Managing a back injury

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 mikespooner 13:51 Tue

TLDR - anybody else experience returning to climbing after a slipped disc and have any advice on keeping it under control?

I just recently passed 2 years since injuring my back pretty badly (a twist while coming off a bouldering wall leading to a prolapsed disc) and now with light at the end of the covid tunnel, I'm starting to get hopeful of getting back into old habits and climbing as regularly as I used to. 

Without going through every detail, I tweaked my back at a wall and over several months it degenerated to barely being able to walk without intense pain. I was diagnosed with a prolapsed L5/S1 disc and narrowly avoided having microdiscectomy surgery just over a year ago to relieve the pressure on my nerves, things having loosened up slightly a week or two before it was scheduled (still unsure whether that will turn out to be the best decision in the long run!).

I spent most of lockdown doing physio and strength work and got to the point where it no longer bothers me day to day. Last autumn, I got out climbing outdoors a few times for the first time in a very long time and it managed to survive a week-long bike trip, so was feeling really positive about how it was progressing.

However, just before Xmas I visited the wall a couple of times within the space of a week, the most frequent climbing I'd done up to that point, and gave myself a bit of a scare. I think a combination of pushing myself a bit far, overdoing the body tension moves and falling onto the mats a bit hard a couple of times set my back off again. I was back to the constant background pain and stiffness meaning I struggled to do much more than hobble around, which thankfully subsided within a 3/4 weeks.

It was a frustrating reminder that despite feeling stronger and fitter than I've been in a long while, that there's still a weakness there. I do want to get back to the point where I can climb 3/4 times a week and operate at the grades I used to. I don't want to overdo it and land back at square one, nor do I want to operate well within myself for the rest of my climbing career! I guess I'm also a bit paranoid about it ever being robust enough that I can trust it to last multiple days in the Alps or even just a hard multipitch day.

I was wondering whether anyone on this forum had experienced something similar and had managed to get back to something resembling normal? As things get back to normal I want to restart going to a physio regularly etc to try and keep things in good nick. But I was wondering if others had had to adapt their climbing in any way or had any advice for managing a similar injury? Thanks in advance!

 gallam1 14:01 Tue
In reply to mikespooner:

Here are a few suggestions that worked for me:

Take up karate, yoga or something similar.  Swimming really helps too.

Buy a sit-up machine of some sort and use it a lot to get your core really strong.

Completely give up bouldering because the impact will stop the other things fixing the problem.  This may be permanent, I'm sorry to say.  Avoid high impact sports like running and squash.  Compensate by taking up sports climbing and top-roping short physically intense routes.

It's a real nuisance and I'm very sorry that this happened to you.  It may at its root be an injury to your stomach/core muscles (hernia-type injury which is relatively easily fixed). 

Best of luck!

Post edited at 14:03
 nniff 14:14 Tue
In reply to mikespooner:

No more jumping off, and especially no more dynos. If you have to jump, then as controlled as possible - I'm afraid I go for the full para-roll every time these days if it's more than a few feet. 

Other than that, take it easy as you build up and stop if you think it might go wrong.  It's really, really not worth it for a few feet of plastic and a tick of a route that won't be there next week anyway.

Outside - apply common sense and use poles for walking with a rucksack

Personally, road cycling has been hugely beneficial to my back (and general fitness)

 Marek 14:17 Tue
In reply to mikespooner:

I had something similar following a car crash about 5 years ago, although in my case it was at the other end - C5 - and probably associated (via degeneracy) to another crash about 30 years ago. Like you, severe pain, almost had the vertebrae fused round a CF disc. Surgeon suggested at the last minute to give it just a few more weeks and some exercise to strengthen the neck muscles. Now I'm pretty much back to normal - in fact perhaps even better since I have more neck mobility than for decades.

BUT... I'm now paranoid about any shocks to the spine and will not jump down from anywhere near the top of the bouldering wall. It's now strictly climb-up-and-climb-down. Sadly my local wall did seem to have a tendency to  set problems with a dyno as the last move which was frustrating!

