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  • dkb66
    Member
    Post count: 2

    I had lumbar microdiskectomy on L5 and S1 two weeks ago today. I’m 45 yrs old and have been a weight lifter and a very active preson my entire life. In July I completed the P90X workout and was in the best shape ever or so I thought until I bent over a grabbed a barbell and I felt my back go out in a instant. Now after the surgery I’m doing great but when I ask my doctor about getting back to being in shape he replys I’m gonna have to change my way of life.He’s a 55yr doc and kinda old school. So my question is when can I start back or can I start back with weights.And do you feel that it’s safe to do push ups,pull ups and dips now? Thanks

    Donald Corenman, MD, DC
    Moderator
    Post count: 8408

    I assume this is the first and only herniation at L5-S1. The cause of the herniation is a combination of genetics and activity. If you have read the website under lumbar disc herniation, you will understand that the tear in the disc doesn’t heal. That does not mean that you cannot return to sports including competition but you have to be smarter about it and accept some risks.

    The website has a section “recovery information by surgery” and then “lumbar microdiscectomy”. Much information will be gleaned there.

    Normally after a microdiscectomy, I have patients attend 6 weeks of physical therapy by well-trained therapists. These therapists have a protocol to watch body mechanics for faults and strengthening progress towards full recovery. You should be able to get back to the gym without restrictions. There are some caveats however.

    I harp on prevention of BLT or bend, twist, lift at the same time as this position is the most hazardous for recurrent herniations and new annular tears. Also, weight born squats and weighted lunges create great shear stress on the lower lumbar discs and should be avoided.

    Ask your surgeon if he or she would consider a referral to a well-trained physical therapist for a rehab program.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    dkb66
    Member
    Post count: 2

    Thanks so much for your help I made a list of the things to ask my doctor when I go in tomorrow.Maybe they will have a good rehab program and I can get back on the road to being in shape and good health.

    Vince77
    Member
    Post count: 3

    Dr. Corenman,

    After living with on-and-off again pain for a decade I had a microdiscectomy at L5-S1 in Feb. 2010. I took rehab slowly and strictly adhered to the recovery protocol (something I have rarely done in the past). I did not exercise, other than walk, for about 10 months as I know cartilagenous tissue does not have it’s own blood supply and takes longer to heal. I have also had a herniation (MRI confirmed) at the L4-L5 level for 11.5 years now. It was not operated on as the surgeon did not believe this level was causing my pain.

    I have always been an extremely active person. I love my Crossfit workouts (I go very, very light on the weights) and picked up running post-op. After running sprints four days ago, I have some discomfort close to the surgical site and some minor nerve pain. Outside of an MRI to confirm, and if you are comfortable giving your opinion on something like this, what are the chances I reherniated my L5-S1? Or could it be the L4-L5 level? Or stretching of my scar tissue? What are the possible long term effects if I continue my exercise regimen?

    I have been icing and taking NSAIDs since it starting hurting again. I made an appointment with my surgeon, but not until mid-November.

    I apologize for the barrage of questions and am sincerely grateful for whatever responses you provide. I had my 20s taken away due to my back and am quite fearful of now having my 30s taken away as well.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8408

    Let’s start with why you had a microdisectomy after 10 years of pain. Where was your pain? Was it buttocks and thigh pain or was it lower back pain? The reason I ask is that buttocks, thigh and leg pain is typically caused by nerve root compression and lower back pain is typically caused by problems with the disc itself. What did the surgery do for you? Are you better, is the pain more intense, less intense or changed in quality? What are your current symptoms? Do you have more pain with standing and walking or with sitting?

    No exercise for 10 months after surgery causes deconditioning of the cardiovascular system and muscles. If you were more active prior to the surgery, did you reduce activity secondary to recommendations?

    I suspect that your surgery was at the L5-S1 level as you report a preexisting herniation at the L4-5 level that was not operated on. How big is this herniation, what side is it on and why did your surgeon indicate that it was not causing symptoms?

    Please let me know about your current symptoms and we can look further into the potential causes.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Vince77
    Member
    Post count: 3

    Thank you for the very quick response.

    I had nerve pain from my hip all the way to my toes on the right side only. I never really had any low back pain. My surgery was great. I could exercise again and sit without pain. It did, however, take a while for the nerve to heal since I waited so long to get the surgery.

    My current symptoms are low back pain and mild nerve pain on the right side to the calf, that is better with heat, not ice, NSAIDs, walking, and rest. Both the lumbar pain and nerve pain are gradually getting better 4 days after the initial onset. There really is not anymore pain sitting versus standing. It does seem that no matter what stretch I do I cannot find the stretch that targets my low back pain. I have stretched my glutes, psoas, hamstrings, quads, and, piriformis. I get nerve relief when I stretch these muscles, but not low back pain relief.

    I selected my surgeon based on his experience, medical school, place of residency, and because he told me he operated on professional athletes who went back to their respective sports without problems. The only restrictions he placed on me were no weight bearing squats.

    This is a synopsis of my post-op report:
    PROCEDURE: Right L5-S1 laminotomy, medial facetectomy, and foraminotomy with microdiskectomy.
    FINDINGS: Large right L5-S1 disk herniation and severe lateral recess stenosis. Large L5-S1 paracentral disk herniation eccentric to the right side causing right lateral recess stenosis and compression of the traversing S1 nerve root.

    MRI Report:
    L4-L5 6-7mm; Lateralizes more to the left and combines with facet arthropathy to create bilateral compression of the L5 nerve roots, left more than right. (You of course know much more than I do, but I am guessing since I did not present any pain on my left side he chose not to operate. However, a week after surgery I experienced numbness in both legs which was attributed to “disk settling” and nerve healing.)
    L5-S1 8 mm
    Mild degenerative sclerosis right SI joint.

    Thank you very much for your time.

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