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Herniated disk & continuing to train for a marathon


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Author Topic:   Herniated disk & continuing to train for a marathon
WendyCity
Cool Runner
posted Jul-16-2007 10:16 PM     Click Here to See the Profile for WendyCity     Edit/Delete Message   Reply w/Quote
After two rounds of physical therapy, an MRI which revealed a slight herniated disk at S1/L5 and an ineffective cortisone injection, I've embarked on a third round of PT with a therapist who is McKenzie trained. While the stretches I've been given give me temporary relief, I still have a lot of burning/aching in my lower back and mild sciatica. My therapist told me that my running is probably not the cause of the herniation, and that continuing to run may not cause more damage to the herniated disk. Well, I'm continuing to train for the Chicago Marathon (conservatively by stopping every two miles to do my McKenzie stretches and alternating one minute of walking every few miles) but each time I go out, within two miles, the burning in my lower back begins again.

Should I listen to my physical therapist who's given me the green light to continue to run? If I'm having this much trouble during my 6-10 milers, I worry that 26.2 will be impossible! I have 100 days until the marathon and *really* want to do this, particularly since I'm an American Cancer Society charity runner and have raised a lot of money already from folks who want me to run in memory or in honor of a loved one. My legs, heart and lung are strong and so is my willpower HOWEVER, I really don't want to do more damage. Will I??

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WendyCity
http://interwovendesign.com/kick/userdisplay.php3?username=WendyCity

[This message has been edited by WendyCity (edited Jul-16-2007).]

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ForceD
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posted Jul-17-2007 09:31 AM     Click Here to See the Profile for ForceD     Edit/Delete Message   Reply w/Quote
Wendy,
I too have had lower back/disc/sciatic problems. I’m 46 now. When I was 27 I had surgery (laminectomy-discectomy) for a bulging disc at L4/L5. I’ve recently been diagnosed with another major bulge on the disc between L5/S1. It’s been there for years I know because I’ve had frequent sciatic flare-ups. So, I’m scheduled for surgery on August 3rd to remove the bulge. My docs and physical therapists have said essentially the same thing about running and my back/disc problems. “Although running doesn’t help it, it isn’t the cause of it. If you feel good doing it, continue.” In fact, the doc that is going to perform the upcoming surgery said that being in good physical condition over the years has probably kept me from experiencing more pain. I’m sure that, like me, the non-runners in your life try to convince you that the constant pounding of running is to root of your problems. But running has not caused any of my disc/sciatic problems.

Dan

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WendyCity
Cool Runner
posted Jul-17-2007 10:21 AM     Click Here to See the Profile for WendyCity     Edit/Delete Message   Reply w/Quote
Wow, that's interesting. I certainly hope I won't eventually need surgery! Good luck with your's, though!

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ud
Member
posted Jul-19-2007 01:02 PM     Click Here to See the Profile for ud     Edit/Delete Message   Reply w/Quote
I had a herniated L3L4 disc - it was a nightmare - the pain was insane - as I am sure you are aware. My doctor encouraged me to try everything possible before surgery. two things helped me more than anything:
1) Yoga (in a heated room with an instructor)
2) Book - titled - Back Rx by Vijay Vad

Good luck

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littlewaywelt
Cool Runner
posted Jul-19-2007 01:23 PM     Click Here to See the Profile for littlewaywelt     Edit/Delete Message   Reply w/Quote
had surgery l5s1 laminotomy & discectomy and couldn't run for about a year. finally ran again and reherniated in a marathon or just after. had surgery again. can now run & live pain free.
do cortisone first and pt, yoga, etc. surgery works, but there are plenty of horror stories out there about it making things worse.

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deg
Cool Runner
posted Jul-19-2007 05:15 PM     Click Here to See the Profile for deg     Edit/Delete Message   Reply w/Quote
wendycity - i've always heard you should let pain be your guide. i managed to run a fair amount of long runs and halfs with similar issues (see below) - did that provoke current flareup? who knows...the doctor certainly doesn't seem to!!!

related question:

i'm currently dealing with the same thing - hernia at L5-S1 and deteriorated disc at L4-L5. ignored pain for months (kept running of course, but had to reduce) and finally saw a dr about 3 weeks ago. anti-infl. didn't work, now trying oral cortisone. started PT this week but it hurts me way more than running did!!! but the dr told me in no uncertain terms not to run for the forseeable future. this is annoying as running never actually hurt! the pain comes the next morning, but i haven't noticed it as being any different than any other morning.

