Disc herniation Precision Movement
The most common injury I see in my practice is varying stages of disc prolapse. Most people steer clear of any movement when they have a disc injury for fear of setting off the intense and unbearable pain and making the injury worse than it already is. However, as my client Mr A discovered, the right type of exercise is actually the safest and most effective way to manage your disc injury going forwards. Read on to find out how Mr A went from daily agonising pain for years to no pain at all in just 3 months.
What is a herniated disc?
A disc prolapse (often called a slipped disc) is where the jelly (nucleus propulsus) in the disc inbetween two vertebrae pushes out and sometimes through the outer ring (annulus fibrosis) of the disc into the spinal cord canal. It can push on the nerve roots and cause pain in the local area, or affect the nerve down through the hip or down the leg. Other more severe symptoms that can occur are numbness, tingling, an electrical feeling and temperature change down the leg often referred to as sciatica which I talk more about in my article entitled '
How Corrective Exercise can help Sciatica
'.
Causes
There are many reasons why a disc prolapse occurs. It can occur from a trauma such as a sports injury or a car crash that results in a blow to the spine or surrounding areas. A more common cause is from poor posture leading to ligamentous creep over a number of years. The vertebrae are designed to keep the discs in place but it is repeated poor posture and inactivity that leads to the disc creeping out. I talk more about this concept in another article entitled "Ligamentous Creep - the poisonous weed of inactivity" - coming soon so make sure you stay tuned via my newsletter! Other factors such as nutritional health play a part in disc and spine health.
In the case of Mr A - there was no traumatic accident. He had been inactive for most of his adult life and his sedentary desk bound job probably did not help in preventing his back pain and subsequent injury develop.
The 4 stages of disc herniation
The first stage is referred to as a disc bulge. This is where the outer ring is intact and the inner jelly just pushes out creating a bulge. The second stage is called a disc prolapse where the outer ring is weakened and the jelly begins to push into the weakened area but the outer ring remains. The third stage is called extrusion where by the jelly breaks through the outer ring. The fourth stage is called a sequestration where fragments of the jelly enter the spinal canal.
The last two stages have an added complication in that pain may also occur from chemical irritation of the jelly in the spinal canal. This can be more challenging to manage as the pain is not just coming from mechanical causes. Unfortunately, once your structures, namely the disc, is damaged it cannot be repaired. However, management through medical treatment and corrective exercise can be exceptionally effective.
In the case of Mr A, he had suffered from back pain for 15 years. It was diagnosed as a disc prolapse and 12 years later he had surgery, a micro-discetomy to remove part of the disc that had moved into his spinal canal and was causing agonising daily pain. 12 months after his surgery, he came to see me still in terrible pain.
Exercise to the rescue!
Exercise is an incredibly important and often successful part of recovery from discomfort with disc herniation. Nearly all people I see in my practice have a disc herniation from inactivity, poor posture and sitting at a desk all day.
A common postural imbalance that correlates with disc herniations is a very flat low back often coupled with tight hamstrings. I also see a fair amount of people with an excessive upper back curve and weak postural stabilisers throughout the spine. However, just sticking your butt and chest out and stretching your hamstrings will not fix the problem - in fact you could make your pain much much worse!
There are specific stretches, mobilisations and exercises I give to correct these imbalances and help the disc sit better between the vertebrae. Often breathing mechanics, core activation and localised spinal stability are compromised as well. Each person I see has different imbalances and to a different extent which is why it is not possible to give blanket advice and exercises.
John Medina explains in his book 'Brain Rules' how exercise also helps to increase the growth of new blood vessels throughout the body to get deeper access into the tissues. This helps the tissues dispose of toxic waste that builds up in and around an injury and areas of pain. The more you exercise, the more tissues you can reach and the more toxic waste you can get rid of. Exercise actually physically aids your recovery.
Mr A had many postural imbalances that were causing more stress on his disc injury. Even though he had surgery to remove a part of the disc that was most irritating, his spine was very unstable and he had lots of tight muscles in his pelvis and upper back. He worked with me for 3 months and diligently followed his exercise programme. Within 4 weeks he was noticing a marked decrease of discomfort on a daily basis and by week 8 he was virtually pain free.
What can I do now?
Ideally seek out a specialist in corrective rehabilitative exercise who can assess your whole body postural alignment. It is increasingly common to hear and see of patients doing exercises poorly or completely wrong which can make symptoms worse. It is imperative to do your exercises with good form and it is advisable to do them under the observation of a corrective exercise specialist like we have here at Precision Movement. This is mainly because your body will have a preferred way (poor alignment way) of doing movement and with each repetition you do you'll need to remember and apply newly learned alignment to make desired changes.
If you are suffering with disc herniation related pain please do email me at
to set up a complimentary 20 min phone consult to see how I may be of assistance to you. You don't have to suffer forever - life is too short!