It has been an interesting experience as a Physio with 25 years’ experience having recently injured my lower back worse than ever before. I have been treating people with these injuries for many years but gained some interesting new insights from the other side of the face hole.
How did I hurt myself?
I hurt my lower back lifting something awkward and heavy. The Christmas tree (normally consigned to the shed at this time of year) that required shifting to allow some renovations to said shed. I normally use a sack truck to move the Christmas tree as it is about 30 to 35 kg. On this occasion I had to lift it over a fence and changed my mind how I would lower it halfway through the lift. Awkward! I felt the strain but felt only minor discomfort and had lots more to lift. I continued to lift other tubs and boxes until my muscles tightened up so much (to protect me) and I had to lie down. The unexpected load that resulted from my ‘change of mind’ meant that my muscles could not take the strain and it was transferred to my ligaments and Spine. Damn!!
So … I finally did the right thing. I laid down on the floor for the rest of the afternoon and did not help my wife with the dishes or other chores. The next day I awoke very stiff and unable to put my socks on. Looking at myself in the mirror I noticed that my spine had a definite lean to it.
We call this a ‘list,’ … like a ship that lists before sinking. It is a protective mechanism that the body uses to take pressure off discs. It is always counter -productive.
I knew what I had done and promptly booked myself in with one of the other Physio’s in our team. Daniel assessed me well and treated me exactly as I had taught him in a “training session” some five months earlier. He used traction techniques to reduce pressure on the disc. He used gliding techniques to ease pressure on the nerves. He used firm massage and dry needling to relieve the muscle spasms. I felt immediately better, but remained a little listed.
I returned home and carried on with tasks that I had been unable to complete the day before. I avoided heavy lifting and instead pruned trees avoiding bending over. The reaching and stretching however still proved too much for my irritated disc and the muscle spasm all returned as did the list.
Back on to the floor I went! More anti-inflammatories, more rest, and then over the following days more physio, more heat packs and stretching exercises. Walking is usually good therapy for people with a stiff back. It is however not recommended for people with a list. I found out why this is by trying to ‘walk it out’ while still a bit listed. And I ended up very stiff, very tight and back on the floor again!! My lesson here, don’t push activity or exercise until it all listing is corrected.
With more physio Daniel straightened me out again and three days later I returned to work. Having not been at work for well over a week I was very heavily booked and worked from 8 AM until 6 PM as usual. As a lot of my work involves bending forward, my back was pretty stiff the next day. Luckily, I had a rest day. Unluckily (or perhaps stupidly,) I chose to spend the day sitting and driving for a total of eight hours. Groan. Most people realize that sitting with an irritated disc is not recommended and I learned a lesson why this is so first hand. Climbing out of the car at 10 PM having just driven back from Adelaide for the second time on the day the ol’ list returned. The bad news, I had a full list of clients the next day many of whom I had already rescheduled once and really needed to be seen. So what did I do? I took some medication (“soldiered on “) and modified my work as best I could. I got Dan to straighten me out as best he could mid-afternoon, continued working until 6 pm. By the time I staggered home at the end of the day I was worse than ever!! The pain had now spread into my leg and I realised “oh this is what sciatica feels like”.
It seems I am either a slow learner, a terrible optimist, or a bit of a dill. Most likely a combination of all three. This time I was determined to correct the list before attempting anything. I spent all weekend lying down using the exercises and strategies I generally recommend to my clients. I did not lift, I did not sit, I even ate all my meals lying down. I took anti-inflammatory medication and paracetamol every four hours and nearly died of boredom, looking out the window at all the jobs I needed to be doing. With more physio on Monday and a trip to the doctor to arrange a prescription for some stronger medication, I slept much better and woke up pretty much straight after the third day of rest! The pressure on the disc bulge in my back had resolved but the muscles that had been holding me in that weird, crooked way did not want to let go. Marc our Senior Physio, released the pressure on the nerves and the tight muscles and I was straight!!! Hooray, straight for the first time in a fortnight. Now that I am straight I have started my Pilates, exercises to activate the core muscles and glutes to keep myself straight. I plan to walk slowly and correctly and to continue my Pilates to maintain the restored alignment and balance. I am grateful for the assistance I have received from our Physio team, the doctor and my family, especially my kids who have been putting my shoes and socks on for me over the past week.
To summarize the lessons learned for me and perhaps for others you may know who have had disc problems resulting in a listed / crooked spine:
1. Don’t continue lifting after hurting yourself.
2 Don’t try and walk out the list, or do physical jobs while listed … It will only make things worse.
3. Listen to your physio about the best positions / exercises to use
4. Lie down if listed and take medication until you can stand straight (be patient…this may take 2 to 3 days)
5. Prioritize your own health. We only get one body.