Injured but looking to stay fit
February 15, 2010 3:32 PM   Subscribe

How do I maintain the fitness results I've achieved in the past month while out 4 weeks or so with a lower back injury?

In the past 30 days, I've lost fat and gained muscle due to the rigor of p90x and a careful watch of my diet. I was all ready to "bring it" in phase II, with an increase in weight and intensity, when I reinjured my lower back (bulging disc). The injury was not directly related to the workouts but is quite painful nonetheless and the second time it's happened to me. Thankfully, a last minute cancellation allowed me to meet with a physical therapist today who advised that I follow the routine in Robin McKenzie's "Treat your own Back", which I am familiar with and believe effective. He went on to say that the healing time could take a few weeks to a month or so. Bedrest is not advised and I'm okay enough to walk at a moderate clip for about an hour. My arms, chest, upper back, and legs are also pain-free.

It's quite distressing for me to put the p90x on hold but I do not want to further injure myself and would like the scar tissue to fully heal and become more extensible than it has been. That said, I'd like not to lose any ground during this month of recovery. Is that possible? If so, how? And, is it possible to actually continue my strength training in some sort of modified way while injured? Lastly, how shall I readjust my diet to compensate?
posted by ranunculus to Health & Fitness (6 answers total) 3 users marked this as a favorite
 
Speaking as one whose own bulging disc, self-inflicted just before Christmas, has only just now got to the point where it doesn't hurt every minute of every day: you don't attempt to do anything with your body except resting it enough to let that disc heal, plus whatever gentle exercise your physio recommends.

would like the scar tissue to fully heal and become more extensible than it has been.

Yeah, we'd all like lots of things. This one is not going to happen. When you bulge a disc, it heals up harder, not stretchier.

That said, I'd like not to lose any ground during this month of recovery.

This, unfortunately, is an unrealistic goal. You will lose a certain amount of ground. You need to accept that this is so, not fret about it, and just concentrate on resting your back until it heals. It will be slow. Don't expect it to stop hurting for at least six weeks.
posted by flabdablet at 3:46 PM on February 15, 2010


Response by poster: you don't attempt to do anything with your body except resting it enough to let that disc heal

Sorry, but this is bad advice. After the acute pain has subsided (one day in my case) it is best to regain mobility as quickly as possible. Provided there is no acute pain, avoiding vigorous activity is not recommended.

When you bulge a disc, it heals up harder, not stretchier.

This is true for immature scar tissue, where the fibers are disorganized. In mature tissue that has not been scarred, the fibers are organized in a parallel direction. Flexion exercises create surface tears on the disorganized scar tissue, helping to realign them in a parallel and organized fashion, enabling extensibility and full healing.

You will lose a certain amount of ground.

I believe that I don't have to. And I'm hoping others will show me exactly how.
posted by ranunculus at 4:23 PM on February 15, 2010


I would be wary about strength training; clear any lift you're planning on doing with your PT before going out and injuring your back even worse. P90X focuses mostly on isolation lifts, IIRC, so you might be able to work with your PT to modify the program in a way that won't put you at a greater risk of re-injuring yourself. And be sure that you're using proper form -- even something as simple and non-back-related as a bicep curl can mess up your back if you're not doing the lift correctly (think about that guy in the gym who tries to curl more than he can lift and ends up making his back all concave-looking... definitely not what you need right now.) Unless you're specifically told it's okay, stay away from compound lifts like squats and deadlifts, which involve either loading the spinal column or working muscles in the low back.

I think that flabdablet is right in saying that you're likely to lose some ground during your recovery month. That's just how fitness goes -- we're all works in progress, and sometimes that progress goes a little retrograde. It's really disappointing to suffer an injury right when you were hitting your stride, but you will be able to gain back any ground you lose, as long as you treat your injury with the care it deserves. I speak from bitter experience -- I injured my knee at the end of last year's racing season (I'm a mediocre distance runner and triathlete, but I have fun), ignored it because I wanted to run the last race on my calendar, made it worse, and set myself up for a 4-month recovery instead of a 2-week recovery. I'm still not back to the halfway point of where I was before my injury. Injuries need to be respected -- even if you lose some ground at the outset, you're better off not pushing things too hard.

I would suggest being as active as possible during your recovery, but finding fairly gentle activities that won't put a lot of stress on your spinal column and that your PT okays. Moderate walking, recovery-oriented yoga (be careful of poses that put strain on the lumbar spine, obviously), and swimming all might be okay for your condition. Swimming, in particular, might be good. It's a very low-impact exercise, it will build upper-body strength as well as upper back strength, and it will also help with maintaining core strength. But check with your PT first, because I would feel horrible to suggest something that resulted in your getting hurt worse.

Also, be VIGILANT about your diet during the recovery period. It's very easy to eat more when you're laid up with an injury, and a month is more than enough time to eat yourself right back to where you were at the beginning. Keep a careful watch on your diet; focusing on losing weight might result in your losing some muscle, especially if you aren't lifting, but you should be trying to maintain the fat loss that you've already achieved.
posted by kataclysm at 5:28 PM on February 15, 2010


I don't know how your injuries compare, but a friend with a lower back injury was advised to swim, particularly the backstroke. Might be worth looking into that. Here's an article about swimming and back injuries, with some cautions.
posted by salvia at 6:17 PM on February 15, 2010


I've had a bad back for years and I can tell you that swimming might be one of the best options for you (so definitely seconding that). You can start slow (before busting out laps) and do aerobic workouts in the water. See examples here.

Walking at a light pace for a longer time would work as well and you may also want to consider stationary bike as well.

As always, pay attention to your body's signals of pain and adjust your workouts accordingly. You may find it more helpful to do several shorter workouts during the day. You can continue to lift weights for your arms and build and maintain your core strength. Good luck!
posted by icy at 7:49 PM on February 15, 2010


re: stationary bike -- I would be cautious about this. More recumbent styles of stationary bike could be great. But spinning bikes, and other styles that mirror "real" bikes, cause you to lean forward, stressing the lumbar spine.
posted by kataclysm at 7:01 AM on February 16, 2010


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