Slipped disc (back, not wheel!)

ratperry

Hi fellow triathletes,
I completed two IM distance races this year, got a PB at IMUK and trained injury free. A month after IMUK I went camping, slept on a Thermarest and woke up with back pain, unable to bend forward. The pain radiated into my buttock and thigh over a period of weeks, meaning that cycling and running had to stop, and even swimming (or at least kicking during swimming) became painful. I have finally been diagnosed with a slipped disc (or rather bulging and degenerated disc) at L4/L5. I am now starting physio, strengthening my core and considering taking up pilates. my questions are:
1) Is there any evidence to suggest that the impact of training for IM distance races (especially 2 in one year) causes excessive 'wear and tear' on spinal discs?
2) Do you think I'll be able to race triathlon again, and should I give up the longer distances, including stand alone marathon running?
I'm sure loads of you out there have suffered with the same, or worse conditions. I'd be interested to hear your experiences.

cheers

LancsRider

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ratperry

Flipping eck what an amazing journey you've had. Mine is nowhere near as bad as yours, I can stand comfortably, walk slowly ok, it's just bending to put on socks/ brush my teeth is impossible. The diagnosis was based off an MRI/ consultant spinal orthopaedic surgeon. It's degenerated and is bulging. I agree with you though, the fitter I can be, the better. Winter is a great time for core work anyway! I guess I just wonder if the impact/ wear and tear has contributed- as soon as you tell people, they say 'well you do do ALL that training'...but heck the pros are doing IM more than twice a season, and probably twice as much training per week as me. I guess I'm worried if I do train for another IM or marathon and the disc herniates I might feel a bit stupid. But maybe life is too short not to do things we love because of the what-ifs. As you say, I could twist to catch a falling object and pop it. Thanks for your thoughts. Good luck in your IM quest!

ratperry

Or was your IM race this year?

LancsRider

I have yet to race IM and will turn up when I know I have a very good chance of what I personally consider of finishing in a good competitive time, in the meantime I will work hard towards my goals.

If you disk is degenerating and its nucleus therefore is lacking some of the radial support structures to keep it in optimal shape and position I can see how you might feel the daily training punishment is potentially having a negative impact. My imediate reaction is to try and keep the training going, for me a lot of the solution has been about good posture and an almost sub-concious awareness of what I need to do to protect the injured area. As this is very much behavioural it does take time and I guess you are only begining to go down that line now.

The gut reaction is to try and protect the area by clamping down on it which tends to lock in the problem. I know for example when I have overdone things and am extremly careful for a day or so, I then know the next stage is to work on flexibility exercises, after a day or two the best thing is to go out and run through the discomfort and simply let the very complex systems in my back work out how to release that stress and stiffness in their own natural way. In many ways this takes confidence and is helped by experience. What initialy would have worried me as severe pain, is simply now a 'whatever' cut down a bit, be careful and look forward to getting in some better work next week.

The worst prognosis is the disk gets so bad it is not playing any funcional role in the spine, the solution here is often to remove it and fuse the two joints together. In this scenario its not the damaged joint you should be concerned with but how healthy and flexible the two adjacent ones are. In this respect personally I felt if this was going to have to be done anyway I may as well get the most out of what was damaged in the first place even if it was a bit knackered. I can make this point quite flipantly because in my case I knew for certain to the minute in fact how the injury happened. I also knew that whilst I had done the damage in two areas, the worst being the same joint interface as yourself, this is often the case, I was confident there were no issues elsewhere. If your medical advice indicates that this is a potential problem throughout your spine then I would stand back and say what do I need my health for and completing another couple of Ironmans is pretty insignificant if you look at today's age expectancy rates.

To finish on a positive note some of the worst things for me to do and my partner has accepted this over the years is stand for any time leaning forwards, or engaging in repetitive back hindgeing movements, as such washing up a lot, ironing, cutting the lawn, liffting shopping out of the boot of the car etc are all off bounds for me, brilliant !!!

ratperry

Ha ha! Sneaky! Heeded your advice, had a sweaty 50 min turbo session. Felt great, kept up on hoods. So we'll see. Thanks for all the advice. Good luck with your Ironman path. It's a crazy thing to do but ultimately amazingly gratifying .

lukephysio2

I think you both suffer from the same problem in that the disc has herniated and the radiating pain you are feeling is from the sciatic nerve as the nerve roots go from the lower back. Good exercises I would do is for transverse abs and multifidis. Look up the literature theres loads of it. hope thats helped abit. hope a fast recovery.