This lower back tweak has happened 6 times in about 6 years and recovery is predicable. I go from having difficulty walking to back to skating in just over a week. This doesn't seem so bad you might say and could be considered the price for skating into middle age. Except 3 of those occurrences were in the last year and in between I get bouts of mild aching and an occassional pain when I bend over.
Looking back these seem to occur without warning, but do correlate to overdoing things eg. I've done it surfing all weekend then popping ollies on a monday. This recent one was from several days of high impact skating in a row. It also happened surfing. So part of the solution I've decided is to skate less - been doing 6 - 7 days a week since christmas (temporarily given up surfing on weekends to focus on skating - I was having a good run with learning tricks). However I reckon something isn't right with my back, for a couple of decades its had a tendency to ache at times and sometimes just bending over causes discomfort. After the last incident its got to the point where I am nervous about the future prospect of high impact skating (nollies, ollies and stuff). High impact flatland skating is what I like best, I don't want to give it away just yet unless I have too.
My symptoms are sore spot just to the right of the spine in the lower back. Pain extends either side and slightly downwards of that area, but never into the butt or legs, so no sciatica. Coughing or sneezing does invoke pain during that acute period. I've no idea what bit of my back has failed - disc, facet joint, ligament, muscle? Getting in and out of bed, putting socks on very difficult. Aching while sitting and standing, but one is not worse than the other.
So 3 days off work, then saw a chiro for the first time in my life. I went 1 week after tweaking my back and got given a number of tests such lie on back and lift one leg, both legs. Sit while the chiro presses down on my shoulders, bend forward with straight legs, bend backwards.... None of these caused pain although I stopped short of pushing it beyond the discomfort barrier, however this is the way my recovery goes, I reckon most of these would have hurt in the week after the tweak. One thing which did seem difficult/uncomfortable was the straight leg raise of both legs while lying on my back while manual pressure from the chiro was applied into the top of my head.
Appointment 1 also included manual prodding down my spine. This produced a diagnosis of 3 problem regions called "subluxations" - neck, mid back and lower back. From what I gathered on the internet "subluxation" is a misnomer in chiropractor's terms. It might mean a true joint displacement, however it is a general term which means that some spinal joint isn't operating properly in harmony with the rest of the spine - cause could be muscle imbalance, nerves not firing properly, posture, reflexes protecting some weakened structure - whatever. The chiro agreed with my layman's understanding of a subluxation. The lower back is the only bit of my spine that produces pain however I am open to the idea of things not being right elsewhere. I have rounded shoulders from bad asthma as a child and general sloppy living and working in front of a puter hasn't helped my posture.
X-rays were ordered and explained in appointment 2. This is where I hoped to get some definate diagnosis - what I really wanted to know is do I have a herniated disc or something else such as facet joint sprain/strain. A little bit disappointing was that I did not get this sort of diagnosis. The x-ray does not show this sort of detail and the chiro was more interested to see the shape, placement of the bones in my spinal column as well as the overall spine curve in 2 planes (sideways and rear view). The x-ray however does show the thickness of the discs, there is one thinned disc in my neck right next to a vertebrae which is slightly mishapen. My neck is asymptomatic. However all the discs in my troublesome lumbar region looked a good even thickness (although this doesn't rule out a disc bulge according to the chiro). Some of the curves in my spine aren't ideal in both planes, but nothing extreme and the sideways curve from a rear view x-ray was not quite into the "scoliosis" region.
despite the lack of detailed diagnosis, I am encouraged that the chiro has spotted some "subluxations" with the manual probing in appointment 1. These problem areas are somewhat backed up by the x-rays in the mid back and neck. The x-rays were not available for appt 1 so I have some confidence about her abilities. The chiropractic theory is that getting these joints to operate properly will allow my back to heal itself without the uneven load/movement that it is currently subjected to.
As well as an explanation of what the x-ray showed I did receive 4 "chiropractic adjustments" in appointment 2. The first was administered with what looked like an instrument for killing livestock in an abbattoir. Ok, I've never been to an abbatoir, but thats the image that came to mind from the spring loaded gun that was pressed into my neck. Fortunately the force was demonstrated into my hand first and its nowhere near what I would imagine to be fatal.
More unnerving was the snap/crackle/pop from pressing into the middle of my upper back. Even more unnerving was the crunch from my lumbar region which was produced by twisting my lower half while my upper half was lying sideways on the bench. Another non twisting adjustment to my lumbar region was also administered. About 10 mins worth of adjusting and that was it.
