Tag: back injury

This sucks

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So, my last post was on September 2nd.  Ten days ago.  At that time, my back was killing me and I decided that I needed to really lay off the rowing until I figured out what was going on.  I bought the book “Back Mechanic”, read it cover to cover, and I’m trying to use the good advice contained within.

This advice can be boiled down to:

  1.  Avoid aggravating your injury by practicing good “back hygiene”.  This means sitting up straight and avoiding positions that hurt.
  2. Figure out the most likely cause of pain by doing some diagnostic tests.  (For me this resulted in a likely diagnosis of a disk injury in the lumbar region.  One fun fact that I learning is that disks are hydrophylic, which means that they absorb fluid over night and are “puffy” in the morning.  So, if you have a disk impinging on a nerve it will probably hurt more in the morning and will feel better after the disks lose a bit of fluid over the first hour or two of the day.  Interestingly, this makes you more susceptible to disk injury first thing in the morning too.  So once I get back to rowing, I should do a non-rowing warmup before taking a stroke)
  3. Start strengthening your core muscles with a set of defined exercises that utilize a limited range of motion, but help to work on the muscle balance in you back and abdomen
  4. Don’t do any stretching to the limit of you motion until you are pain free.  Stretching will essentially release chemicals that ease the pain immediately, but will continue the inflammation cycle and slow down recovery.

So, I’ve been dutifully doing my core exercises nearly every day.  They are boring and a pain in the ass, but I have to put in the effort.  Over the ten days, the amount of pain I feel in the mornings has been steadily decreasing, but is not going away.

Yesterday I went to the doctor for my annual physical.  I asked him about my back issues and he diagnosed me as having a problem with my SI Joint.  This is the joint between the Sacrum and the Ilium.  I am less than completely convinced he is right.

1200px-sacroiliac_joint

So, he has set me up for x-rays next week, and referred me for physical therapy.  I need to find myself a PT that understands rowing.

I also discovered to my horror that I have gained 12 pounds over the past couple of months.  I guess my eating hasn’t changed even though I’m burning a thousand less calories a day.  Another thing I have to fix.

In terms of training, here’s a quick synopsis of the past 10 days.

9/3 – Another walk around the island.

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9/4 – Another walk around the island.

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9/5 – Fly off to California – no training.  Used a lumbar cushion on the airline seat and that seemed to help reduce pain.

9/6 – 60 minutes in the fitness center.  30 minutes on the treadmill set to max incline at 3 mph, a fast walk.  Then 30 minutes on an elliptical machine.

9/7 – 48 minutes in the fitness center.  30 minutes on the treadmill same deal, max incline, fast walk.  Then I moved over to the elliptical for another 30 minutes.  18 minutes into that, I got a call from the guy I was meeting saying that he was in the lobby.  I thought I had another 45 minutes before he was arriving.  Dashed off to the shower.  Long day of meetings.  Caught the red eye home.

9/8 – Got home around 7am and slept for a couple of hours.  Then worked from home.  Late in the day, I decided to go for a short run to see if my back would tolerate that.  It did.  I ran for 30 minutes and then walked another 15.

9/9 – We headed back to the Cape on Friday evening and I’m glad we did.  Saturday morning, it was incredibly beautiful out.  I went for another walk around the island.  I was feeling a lot of stiffness from the run on Friday, but my back was not significantly worse.  The tide was low so I could get out on the sand flats a bit more and watch the birds.

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9/10 – Same thing as the day before.  Another glorious day, another walk.  Still sore from Friday’s run, but less so.

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9/11 – Monday.  I had my doctors appointment, then a few hours of meetings and then headed off to the airport.  I flew out to Las Vegas for a conference, arriving around 8 pm.  Got to the hotel, grabbed dinner and went to bed.  No training.

9/12 – Tuesday. I slept in a bit longer than I should have, so by the time I did my core exercises, I only had enough time for a 30 minute death march on the treadmill.  I did that, showered and went to the conference.  This finished around 5, and so I headed back to the gym.  Now this hotel (The Wynn Hotel) has a fantastic fitness center.  Lots of treadmills, stationary bikes, and a nearly new Concept2 Model E rowing machine with PM5.  I managed to ignore it this morning, but it’s siren song was way too tempting for me this afternoon.  I melted under the pressure and before I knew it I was sitting on the seat, linking my phone to the PM and firing up painsled.

Part of me thought this was pretty stupid.  But part of me thought that a session done at lighter pressure would be a gentle test to see if I might be ready to resume some light rowing specific training.  I decided to do 30 minutes and to up the stroke rate by 2 from my more normal stroke pressures.  So 18 SPM would yield 160w and 20 SPM would yield 180W.

I also wanted to really focus on trying to limit my over reach at the catch.  I’ve been dropping my legs apart to get more length and I suspect that this new aspect of my style is what is putting more stress on my back.  So the goal for the day was to row with my knees together, even at the catch.  I caught myself slipping a few times, but generally it was OK.

