 Poster: A snowHead
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I am about to have one and was especially interested in rehab periods, both advice and reality. It s for a prolapsed and fragmented disc in L5S1, after cortisone epidurals have shown little long term benefit.
Thanks all
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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mishmash, I had one in Jul 2011. A fragment of the herniated disc (L4/L5) was impinging my spinal cord, so quite unpleasant.
Recovery from the surgey was pretty quick. Up and shuffling as soon as I came out of the recovery room. Had some nerve damage (not from the surgery, from the herniation), so some muscles in one leg weren't kosher but came right with lots of physio. Started physio straight away in the hospital. Walked every day until I could start swimming once the stitches dissolved (around the 10-day mark). Had physio sessions twice a week for the first few months, then once a week thereafter. Did a lot of additional physio homework every day. Continued to swim, returned to Pilates and cycling at the 6-week mark.
Went skiing four months after the surgery but due to nerve damage, the one leg didn't work properly, so it was difficult. However, skiing helped to strengthen the leg and get the nerves firing correctly. Went skiing again three months after that.
Continued with physio for a further year, taking me up to Dec last year – the gammy leg is now almost 100% and am doing a season in Chamonix as part of the physio (heh).
Pain: prior to the surgery, I had pain at 9 on the pain scale (moaning/shouting/writhing, not pretty). Since the surgery, I sometimes get little twinges, around a 1 or 2 on the pain scale (feels like a pulled muscle) if I spend too many hours at my desk without moving.
I was really motivated to return to skiing, so I put in massive amounts of effort with the physio, which helped the recovery. The important thing is to keep moving, don't lie in bed or on the couch, do what your physiotherapist tells you to do.
Good luck, when's your surgery?
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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Scheduled for 1st thing sat a.m. - I ve been told water resistance training is what I should kick off with. Also we have ( family) skiing booked at week 6 & 7 (ie Easter) which I have low expectations of being ale to participate in, especially as I have big plans for 2014....
I ve been trying to research lumbar belts to use as protection while skiing (as opposed to pure back (ie spine impact ) protectors - any ideas or are they a waste of time anyway.
How long prior to the op were you incapacitated ? Did they try epidural cortisone with you 1st as well?
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My disc basically exploded early May of that year (slight skiing mishap while carry too many kilos of heavy camera equipment in my backpack and going over a small bump). Returned to London three days later and spent from then until the surgery mostly in bed (drugged out on opiates) because I couldn't sit at all, walking was tricky with the gammy leg and was in heaps of pain. Lost most of my muscle mass and strength during that time and all of my cardio fitness.
Surgeon spoke to me about epidural but felt I was too far gone for that (he had to remove the fragment from my spinal cord, no matter what).
I don't believe lumbar belts will help because they don't prevent compression. To be honest, I think they would be detrimental because they would stop you from using your core muscles to support your spine, which is the opposite of what you want.
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Thanks, very helpful. Was the leg weakness numbness, muscle weakness? What kind of Physio stuff? Glute activations, cat stretch etcetc? I realise that I m going to be doing a lot of "core"....
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mishmash,
I've had and epidural (quoted 20% success.) had it quickly within two weeks and was skiing a week later.
The nerve damage from the disc prolapse and inflammation produce the pain, and reduced nerve function ie weakness and numbness.
You can just about ignore the numbness but if weakness progressive then they will probably offer discectomy.
They'll get you up quickly, as ZeroG says.
Avoid a brace.
Get a good spine physio who should assess, where possible, why the disc went. In my case very stiff thoracic spine ( the bit with ribs attached) which overloads the lower spine. occupational hazard for me unfortunately. Skiing really stiffens my thoracic spine aswell.
They should the assess posture and correct that aswell.
When spine flexible and in good position hammer the core stuff to maintain the posture. The core muscles can become very wasted after back pain .
Weakness in leg slow to recover, as said above,. Power can be recovered much quicker than bulk so concentrate of that not appearance of muscle.
Good luck Saturday.
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| Jonathan Bell wrote: |
mishmash,
. In my case very stiff thoracic spine ( the bit with ribs attached) which overloads the lower spine. occupational hazard for me unfortunately.