I've never had any issues about body tension or general movement, just an aversion to shock. I still do the neck strengthening & mobility exercises a couple of time a week. You have to remember the damage is there even when there's no pain and modify your activities accordingly. In my case bouldering was just a way of maintaining strength/technique for roped climbing rather than an end in itself, so the no-jumping/falling rule wasn't really a problem. If you are more of a committed boulderer, then it may be more difficult.

Good luck.

Oh, and I'd second what nniff said above about cycling. Amazingly (in my case) I could ride a road bike comfortably long before I could walk far, never mind run. How that worked, I don't know, but I was really thankful for it.

Post edited at 14:24
 mikespooner 14:52 Tue
In reply to Marek and nniff and gallam1:

Thanks all, not what I wanted to hear about bouldering but I don't think it's a coincidence that I hurt myself after trying to get back on the bouldering wall. I hadn't been jumping down from the top, but it was the first time I'd pushed myself hard enough to fall off properly. Strangely, I've found that I've managed to get back into running OK and don't suffer from the impact from that, perhaps that's what made me slightly overconfident getting back to the wall!

It's a shame as although I primarily climb with a rope outdoors, bouldering was always my favourite activity indoors because of the social aspect. I think I'm just going to have to be sensible and leave it a good while, bouldering's never been the end in itself for me. I had been telling friends at the start of 2020 I'd be keeping away from bouldering for the foreseeable, guess I'll just have to keep that up a bit longer.

It seems like shock is the big thing to avoid. I did always have a strong core before hurting myself, and I wonder whether issues I felt with tension was actually just not being as well trained as before! (gallam1 - I'm slowly working my way round most of the muscle groups to try and identify if there is some kind of underlying cause like that, hoping that's something some longer-term work with a physio will help with)

Marek - I had the same with cycling. The first thing I was able to do was get back on the bike for the commute, even though when I got there I was still hobbling around the office. I think it went a long way to helping me start to loosen it up.

Thanks all for the advice!

 CatrinJ 14:53 Tue
In reply to mikespooner:

Hi

A few years ago I had a slipped disk (L4) and eventually had to have a micro discectomy which fortunately sorted the main pain. I was stiff for a while afterwards but did a lot of pilates to help my recovery and focus on getting my core strength back (this is something that definitely goes when you have back issues). This was good for preventing the same issue returning. Now I’m lucky to have made a full recovery.
 

My advice would be to work on your core strength to support your back. Swimming is also really good for me but not breast stroke (unless I’ve warmed up a lot first).

In terms of climbing, I’m aware of the jmpact of falling and try to downclimb more when bouldering to avoid the impact. 

prevention is better than cure... keep stretching and warm up before exercising. And now maybe because I really don’t want a return to the slipped disc days If I have any niggle in my back I try to address it straight away and avoid holding myself stiff to stop the pain- warm pads, back massage etc

All the best

 Iamgregp 15:02 Tue
In reply to mikespooner:

My partner had a slipped disc a few years back.  Again hers was the other end (C4/5 I think) and it was horrifically painful and long lasting whilst she was suffering from it.

However, although she says she can still "feel it" and sometimes will back off things if it doesn't feel quite right, she's returned to climbing, cycling, yoga, boxing (just training) and all of the other active stuff she did prior to the injury and has been able to get back to and go beyond the level she was at before.  

Also, it's worth bearing in mind that the road to recovery is never linear.  There are always going to be little setback and bumps in the road along the way.  It's frustrating when they happen though, hugely so. 

Try not to rush things too, I know the temptation is to want to get back into the swing of things and go climbing 3 times a week, but be kind to yourself and your body.  Ease yourself back in and don't ask too much too soon.  Again, it's hugely frustrating.

I'm no expert but like others have said, I suggest laying off the bouldering and opting for something with less likelihood of shocks to the spine, at least for a while whilst you're still recovering.

