What To Do About a Herniated Disc
If you have ever dealt with any kind of back pain, you can probably agree the condition is an aggravating one. Any injury can be frustrating, but spinal issues are at the top of the list. Low back pain is one of the most common complaints of pain seen at doctors’ offices and physical therapy clinics. It can be caused by many different mechanisms, but the worst cases most likely involve a gradual onset that turns into a chronic issue. Once back pain gets into the chronic stages, it gets difficult to treat and patients become prone to further injury. When back pain involves nerve impingement, the treatment becomes even more difficult, involving a heck of a lot of patience.
What is a Herniated Disc?
The vertebrae in the spine are each separated by rubber-like pads, which are many times referred to as the “shock absorbers’ of the spine. During childhood, the discs are naturally filled with fluid and considered springy, but as we age they will actually harden over time and are less likely to aid in any kind of absorbent for forces. They become more prone to injury. Since the discs are tightly packed in between bones held in place by ligaments and tendons, any abnormal stress such as forceful bending and twisting will cause the discs to bulge out causing pain and potentially impinging on the surrounding nerves.
For the majority of new cases, where the back pain is mild, conservative management is successful. Understanding the cause of your herniated disc is the first step in treatment. Using over-the-counter anti-inflammatory medications will help with pain and swelling, as well as icing every day. The majority of insidious onset cases (non-traumatic) respond well to a core strengthening program. Heavy lifting, constant twisting or bending, or prolonged positioning can all lead to disc herniations, as the muscles in charge of performing these activities get fatigued quickly if they do not have their full strength. Running-related herniations can result from weak core muscles as well that do not tolerate the constant pounding for miles.
Specific Core Exercises
The majority of herniated discs occur with flexion-based movements, meaning when the spine bends forward. Therefore, the opposite types of movements should be incorporated when performing exercises. Examples are superman lifts, bridges, prone press-ups, and hip extension. These types of movements will promote pushing the disc back into place between the vertebrae and strengthen the muscles in charge of keeping it there. Once symptoms are under control, then more advanced core exercises, even inflexion, can be incorporated for overall stabilization.
Severe Nerve Impingement
More advanced herniated discs can pinch nerves that run from the openings between the vertebrae to the muscles of the lower body. This will cause symptoms of pain, numbness and other sensory issues, and weakness in the muscles. Treatment is still possible but can take much longer. Extension-based exercises, along with pain management such as electrical stimulation, ice or heat, and gentle massage are part of the treatment program. This will eventually reduce any inflammation, muscle guarding, and pain, as well as help, push the disc back into place.
What is the Prognosis for Returning to Running?
As with many other injuries, running is usually off limits with disc herniations in the spine. The constant pounding adds increased pressure to the back, which can cause the disc to further herniate and impinge on nerves. Until the core muscles get stronger and can keep all structures in place with high impact activities, runners should focus on cross-training exercises such as swimming, walking, and the elliptical. Since the bike requires a bended position, it is not advised to use this form of exercise. By combining safe cardio alternatives with core strengthening exercises, runners can get back into their training routines rather quickly.
Once running is resumed, runners must adopt the safest regimen to decrease the risk of reinjuring their back. Short, low intensity runs with walk breaks should be the initial focus, in order to evaluate whether your back is strong enough to withstand the impact of running. Since those with a history of lower back issues are prone to further injury, it is best to adjust training programs to limit this risk. Running on even pavement is important; therefore sand and trail running should be avoided as this increases the impact of the exercise. Getting your form evaluated by a professional is also helpful, as this will guide you to improve pelvic alignment, stride length, and overall imbalances.
Back pain is one of the most frustrating conditions for anybody. The spine has numerous structures that can be affected by posture, weakness, and traumatic injuries. Symptoms present very differently for everyone, so specific treatment approaches that work for one runner may not work for another. If you are patient and keep up with strengthening your core, running is possible with a herniated disc. If symptoms continue after several weeks, it is best to consult a doctor for further evaluation and treatment options.