Disk Herniation & Fencing

[Philistine]

I've just got results back from an MRI--Large herniation at L4-L5 and spinal stenosis.

Right now, the major pain issue I have is pain in the left leg (especially calf) after I've been walking for a while, but between that, and the initial back pain (which was getting better and then started again), I've been out of fencing since March or so.

Anybody had similiar issues? How long were you out, and did fencing exacerbate the problems? Any advice?

Not extremely impressed with the physiatrist I've been (briefly) seeing. Basically I've been told light exercise, try to strengthen back and abdominal muscles (which is sensible). I'll be going back to my primary doctor to get a recomendation for some sort of rehabilitation--but looking for fencer's experiences.

Thanks!

--Philistine

[Mr Epee]

Lower back problems are common in fencing.

High impact and change of direction take their toll.

Most people miss the idea that strengthening your abdominal has a huge impact in relieving the pressure on your back.

I have seen many fencers, including some of the best in the world, wearing lower back supports, during training session. I have done this many times myself, but I very much dislike fencing while wearing the device. It is constricting, distracting, and I'm convinced it affected my timing. If you feel comfortable, then I recommend it.

I am not familiar with your fencing level/exposure, but you should first check with your coaching staff to make sure that you are lunging correctly, and then work with your medical experts to see if there are nuances in your interpretation of the actions are agitating your situation. It could help to strengthen your mechanics, and make sure that you don't make a bad situation worse.

I found swimming to be helpful...

[achilleus]

It won't be easy, or quick. Recovery from such injuries are slow, and often frustrating. A lot depends on how serious the injury is, and how hard you train.

Back injuries never fully heal, and fencing strains the lower back as MrE says.

I have had some problems with the back, and the minor ones I've had have kept me out of action for some time. Then again, I train hard with lots of footwork and weights.

Physical therapy, a sports doctor, a chiropractor, and an accupuncture have all been recommended and have been proven to work depending on how receptive you are to such treatments.

Good Luck.

[counterattack]

My herniation was of the cervical spine, and there aren't many similarities in the treatment of the C-spine vs. lumbar. The one thing they do share is an incredibly active and useful bulletin board of current and past spine patients. I highly recommend: http://brain.hastypastry.net/forums/...play.php?f=237

This forum is even more active than the fencing101 forum, and there are several doctors, several chiropractors, and literally hundreds of patients that answer questions and tell the stories of their successful treatments and, equally important, their failed treatments.

I researched and selected my surgery through links and contacts from this site, and a year and a month after my original injury I am mostly recovered, and I've been fencing competitively since 6 months after my injury.

I wish you the best in your recovery.

[Espada]

I took several years off from fencing and had just started back when I was diagnosed with an injury similar to yours (two herniations L4-L5 and L5-S1).

Good news is I am fencing today and have been doing so for about 3 straight years. Bad news is I tried to start back about a year after the injury and couldn't keep it up. It took me over two years before I could fence on a regular basis.

Back injuries take a long time to heal and after one injury it is easy to hurt yourself again. The best advice given to me was to take it slow. Physical therapy was also a big help.

[AntonioDelMonte]

i had a major back problem that took me out of fencing for like 8-9 years but i have been back and competing at a national level since about feb-march so there is light at the end of the tunnel i just hope you get outta the tunnel quicker than i did

[Djej]

Originally Posted by Philistine

I've just got results back from an MRI--Large herniation at L4-L5 and spinal stenosis.

Right now, the major pain issue I have is pain in the left leg (especially calf) after I've been walking for a while, but between that, and the initial back pain (which was getting better and then started again), I've been out of fencing since March or so.

Anybody had similiar issues? How long were you out, and did fencing exacerbate the problems? Any advice?

Not extremely impressed with the physiatrist I've been (briefly) seeing. Basically I've been told light exercise, try to strengthen back and abdominal muscles (which is sensible). I'll be going back to my primary doctor to get a recomendation for some sort of rehabilitation--but looking for fencer's experiences.

Thanks!

--Philistine

Once your hernia is better, you want to have a look at your hamstrings. As a man, they are probably too short. You may need to work on making them more supple. Short hamstrings make people allow their pelvis to slip forward, by-passing the hip joint and replacing it with stress at...about L.4/5, thus giving themselves a hernia.

I don't but this idea that fencing is hard on the lower back. There's absolutley no reason for it, other than bad placement of the pelvis.

[Artisan]

Originally Posted by Philistine

I've just got results back from an MRI--Large herniation at L4-L5 and spinal stenosis.

Anybody had similiar issues? How long were you out, and did fencing exacerbate the problems? Any advice?