Good luck with it.  Stay positive.  Follow the right advice and be patient.  You'll be back I'm sure.

 mikespooner 15:09 Tue
In reply to CatrinJ:

Thanks Catrin, glad you had success with the surgery. Out of interest do you think it helped in the long run stop the issue returning or did it just break the cycle of the initial pain for you? I've read conflicting things on this. In the end I think for me not having the surgery when I had a window of relief allowed me to 'exercise it better' to a certain extent, but I guess I'll never know how things might have been different if I had had it done

 Marek 15:16 Tue
In reply to mikespooner:

If you're suitably nerdy and bored (due to lack of climbing) you could always do what I did: Built a Bluetooth connected 3-axis accelerometer (plus Android app) and taped it to the top of my head. Then went and did a variety of activities to monitor what they were doing to my neck. Not very scientific, but it sent a strong signal (ha, ha) about how bad any jumping/running was. It also showed me that lead falls (indoors at least) weren't too bad. Usually.

It now has a second life as a bike suspension tuning tool.

 mikespooner 15:17 Tue
In reply to Iamgregp:

Thanks, I'm glad your partner has been able to get back into things. I recognise that nervousness of still being able to 'feel it'. I think that feeling of it not being directly physically-limiting (if that makes sense) adds to the frustration. Seems like slow and steady is the way to go!

 PaulJepson 15:19 Tue
In reply to gallam1:

> Completely give up bouldering because the impact will stop the other things fixing the problem.  This may be permanent, I'm sorry to say.  Avoid high impact sports like running and squash.  Compensate by taking up sports climbing and top-roping short physically intense routes.

This. Decking is so bad for an injured back.  

 mikespooner 15:20 Tue
In reply to Marek:

Haha, there's a few more weeks of lockdown to go, so maybe I will!

 Ciro 15:24 Tue
In reply to gallam1:

> Here are a few suggestions that worked for me:

> Take up karate, yoga or something similar.  Swimming really helps too.

> Buy a sit-up machine of some sort and use it a lot to get your core really strong.

> Completely give up bouldering because the impact will stop the other things fixing the problem.  This may be permanent, I'm sorry to say.  Avoid high impact sports like running and squash.  Compensate by taking up sports climbing and top-roping short physically intense routes.

> It's a real nuisance and I'm very sorry that this happened to you.  It may at its root be an injury to your stomach/core muscles (hernia-type injury which is relatively easily fixed). 

> Best of luck!

To offer an alternative perspective, after years of chronic back pain, and a couple of prolapsed disks, saying "f*ck it" and going back to bouldering and taking a few big falls actually helped me break through the soft tissue mobility issues that I was experiencing (due to having protected the injured area from going through its normal range of motion for so long)

Also, sit-ups would probably have been the worst thing I could do - the front of my core was way stronger than the back. Strengthening the posterior chain, along with getting the range of motion back that I'd lost from years of running, cycling and sitting at an office desk eventually sorted me out.

It's a long road, but if you keep at the physio and posture correction your disk can completely heal, up to about the age of 60 (assuming just mis-use injury, not a degenerative condition).

I've had no problem for best part of a decade now, after 2 decades of trouble, and my knees are what scare me in bouldering, not my back 😁

 twoshoes 15:35 Tue
In reply to mikespooner:

I reckon you just need to try climbing a few things and see what works for you. 

I knackered my L5/S1 disk just over two years ago. Couldn't stand, feel my foot etc for a couple of months. It's far from better (I've got a touch of sciatica right now after a bike ride yesterday) but I can do most things, including my day job of dry stone walling and all forms of climbing, absolutely fine.

Contrary to what the others above have found, bouldering helps me. I assume it's the combination of working the muscles and keeping mobile, to the point where I notice my back getting worse if I've not bouldered for a bit. Oddly, I find trad belays, where I might be hunched over at the top of a crag, the worst thing.

