sign. You need to worry when you have solid pain in one spot that never changes. That means that the nerve is really pinched by something and its not letting go. When the symptoms are variable, then its the opposite. You're actualyl DOING something to put the irritation back onto the nerve. Finding out what that is.... well, that would be the million dollar question. :)

One thing I have found is that being very distracted almost always makes a huge difference. I had a big flare-up in July, went on vacation, and compleyely cleared up for a few weeks. That persisted into September. Same thing with social engagements. I remeber one day when my foot was nagging at me all day. I had an old friend comign into town that night and was nervous about it. you know, the old "Great, I have to go out and be sparkling and fun, and my sciatica is goign to drag me down" kind of thoughts.

But I went out and had a great time and there were NO symptoms. Maybe the 2-3 beers helped, but who knows?

I have an appointment with an Osteopath soon. We'll see what kind of angle he can provide.

gavinol
Posts: 1
Joined: Fri Dec 17, 2010 7:01 am

Post by gavinol » Fri Dec 17, 2010 7:14 am

I think that is a good amount especially for a more energetic breed like that. If anything take for numerous short walks throughout the day rather than one or two really long walks. Have fun!

RAS
Posts: 2
Joined: Fri Dec 31, 2010 12:52 pm

exercise

Post by RAS » Fri Dec 31, 2010 1:10 pm

Doug,
As a back pain fighter with fitness training experience I would say keep exercising as much as you can. Personally, when I don't work out and my muscles lose strength my pain increases due to the increased need for bone support. Obviously there are things that are absolutely unthinkable for back pain fighters but I enjoy the benefits of squats and deadlifts and the feeling of being in control that I get from doing them. As for advice: try anti movements. Anti-rotation= Pallof press (most excellent), anti-extension (power wheel rollout, get one at Sports Authority), anti-lateral flexion= waiter's walk, etc). The core stabilizes the spine so it's best to train it to be able to do so, especially when you are doing life activities.

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