I was warned that the body needs to get used to these crunches (called adjustments) and there might be mild soreness the next day. I had already signed a disclaimer acknowledging that there was an association with adjustments and strokes or increased back pain. However I had done my homework and the risk of strokes is tiny, although stats are not rigorously collected. Regardless I have no reason to think I'm a stroke risk. What really concerned me was that 6 years ago I did some stretching on my tweaked back trying relieve the tension/ache and immobilised myself So what I wanted to know was what were the chances of the chiropractic lower back adjustment (which feels quite forceful) sending me back to where I started in acute pain. The chiro said that had never happened in the history of that surgery (3 chiropractors practise there).
After this explanation I suggested that it made sense to not skate the day after an adjustment and the chiro agreed no skating the day after adjustements, just walking. This chiropractic stuff is new to me and all my google homework on this subject had indicated that its not a case of get fixed in a few sessions and then not need it again. To be worthwhile its more of an ongoing thing. So it was not a surprise when I was informed at the end of appointment 2 that to do it properly my case would involve about 9 weeks of twice a week adjustments with regular check-ups after that. I've decided to go down this path.
Its too early to say whether chiropractic treatment together with a reduced skating schedule is the answer, but I have a positive feeling about the black art of chiropractic being able to fix me up. My positive feeling is in the category of faith rather than solid knowledge/experience.
A summary of how things have gone so far is:
Appt 1. monday, 1 week after my "back incident". The manual tests and referral for back x-rays.
Appt 2. next wednesday - explanation of x-rays plus 4 "snap/crackle/pop" type adjustments to my spine. Slight soreness the next day. By friday it had gone and I did some light skating.
Appt 3. - saturday - the same adjustments - but what happened is that having my dodgy lower back twisted quite abruptly and with enough force to make it crackle is unnerving. The first time in appt 2 it caught me by surprise and I remained relaxed during the procedure, but this time I was nervously anticipating it and tensed up just as it was applied. I also did not hear any sounds from my back this time - I suspect coz my muscles were preventing the proper stretch. This makes it less effective and was maybe the reason why my lower back ached a bit the next day - I gathered this info from the internet, my chiro didn't say anything about my tense up.
Appt 4 monday - This time I had done some mental visualisation preparation on sunday. This mental technique is of my own devices - lie on my side on the sofa, let my pelvis gently twist over and completely relax. Visualise my pelvis being forcibly twisted with associated crackle sound effects while I remain completely relaxed. Such is the pain from my back incidents that just lying there at home while imagining the lower back twist made me nervous! However I visualised it until I imagined myself being completely relaxed during the adjustment. This technique worked and the chiro agreed that I did maintain relaxation. I also got to try several pillows and got sold an expensive one which puts my neck in a better position when lying on my back and side. Sleeping on stomach is discouraged, but I don't do this anyway.
Appt 5 wed - got adjusted, but this time the neck was done by twisting my head manually, the spring loaded device was not used. Slight soreness on thurs, gone by friday. I'm happy with the pillow
I am now scheduled for getting adjusted on mon and wed for the next couple of months. I plan on maintaining the skate schedule that I did this week:
monday - morning skate before work, then chiropractic adjustment during the day (the chiropractor's surgery is close to my work).
tues - rest.
wed - morning skate then chiropractic adjustment during the day.
thurs - rest
fri - low impact skate
sat - low impact skate
sunday - rest.
What I mean by low impact skating is nose manuals, tail manuals, flat bank manuals, frontside and backside 180 slides. When I was learning the backside 180 slide I could sometimes feel some discomfort in my dodgy back, however I now have got these sorted and controllable with no low back discomfort. Plus a few 180 no complies which has me doing a light bounce on my left leg and landing with left leg weight emphasis - all my tweaks have involved a right leg loading. Also some micro nollies, but no ollies at all. I don't do all of these in one session though. I'm told "no jumping" which is how I explained ollies to the chiro. Also no shuvits - I was just about there with learning this trick and done smoothly the basic shuvit has little impact, but the trouble is I'm not competent at these and end up bailing and causing impact on a lot of them, so I'm staying away from shuvits for a while. Chiro reckons a few weeks of staying away from high impact. Rest days involve a short walk.
I've also been given daily stretches, which I will explain in another post.