CrossFit Discussion Board  

Go Back   CrossFit Discussion Board > In Sickness and In Health > Injuries
CrossFit Home Forum Site Rules CrossFit FAQ Search Today's Posts Mark Forums Read

Injuries Chronic & Acute

Reply
 
Thread Tools
Old 02-14-2008, 09:03 AM   #11
Dan Hollingsworth
Affiliate Dan Hollingsworth is offline
 
Dan Hollingsworth's Avatar
 
Profile:
Join Date: Oct 2007
Location: Poulsbo  WA
Posts: 129
Re: Disk injury

The MRI will not likely help the PT with their treatment. A good PT should be able to get all the info they need from the history and physical examination. Often times an MRI can just make the situation appear more complex than it is. It's a great tool, but often over utilized.

Epidural steroid injections can be helpful, but more often than not the relief is temporary. Only on very rare occasions have I had patients who reported long-term relief from any steroid injections.

I realize that Joe is very uncomfortable and frustrated because he can't do what he wants, but keep in mind this injury is only 2 1/2 weeks old. He needs to be patient, let the body heal and not rush it. Unfortunately there is no magic pill or miracle treatment that will get him back out there doing broadjump push-ups or maxing out on deadlifts in a day. If you look at the statistics, the likelihood that he will have a good recovery is high, but it will take some time.
  Reply With Quote
Old 02-14-2008, 03:48 PM   #12
Elizabeth Terris
Member Elizabeth Terris is offline
 
Elizabeth Terris's Avatar
 
Profile:
Join Date: Sep 2007
Location: San Diego  CA
Posts: 1,189
Re: Disk injury

Joe is in so much pain he looks ill. I don't think he would make it from Downtown San Diego to La Jolla for PT. His driving/sitting tolearance is less than 10 minutes. He keeps doing his stretches and is trying to keep his upper body strong with pull-ups and ring dips. He tries not to sacral sit, but sacral sitting is the only way he can sit.

Ususally I don't recommend steroid injections either since I agree with you, the effects are temporary. I just wonder if the temporary relief will allow him to do more core exercises and stabilize the spine.
  Reply With Quote
Old 02-14-2008, 04:41 PM   #13
Tom Nguyen
Member Tom Nguyen is offline
 
Profile:
Join Date: Aug 2007
Location: Sacramento  CA
Posts: 228
Re: Disk injury

Quote:
Originally Posted by Corey Duvall View Post
MRI is only needed if Joe has a problem holding his bowel/bladder. This would signify impingement on the cord and is a surgical consult. Other than that, and MRI would do nothing to change the protocol.
Great advice - I wish some of the primary care docs at my hospital followed that. No MRI unless conservative treatment has failed or patient is surgical candidate.

One thing though - an L4-5 disc would not cause cord impingement. there is no "cord" at L4-5. The conus terminates around L1. There could easily be nerve root impingement in the lateral recess or neural foramen which causes bowel/bladder incontinence.
  Reply With Quote
Old 02-15-2008, 02:17 PM   #14
Kirez Reynolds
Affiliate Kirez Reynolds is offline
 
Kirez Reynolds's Avatar
 
Profile:
Join Date: Nov 2007
Location: Litchfield Park  AZ
Posts: 936
Re: Disk injury

I've been through this injury, and I tried to tough my way through it -- I wasn't diagnosed through weeks of ranger training, then months of competitive springboard diving. It ended my running career when I was 19 and I couldn't run for 8 years. (I did gymnastics after 2+ years, but couldn't *run* more than a 1/2 mile without exacerbating sciatic pain.)

I tried 4 epidural/caudal blocks in the first year-to-fifteen-months, which may have treated pain for me but I didn't successfully rehabilitate during that time. I had the same situation where I couldn't sit for more than 5-10 minutes; the epidural block may have alleviated that degree of suffering for me.

I don't have a helpful answer, just some things I learned to do which became lifestyles for me, to manage the pain. Riding in a car was always the single worst exacerbator.

* locking my lower abs to rock my pelvis forward decreased impingement at lumbar curve
* sitting on a chair (sorry don't know the name) with my weight on shin pads, seat was sloped, to minimize sacral sitting
* working at a standing desk
* sleeping with a lumbar curve brace -- I attached it with velcro so it stayed on
* using a pillow between my knees when I rolled to my side, under my knees while on my back (perhaps the most valuable technique I can recommend, it was necessary for me for about 6 years)

I'm sorry I don't have better advice or something to give optimisim or confidence. I tried massage, chiropractors, hanging, steroid blocks, ice, swimming, rollerblading, bicycling (I could bicycle lightly, at least).