I went slowly at first and had to buy a new pad (a big snap one) as I was feeling shocks through my old one, and tend to climb over two pads these days. I'm careful not to miss my pads, downclimb at the wall and I'm wary of highballs, but I've bouldered harder than ever since I hurt my back.

So I'd say give it a whirl. Maybe you have to stop bouldering, maybe it helps and you climb better than ever. Fingers crossed for you.

Post edited at 15:40
 Iamgregp 15:43 Tue
In reply to mikespooner:

Yes I know exactly what you mean about the "feel" and about how it being not directly physically limiting is frustrating - although I've never had a slipped disk I've had pretty regular back issues for quite a while....

Be kind to yourself & you'll get there.  

In reply to twoshoes:

> Contrary to what the others above have found, bouldering helps me. I assume it's the combination of working the muscles and keeping mobile, to the point where I notice my back getting worse if I've not bouldered for a bit.

I would agree. Steep bouldering is great for the core and for general mobility. Obviously just use caution about jumping/falling.

 CatrinJ 16:31 Tue
In reply to mikespooner:

I think it was a bit of both.

My back problems started as muscle issues and spasms and eventually led to a slipped disc I think as a result of the way I held my body to cope with pain (combined with a desk job and not a good set up). I was managing the pain (nerve down my leg leading to numbness) for a long time and had tried a lot of different things with not much success before the op but eventually it started affecting my bladder so had to have emrgency surgery. I felt lucky that it actually got to that stage actually as I would probably still be waiting for surgery now. I was also very lucky to wake up with instant relief from the nerve pain from the op (apparently that’s rare) so in my case it was definitely worth it and meant that I could start the rehab process (pilates for me) and recover. I worked hard on my rehab (had the motivation of doing a ski season after 4 months).

Before the op I tried all sorts and was prescribed strong drugs that didn’t work for me. I don’t think anything (maybe learning to cope with the pain?!) would have worked to sort the disc out. I’m a strong believer in ‘exercising it better’ and that would have worked early on for a lot of people but didn’t for me.

I’m aware that others haven’t been as lucky as me in their recovery. A friend of mine had surgery like me but it didn’t help and he’s recovered via pilates afterwards.

My back is definitely not perfect now and I’m definitely feeling the effects of no regular swimming because of lockdown but as long as I keep moving it’s ok and nothing will be as bad as it was at it’s worst.

everyone is different though. Listen to your body and take it slow. Good luck
 

 nniff 17:16 Tue
In reply to Ciro:

> I've had no problem for best part of a decade now, after 2 decades of trouble, and my knees are what scare me in bouldering, not my back 😁

As one 'matures', one acquires a hierarchy of ailments most at risk.  My hierarchy is flexible (unlike me) and varies according to the pursuit in question:

Bouldering - ring finger tendons, back, knee

Winter climbing - knees, back, (in descent), slight concern over something tendony in my forearms!

Cycling - collar bone, hip

Skiing - knees, left calf, collar bone

Great, isn't it

In reply to mikespooner:

Worth getting a good bed setup to support your back at night 👍

 George_Surf 17:41 Tue
 George_Surf 17:45 Tue
In reply to mikespooner:

I’m not sure how much this helps; I had a herniated disc (basically landing hard snowboarding). It came back after trying a highball boulder. I found climbing even when it was really killing was totally fine (probably good for it?). Walking to the crag hurt and running was never going to happen but I could climb (sport) no worries. 
 

I’d avoid bouldering where you might land from much of a height or just near enough bin it altogether. I slept with a pillow under my legs, drove with a lumbar support, was careful carrying heavy bags and took tons of ibuprofen. Doing core and yoga should help  I would expect trad and sport to be fine, even falling off. For me, heavy impact with the floor is what set it off again...

 Wilderbeest 17:45 Tue
In reply to mikespooner:

I can only echo the point others have made. I found Bouldering/climbing was pretty good for my back....but falling poorly from the last move ... forget it. You end up sore for the next 4/6 weeks.
 

