This week I talked to my doctors, and after meeting with my GP, surgeon, and physical therapist, we finally pieced together what probably happened. We did a back strength test, and the results weren't terrible, but they weren't great either. Add to that an increasing level of higher impact training, and my already compromised back just got overwhelmed.
I was surprised and more than a little disappointed by all of this, because I was really diligent with my exercises, and I thought my back was in great shape. But as I talked with the physical therapist about some back strengthening workouts, I could see what I had been missing. When my back was in bad shape, I was doing these types of exercises constantly; but as my back improved, I gradually replaced those exercises with other things like running and biking. And as my back fitness went down but the stress went up, I eventually passed a critical point where that disk started to hurt. What I should have been doing all along was keeping some of those back exercises in my routine to maintain that fitness; if I had, maybe this wouldn't have happened.
But that's all in the past. It's time to learn from it, and look forward. The first step was my surgeon giving me a steroid shot in my back. For those of you lucky enough never to have had this done to you, let me explain; they take a huge needle (something that looks like it would be used to tranquilize a horse), and the stick it into your spine. Dr. Bacon insists they aren't supposed to be very painful, but I'm an endurance sports guy with a real high pain tolerance, and this stuff is killer. Maybe I'm just not built right for it. On the bright side, my back felt a little better the next day, so maybe it was worth it. Maybe.
The next step is physical therapy. I basically have to do a lot of back extensions, because this strengthens the muscles along the spinal column. A back extension is like the opposite of crunches; rather then bending your head forward, you bend your head back. We did a few exercises last week, and I think this stretch of physical therapy is going to be fast. One, my back is already decently strong. And two, the rest of me is in good shape, so I should be able to do all of these exercises pretty easily. Back strength can seem kind of nebulous, but the physical therapist showed me an easy test to see where I am at. You get onto one of these back workout machines like this:
Then you hold this position for as long as you can. Less than two minutes means your back is weak, and four minutes or more means you are strong enough that you shouldn't have back problems. I could do this for about two and a half minutes, which wasn't bad, but a little on the low side. So this is my goal, get to four minutes. (Insert Madonna- Justin Timberlake collaboration here.)
Something else that will help is if I lose some weight. Those who know me know I'm no fatty, but as I've been able to workout less and less over the last couple of months, I've gained about ten pounds. For most people that wouldn't be a big deal, but as weak as my L4-L5 disk is, every extra pound that I have only puts more strain on it. I have some empirical evidence to back this up: I've attempted running at 145 lbs, 135 lbs, and 125 lbs, and each attempt was more successful then the last. My last attempt had me running for more than two months before things went haywire, so I think I'm real close. I'm around 135 right now, so I'm going to drop down to 120 and see how that feels. That was my weight when I ran the marathon, so I know that isn't too thin for me.
On top of the back-specific PT I'm going to throw in some simple body-weight strength training to build up my other systems, like lunges and push-ups. The therapist said I should avoid movements that involve forward bends, so that is going to make most ab workouts difficult; I will ask him about that specifically and see what he recommends. And I'll go swimming a few times a week to get in a solid cardio workout and help me lose weight.
So this is my game plan. Lately I've been in the dark about my condition and what to do about it, and even though I'm not where I wanted to be at the end of the summer, it feels good to have a clear vision about how to move forward. I have a follow up with my surgeon in a month, so we will see how far I can get by then. Wish me luck!