runner's surgery blog, L4/5, 2008

[runner]

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I went to a physical therapist in kind of an unorthodox way. The PTs I am going to are not experts in ADRs. I know one of the PTs because she is my neighbor and I went to her before my back started hurting on an unrelated matter.
I copied a PT guide they use in the National Health Services in England and gave it to my PT.
The PTs are however really experienced, having worked in hospitals before venturing out on their own. They have also taken care of a lot of fusion/back patients and know my doctor well.

Because I have run a long time, I have had the fortune or misfortune of encountering different PTs. They are not all created equal. Some don't care too much about you and others do.

I would suggest finding a PT that is highly recommended and your doctor knows. I too have a list of exercises/stretches to do at home. I do a lot of work on a pilates reformer machine to try to get my core muscles strong.

I don't know about a lot of people on here, but my core muscles went to mush after my surgery. I really worked on getting them strong before surgery and then puff, it seems like all the hard work vanished post op.
I know they don't cut the abdominal muscles during the surgery, but whatever they do (separate the rextus muscles?), lays waste to the core muscles and makes it difficult to try to get back to square one.

I mean what the heck. I didn't expect the core muscles to be so shot. So I found myself working harder post op than pre op.

The majority of the exercises I do in PT are for core stabilization.

PT poops me out and I have been doing it three times a week and each session lasts about an hour and a half.

There are good PTs out there but you might have to shop around.

Hope everyone is improving daily.

[runner]

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Hey,

Sat through Batman (The Dark Knight) movie without worrying about my back.
Couldn't do that before surgery.
My back is little sore when I got up. But that was a three-hour sit.
Hooray.

[runner]

August 23, 2008, 24 1/2 weeks, about two weeks short of six months post surgery.

Same old story. It is two steps forward and one back. Friday, was back one step as I did something different in PT and have irritated my back muscles.
So it goes. As the back turns...

Went to a pilates class last week and felt real out of shape. I work out and end up hurting and then push ahead. It is difficult to be consistent, except I faithfully go to PT three times a week. It helps.

Next doc appointment is mid-September. I am storing up my questions for him. I look forward to the day that I have less doctor appointments and am feeling more normal--whatever that is.

[runner]

Hey runner,

I was curious what your PT consists of. I will have my follow-up on Wednesday and understand they will wean me from my corset and then start PT sometime in mid to late September. I just want to make sure I do the right exercises.

I had to shift gears from two long walks (2 miles each) to several smaller walks account it was aggravating the muscles.

Glad to see you are reaching a new level of "normal"!!
__________________
MVA on 20AUG07 at work
L4/L5 Annular Tear
One failed epidural 12OCT08
Discogram 10FEB08
ADR Prodisc L 10JUN08

[runner]

Steel,

I will answer you about the PT exercises soon. I have to go for a walk right now. Keep it up. I think it will be a short walk today since my back is a little sore today.
I found a while back that walks over 2 miles hurt some so I'm probably keeping it under 2 for the most part. Last week had a long walk and it took 35 minutes--which is under three miles for sure (I was walking at a good pace).

Feels good when I get to sweat a bit.

[runner]

Hi Steel,

A synopsis of a typical PT day:
1) Start off with laying down on a heat pad for about 10 minutes.

2) PT works on piriformis and spinal muscles, massaging them, getting them looser, putting his elbow into my tight muscles, etc..

3) Stretches with PT doing them. Hamstring, piriformis.

4)Onto the pilates reformer machine. Three exercises, 1) core exercise with feet at table top position, towel between my calves, 2) Heels together, and my hands in straps together--another core exercise like below, initially used ball between knees, 3) hamstring stretch using the pilates strap and recently added, 4) stretching hip flexors on pilates.

5) Walking across room with band around ankles, sideways, about four times.

6) me hooked up in harness as PT guy resists my movement. Forward, sideways and backwards. Four times each way. Coming back facing the same way as to work each side. (Picture a horse howing a field)

7) Bosso ball, balance on ball and hold stick as therapist resists your movement. Knees bent. aND two exercises using low-weight dumbbells (3 pounds?)

8)Bird dogs--hands and feet on cushion bench. making sure not to raise feet too high.

Also different exercises that have irritated my back and thus were discontinued. Fishes on boso ball. No rotational exercises, no full-bridges. No cobra like movements.
Paying a lot of attention to keeping a pelvic tilt with core exercises.
Finish off with laying on ice pad for 10 minutes.

I also have home exercises that I do.

Knee to Chest stretch, bilateral

Pelvic tilt

Supine hamstring strech

Supine piriformis stretch

Gastroc stretch

Soleus stretch

Bird dogs, Arm/leg extension

Trunk stability, straight leg raise

Pelvic tilt with crunches, lifting shoulders off floor.

Steel, you got to remember that my PTs have not done ADR patients before. They are just really good PTs (there are three of them) and I usually now work with only one.
I gave the PT all the PT info I had and he made up a program. They have worked extensively with fusion patients so they have a lot of experience, but some exercises have been kind of hit and miss. Like I did some arm pulls and that messed with my back so no more arm pulls or lat pulls.
Some exercises just don't work and so we have scrapped them.

It varies on how my back feels and how I am doing. Sessions last usually an hour-and-a-half.

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[runner]

Thank you soooo much for this valuable input with regard to PT. I have my follow up tomorrow and would expect to hit the PT path in the next month. I will use your post as a guide when I am out asking questions of the different PT options made available to me. Thank you.

Paul
__________________
MVA on 20AUG07 at work
L4/L5 Annular Tear
One failed epidural 12OCT08
Discogram 10FEB08
ADR Prodisc L 10JUN08