i've been assigned to WALK, swim (which i know i won't do because i hate being indoors and swimming laps), or cycle. has anyone else tried to replace running with walking? how much do you try to do, and how fast? i've been trying to walk as far as i usually run (4-6 miles), and use my garmin to keep me speedy. the problem is, i actually hurt just the same afterwards as i do when i was running!

i'd appreciate any thoughts from anyone out there who's dealt with this... i told my PT that my eventual goal was to return to running and she said "why would you want to do that?"...i immediately thought that i was with the wrong PT...

but i'd like to avoid surgery - so i'm willing not to run for a while i guess...although the other day i ran up the street to catch up with a friend and it felt sooooooooooo gooooooooooooood...

deg

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masrun
Cool Runner
posted Jul-19-2007 08:17 PM     Click Here to See the Profile for masrun     Edit/Delete Message   Reply w/Quote
I am recovering from a herniated disk in L5 / S1. My back never really bothered me much except when lying on my sides in bed. It was the sciatica into my left leg and foot that caused problems. 6 weeks later, it has improved greatly but still have some weakness and numbness, especially in the foot. Anyway, the neuro-surgeon I went to basically said to keep running. Running was not the cause nor will running cause additional problems. You cannot do anymore damage to your back then has already been done by the herniation. Funny thing he told me was that PT would do nothing more then to entertain me as PT will not heal the disc any faster. It just takes time and everyone is different. Cortisone and surgery often create new problems and complications so these should be avoided if possible.

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WendyCity
Cool Runner
posted Jul-19-2007 08:52 PM     Click Here to See the Profile for WendyCity     Edit/Delete Message   Reply w/Quote
Deg, I can relate to you and the various advice you've received *completely*! At least my current PT hasn't told me not to run... so I have. Just got home from a 30 minute easy run half an hour ago. I had the usual stabbing left lower back pain but pushed through it. I've been told that herniations eventually resolve on their own but it's been nearly 8 months already and it's summertime, time to run and jump around! I'm considering looking into an alternative traction treatment with something called the DRX-9000. Very costly, not a lot of providers in my area but a friend with several severe herniations worse than mine swears by it.

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littlewaywelt
Cool Runner
posted Jul-20-2007 11:52 AM     Click Here to See the Profile for littlewaywelt     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by masrun:
You cannot do anymore damage to your back then has already been done by the herniation.

That's not necessarilly true. Relapses happen in ~5% of ppl that have had surgery.
I had L5S1 laminoty & discectomy and had a recurrence (which req'd additional surgery) at the same level about 2 years later during or directly after a marathon.
Running could in theory increase the amount of herniation.


WendyCity,
...that said, I'd listen to your physician & pt person before listening to anyone (including me) on the internet.

[This message has been edited by littlewaywelt (edited Jul-20-2007).]

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ForceD
Cool Runner
posted Jul-20-2007 01:58 PM     Click Here to See the Profile for ForceD     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by deg:
has anyone else tried to replace running with walking? how much do you try to do, and how fast?

deg,
The recent flare-up that cause my current pain…which is resulting in surgery scheduled for August 3rd…happened at the end of April. I was already entered in the Indy Mini Marathon and had my airfare. I didn’t want to miss it. On the other hand running was still a bit painful that soon after the flare-up. I decided that I’d walk it with my sister. This sounds funny: Running that far isn’t a problem. But, I didn’t know if I could walk that far. So, a week before I flew out to Indy I went on a ten mile walk to see how it’d be. I walked it as hard as I could. I ended up going almost exactly half as fast as I’d run that distance and felt like I got just as much of a workout. Be advised thought! The muscles you use, and how you use them for walking is different than running. Then next day my legs we much more sore than if I would have run 10 miles.


quote:
Originally posted by masrun:
6 weeks later, it has improved greatly but still have some weakness and numbness, especially in the foot. Anyway, the neuro-surgeon I went to basically said to keep running. Running was not the cause nor will running cause additional problems. You cannot do anymore damage to your back then has already been done by the herniation.

masrun,
The surgeon that’ll be doing my surgery is a neurosurgeon too. He said almost the same exact words to me that yours did. Others have also told me their docs say it too. But, try telling a non-running spouse that running has no bearing on your back condition. Flare-up and reoccurrences do happen…like littlewaywelt suggests. But, in my case, running has never ever caused a sciatic flare-up for me. I can always trace it back to incorrect bending, lifting, or twisting in awkward positions and not taking my back into consideration before I do it.

Dan

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angrek
Cool Runner
posted Jul-20-2007 02:25 PM     Click Here to See the Profile for angrek   Click Here to Email angrek     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by WendyCity:
I've been told that herniations eventually resolve on their own but it's been nearly 8 months already and it's summertime, time to run and jump around!