Good luck Saturday. |
Same for me, been doing lots of core, stretching etc etc but obviously not enough!!!!!
Got my Physio lined up , already to get going, just need to be patient on recovery I guess...
I ve been discovering there seems more of this around than you think!
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mishmash, apologies for late reply but am sure you'll see this later today/tomorrow after your surgery. If you're not already in theatre, I bet you're lying there dreaming about a big bacon and egg breakfast 
The physio I did in hospital was all core work (leg lifts, leg circles, etc.), gentle pelvic tilts. Also took the morphine drip for lots walks around the hospital. Because I had been doing pilates for years, it was pretty easy stuff even though I had lost strength. Also had to do some balance stability stuff. I believe it's all standard post-discectomy physio.
Continued the core physio post-surgery and worked a lot on stretching (I had been holding my back stiff as a board for so many months that I had lost suppleness in the spinal muscles). It took a couple of weeks until I could do a full child's pose stretch. Also did some glute work at that stage.
All of last year, I continued to swim 2,000 metres twice a week, did pilates three times a week and cycled to and from work every day but did a lot more focused glute physio. A small group of deep glute muscles (that attach to the back of the hip, I think) weren't working properly so rotating that leg wasn't always successful – hence the difficulty skiing initially and up until a few weeks ago. I have also had to work on correcting the over-extension of the thoracic spine in my posture. Changing posture is a difficult thing as you have to unlearn a lifetime's habit.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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It's taken me 4 hours to read it I m so zonked on the meds!
Thanks all ![/url]
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mishmash,  wait until you get locked into the catch 22 that is the morphine-toilet cycle. I was told to click the magic button and dose myself with morphine about 10 minutes before needing go to the toilet, which I duly did. But the morphine made me thirsty, so I drank loads of water, which meant an hour later I needed to go to the toilet again, so I'd click that danged button...
Speedy recovery and let us know how it goes.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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Feeling a lot better today. Almost zero sciatic pain (a little but was warned by surgeon he had a play around with the nerve s there would be a short period before it abated) but obviously some wound pain. Some very simple leg/ankle mobilisation exercises as well. Bit nauseous yesterday, lost appetite but big brekkie this am. Short walk around the room with the nurse and Physio. Generally feeling pretty optimistic !
Oh and having a good hit from the morphine on demand machine as well.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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| Zero-G wrote: |
| mishmash, wait until you get locked into the catch 22 that is the morphine-toilet cycle. I was told to click the magic button and dose myself with morphine about 10 minutes before needing go to the toilet, which I duly did. But the morphine made me thirsty, so I drank loads of water, which meant an hour later I needed to go to the toilet again, so I'd click that danged button... |
That reminds me of the W.C. Fields quote: "I always keep a supply of stimulant handy, in case I see a snake; which I also keep handy"  ...that said, Zero-G, your description of the pain sounds nasty, I remember when you first mentioned the whole thing and I thought "wow, and I was worried about an ACL".
mishmash, good luck and quick recovery!
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horizon, pain is relative. Injuries too, really, especially if they threaten to end an activity you're passionate about. I would be just as distraught about an ACL injury.
mishmash, to be honest, I don't get the big deal about morphine. Yes, it made me feel euphoric but it also made me nauseous, twitchy and cry for no reason. By the afternoon of the day after the surgery, I asked for it to be taken away, so I spent my second and final night in hospital without it. Which meant they could discharge me the next day. The hospital was great (Hotel BUPA I called it) but I was really tired of being woken up every hour to have my blood pressure and temperature taken.
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You know it makes sense.
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Morphine now gone, it def leaves you feeling zonked out and emotionally a bit vulnerable . Swimming pool exercises tomorrow apparently. On the other hand the surgeon called to check and told me he had to clear a lot of fragmenting disc at the disc site, which points to really important core work going forward,
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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Zero-G, hubby didn't rate the morphine either, it did absolutely nothing for him at all.
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Poster: A snowHead
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Hells Bells, it definitely helped me with the pain but it was mostly unpleasant.
mishmash, in the pool tomorrow? I wasn't allowed near a pool until the wound had completely healed.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Yes, walking hydrotherapy pool with waterproof dressings under the Physio, still in the (private health insurance) hospital .
