Monday, January 30, 2012

Getting back in the game. Recovering from a bad back.


Having been asked many times about writing and sharing more about what has helped with my dicky back, the injuries and rehab involved. Heres my attempt at capturing some of what has been involved since Beijing. 

**Little or Big note is this became a longer post than planned. Much longer. 

Let me start by saying my simple view is aligned with the age old saying, 'Use it or loose it.'

Currently the example I need to share of what's possible by taking a systematic and long term approach to building back to being able to do amazing things after having a back injury involves ergo work. Most in rowing would agree the ergo or rowing machine (stationary) probably put as much strain on the lower back as you can. Obvious compression increase when on spinal discs when we are in a seated position. To add to this the forces require then to push the legs and draw a handle then compounds the compressive forces. Any disc degeneration can become problematic and instability and poor posture will be exposed. 

I am aware various models about how we should row attempt to improve posture and spinal shape, yet often I sense these can make things worse. So the load can be a problem and then the added stress of load with duration becomes a recipe for further issues. Now this is true to an extent but I feel there is a solution.

So now for a few examples.

First one: 1 hr ergo I was able to recently do with out back pain but loads of other pain from muscles and fatigue from the effort. No back and only because I have taken two years to build up to being able to do it. Two year with the approach above.

Second: 6km ergo with the fan setting to 10 which is the heaviest load on The machine which I did last summer 12 months after getting back on the ergo for the first time.

Third: Max effort ergo session for 10 strokes on fan setting 10. This has taken the two years also with the last three months involving less strokes and very short sessions.

The above is about me feeling confident I can handle any load and durations. They have been my tests. The building process to be able to do these after two back surgeries has been long, slow and very deliberate. It has also been combined with many other activities including, land based body weight session, stretching, yoga postures, riding sessions indoors and out, rowing sessions with sculling and sweep, running, walking (lots of walking), surfing, visualizing, lying down (simply doing this in between and after session I believe helps), and quality sleep. 

The many activities have involved feeling what works and working out the difference between health pain and pain the is a bit nasty and not so good. Adding to the above activities I have tried at times to be better with my diet which comes and goes. I am no expert but I do notice the difference with the foods and drinks I consume. Plenty of articles out there about what we put in our bodies and the effects on injuries and rehab.

Each activity and any thing being used to aid the process needs consideration and more importantly it needs to be part of a systematic approach. 

Something's I have that personally work for me and yet I would not say they are for everyone. I often prefer to stretch before I go to sleep. These mainly involve quads, ITB, hip flexor, glute's, hamstrings with shoulders and lat's work. Big thing is range of movement being maintained. Now I don't think in terms of isolation but rather the connectivity and linkages of these areas. 

As for being systematic what I found post surgery each time was by doing very short durations or intervals of activity and using the rest times to stretch, walk or lay down it allowed unloading. The intervals that I used we as short as 30sec but with solid pressure and in the early days I would do 5 x 30sec with 5min in between. Once I was able to do intervals of 30sec at rate 20 with splits close to 1.40 then I started playing with increasing duration plus then started to change fan setting. Once I was able to do 3-5min effort in the low 1.40's I was confident my back was holding up well. This took some 3 months once I started doing the ergo work. Most days I would get on the machine while also doing my bike riding and a couple of rows a week. It was like inching forward day by day until I was again able to do 15-20min efforts with various rates and was feeling less vulnerable with my previous injuries. The process was not linear though it was fairly up and down. With some days the obvious regression in my capacity to deal with the load meant either not doing the session or pulling back in the duration or number of intervals. It required a intuition and common sense mostly and yet some times working out the difference between the types of pain required sticking it out to get a feel for the limitations and often barriers. The days when I pushed through when it felt like healthy pain I was amazed at the break throughs in what was achieved. Only other thing to add here is I would build up to the point where I felt tender in a way that was not helpful. My sleep would suffer and generally I would start to feel demotivated. Once I reached that threshold I would take a couple of days off and then start the rebuild process again. This was a significant shift in mind set. At first I felt guilty but with time and the clear benefits I started to enjoy seeing how far I could go in terms of days before needing and relishing the down time.

'STOPPED DOING WEIGHTS'

What I have stopped is doing weights training. Sure I do body weight activities but for me it's about functional movement and coordination. I guess that why I have found a place in my preparation for the rowing machine. With my back I find it a great test of strength, connection between hands and feet and endurance. 

Walking daily has been essential with night time walk with the dog going from 10 to 30min. Then I make sure I am active during the day with commuting on my bike or walking to where I have to go. I mentioned earlier laying down I feel some much better if between session I can get horizontal. Even 30min unloading my back has become something I crave and notice when I don't do for a few days. 

