As most readers are aware, back in 2004 I was seriously injured in a work-related accident. After two surgeries, culminating in a spinal fusion, I ended up with a damaged left sciatic nerve, and in pain 24/7/365. I can keep the latter under control if I work at it, and use pain-killers when needed, but it's no fun. It's restricted my mobility, so that I can't walk too far without needing a stick, and not much further before I have to sit down and let the pain subside before going on. Running is out of the question, and my sense of balance is also affected, so that cycling (on roads, anyway) can be tricky.
Another result of the injury was that my neurosurgeon told me I'm restricted to carrying not more than 25 pounds for the rest of my life. I'm afraid I've honored that more in the breach than in the observance on occasion (try moving house carrying only 25 pounds at a time!), but generally the pain issue has helped forced me to observe it more-or-less faithfully. I'd hoped to do more strength training to compensate for the enforced lack of aerobic exercise (see preceding paragraph), but found that I simply couldn't tolerate very much weight on a barbell before my back went on strike and started hurting me badly. To add to my difficulties, over time I've developed arthritis in my spine, which I'm told is a normal side-effect after a spinal fusion. It adds to the pain burden and further restricts flexibility.
I've been struggling to find a "middle way", some form of exercise that can help keep me a little fitter than a jellyfish, but won't trigger my pain reflex or mobility issues. I've been working out with dumbbells rather than barbells, because a dumbbell doesn't rest on my shoulders or neck or spine, making it less stressful. I can add weight to a pair of dumbbells, as heavy as my restrictions will allow, and use them in movement exercises to keep my muscles in trim. (There are lots of exercises that use them.) I haven't tried kettlebells to any great extent yet, but may do so soon. (On the other hand, is it worth using kettlebells when one's already using dumbbells? Will readers with experience of both comment, please?)
I'm trying to combine dumbbells with step training. The latter has been used for decades as a conditioning exercise for new workers on South African mines, and I'm familiar with the way they do (or did) it. I can't do it for long periods or at high intensity, but I can manage a few steps up and down while using a dumbbell in various exercises, then take a break before doing it again. (I seem to use a lot more weight on my dumbbells than is seen in most videos of step exercises. Those things are tiny!) I hope the added workout will help my cardiovascular health to at least some extent.
Are there any other alternatives for someone in my position? I'd appreciate suggestions from readers, please. I don't want to die because I've become an unfit slob, but compared to most people my age, that's what I am, because I can't exercise anything like as hard or as fast as they do. If you can offer suggestions, please do so in Comments.
Thanks.
Peter
THe two things that come to mind are swimming/water aerobics or a soft martial art like aikido or tai-chi.
ReplyDeleteI'll second the swimming (or water aerobics, which are recommended for low impact fitness). I broke my back at 15 and had bone grafts to fuse T12 to L1 and swimming was recommended. Check with your orthopedic surgeon about this. If there is a gym with a pool or a community pool there should be water aerobics sessions available. I just preferred swimming, but any water sessions will be good resistance therapy w/o the impact problems. Any moves that twist your back should be avoided. I remember having to argue that a flip turn doesn't twist in all 3 dimensions at once.
ReplyDeleteI'll third the pool. Not to swim, but simply moving in water is resistance and a good place to start, while supporting the weight off the joints (and that includes spine).
ReplyDeleteExercise bands can do much the same as dumbbells with the advantage of getting the gizmo that hooks into the door frame, then you can do the same as a bench press only standing up. I do that to keep my punching strength up. Along the same lines are a double end bag to keep your reflexes sharp. A speed bag is good for hand speed and endurance but may aggravate your back. The size of the bag determines how hard you need to strike it. A 6"x9" would be a good size to try. If you can find a boxing gym nearby, try both the double end bag and speed bag. If they work for you, they're cheap enough you can get set up at the house.
ReplyDeleteSwinging India clubs is great.
ReplyDelete@Sentenza: Thanks very much for mentioning India clubs. I've never encountered them before. I looked around online, and they appear very promising. I've ordered a lighter-weight starter set, and I'll give them a try. I hope they'll improve my flexibility and balance, for which regular dumbbell exercises don't do much.