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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Hydrotherapy really surprisingly tiring - focus on leg raises through the toes on the underperforming leg, which I discover to my shock I can't do out of the water. Long kip in the pm, lots of visitors...
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Hi,
Hope your doing ok and are on the mend. I had mine done 10 years ago and never looked back. I limped into the surgery after months of misery , pain and neurological problems and left after the surgery three days later with no limp and without the need for pain relief. I was diligent / obsessive with the post op physio and recovered well enough to be back work within 8 weeks. I still get a bit of backache worthy of the odd paracetamol but nothing more than that. Stick with the physio and you will be on the mend in no time and back on your skis next season!
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Thanks, now at home with (almost) zero pain from the sciatic nerve - just some tweaks from where the surgeon had to jiggle it a little. What has surprised me is the calf weakness from the nerve compression and how tiring a lot is. Realise I am going to have be patient but also know I have missed and will miss some really high quality skiing this year. Family trip at easter and I am considering some very gentle hours out - am I mad?
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Probably I think you need to seek advice from the professionals on that one, I think I would have felt a little vulnerable that soon post op. it takes a while to regain you general fitness apart from strengthening core areas. I am sure someone more qualified will be able to give you some good advice but I would say take it slowly and think about the long term.
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i know, really just thinking about an hour max on a green/blue in order to get to lunch - and only if the snow is fresh/soft. I did go into the injury fit and strong! but I am fast realising that I am having to take it all very very slowly....
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mishmash, at the end of Dec 2008 my hubby had a ski accident and fractured c6, had anterior fusion and discectomy. Neck bears much less weight than lumbar spine, although of course it does support the head. He managed some skiing at the end of April, but he was in quite a bit of discomfort (he refuses to say pain). He was fit and strong too before the accident. Someone I know with lumbar surgery wasn't able to ski that winter at all.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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mishmash, it all depends on how quickly you heal, how strong your core is and, I suppose, how much disc material was removed.
You may find the small jolts you get from skiing on slightly bumpy pistes (not moguls, just the standard uneven surface) uncomfortable that soon after surgery. I certainly found that when I went back to cycle commuting to work, despite riding a MTB with suspension. And that was taking it really slowly. I think skiing may jolt more. You can only try 
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Zero-G, I was thinking about the bumps too. I think that was what bothered J most.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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Off to see surgeon on monday for 2 week post op review. Been 99% sciatic pain free, but the remarkable right leg calf weakness is still present and feels basically like a calf strain, pull or similar. Some occasional dull ache within the back, but I think that is pain directly related to the op wound or muscle itself - I ve been meds free for a week anyway!
Any non obvious questions you think I should be asking?
Oh, and I take your points re bumps entirely. I think it is 99% likely I wont ski at all.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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| mishmash wrote: |
| Off to see surgeon on monday for 2 week post op review. Been 99% sciatic pain free, but the remarkable right leg calf weakness is still present and feels basically like a calf strain, pull or similar. |
My disc back in December affected my thigh muscle( quads) . Have been ski touring today and yesterday 1.5 hrs each time and the right thigh is quite sore as it has had to work harder. However I can't see any better way to encourage recovery besides the strengthening I did before I came out. I'm doing my stretches religiously.
The back a the will probably settle but do your " core work"
Questions: try and get some time frames from your surgeon on recovery back to skiing and thendeidhow hard you are going to work at it!
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Update - Seen the Surgeon, Physio and Hydrotherapist all this week. In skiing relevance, surgeon says ask the physio about skiing and the physio says skiing at easter no likely problem (but not what intensity/level). Also first physio to recommend/support the idea of a lumbar support/aid while skiing in the form of one of the Ortovox freeride packs which have a nice fat neoprene velcro support belt which you can cinch on and off. Surgeon also said you can start to prolong sitting (up to 30 mins if no pain), commence driving week 3 ( main issue entry/exit into car for him and prolonged sitting)
I think there are specific reason for this in my case - the disc was so knackered that it cannot herniate or fragment further according to the surgeon so there is no more fluid it can spill onto the sciatic nerve and will now desiccate and my core was strong-ish prior to injury so is returning faster than might be normally anticipated. So the main risks for me right now are excessive flexion (forward/back) and rotation movements that grind a further fragment of disc off before it has dried out to the point that that cant happen.