I did a couple stupid things years ago and ended up with upper and lower damage. I think I had like 3 upper that I damaged then during a move and 2 lower lumbar from a cliff diving accident a few years previous. Couldn't even walk straight for about a year and I'd randomly just get dropped to my knees or go down for a good face plant on occassion. Those were fun. It became very comical to me at the time. It took a few years, but they all worked themselves out. (didn't have health insurance at the time so I didn't have much of a choice) I've been completely (ok, 99.9%) pain free for about 3 years now. Took about 5 years total. Probably took a little bit longer for mine to heal because I didn't just have a single herniated disk, but everything did heal on its own. Back pain is for the birds.

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angrek
Cool Runner
posted Jul-20-2007 02:28 PM     Click Here to See the Profile for angrek   Click Here to Email angrek     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by ForceD:
masrun,
But, in my case, running has never ever caused a sciatic flare-up for me. I can always trace it back to incorrect bending, lifting, or twisting in awkward positions and not taking my back into consideration before I do it.

Dan


That's about my experience with it. I could run or bike a couple miles just fine but reach into the fridge for a pepsi the wrong way and I'd drop like a brick.

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WendyCity
Cool Runner
posted Jul-20-2007 09:24 PM     Click Here to See the Profile for WendyCity     Edit/Delete Message   Reply w/Quote
ACCKKKK!!! I cannot take this anymore!!!! I've been in so much pain the last three days that I've scheduled a second cortisone injection (even though the first one didn't work for more than 4 days.) I'm at my wit's end! Tomorrow is a marathon training scheduled long run "cut back" week of only 8 miles, which normally, I'd sail through with relative ease. Next week it's 12 miles. Yesterday I ran for 30 minutes and had to stop FOUR TIMES to stretch my lower back. Tonight, I'm so sore that I limped home from work and went to bed with an ice pack for a two hour nap. Sheesh, I feel like I'm 90 years old!

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WendyCity
http://interwovendesign.com/kick/userdisplay.php3?username=WendyCity

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angrek
Cool Runner
posted Jul-20-2007 10:07 PM     Click Here to See the Profile for angrek   Click Here to Email angrek     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by WendyCity:
ACCKKKK!!! I cannot take this anymore!!!! I've been in so much pain the last three days that I've scheduled a second cortisone injection (even though the first one didn't work for more than 4 days.) I'm at my wit's end!

Well, if you're in that much pain and it hurts to run, me personally? I'd back up and punt. There are always races to be run. Fixing your back though... Don't get me wrong...I'll run through pain and injuries, but after 4-5 years of severe back pain, that's one of the few things I won't try to run through. Just my thoughts on it. Funny name btw. My dad grew up in Rockford and Oak Park.

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WendyCity
Cool Runner
posted Jul-20-2007 10:13 PM     Click Here to See the Profile for WendyCity     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by angrek:
Well, if you're in that much pain and it hurts to run, me personally? I'd back up and punt. There are always races to be run. Fixing your back though... Don't get me wrong...I'll run through pain and injuries, but after 4-5 years of severe back pain, that's one of the few things I won't try to run through. Just my thoughts on it. Funny name btw. My dad grew up in Rockford and Oak Park.


I know, I know... I may have to admit defeat! I'm trying to stay optimistic, though. Glad you like my user name. Pretty clever, huh!

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angrek
Cool Runner
posted Jul-20-2007 10:59 PM     Click Here to See the Profile for angrek   Click Here to Email angrek     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by WendyCity:
I know, I know... I may have to admit defeat!

You're not defeated if you get back up.

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WendyCity
Cool Runner
posted Jul-21-2007 05:37 PM     Click Here to See the Profile for WendyCity     Edit/Delete Message   Reply w/Quote
Well folks, another crappy run today. I was supposed to run 8 but only managed to complete 6.5 (run/walk). I walked the rest of the way home while crying. The pain in my lower back has become unbearable, so my marathon training may very well have ended in Lincoln Park by the water fountain two miles from home. Prior to this, I was able to run through the twinges and tightness but it's getting worse. It'd be stupid of me to try to continue with these mediocre attempts at running. Frustrated that the PT, stretching, Celebrex, chiropractic appointments, deep tissue massages, and one steriod injection haven't worked for the past 8 months. Looking at my MRI films, my doctor told me it is a "mild" herniation pressing on my sciatic nerve (and from what I saw, it doesn't look that major) but based on my constant pain, it's in no way mild to me! I'm going to get another injection but I'm not that optimistic. Must I consider surgery?