Not extremely impressed with the physiatrist I've been (briefly) seeing.
Thanks!
--Philistine

Man... sorry to hear that... I had similar injury, only L5-S1, next one down, but from playing Hockey, before my fencing career started. That was 6 years ago and I consider myself 95 % recovered and am totaly pain free today, WITHOUT SURGURY. I can provide you with a lot of information about different therapies I tried, as well as the doctors I saw in the Philadelphia area.

I had a pretty severe case, and narrowly avoided surgury. Shortly after, I was given oral steroidal anti-inflamitories which helped quite a bit, and enabled me to do the physical therapy. I was unable to walk with out a limp for about 3 months because the nerves in my left calf were affected and could not work for 5 months because of the referred pain from the damage to the sciatic nerve. Once the vicodin prescriptions ran out, I was depressed, disabled and felt maimed. The standard treatment was just physical therapy, and around the clock high doses of ibuprophen, which the HMO required I take for at least 30 days or until I developed an ulcer before approving a drug called Relafin, which is used for treating arthritis. This worked really well for me and got me going again, moving around and exercising (with care). As I understand it, one of the problems with disk / spine injuries is that the inflammation is hard to get rid of and results in scar tissue, because of poor circulation in the area around those tissues - systemic drugs and even the body's own natural healing processes have a hard time getting to the affected areas. Physical therapy, traction, stretching and light exercise all help to promote ciculation and healing. I used an inversion table 2-3 times a day for a couple months and believe it helped. I also went regularly to a skilled chiropractor I trusted and had been seeing before the injury.

I started fencing two years later. I've found that my "back awareness" is a constant reminder for me to maintain good form. I still have spasms in the affected calf - it doesn't help that it is my back calf. Sometimes if I lift something incorrectly or too heavy my left little toe will itch - letting me know that even though the disk is healed, I'm making it bulge enough to squeezed the sciatic nerve. It's a good warning system.

I was told that part of what might have contributed to my injury was the strength of my upper thighs and hip muscles from skating - and lack of flexibility in the pelvis as a result, causing the lower back to do more work when bending. I know however the injury was due to being borded in the corner by #12.

Be patient - it will take time. The torso strengthening exercises will help in the long run but don't help with the acute situation you're in right now. The more you can move around and stay active the faster you will heal, as long as you don't re-injure it. Keep your weight down while you recover. Use a lumbar cushion in all your chairs, car seats, even in bed sleep with a little padding under your lower back to promote a good curve in your spine. Visualize that disc in your back healing, becoming firmer and more supple - refilling with fluid. See it being pushed back into its correct place by the correct forward curve of your lower back. Try to keep doing the stupid exercises for at least 18 months, even if you start feeling much better. Tai Chi is excellent. Swimming is also great - but after fencing saber you'll find it mind-numbingly boring.

If you want to try an inversion table, let me know. You are welcome to mine. Send me a PM or contact me through Delia or someone at FAP.

Best of Luck...
Tony

[CaptainA]

I had a bad disk herniation this time two years ago. I took most of the season off, and ended up having a microdiscectomy in January 04. I was back fencing Divisionals (slowly) in April. The time off was good for referreeing.

You can fight off a bulging disk with Physical therapy, and a lot of core strength, but it takes more time and discipline than most people have. I had a blown disk, so there was no issue as to treatment- I was lying on the floor talking to clients.

Maintenance of core/ abdominal strength is a must. Swimming, Pilates, and tai chi are great to combine with your regular exercise regimen, but you have to maintain those abs. Get a referral to a good manual physical therapist- it really works, but you need someone who knows more than "heat, ultrasound and massage."

Stay away from the inversion table!

[CvilleFencer]

I had an injury very similar to yours about a year or so ago, although maybe not as bad as yours. I tend to be both stubborn and stupid so I put off going to the doctor for about a week as we had our Division Champs Tourney (obviously not able to fence... even though I tried.) and a demo that I had contracted to do. Thanks to lots of vicodin and a few choice other remedies I made it through but I was not able to even half *** fence for a several months and not really back to close to normal for about eight.

I have since switched almost completely to epee, paid a lot more attention to my posture and footwork and am more careful in how I move. I still get a fair amount of leg/back pain when I overdue it, but it is much much worse if I try to fence foil for some reason. As far as I am concerned, it is proof that foil is bad for you... Still, even in epee if I am doing a lot of lunging or really fast attacks/fleches my sciatic nerve and lower back will flair up and I will be useless and miserable for a couple of days. I sometimes wonder if it will ever completely heal but I have other issues from a previous serious accident and it is hard to tell what is from which injury.