ReplyDeletePeter try a pool hydro therapy can definitely help.
ReplyDeleteAren't you in/near Wichita Falls? If I were you, I'd get in touch with Mark Rippetoe at Wichita Falls Athletic Club. He has experience working with injured people, including people with spinal fusions. I'd be surprised if he wouldn't be able to help you get back under a barbell safely.
ReplyDeleteYou can check out his site at https://startingstrength.com/.
Try swimming or even water aerobics - muscles get to move without fighting gravity. And I've seen it do wonders for people with various orthopedic injuries (including myself).
ReplyDeleteTry postural therapy, specifically the Egoscue Method. You can buy Pain Free by Pete Egoscue from Amazon. Got my son out of a wheelchair 3 years ago, I use it 5 days a week to keep pain at bay. Check out theposturepainconnection.com for more information. I am a long time reader, but haven’t commented till now. One other thing: I ride a tricycle several times a week. No worries about falling off, great exercise.
ReplyDeleteI have arthritis in multiple joints and I found water aerobics to be incredibly helpful. There were people who were more disabled than me who also loved it.
ReplyDeleteI have found CBD oil, taken internally, to b/slap sciatica. Of course, YMMV.
ReplyDelete6 spine surgeries, 13 fused, pain 24/7, HATE meds but no choice most of the time; leg pain opposite side of yours. Includes lower back and shoulder/neck. Bet you can't wipe your butt with both hands, too. Me one side only and by the slimmest of margins. "pain in the ass" is poor humor.
ReplyDeleteLong OSHA bar vertical on living room wall, several exercise tubes attached. Amazing how distracting TV can be -- a good thing.
Could pulley and weight, I suppose.
Separately, a pole, floor to ceiling, also with tubes, friend-made instantly moveable attaching points; can send pics. Pole removable, neato the whole thing by a very inventive friend. He also made my front door rubber-covered ramps; little need, but when I do they are lifesavers.
Two pulleys ~3' apart in ceiling, rope and handles to keep shoulder Range of Motion. Same as at PT. Could weight it, I suppose, but not the purpose -- only RoM. Use sitting or standing, just knot the rope to shorten for standing.
All of this was done personally, no purchased "equipment."
Lower back pain helped tremendously by a Venom Back by Hyperice. Highly recommended. Used at PT and bought one.
Also "Stander BedCane, Adult Bed Rail" at Amazon for getting out of bed. So simple it's crazy, but makes MAJOR difference. At times the ONLY way I can get up due to pain level, no exaggeration. Effective many times its simplicity. Holds a bunch or remotes, flashlight, and objects of your choice. No kids in the house so I don't need a safe at bedside. Useful if I can't get to the bedrail-mounted tool.
If you can't find and need my address Jim has it.
Have you tried bicycling? I have back, neck and sciatica problems. I find walking has my hip and sciatica screaming within a half mile. Today I rode my bike 23 miles. It was over 90 today so I'm whipped but not in pain.
ReplyDeleteI ride a recumbent exercise bike. With a 2 inch seat pad and a soft pillow on the backrest. I ride 11 miles a day.
ReplyDeleteI had back surgery April 2019. Have a fused lower spine.
The bike ride is an easy no impact exercise.
At 67 yrs old it has helped me be able to garden again.
I find that when my back really starts to give me trouble, a little bit of time on one of those gravity tilt tables really helps decompress vertebrae and slowly stretch muscles. A nice feature is that you can go very slowly from perfectly flat to totally inverted (head down) as gradually as you like. The further you tilt, the more your body weight helps stretch things out.
ReplyDeleteMy back issues were all muscle strain related.
I damaged my back as a teenager and was in pain not quite 24/7 but too damn often for the next 30 years. Couldn't stand straight, couldn't sit straight, muscle spasms so bad I couldn't breath, etc. Did my best to keep active but never knew when it might strike, often from just some tiny mis-motion or slight twist. Sciatic nerve damaged enough that I still have a big numb spot on my leg. Never had surgery because of a good friend with a similar issue who ended up in a wheel chair after multiple "corrective" surgeries. Doctors prescribed muscle relaxers, pain meds, exercises, etc. Everything they did seemed either not helping or actively made it worse. The only good muscle relaxer I ever found was slightly too much wine.
