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Ed Hartouni
Trad climber
Livermore, CA
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Topic Author's Original Post - May 29, 2007 - 01:29pm PT
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Roger wanted me to welcome yo to old age, but I have been so busy dealing with my broken body that I forgot... so I thought I would illustrate with an example. And any of you out there that recognize my symptoms and that can recommend some PT, surgery or a quick method of suicide can chime in...
About three summers ago I completed a "home project" in my backyard, taking out concrete and replacing it... which culminated in hand mixing and pouring about a yard of concrete in a day, yep, about 35 80# bags. The patio is great looking with wonderful sandstone tiles...
...of course, my back was "a little stiff" the next day... I went to the gym Tu and Th night, and then went up and did Braille Book the next weekend, still a little stiff, and then the next Tu when I was in the gym pulling a left hand undercling over a roof I heard a good squishy "pop" in my lower back.
I asked to lower, and started stretching, but I just got stiffer and stiffer as the night wore on. I crawled back to home, and proceeded over the next 3 days to become really really hurt. Numbness and pain on my left leg indicated interference with the L4 left side nerve bundle. I couldn't really walk very far, there was one position that I could lay in comfortable, a V position on the couch.
Eventually I went to my HMO and the Doc. looked at me, took a partial history ("oh, you're pretty active, but your foot is not drooping, here do these exercises") and didn't suggest anything other than a set of exercises. I did those...
...since then, I agrevate the injury especially in chimneying, when the left leg presses in on the rock. This was a real problem on Peter Pan with endless 5.7 chimneying. This weekend it was agrevated on Arrowhead Spire in the little 5.6 chimney there.
I suspect a problem with the stablizing muscles of the back, right now I have trouble lifting my left leg, much lower back pain. So it is possible that I did real damage to the muscles there. On the other hand, if it is a nerve problem my body only thinks it is hurt, but I can't do anything anyway... very annoying.
Someone suggested "nerve gliding" exercises, but I couldn't find a good description of the exercises...
...I'll start some mild Yoga once I can lift my leg again, probably sometime this week. But any advice would be most welcome.
Oh, and yo, welcome to old age, may you learn to age with more grace than I...
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dirtbag
climber
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May 29, 2007 - 01:31pm PT
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Father Time could use a BJ from Mother Nature.
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Ed Hartouni
Trad climber
Livermore, CA
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Topic Author's Reply - May 29, 2007 - 01:36pm PT
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I'm on travel, and my own personal Gaia is at home working in the garden dealing with her own broken body issues (she doesn't demand more from me than she does from herself).
On that front, you cannot make the excuse that yardwork is too hard on the bod and then go out and climb all day long in the Valley, it just doesn't cut it...
And yo take note, no one wants sex if they can't even get into bed, sit or stand comfortably. Since one or the other partner is often in that state, it takes a bit of time to coordinate a mutual "in the mood" moment....
...good luck.
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Ouch!
climber
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May 29, 2007 - 01:38pm PT
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dirtbag
climber
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May 29, 2007 - 01:39pm PT
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Brilliant!
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Bruce Morris
Social climber
Belmont, California
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May 29, 2007 - 01:55pm PT
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Sure sounds like the beginning of a herniated disk around L4. You need time or luck or both. Might even heal on its own. Who's to say?
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cintune
climber
Penn's Woods
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May 29, 2007 - 02:23pm PT
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"Time treats everybody like a fool." - Warren Zevon
Or in the immortal words of my grandmother, Ah the hell with it, why not just die already! But she was 88 then. Gotta roll with the punches.
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Fletcher
Trad climber
Varied locales along the time and space continuum
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May 29, 2007 - 03:04pm PT
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Hey Ed,
I feel for you. I've been working with some lower back pain for several years and have slowly made progress to where I'm feelin' "pretty, pretty good" now. Of course, I did something to my should about two months ago. That's almost back now. This must be my introduction to geezerdom. :-)
I found that my yoga practice has been really helpful for my back, in general. I would avoid, though, videos like the one I saw on an infomercial the other day: "Yoga Booty Ballet." WTF???