In short, give it plenty of time to heal correctly. Please be less stupid than I was and give it a proper amount of time to heal and use physical therapy effectively and regularly. Best of luck with it, and wishes for a speedy recovery!

[Sisyphus]

I feel your pain!

I injured my lower back early May of this year. The doctor thinks I initially did it by sneezing or picking something up (incorrectly), but fencing certainly exacerbated it. (I was lunging when I felt the sharp pain.)

The physical therapist recommended core, lower back strengthening exercises. Friends, family, fencers have been giving me advice and phone numbers to their masseuse, chiropractors.

It's been 3 months and I still don't feel 100%. I'm realistic that it is going to take alot of time. I don't plan on fencing much this season. Emotionally and psychologically it's been hard. This is the first injury that's affected my ability to enjoy a sport that I am passionate about. And is making me unsure whether I will ever be able to participate at a competitive level again.

Good luck to you. I wish you a speedy recovery.

[Mr Epee]

Originally Posted by Sisyphus

I feel your pain!

I injured my lower back early May of this year.

Stop pushing that rock!

It's just not going to happen...

[sabreman]

I have problems with L5 S1. It acted up recently after an office move and increased fencing. Had big problems at SN and could hardly raise my leading leg going into the de's. Now trying to rehab but it takes time. I am pretty much sure I will never be 100% but not ready to give up fencing.

[TLH]

Some previous info on the back thing....

Unless you have frank symptoms of loss of strength or sensation, or bowel or bladder malfunction, the initial treatment of nerve compression or muscular strain is conservative in nature. That would entail stopping of jumping, twisting, bending,etc. (I gave up golf for 6 months - my injury was pre-fencing). Resting with your knees bent and heat to the back/hip, along with medicines to help is the remainder of the usual initial treatment. Most would treat with actual narcotic pain meds, along with antiinflammatory meds (ibuprofen is a fine start) and a muscle relaxant. Go ahead with return to walking activity as soon as tolerated. Never ever sleep on your stomach again if that's something you do. A round of steroid medication may be beneficial as well. Xrays are not necessarily needed immediately, depending on your history and findings.

If indeed you do have a herniated or bulging disc, there's still hope for a non-surgical recovery. I had loss of strength climbing stairs, and a decreased knee jerk reflex and did fine without surgery (normal findings in less that 6 months and no recurranxce despite 2 years of fencing now) Time is your friend with these injuries as well - you may need to hold off on fencing for a while but should be able to keep up with your fitness, and even improve it while things calm down enough to let you return to fencing. A sports medicine doc/clinic could prove especially helpful in helping you prepare/strengthen/stretch to facilitate a return to your chosen sport.

If you continue to worsen or persist with problems, eventually they would want to do an MRI to define the level and extent of your injury, in consideration of possible surgery or other treatment. As a very general rule of thumb, disc surgery can work very well to relieve LEG symptoms, but can fair much less well for back pain - not what you'd think, huh? Most of us would delay as long as possible before getting surgery just for back pain.


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Some of that was a little out of order, but I think it applies. There is a good set of "core strenghening" exercises explained and illustrated at mayoclinic.com that I often refer patients to. Mr Epee is right - our neglected anterior abdominal muscles are really important. Start and continue and advance with those type exercises as tolerated. Then continue to use them as part of a daily stretching and maintainence ritual. If you can establish that as a successful habit, I think you would have a good chance of long-term successful avoidance of repeat injury and the intermittent vaguaries of low back pain. At one point in time, I went for 2 1/2 years between episodes of back pain using a twice daily regimen. Then I got married, life's priorities changed, the waistline grew, and back came the chronic intermittent pain and then my brush with a disc problem.

Philistine - a few other specifics. Exercise, generally and specifically focused to your back is essential, especially in the setting of wanting to return to your sport. If you can set up aerobic exercise of at least 30 minutes 3 - 5 times a week, you'll lose weight, become more fit, and benefit in general as well as your fencing. Don't lay or sleep flat on your back - that continues to strain it. Knees should be bent with pillows underneath, or positioned on the side in fetal position, or semi-reclining in the Barcalounger with heat (my favorite). A lumbar pillow should be added in that situation to maintain the back's normal "lordotic" curve. I would recommend continuing on some antiinflammatory, and possibly a muscle relaxant. A short course of oral steroids, or even epidural steroids from an anesthesiologist may help you avoid the need for surg.

Let me know here or by pm if you have any other specifics or questions and I'll try to help. Hopefully, you've got a GP or other primary care to assist you as well. I hope you're making progress.

Later - TLH