ReplyDeleteWhat actually helped? Kayaking. I was concerned that sitting in a kayak would be a bad thing, but I found that after a few trips I started to feel better. Turns out it was because of the specific motions one makes while kayaking. In a canoe, you paddle by stroking on one side or the other. In a kayak, your arms and paddle are locked in a rectangular shape and you twist your torso to paddle. That twisting motion, combined with the resistance of the paddle, exercises the diagonal muscles which criss-cross on your lower back. For the first time in 30 years I started to feel pain free and stronger in my lower back! These days I no longer kayak, but now if I start to feel a twinge, I have adapted a simple exercise that substitutes for paddling. I get two 5 or 10 pound barbells (or two jugs of milk) and hold them out on the left and right, one on each side, with my arms at about a 45 degree angle. I twist my torso back and forth maybe once every two seconds. DO NOT TWIST FARTHER THAN IS COMFORTABLE. You are not trying to be a contortionist. You just want to exercise the muscles. The inertia of the weights in my hands puts enough resistance to the motion that the lower back muscles have to work a little. Use your own judgement to decide how long to twist. The next day you can move a little faster, get some extra resistance from the inertia. The faster you twist, the more resistance your muscles face. You should feel results within a couple or three days.
If that works, great. It works for me. The doctor's exercises made it worse -- sit ups, touch your toes, etc. Hope this makes a difference for you. People who have never experienced severe back pain have NO IDEA how bad it can get.
Swimming. Period. My Mom continued to waitress for 9 years with6 ruptured disks with swim therapy 2 days a week.
ReplyDeleteAdditionally I'd recommend Relief Faction. Yes it is $80 a month but I am former air assault and 15 year past my doctor's knee replacement recommendation and PAIN-FREE everyday taking 1/3 their recommended dose.
Plenty of good exercise suggestions above.
ReplyDeleteThe other issue is weight loss. First thing to grok is that you literally cannot burn calories through exercise faster than you can eat them because you are not a 20 year old lumberjack doing things the old way pre mechanization.
For the love of Gnon, learn about low carb diets and possibly go Keto. By Low CarbI mean LOW. Not American BarcaLounger sorta kinda almost sometimes Low. LOW. Google up Ivor Cummins and watch his YouTube videos and read his sources.
If you do die before your time, it will be from cakes, pizza, breads, cookies… etc. IOW T2D whether diagnosed or not (and the accepted diagnostic criteria are a joke and only catch you when you’re already very far gone) There’s a lot here which is tied up with emotional/social/marital connections to carbs and their preparation and consumption together… so you have to decide whether or not you believe them to be deleterious and then make some painful adjustments. As a married man, not something you can hope to do by yourself.
Yes, yes… Can’t do this when you’re in post-apocalyptic survival mode… but right now you can.
Also look into good chiropractor care. My husband reached a point he almost couldn't walk. We had just bought our property and I was looking at adding ramps and everything else needed for a wheelchair. After a year of treatment, he is cutting down trees and carrying whatever needs done. A good chiropractor can do wonders.
ReplyDeleteI second Egoscue and tai chi. Those, plus a good chiropractor, helped me mostly recover after my brother accidentally tipped an unsecured trailer over while playing hide-and-seek, and the axle hit my neck (I was hiding underneath). After 5 years of terrible daily migraines, the Egoscue method helped reduce the frequency of my bad pain days to once a fortnight or so, usually when I've pushed myself farther than I ought. Tai chi is great for those who suffer from balance issues or have old injuries; Qigong is also good. It's also surprisingly good cardio. Also, you can do both Egoscue and tai chi with minimal equipment and very little floor space.
ReplyDeleteRegarding the comment about using a chiropractor:
ReplyDeleteAs a clinic owner stated, chiropractic is as much an art as it is a science. My experience with it was that 3 of them doing the exact same moves gave me three different results.
1) Leave in worse shape than I arrived in.
2) Get some reasonably good results.