I also have had a few very good chiropractors. Again, not all chiro's are the same. It's important to find one who's a good fit for you; particularly in understanding the kinds of things you do (like climbing).
I've found that a lot of MDs seem to only know about treating the pain and making it go away. I specifically don't mind the pain so much. I'd rather not have it, but I can handle it in my case. What I really want to do is correct the imbalances that are causing the problem in the first place.
It's taken a lot of patience, but I've had some good results.
Good luck to you and best wishes for for a healthy return.
Fletch
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G_Gnome
Trad climber
Knob Central
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May 29, 2007 - 03:12pm PT
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Having crushed the nerve bundles at L4/L5 catching a falling climber, I am hear to tell you to get to the chiropractor. Find one that is sports oriented! Get him/her to do the electro stim on your back BEFORE cracking you so that those sore muscles are all lose and too tired to fight. Check yourself out in a mirror while standing naked. Is one hip higher than the other? If so, then the chiro can fix you but the hip will rotate again. Stretch a LOT! I would start a Pilate's regime but only with a certified instructor using a reformer. And tell the instructor about your problem.
You can get better. It takes constant vigilance and there will be relapses, but you can be pain free. It's all up to you.
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Crimpergirl
Social climber
Hell on earth wondering what I did to deserve it
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May 29, 2007 - 03:19pm PT
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I recommend also the chiropractor who is a sports-oriented one. Generally you can find one that treats extreme athletes and deals with soft tissue as well.
Do not be alarmed if you begin to fall in love with your chiropractor either. That is perfectly normal given what they'll do for you.
Finally, I have to disagree - yard work is brutal and can cause serious injuries. I can climb all day and be fine, but a day of yard work destroys me. Shopping is equally brutal. Stick with the safe and gentle world of climbing.
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jstan
climber
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May 29, 2007 - 03:24pm PT
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Ed:
After three too many tries on a boulder problem around 1980 I was put in traction at the hospital when I got home. Between 1980 and about 1997 I had constant lower back pain but no obvious neurological symptoms. Let me take that back. I have always had neurological pathology, above the neck. I had always blamed my problem on Australopithecus’s laziness for not building a good walking mechanism. But it turns out we know that early homo sapiens was a walker because of his very robust large toes. Toes I had never used. Clearly I had never actually learned how to walk using the calves and glutes. After perhaps three months of towing tree branches through soft beach sand the pain was gone. When sleep does not come at night I do isometrics on the abs, gluteus maximus and medius. Just doing one set allows me to feel the improvement. While building the new mechanisms I found hiking was less energy efficient than my old mode of mobility by perhaps 20% to30%, at least as measured by respiration. Once they had been built the disadvantage was approximately reversed. A year or so ago I was tested while tunneling through sandstone about six feet down in the building of an area drain for our patio. It involved repetitive large forces in very cramped positions. No problem. In my case and perhaps for many others who spend most of their time sitting, the lower back is not getting needed support from leg muscles and the girdle of muscle around the waist. I understand that has been well demonstrated among the general populace.
I did not have neurological symptoms so apparently there was no problematic impingement upon nerves as they leave the vertebrae. My daughter once, quite proudly, told her daycare teacher, “my dad is a fake doctor.” Accordingly I will refrain from making any suggestions. My guess is you have a really excellent chance to fix it.
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John Vawter
Social climber
San Diego
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May 29, 2007 - 03:36pm PT
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After three years, you are well into the chronic phase. So I don't have to warn you about making sure that the doc looked at the x-rays and cleared you for exercise. In my experience, that is all an M.D. is good for, unless it's an osteopath or a sports medicine doc. Even then, they usually refer you to the experts for the exercises: physical therapists. They are the ones who deal day in and day out with rehabbing an injury that doesn't lend itself to a quick fix.