My view of the human spine and the various elements that enable us to move and do the activities we do is that it needs conditioning, obvious I know but its how to reach high levels of conditioning which can sustain health with stress's, loads and intensities. Building up to high levels takes time, is individual and requires adjustments and adaptations. Things like disc health and degeneration I feel can be turned around but require attention and effort daily. 

Example of how I approached the Ergo build up:

Day 1 started with a simple 3 x 30sec @ 1.50 splits on rate 20. This progressed to 5 x 1min @ 1.46's then 3 x 3min @ 1.45's and so on until 3 x 5min and 5 x 5min @ 1.45's. This was about 4 weeks until I started changing rate and also changing load with various fan settings. After 12 weeks I was able to do 4 x 5min fan setting 10 on 1.42's. After 4 months I had done a few 6 km ergo's and by 8 months had complete a 6 km ergo on fan 10 just over 19min. That day I felt confident my back would be able to deal with the loads and training as long as I maintain my focus, effort and approach.

Rowing as an activity I feel is great for my back and yet at times I have been severely injured. I don't feel the action of rowing has been the cause so much as the lack of awareness for posture, load and managing self. Everyone is different and I guess since being an athlete most of my life has had me involved in very specific program at times where there have been benefits but also disadvantages. Exploration has become a great focus, along with increasing awareness. So I have often been working to find activities that allow me to do what I need to do. Then with this comes awareness. It is never ending and so I am still very much open to seeing what promotes capacity. One thing is for sure if I wish to row then avoiding the movement or avoiding load from what I have sense is not the answer. 

It becomes a game of facing the demands of a sport in a way that I feel will help my back while ensure best performance. Choosing to row long, to hang off the handle and train in a way to fully challenge my body and back is and will continue to be key. Embrace the stress's and loads, but doing it in a way to improve health rather than reduce it.

Having now returned from two back surgeries I love the idea that what I am doing flys in the face of certain people thoughts about it even being possible, or that the risk is to high of even further major damage. I have lived in fear of hurting myself and I don't like it. So this whole process has really been about confronting my fear. Today as I sit here on a journey towards the London games I have not fear. I respect what I can do and appreciate the vulnerabilities. To train with freedom is something I am enjoying and will continue aim for.

4 comments:

matta said...

Drew,
I found this post very helpful - many thanks! It makes sense - though I hadn't thought of it - to walk in the evening and stretch before bed.
Three follow-up questions:

1. For best comparison, I had two laminectomies. What was your surgery?

2. The progression on the erg made perfect sense. Just a couple of clarifications: on the :30 pieces, did you do 5x:30, then rest 5' and then do another set of 5x:30? If so, how much time between the :30 pieces?
Also, it looks like you started about 15 splits (1:50) above your best 6k split. Is this correct?

3. You were very clear: no weights - but instead body weight exercises.
Do you do press-ups (we yanks call them push-ups) or pull-ups?

Thanks for your help. I'm sure the online rowing community would enjoy the info, but if you don't feel like posting, you can just email me at abel.matt@gmail.com.

All the best on your preparations,
Matt

Louis Neilson said...

@Matta i believe you wait until your heart rate has settled to double that of your resting HR. Hope this helped!

http://www.allostasishealth.com.au said...

Thanks for sharing your experience.

J.T.R said...

Drew,

As University rower currently trying to get back from a back injury, your posts are extremely motivating. I was diagnosed with a double bulged disc and a bone spur formation with some disc degeneration at the l5, L4-L5, L5-S1 back in February of last year, the year has been quite a struggle.

I have worked my way up. I did three weeks of novice before everyone in boat quit. Went out to Victoria, BC and rowed under Doug White in the single. I came back for second year and made the JV squad. I loved it so much I went back to Victoria to row with the UVic summer club underneath Howard Campbell. That summer was amazing but I went from a beginners training load to pretty much 3 times a day, 6 days a week with extremely hard workouts, by the end of the summer we are getting close to 18-20k steady states done in the morning.

That moment making Varsity was unbelievable, it took me three years to do a thing some people don't but the pressure was high and injury started taking place, I wasn't saying much until I couldn't do anything because of the amount of pain.

I decided to coach this season, while it was a fun experience, I wanted to be in the boat badly. I was getting back into the winter training groove since I go to Queen's University in Kingston, where the winters are gruelling. I think I have may have reinjured my back and am stuck in the limbo of do I move on to coach for the next little while, or still try to get back into?

Definetly has been messing with my head.

Your blog allows me to see that other rowers have gone through this experience as well, I was wondering if you had any tips, health sources, anything?

My email is jaketrothman@gmail.com

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