3) Feel GREAT, and find that my spine is now straight, and have it be that way for several days.
These results were consistent with the three docs. Every time, over years. The difference seemed to be the amount of force applied, and for me, the more force the better.
BTW, a D.O.(Doctor of Osteopathy)(physician) is also a chiropractor.
I should also mention that a sister with really bad sciatica (hunched over sideways nearly dragging her knuckles on the floor) found acupuncture worked for her, where a limited attempt at chiro didn't. Nothing else did, either.
ReplyDeleteOne approach that isn't obvious to most people is to talk to a Physiatrist. That's a Sports Medicine physician. They are really hot on physical therapy to fix structural problems. I spent years dealing with MD's who had no idea how to handle body problems other than to prescribe drugs of various types, or send you to the hell known as "back school". BTW, any time a doc talks about "back strain", it just tells you they don't know what they are talking about.
Swimming, for sure.
ReplyDeleteNote on the bicycling, I ride a bike that allows me to sit upright. the particular brand I favor is the Electra brand "Townie". Though they also make ELECTRIC townies, my only experience is with pedal powered bikes. There are other "comfort" type bikes, but I'm not familiar with them. "gmadee" above mentioned recumbant exercise bikes, good choise for exercise equipment, a recumbent bike for the streets is another subject. For the record I'm 73 and weigh 270.
ReplyDeleteI second the recommendations of Pete Egoscue's work and of Mark Rippetoe. You might also want to look into Doug McGuff's work. McGuff is (or was) an ER doc who is also an expert in strength training. I've got some other ideas which I'll communicate privately.
ReplyDelete@Don C: No, a DO isn't a DC. DOs in the USA are licensed physicians, prescribing drugs and performing surgery if they desire to. Some do no Osteopathic Manual Therapy (OMT) at all. That said, there are some wonderful techniques in the OMT world, some of which are taught to non-osteopaths, including chiropractors. And some of which overlap with things that chiropractors do.
DCs specialize in adjusting the spine (and extremities) by means of a wide range of techniques (some choose to use only one technique) and not only do not but in most states, may not perform surgery. In a few states, minor surgery is part of the chiropractic scope of practice, though that requires extra training and certification. The same is true for acupuncture. DCs aren't licensed to prescribe drugs (except in surgery states for local anesthesia and other things relevant to minor surgery.) Many employ nutrition and herbal medicine in their practices.
Andrew Taylor Still, who founded osteopathic medicine, was a licensed physician. His work was meant as a reform within the world of late 19th century midwestern medicine. Daniel David Palmer, who founded chiropractic, was a grocer who in the late 19th century developed an interest in anatomy and healing, set up in practice, had some good results, and started teaching what he did. Palmer was in Iowa, A.T. Still in Missouri.
If you do decide on swimming, you'll probably benefit from using a lap swim snorkel rather than turning your head. When you're dealing with compromised nerves and joints, technique becomes critical.
ReplyDeleteI have found these, or something like them, to be very helpful for water exercise. You can get really aerobic if you want:
Peter- what you describe sounds exactly like me- I have degenerative disc disease, and osteoarthritis, mostly lumbar, and have had two spinal surgeries (laminotomies- not fusions thank God) to free compressed nerves which have provided some relief. I cannot walk even for 10 minutes without needing to stop. My pain level is never less than a 5 of 10 and on the bad days it has been at 7 or 8. Overall, I cannot manage without pain meds every day; the only variation is how much.
ReplyDeleteCompounding my spinal problems is my atypical Parkinsonism which causes leg pain, stiffness, balance issues (falls) and freezing of gait- which makes walking very difficult apart from my back pain.
The one thing that as helped my back pain the most is Radio Frequency Ablation...if you haven't had this done you should consider it, I have had 2 at different lumbar locations and am scheduled for a 3rd one - this time at my S/I joint.
Unlike you, however, I am ready to be with Jesus in a new disease/pain free resurrection body.
ReplyDeleteMultiple knee, back, and shoulder surgeries.
I tell people that pain is a great teacher...and that I am just a poor student.
I told wifmann I need to start acting my age and that might help.