I had chronic low back pain from about age 26 until about two years ago. My problem was caused by a disk that would swell up. I had an injury that sounded a little like yours (I felt something give in my low back while lifting), but I didn't have any pain radiating into a leg, and no numbness. But I could not bend at the waist without pain, among other things. When I reinjured it, I would get painfully stiff.
For acute pain relief I went to a chiropractor, or the accupuncturist, depending on symptoms. I went the longest without pain when I went to yoga twice a week. But regular exercise of any kind helped.
My chiropractor told me that within a few years after age 50 ('04), my problem would go away. Apparently, as tissues age they become less able to absorb fluid and swell. I haven't had a low back spasm for almost two years.
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John Moosie
climber
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May 29, 2007 - 05:23pm PT
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Go back to the doctor. Don't accept pain as a consequence of life. You don't have to hurt. Your doctor isn't a mind reader and won't know that what he told you didn't work. Doctors today usually start with the simplest solution. You are responsible for letting him/her know if it worked.. If it didn't work, then go back and tell them.
Make them look harder. Most of the time they wont unless you push them. This is a result of the HMO philosophy. After you get a more thorough diagnosis, then you can better figure out what course of treatments are available. Its amazing what a good physical therapist can do for you and its incredible how aweful some of them can be. One can be a 5.14 therapist and another can barely walk on flat ground. The problem is in figuring out who is who.
I am just guessing, but you probably have the resources to push this. Accupuncture, physical therapy, cranial sacral treatments and chiro can do wonders, but it helps to have a better idea of what is going on and it is super important to find someone good. So I highly recommend that you look for someone who is good at these kinds of problems. They can make all the difference in the world.
My experience: 20 years of back pain and seeing multiple docs and then finding one good physical therapist who did more for me in 8 weeks then I got from any other doc. Too bad he moved to a childrens hospital. The guy is a genius. The pain isn't gone permanently, but most of that is my fault for not doing my exercises and stretches.
John
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Urizen
Ice climber
Berkeley, CA
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May 29, 2007 - 05:37pm PT
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1) Don't let any surgeon cut on you. Not now, not ever. Listen politely to anyone who recommends surgery, then proceed to:
2) Contact Western States College of Chiropractic in Portland and ask for a graduate practicing in your area, such as Michael Gabrielson in Pleasanton. All chiropractors are not created equal!
3) Start swimming regularly, and don't stop. Even if therapeutic stimulation/manipulation can relieve your symptoms, you will require constant maintenance to remain pain-free. Lumbar spine mobility is crucial, if your symptoms derive from a disc herniation or bulge impinging upon nerves. Get a "tune-up" from your chiropractor a couple of times a year even after the present crisis is past, and get into a lap pool at least every week. Create a place at home where you can stretch every day, as soon as your level of pain permits.
4) Your quality of life and sport in the future is very much up not just to your physician but to you. What you're suffering seems like enfeeblement now, but if your case and your cure turn out anything like mine--and it certainly appears to be so far--you may within a few months be able to recognize that your body is instead offering you an opportunity to change your training regimen and expand your range of activities. Good luck!
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the Fet
Knackered climber
A bivy sack in the secret campground
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May 29, 2007 - 05:45pm PT
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Get multiple opinions from different types of docs before you do much of anything. You may need chiro, or PT, or *shudder* surgery. Be prepared for conflicting advice, and make the decision yourself based on all the evidence.
If you visit a chiro, they should be thorough and do x-rays before any adjustments. If it is a bulging disc, an adjustment could make it worse.
Crunches will help long term. When your abs are strong they stabilize the back too. But I'd find out what the pain is from before doing anything but gentle stretching, heat, and/or ice.
I was in constant pain for years (like a hot knife stuck in my back) before I found a chiro who could correctly adjust my back. Basically an injury caused scar tissue, which freezes the vertabrae in a position that's out of place. The out of place spine pinches nerves and my back knots up like a monkey fist. After a year or so, I figured out how to do the adjustment on my own.