Down climb everything.

 alex 18:39 Tue
In reply to mikespooner:

Nothing quite like a bad back, been there with the L5 S1 pain... ouch. 

A few things that really helped me (apart from obvious yoga, etc):

- Downclimbing most problems

- not having a car seat where knees were higher than hips. Swapping to a higher car made all the difference. 
 

- using a lumbar support in the car / at work

- when it’s less painful getting one of those back stretchers you see advertised on Facebook. 
 

Good luck!

 Rharrison 18:40 Tue
In reply to mikespooner:

Hi Mike,

I hurt my back in Spring 2018  (a weird twisty move at the bouldering wall), turned out be L5-S1 with the main symptom being terrible sciatica in my left leg, and complete loss of power in my left calf.

I took quite a while off bouldering, reintroducing it slowly and staying away from anything more than 20deg overhanging, anything requiring a lot of body tension or just any weird moves. I think I avoided this kind of stuff for around 2 years. Slabby and less steep stuff was probably okay for me around 6 months - a year after the initial injury. I didn't live near a wall during this time, so there wasn't any temptation to go otherwise I'd have been screwed! I did have one of my best winters of ice climbing and skiing that year though, so it wasn't all gloom- it just meant I needed to forget about hard bouldering for a while.

It's been a long road, but I'm now basically at 100% with it- my left calf will get sore after a run when the right one doesn't, and I've had the occasional muscle spasm in my back, but there's nothing I feel like I need to avoid any more because of my back.

My principles for recovery basically were:

don't do any movement/position which causes pain (for me this was anything with flexion of the spine)

do plenty of static core exercises (e.g. plank, not leg raises!), hang of a pull up bar (to decompress) and cobra position (extension)

Try to move as much as possible. Sedantry is the worst thing for it. As long as you're keeping your spine aligned, you won't be causing more damage.

I think this approach is pretty good, but it means that your back will eventually get very stiff (as mine did!), as you'd always be keeping it aligned and avoiding flexion. I've been trying to remedy this, with the help of a physio, over the last couple of months and have seen good progress- I can now get my palms to floor in pike position, which a while ago I would have thought unattainable. If I'd had a good physio helping me along the whole journey, then maybe I could have made this transition from protecting my spine, to mobilising it again, a bit sooner.

Sorry for the rambling post. I totally feel your pain, it will get better but you'll probably need to re prioritise some things. The period when I was injured actually liberated me in a way: I'm now a little less climbing obsessed, but discovered many things which I now value really highly (fishing, playing music, trail running, paddling). Swings and roundabouts! If you've got any questions feel free to send me a PM.

 Nic 18:50 Tue
In reply to mikespooner:

Lots of (mostly...) good advice above, to summarise my experience of several years ago:

(1) pilates or similar for flexibility and core strength

(2) take a good look at your posture (I discovered walking like a gorilla with my bum sticking out was *not* ideal)...try standing against a wall with your heels touching it. If you're like me your shoulder blades will be several inches away...force them back against the wall, you'll have to rotate your groin out to achieve this...but this is how you should be standing!

(3) yes avoid falling off if at all possible, but equally take every opportunity to hang off an overhanging wall and just feel that back streeeeetching..

(4) someone mentioned bed - get a pillow and (if you sleep on your back) put it under your thighs; if on your side between your knees. Also avoid having anything heavy on your feet (which will stretch your body the wrong way...Mrs Nic insists on having some heavy blanket thing laid over the foot of the bed which I always have to kick off)

 Rharrison 19:16 Tue
In reply to Rharrison:

Just to add a more positive tone than my last post, I'd like to say that although it was about 2 years until my back was 'recovered', in the 2 years following my injury I managed:

A couple of amazing sail and climb trips in Lofoten, and a great trad trip to Wadi Rum

A lot of quality ice and alpine climbing including some great first ascents

Taken my skiing up a few notches

Circumnavigated Svalbard on a sailboat

Fished a lot of trout

Kayaked a few class III whitewater runs (zero pre back-injury)

The list could goes on! I had to look after my back to varying degrees on all of these trips, but they were doable and I didn't have to sacrifice recovery to do them.