Tai Chi is good, as has been recommended earlier. I'd also suggest a less-stressful version of yoga. The latter builds up a different kind of flexibility and strength that isn't like normal lifting of heavy things. BUT...You definitely want to get into a starter-type yoga and not leap into the deep end (like I did). :)
ReplyDeleteAnother vote for the swimming pool.
ReplyDeleteFor aerobic exercise, I row 8 miles a week, on a rowing machine at the gym. Its readout is calibrated in meters, so 1,609 meters is a mile, 3,218 is 2 miles, etc. At first you might notice a bit of back issues, but proper stretching and good posture while rowing will alleviate that. It's a good overall body movement and it's not impactful like walking or running is. As to weights, you probably don't want to know about that, it's BRUTAL even for me, and I'm in excellent health.
ReplyDeleteBut do give rowing a try. I also think swimming might be good for you...check it out, at least.
For the pain, I would highly recommend a Frequency Specific Microcurrent (FSM) device. They aren't cheap, but they work wonders for many people, including a VAST reduction in pain. My wife uses one every day, and she is so amazed by it's performance, she calls it her "Voodoo unit".
ReplyDeleteShe has Doctorate in Pharmacy, and has done clinical research for over 30 years. Feel free to email me at vfruhkda@private43.com if you would like more information.
I should have said, we're not selling or affiliated with the company that makes these FSM's. We hopefully could point you to a local person who could help you with one.
ReplyDeleteBased on my experience with joint damage and balance issues I would start with the 5BX bodyweight exercise program developed by the RCAF back in the 50's. Here's a link to an online version of the book: https://www.scribd.com/document/502815652/RCAF-XBX-and-5BX-Exercise-Plans. I like the program because it has stages based on how fit you are and it moves you gradually from stage to stage. You could easily add light weights if desired, if you want to delay moving to harder versions of the exercises. I like the 5BX routine because it can be done anywhere, anytime, without equipment. It can be your entire workout or provide a base of fitness you can expand on with other disciplines.
ReplyDeleteYoga can be an excellent workout - this video (https://www.youtube.com/watch?v=qX9FSZJu448) about how DDP Yoga helped a disabled vet walk again - and then run, and sprint - makes we want to try it. DDP Yoga skips all the silly names and mysticism in favor of a more grounded approach, and Yoga explicitly says 'If you can't do this movement today, don't worry about it'.
Pool workouts can be excellent, but the nature of the beast makes it harder to do on a regular basis (unless you happen to have a pool, or a very friendly neighbor with one).
Rowing machines are great exercise and excellent for your back. The rowing machines about the GW (USS George Washington) were always in use, frequently by the resident SEALs or UDTs - the UDTs were scary good on them.
Martial arts - I would see a doctor about the balance problems to try and determine the nature of the problem. As a former Aikidoka, you don't want to lose your balance while you're practicing these. They're soft martial arts, but there's nothing soft about the ground if you fall wrong.
Exercise bands - I have had coaches who swore by these, especially on the road. I've never had much luck with them; the leverage and direction of the force exerted on your body depends on how you're pulling on them, not gravity. This can cause problems, especially if you happen to be loose jointed or have joint problems.
Every person's body and damage is different. Take your time, research and experiment. Find what works for you.
As someone with chronic back pain, I can tell you it's about flexibility, not muscle. I wish I hadn't quit yoga.. There's a variant called "Yin Yoga" where you get into a position (or as close as you can) and simply hold the pose, for 15 to 30 minutes. We aren't talking about planking--it isn't about building muscle or stamina. Instead, your fascia and other connective tissue begins to relax. And you use that time to meditate and calm your mind (or pray), and after doing this for a while your pain lessens. Tai chi is also great, and I agree with water exercise.
ReplyDeleteA friend who was a Crossfitter ( which I DO NOT ADVISE) took me to a cryotherapy session once, and I felt great for a few days afterwards. In addition to time in the sub-zero booth, they also applied cold to my lower back. I know there are athletes who swear by it, and I've only done it the one time, so I'm not endorsing, only mentioning. Do try the Yin Yoga, if you can find an instructor in your area.