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WendyCity
http://interwovendesign.com/kick/userdisplay.php3?username=WendyCity

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lstall
Cool Runner
posted Jul-23-2007 10:00 AM     Click Here to See the Profile for lstall     Edit/Delete Message   Reply w/Quote
I have something similar going on. Haven't had an MRI yet, but my family doc (took x-rays which showed nothing, and prescribed some super-NSAIDs which didn't help, and muscle relaxers which put me to sleep) has referred me to a sports med. doc, who I go see on Thursday.

I have averaged 40-50 mpw for the past three years, ran two marathons already this year (Boston 3:53:05 and Madison, WI 3:40:51) and several shorter races. This all started a month after my second marathon when I bent over and reached for something in the garage. Back spasms made it hard to even move for a couple days. Then I started running again, it hurt, but not enough to stop. Did a 40 mile week, then foolishly ran my hometown 4th July 10K. I had to stop at 5 miles. Could barely walk afterwards.

Since then I tried running a few times, but the pain starts then it gets hard to even move my right leg. Went from stopping at 1.75 miles to 1 mile, to 0.5 miles, and 3 blocks the last time. I've had lots of injuries, but none like this. It seems to go away, mostly, doesn't affect swimming, biking, walking, but as soon as I try running, wham! It's got to be some nerve-related thing (sciatic, pinched by muscle, or worse disk....).

So I haven't run for almost a week now, and again it's feeling better. I almost feel like trying to run again, but I should probably wait until Thursday to see the sports doc. The really frustrating part is I'm signed up for the Lakefront Marathon in Milwaukee on 10/7. I was cutting it close as it was, planning on using the Pfitz 12/55 plan, but the first week of that is already missed....

Good luck to both of us!

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- Larry -
I finished Boston 2007!!
Next: Lakefront Marathon 10.7.07
My Profile

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littlewaywelt
Cool Runner
posted Jul-23-2007 10:57 AM     Click Here to See the Profile for littlewaywelt     Edit/Delete Message   Reply w/Quote
This is all very new to consider surgery, even a cortisone shot imo. As far as I recall, shots were done in a series of three over a few weeks.

You should probably try and spend about 6months- a year trying alternatives. While surgery works well when it's indicated, it can't be undone, especially if you end up needing a laminectomy & fusion.

Try several months of pt, including core exercises, spinal traction (boy does that feel good) ultrasound, ice, anti-inflamatories, etc. This is very effective for many people.

Rule out other causes as well like pinaformis. I saw one 2-3 hour program on back issues in America where a doc commented that many ppl have herniated discs and don't even know it. He further commented that it's not necessarilly the source of the pain. You could have a herniation, but the pain might be coming from a tight pinaformis that's squeezing the nerve and stressing the back muscles.

Surgery usually is indicated for moderate + sciatic pain. It doesn't always help with back pain. There's also a newer option too, but I don't remember the name. It's something like nerve therapy which supposedly is amazing for back pain. They basically put a small battery in your butt and attach some electrodes directly to the nerve endings. It provides stimulation that is supposed to cancel the pain. I met someone that had this done and she said it completely changed her life. It, unlike most alternatives, is completely reverseable.

You have just started down this road. If you're impatient you're bound for problems. It's a long road for most. At this point, I'd say run if you can, but be prepared to stop.

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glee1949
Member
posted Jul-23-2007 10:33 PM     Click Here to See the Profile for glee1949     Edit/Delete Message   Reply w/Quote
Last June I suddenly had pain in my sacro area and the next day I went to the hospitalized and found out I had four herniated disks including a 6 mm and two 5 mm and one 4mm herniation. My right thigh went numb the next day and is still numb. I had been a runner for 30 years and I believe my disks got into trouble in the last couple of years by stretching whereby I could put my forehead on the floor between my legs while bending at the waist. Problem is I bent at the back whick likely lead to the herniations. I couldn't stand up for 4 weeks for more than a minute and the pain was brutal but it went away in 6 six weeks. I stopped running of course and continued swimming but for 3 months, I had nerves jumping in my upper butt while swimming. The running police will not knock on your door if you can't run.
For therapy, I had PT then chiro to straighten out my spine at the base. He says I can run and I tried it for a month but just before I herniated the disc, I pulled something in my upper legs while doing one those crazy forward stretches and running wasn't much fun. I have decided to just swim for now and skate and not risk any further damage to my back. I can't have an MRI since I have a pacemaker and that is another reason for me not to risk anymore damage through an impact activity. My back settled down after a few months and swimming is pain free and I have always swam along with running so it's easy to take. Do I miss running? Yes but I miss my healthy back more and swimming and skating and just walking seems fine. You have to listen to your body. Back injuries are serious and very painful as you know. See ya in the pool. Googles are cool!