Hopefully this adds a little optimism.

Cheers,

Rory

Post edited at 19:17
 timparkin 21:45 Tue
In reply to mikespooner:

I have a fused L4-L5-S1 (basically replacement L5 vertebra with titanium cage - all a single big bone now). it's over 10 years since but I'm climbing lots. The thing I realise is that your back gets shorter and longer over time. When you sit for long periods it gets shorted. When you're moving around, walking over rough ground, lying down, it expands. When it's long it can take quite a bit of impact. When it's short it can't and will get tweaky. So cumulative strain is the issue. 

Bouldering is great, I've got a moonboard but we installed soft 12" pads under it and I'm generally OK falling in control. Some gyms have harder mats and I'm more cautious. 

Long periods in front of a computer sitting really screw my back up as it gradually shrinks down under load and then it gets extra sensitive. Climbing actually helps it usually, lots of movement etc. Core is good and pilates worked for me historically but climbing replaces this now. 

Mostly, get used to listening to your body closely and you'll learn the triggers. Hope that helps

Tim

 mikespooner 10:57 Wed
In reply to everyone:

Loads of kind replies to this, thanks everyone! Looks like it's more common with climbers than I expected and it's really heartening to see how others have managed to get back to things. I definitely feel more confident about starting to build up the volume and exploring the limits again, albeit perhaps with more of acceptance that I'm not as bulletproof as I once was!

 Neil Henson 11:06 Wed
In reply to mikespooner:

I've battled with back trouble for the last few years, although not as serious as yours by the sounds of it. Some things that have helped me are:

Anti-inflammatories (I prefer to avoid medication if I can help it, but it does make a difference).

Learning how to stretch properly with the help of a decent book.

Changing my mattress (this was the big one for me).

Still not free of back discomfort and generally poor flexibility, but definitely improving. 

Hope this is useful. 

 mikespooner 11:07 Wed
In reply to Rharrison:

Really appreciate this post Rory. I think I've also become less climbing-obsessive by being suddenly forced to fill my time with other things. At the same time, I think it also made me realise how much I valued the times I was able to spend doing it!

 mikespooner 11:10 Wed
In reply to Ciro:

This is really interesting, I think I was much the same with a much stronger front core than back. As well as the flexibility, I've actually found working posterior chain strength, doing light deadlifts or squats, seems to have given me the most relief.

Post edited at 11:11
 Marek 11:26 Wed
In reply to Neil Henson:

> Anti-inflammatories (I prefer to avoid medication if I can help it, but it does make a difference).

I'd be very careful with this. NSAIDs like Ibuprofen are great, but long term use runs a risk can result in serious kidney damage. I've now been told by my doctor to cut them out completely (well occasional use only) and to stick to paracetamol and co-codamol (which sadly has it's own unpleasant side effects).

 Iamgregp 11:38 Wed
In reply to Marek:

>  (which sadly has it's own unpleasant side effects).

They ought to supply prunes with the pills....

 Neil Henson 12:27 Wed
In reply to Marek:

Thanks. I am doing my best to wean myself off them. Generally prefer not to take any tablets if I can help it.

 Marek 14:30 Wed
In reply to Iamgregp:

> >  (which sadly has it's own unpleasant side effects).

> They ought to supply prunes with the pills....

Actually, I never had THAT problem (forewarned), but I hated what they did to my head (hallucinations) and the eventual withdrawal symptoms (insomnia) I could have done without.

 Iamgregp 18:01 Wed
In reply to Marek:

Yeah the codeine in them is an opiate so can cause some really unpleasant side effects.  The worst part about the side effect I had (yes, THAT one) was that it still afflicted me even after I'd come off them, it took weeks for things to return to normal...


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