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Roger Breedlove
climber
Cleveland Heights, Ohio
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May 29, 2007 - 06:04pm PT
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I have a funny story to tell about my aggressive management of my aches and pains. Last year I trimmed my hedges with a faulty hand trimmers that did not have a cushion to temper the stop when I whacked the blades closed. I created a nagging and sometimes very painful forearm nerve impingement. After a few months of pain, I visited my sports medicine doctor. She prescribed a specific stretching method that had good success. (For the record, I was told to put my elbow on a table in front of me, turn my palm toward my shoulder, and gently push my hand toward my forearm.) I did this exercise for another few months with no change in my condition, which was worsening.
I returned to my doctor and she sent me to a hand specialist, whom I intended to ask for a surgical relief, since this is the same path I have followed for all of my other spectacular repairs in the past. The specialist examined me and agreed that I had the sort of impingement that my sports medicine doctor had concluded.
He then asked how long I had done the exercise. As he asked, he instinctively straighten his arm along his side and curled his hand up while rotating his straight arm at the shoulder. I notice that the back of his hand was easily 90 degrees to his arm.
I put my elbow on the table, bent my wrist to the maximum of about 60 degrees and gently pulled it down. I commented that he was much more flexible than I was. He commented that I was not doing the exercises correctly.
"keep your arm straight when you stretch you wrist. It doesn't work the way you are doing it," he said.
That evening, I put the back of my wrist on a stool and with a straight arm pushed gently. It yielded. Within a week I could bend my wrist to 90 degrees of my arm and the pain was gone. Eight months of enduring limiting pain because to one part of the instructions on stretching was missing. Jeeze.
I also got new hedge trimmers.
Sorry about your pains Ed.
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G_Gnome
Trad climber
Knob Central
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May 29, 2007 - 06:48pm PT
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The true lack of knowledge and/or caring by many doctors is the problem that you need to overcome if you pursue this along that channel. As an example, sometime in my 30s I took a surfboard to the head on a BIG day. I had a horrible concussion for a few days but then life went on. Well, it turns out that the blow turned off the electrical connections to my pituitary gland. As my body slowly fell apart and I got old while I was only in my 40s I went from one doctor to the next. About the 6th one took one look at me and correctly diagnosed my problem. That means I had to go thru 5 quacks to find one decent doctor! The good one was not educated in an American Medical institution, by the way.
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J. Werlin
climber
Cedaredge
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May 29, 2007 - 09:26pm PT
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Hey Ed--this is what I've been doing for my chronic back pain (which is now gone, except when I go too long between visits): I see a lady trained in cranial-sacral, massage and structural integration (generic for rolfing). The theory is that some muscles or muscle groups are not working correctly pulling bones or vertebra out of whack. I like this approach as it is strong on the pound of prevention end--asking WHY is this happening.
Good luck mate, pain is no fun.
-JW
PS: In my experience OT's or PT's are much better body mechanics than MD's, FYI,IMO OK?
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Watusi
Social climber
Joshua Tree, CA
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May 29, 2007 - 09:40pm PT
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Ed Hartouni
Trad climber
Livermore, CA
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Topic Author's Reply - May 29, 2007 - 09:42pm PT
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thanks all for the advice... I'll go back and see my Doc, though I really don't communicate well with him, I'm sure he's getting gold stars for keeping the costs down.
I am trying to do this without surgery but the doc didn't take any x-rays, and since I'm a tough bugger he probably thought it was just some little back pain... pain is difficult to be objective about, and I am willing to tolerate a lot.
When I did get PT it was great... so at least I think I know one PT at my HMO who would be great.
I've never done Chiro before, I know people swear by it... not sure it's alignment but it sure could be.
Right now it's the "old drill" to get back to shape. I'm sure I'll be fine coming up soon. Just not a good thing for the future, my guess. Gary's advice is Yoga... so I'll do that soon.
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