Waking up this morning the cramp from yesterday had eased a little, but I still looked like one crooked bastard. Unlike yesterday, I was actually able to bend to the right a little. Needless to say, I did not go to work today. Instead I stayed home and felt grateful that I had an appointment with a back specialist in the afternoon.
I was met with a friendly greeting at the clinic, the kind of service uncommon outside the private healthcare sector. The waiting room was filled with pictures showing off acrobatic feats and healthy spines. I can see how some patients might become a little depressed by this after struggling to reach the clinic with an aching back, but I liked them for what I presume was the reasons they were put there in the first place. Help just around the corner. But then, I assessed my pain level as a modest 5 on a scale of one to ten on the registration form… With a major nerve impingement the trapeze dolls could have been in grave danger.
The therapist, a guy about my age, was inspiring and talkative. First we sat down and went through my injury and treatment history. I had actually prepared a somewhat detailed outline that I handed him. Thanks to this blog, it was a breeze to write down exact dates and details that otherwise would have been but foggy estimations.
Underwear time! He had me do repetitions of ten bending in different directions in order to assess whether a certain movement aggravated or lessened the protective response and pain. After I finished a movement his trained eye scanned me for minute changes in posture. He had me bend forward as far as I could go (painful), backwards (felt surprisingly good afterwards), to the left (so so) and to the right (not painful).
He told me that he was assessing me using the McKenzie method, which he proceeded to outline in some detail. If I understood him correctly, he explained that the fluid nucleus of the discs can be displaced causing overstretching of soft tissue around the vertebrae, which in turn would cause pain. The task of the assessment movements is to determine in which direction the spine has to be moved in order to counteract, and ultimately correct, the displaced fluid nucleus. After it was clear that extension (bending backwards with hands clapped around the lower back) caused relief, something that apparently is usually the case, he had me lie down on the table.
First he checked my mobility, such as seeing how far forward he could lift my legs before pain set in while I was lying on my back. Lifting the right leg it started hurting in the back first, with the left it was the hamstrings. After giving him an affirmative answer to the question of whether the osteopath had adjusted my spine, he also had me lie on both sides in turn and he pushed down hard on the leg bent on top. He didn’t do it with quite as violent leverage as the osteopath had, and I could not feel any cracking. I got the impression that he felt that it was way too early to do any heavy adjustments, but these quick jerks showed him that my back is elastic and responsive.
He then turned me on my stomach and had me do ten repetitions of pushing my upper body up with my arms as far as it would go (known as the cobra position in yoga). Then this was repeated in what he called a banana position, where the feet were pushed to the left and the hip to the right (hip away from the pain that is primarily to the left of the lower back). Indeed, I felt like any ripe banana in this position. It did not feel half bad.
Concluding a visit that had lasted a leisurely 40 minutes or so, he wanted to know whether I would be willing to come in for further sessions. Although my wallet is not as full as I’d like it to be, I naturally said yes. We booked a time for next week’s Tuesday, when another therapist will test me on various exercises in their rehab room. The idea here is that she will form her own opinion independent of his and then we will together think of a suitable approach to healing. “Scientific”, I remarked. It might be a McKenzie approach or something else; preliminary he told me that my case shows some deviation from the standard case.
In the meantime, he told me that I should do repetitions of ten in the banana position once every hour and any of the other movements we had tested that felt good. Self-assessment is key in this phase.
This visit left me feeling quite good. Although I confess to having hoped that he would crack me straight (in retrospect I can see why this would not make much sense at the moment, cf. Vince’s excellent comments) and felt a little tender from all the end range of motion movements, especially the forward bending that made me hurt at the spot of the original injury, I was very impressed his thoroughness and willingness to listen and discuss. He agreed with my thoughts on trigger points and was very encouraging when it came to my training. Before the visit I had visions in my head of him shaking his head when he heard that I injured myself doing a good morning (”stupid stupid”), but no. He also agreed that I could well continue my bench workouts as normal, although I might consider going a little lighter than singles. I mentioned doing reverse hypers and that they did not seem to aggravate my condition and he gave the green light for those as well. Not that I feel like doing any of those, or any benching for that matter, before my body is upright again.
This continuing back pain saga is inducing a split personality… On the one hand it sucks that I haven’t been able to go for any deadlift or squat records in five months, but on the other hand I am intensely intrigued by this opportunity to learn more about how my body works. I am now doing things with tennis balls and banana shapes that I could not have dreamed of before. I also hope that these posts might be of some help to others with similar injuries, while functioning as a gentle reminder to the healthy among you. Lift strict, learn what you can ahead of time and never hesitate to consult professionals. I for one will be very happy about this knowledge once I get old enough to walk around with a cane. Perhaps I won’t even need one.