It sounds like he's hurt bad enough not to make the stupid initial mistakes I made which worsened the condition and possibly kept me injured for years longer than I should have been. On the optimistic side, I competed in gymnastics and equestrian polo, and trained in muay thai, within 18 months of my initial injury.
  Reply With Quote
Old 02-15-2008, 04:16 PM   #15
Charles Patillo
Member Charles Patillo is offline
 
Profile:
Join Date: Aug 2007
Location: Blue Springs  Missouri
Posts: 2
Re: Disk injury

If your friend truly has a ruptured disk he will most likely need surgery to properly repair it. The human body does not repair a ruptured disk. Your nervous system finds a way to deal with the pain. In 2001 I ruptured my L-5 disk lifting railroad ties for some landscape work (You can get this injury lifting what you think is an easy weight to handle. After the event I realized I was lifting too much with my back and not my legs.)
The insurance companies will do everything they can (Physical therapy, shots, etc.) to avoid having to pay for surgery and they know that if they stall you for a month or so the pain will start to subside and you'll think you're getting better.
Fortunately my Doctor was insistant I get the surgery and my insurance company relented. My surgery was scheduled for about one month after the injury and yes my back did feel better but I could not walk without a limp.
The results, after the surgery and a few months of healing my back was in better shape than it had been in years.
Your friend may also want to consider not lifting real heavy weights from the floor anymore (I'll probably get flamed for suggesting this.), it won't be the end of the world. I still do deadlifts but I do them from a little below bench level. As you get older and accumulate injuries you make adjustments. Just my two cents.
  Reply With Quote
Old 02-15-2008, 06:02 PM   #16
Dan Hollingsworth
Affiliate Dan Hollingsworth is offline
 
Dan Hollingsworth's Avatar
 
Profile:
Join Date: Oct 2007
Location: Poulsbo  WA
Posts: 129
Re: Disk injury

Charles,

Since we don't know the specifics of your injury nor do we really know the specifics of Joe's injury it is impossible to compare the two situations. To imply that the only reason people don't get surgery right away with herniated disks is because the insurance companies don't want to pay for them is just plain wrong. You have to look at the clinical research that has been done. The evidence overwhelmingly shows that in a large majority of cases surgery is unwarranted. When you compare those who had surgery to those who opted for conservative treatment, the long term results show no significant difference between groups. Bottom line, why expose yourself to all the risks of surgery if you're going to be no better off than those who went with conservative treatment.

Now, having said all that, are there cases where surgery is the obvious choice? Yes, absolutely! In severe cases where there are bowel or bladder issues, profound limb weakness and other red-flag signs, then surgery is absolutely warranted.

Glad to hear that your situation turned out well with surgery, but not all cases are alike. Even if the symptoms sound similar, each case has to be treated on an individual basis.
  Reply With Quote
Old 02-15-2008, 06:15 PM   #17
Elizabeth Terris
Member Elizabeth Terris is offline
 
Elizabeth Terris's Avatar
 
Profile:
Join Date: Sep 2007
Location: San Diego  CA
Posts: 1,189
Re: Disk injury

Joe was evaluated at United Rehab today. He will be attending PT 2x per week for the next month and doing his daily stretching routine. It was advised that he not lift anything heavy overhead (no push press, no jerks etc.) no jumping, and no twisting. He will continue to do the McKenzie stretch. With any luck he will be back to fighting fires in April.
  Reply With Quote
Old 02-16-2008, 10:24 AM   #18
Josh Briggs
Member Josh Briggs is offline
 
Josh Briggs's Avatar
 
Profile:
Join Date: Apr 2005
Location: Canmore  AB
Posts: 56
Re: Disk injury

http://board.crossfit.com/showthread...sh+briggs+disk
  Reply With Quote
Old 02-20-2008, 09:52 AM   #19
Scott Parker
Member Scott Parker is offline
 
Scott Parker's Avatar
 
Profile:
Join Date: Dec 2002
Location: Denver  CO
Posts: 489
Re: Disk injury

joe-

it was nice talking to you yesterday and hope your back is feeling better. believe me, i feel your pain. if you or anyone else is interested, i saw a rehab doc yesterday and updated my post on my back issues. learned some interesting stuff.

get well soon! spoke to raj last night and may come back to CFSD for a few months in the sunmmer!

Last edited by Scott Parker; 02-20-2008 at 09:53 AM.. Reason: spelling
  Reply With Quote
Old 03-02-2008, 09:07 PM   #20
Elizabeth Terris
Member Elizabeth Terris is offline
 
Elizabeth Terris's Avatar
 
Profile:
Join Date: Sep 2007
Location: San Diego  CA
Posts: 1,189
Re: Disk injury

Hey Scott-

Joe's fed up with being injured so he's going to start training at CSFD after a 5 week break.

Hope to see you this summer!

ET
  Reply With Quote
Reply


Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off

Forum Jump

Similar Threads
Thread Thread Starter Forum Replies Last Post
Disk Protrusion and Crossfit Corey Duvall Health and Medical Issues 2 11-18-2007 07:03 AM
A Somewhat specific Herniated Disk Question Josh Briggs Injuries 3 02-02-2007 12:40 PM
Boxing with 2 cervical disk herniations Elliot Royce Injuries 2 11-02-2006 07:22 AM
Morning workouts and herniated disk Daniel Doiron Injuries 10 03-06-2006 08:42 AM
Ruptured L5/S1 disk Beth Moscov Injuries 10 01-23-2006 09:25 AM


All times are GMT -7. The time now is 06:27 AM.


CrossFit is a registered trademark of CrossFit Inc.