9-12a.png

9-12b

        Workout Summary - media/20170912-2040320o.csv
--|Total|-Total-|--Avg--|-Avg-|Avg-|-Avg-|-Max-|-Avg
--|Dist-|-Time--|-Pace--|-Pwr-|SPM-|-HR--|-HR--|-DPS
--|07278|31:07.0|02:08.3|169.9|18.9|145.0|157.0|12.4
W-|07280|31:07.0|02:08.3|169.1|18.8|145.4|157.0|12.4
R-|00000|00:00.0|00:00.0|000.0|00.0|000.0|157.0|00.0
Workout Details
#-|SDist|-Split-|-SPace-|-Pwr-|SPM-|AvgHR|MaxHR|DPS-
00|02417|10:00.0|02:04.1|182.4|19.9|132.3|148.0|12.1
01|02364|10:00.0|02:06.9|173.6|18.7|150.1|155.0|12.6
02|02322|10:00.0|02:09.2|162.8|18.0|153.5|157.0|12.9
03|00176|01:07.8|03:12.2|068.3|17.7|148.3|157.0|08.8

Not very impressive, but I was glad to have done it.  My back is letting me know that it’s a little unhappy, but the true test will be how it feels in the morning.

After that, I had reached my 30 minute limit for rowing, so I moved over to the treadmill and did  20 minute death march.

Tomorrow, I head home.  I might have time for a quick workout in the morning before I leave, but I will only go if I’m not paralyzed with pain.

 

Back Injury

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Injuries are an unavoidable part of being an aging athlete.  Generally, they are minor twists, scrapes and contusions, but some are more serious.  Over the past 8 years, I have worked through a whole assortment of injuries

  • Rib Stress Fractures (cured by rest)
  • Osteo-arthritis in my knees (treated with cortizone shots and improved with arthroscopic surgery)
  • Sciatica (improved by using seat pad on the erg and better seat in the boat)
  • pinched nerve in my high back (trained through)

Now I am working out how to manage an injury to my lower back.  I hurt it in an open water session a couple of weeks ago.  I didn’t notice it at the time, but by that evening, I had trouble standing up.  It was a very localized pain right at the top of my left buttock, between my spine and my hip.  If I stood straight up, I could lean slowly forward at my hips and it would hurt at a very specific angle, around 60 degrees from vertical.

After that, I would stretch and maybe take a day or two off from rowing and then return.  The back pain was there, but manageable and I thought it was improving.  Then on 22 August, I did a sprint workout, a Pyramid session (250/500/750/1K/750/500/250) in my single.  I felt fine immediately afterward, but by the end of the workday, it was very painful  to stand up from a sitting position and the pain made it difficult to sleep in any position but flat on my back.  I took two days off of rowing and then eased back in with some lighter pressure endurance sessions.  It still hurt when I woke up in the morning, but felt pretty good through the day and at night.

On 29 August I rowed out on Lake Quinsigamond with my friend Joe.  We did a 2 min on / 1 min off session.  This was a bit moretame than a pure sprint session, with stroke rates around 26-28 for most of the on sessions.  But the same pattern occurred.  Felt fine right after, but by the end of the day, I was in serious pain.  Again, I could only sleep on my back.  The pain in the morning made it a challenge to bend over to put on my underwear and pants.  Working out was out of the question.  I’ve been trying to figure out what to do since then.

I even went to the unimpeachable fount of information, facebook, and posed the question to the master rowers group.  To my surprise, I’ve gotten over 120 replies so far and a lot of good advice.  Here’s a synopsis of what I’ve gleaned and the framework of my plan.

  1. Make immediate changes to try to improve my spinal hygiene.  This includes getting a lumbar support brace to remind me to sit up straight.  Sit on an exercise ball.  Stand more (I’m going to ask for a standing desk at work)
  2. Take anti-inflammatories (Ibuprofen for now) as needed
  3. Stop rowing until I get cleared up
  4. Seek a genuine medical diagnosis so I understand what is going on in there (I’ll get a referral from the guy who did my knee)
  5. Learn all I can about back injuries and how to manage them (Many people recommended this book “The Back Mechanic” by Stuart McGill.  Other folks pointed me to this online presentation by Fiona Wilson)
  6. Once I have a diagnosis and treatment plan, find a physical therapist who does a lot of work with rowers to help me figure out a plan to strengthen my core and improve my injury resistance (If anyone knows a good physio in the Boston area, please let me know)
  7. Multiple people commented on my posture in my facebook profile picture which shows me with an unusual amount of layback.  They recommended that I get some immediate coaching.  I think that is actually really good advice.  Once I can get back into a boat, I will try to find a good online (or local) coach.  I have higher hopes for online coaching since my training schedule is so constrained and variable.

Who knows how this will go or how long it will take to get better, but my priority is to get healthy and fix whatever elements of my rowing style (and lifestyle) contributed to injury before resuming hard training.  My most important objective is to be able to row until I am very, very old.  I don’t want to do something now that will jeopardize that.

So, for now, it will be cross training.  Walks, jogs, maybe some biking if I am pain free.  I won’t scratch from the HOCR yet, but I’ll make a decision about that in a month or so.

By the way, today, I went for a nice 4km walk around the island.  About 40 minutes or so.

Walk around Lt Island