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WendyCity
Cool Runner
posted Jul-23-2007 11:22 PM     Click Here to See the Profile for WendyCity     Edit/Delete Message   Reply w/Quote
Aw geez, I really don't want to have to substite my running for other sports permanently. Everyone's situation is different, I guess. I'm waiting to hear back from the doctor who did my first injection regarding having a second. In the meantime, my running coach told me that I can train for the marathon on the bike/elliptical and maybe a treadmill, and still finish the race. I'm going to lay off the running for now, as much as I hate to. My situation isn't as bad as your's, glee1949 (from what I've been told) but it's enough to impact my daily life.

In the past three days, four people (non-runners) have implored me to STOP RUNNING!!!! "It's so rough on your knees and back and joints", etc. Lifelong runners out there, how many of you have been told the same thing? How do you respond? I get so mad! Research has shown that running actually builds bone mass, and I for one have run for 22 years without one single injury! I'm not a high mileage runner (except for marathon training, but I'm doing a novice plan), and I never run two days in a row. I switch off between two great pairs of ultra stability shoes, my form is impeccible, and I run on dirt whenever possible. How do I explain that my disk herniation is NOT due to running (although it's aggravated by it right now) but age-related? In fact, I've probably had this herniation for a long time with no symptoms until last fall. Aaaaaanyway... I am tired of complaining. The running will be reduced from 25 miles per week to 6 or less, and my training will continue on the elliptical. The saga continues....

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WendyCity
http://interwovendesign.com/kick/userdisplay.php3?username=WendyCity

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WendyCity
Cool Runner
posted Jul-23-2007 11:24 PM     Click Here to See the Profile for WendyCity     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by glee1949:
I can't have an MRI since I have a pacemaker and that is another reason for me not to risk anymore damage through an impact activity.

You have a PACEMAKER?!? Wow, I am SO impressed! What the hell am I complaining about with my little 'ole herniation vs. your pacemaker? You could probably kick my butt in any sport!

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littlewaywelt
Cool Runner
posted Jul-26-2007 12:59 PM     Click Here to See the Profile for littlewaywelt     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by WendyCity:
In the past three days, four people (non-runners) have implored me to STOP RUNNING!!!! "It's so rough on your knees and back and joints", etc. Lifelong runners out there, how many of you have been told the same thing? How do you respond?


I respond with this, and both my neurosurgeon and sports med ortho guy agree with me: running is great at building balance core muscles and good for posture and impact problems can be dealt with by proper shoes and technique. That running is tough on knees & joints is a comment nearly always reserved for inactive ppl who try something once an quit.

I'll tell you that as someone that has suffered back problems and two operations, my back has never felt so good as when I'm running 30-50 mpw in marathon training in the summer. My back just feels strong and almost always pain-free.

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ud
Member
posted Aug-01-2007 09:32 PM     Click Here to See the Profile for ud     Edit/Delete Message   Reply w/Quote
Wendy - I feel your pain - my herniation was diagnosed as mild/slight and it felt like a dentist drilling a cavity without novacain for weeks on end!!! Not to mention those who told me to give up running forever - basically impossible for us runners to do.

When i was at the end of my rope I promised my self the roads were going nowhere and I stopped running cold turkey for 8 months to heal my back - stretching and yoga saved me - I am running now....except for a new injury - hip pain - but that is another post

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WendyCity
Cool Runner
posted Aug-01-2007 09:44 PM     Click Here to See the Profile for WendyCity     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by ud:
Wendy - I feel your pain - my herniation was diagnosed as mild/slight and it felt like a dentist drilling a cavity without novacain for weeks on end!!! Not to mention those who told me to give up running forever - basically impossible for us runners to do.

When i was at the end of my rope I promised my self the roads were going nowhere and I stopped running cold turkey for 8 months to heal my back - stretching and yoga saved me - I am running now....except for a new injury - hip pain - but that is another post


I'm now in exactly the same place as you were: NO RUNNING. I've always run because it's fun. It's no fun when it hurts. My body's telling me to take a break... so I joined my marathon training group tonight and watched them take off without me, and cheered them on. Then I went home, a bit bummed out. I'm going in for my second cortisone injection on Friday. I hope this time it works!

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WendyCity
http://interwovendesign.com/kick/userdisplay.php3?username=WendyCity

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