The Hydrotherapist ("physio in a pool") lady was also pretty impressed having been away for a week with my "form". The land Physio highly recommends I continue the Hydro as much as possible - and I do think that is is the therapy that has helped most and fastest - because you can exercise moderately with the water supporting your bodyweight for longer (30 minute sessions) so soon after a major procedure (is it a major procedure? feels like it ought to be !!). Ironically the nearest Hydro facility to me is probably the Wimbledon Clinic but I am now "locked in" with the therapist who saw me 1st as she is best able to monitor progress etc. Re: issues with the wound and water, I was given good waterproof dressing covers, but the wound has now healed.
Fingers crossed I continue on the mend, it is hard work but i can already feel vast improvements ( but got on my bike for a short spin and that was NOT a good idea...)
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You know it makes sense.
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mishmash, stick with it, you know the hard work you put in now will only aid your recovery. Good on you!
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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Now able to get back on the static bike at the gym - I think I m about 70-80% of where I was. Keen to rebuild some aerobic/cardio/anaerobic fitness ahead of physio giving me a ski/ no ski look on the 18th ....More complex land physio exercises and still doing hydrotherapy. 4 weeks post op tomorrow!
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Poster: A snowHead
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Well I managed to get going after all, and in fact it all came back together quite well - a short video of me filming a mate who came out as well:
http://vimeo.com/63664937
All helped of course by some seriously excellent snow.
I m convinced that the skiing has actually helped the regaining of fine motor control in the right leg - on return the physio says my "calf raise" is now much stronger!
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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| mishmash wrote: |
| I m convinced that the skiing has actually helped the regaining of fine motor control in the right leg |
I would say you're probably right.
Although I had almost 100% walking function, I still struggled with some rotation and some abduction, both of which you do when skiing. Skiing this season seems to have resolved that but the muscles involved with those particular movements do still tire more quickly than in the unaffected leg.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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mishmash, fantastic result! Well done. 
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You need to Login to know who's really who.
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Oh and great stoke, btw, looks yummy
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Indeed, excellent news
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mishmash, yes, well done! I'm assuming you, Zero-G and Jonathan Bell, were all treated in London? Any recommendations? I'm asking on behalf of a 74 year old on a fairly long NHS waiting list for first attempt with the cortisone at Stanmore... wondering whether it's worth suggesting private to move more quickly, particularly if surgery turns out to be the requirement..?
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miranda, yep, I was treated in London. My surgeon was Peter Hamlyn (neurosurgeon) and he was great. Saw him on a Thursday, had surgery the following Tuesday. Gerard Hall was the rheumatologist who referred me to the surgeon – he was excellent too and had a lovely manner.
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Zero-G, that must have been a truly horrendous experience; what a relief that you made a good recovery (but such a long time!)
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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miranda,
I got a colleague called Andy Nicolaou to do my injection. He is a very good pain specialist and does lots of injections.
Jason Bernard and Tim Bishop are in Wimbledon and are both vey good and do not " over operate"
They have NHS practices at St George's as does Andy Nicolaou
( I declare a conflict though as Jason and Tim work at Wimbledon Clinics)
If you want more detail pm me
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Wondering if anyone can give me any advice, just to add to my list of injuries Ive got 2 prolapsed disc at the bottom of my back. Been giving me lots of trouble. Lost feeling in half of left leg and on some days the pain is unbearable.
I've had two lots of cortisone injections. The first did nothing at all. I was later told they weren't put in the right place so 6 weeks later I had a second lot they made a huge difference at the start and six weeks later feel like I'm back to square one with pain and numbness.
Would anyone on here recommend not having surgery and going down another route? I would love a quick fix just to get rid of the pain but I know that's not going to happen. Also what's the recovery like for the operation?
Any advice is very much appreciated. Feeling a bit lost and don't really know what a
My options are/if I have any.
Thanks.
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