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June 26, 2017 10:29 AM   Subscribe

Help me figure out a calorie-blazing cardio workout now that I'm living with a (seemingly) chronic lower back injury.

(Stats: I'm 40 years old, male, previously highly athletic but I've been in a workout slump over the past year due to a drastic increase in car commuting and dealing with the emotional exhaustion of caring for (and losing) my best pal to cancer. Yes, I know AskMe gets lower-back exercise questions about once every two weeks. I've read this question about weightlifting specifically, but this is more of a hard cardio-based question, since that's what I really love.)

About four months ago, after suddenly not being able to get out of bed one morning, I discovered that I have some kind of chronic irritation or compression at my L4/L5 vertebrae. Being uninsured, I had to make do with a chiropractor recommendation from my PCP. She got my lower back stable enough, but it still feels weak, like a balsa wood carving that's been shaved into a narrow hourglass shape. I've been indefinitely warned off of running or doing any kind of high-impact exercise that could run the risk of agitating or further compounding the pressure on my lower back. Trouble is, running (and everything like it) is what I love.

I've also gained about 10-15 pounds - first from being unable to do any real exercise while my back was in recovery/treatment, and since then from being confined to certain limited types of cardio. I've been hitting the elliptical fairly hard about 5x a week (averaging 88-90% maximum heart rate for 45 minutes, according to my Wahoo Tickr), and I also take my bike out for a good ride (40 miles) once a week. But it's getting tedious, and I've been gun-shy as hell about starting any kind of weight-lifting regimen for fear of tweaking my back.

So, needless to say, I'm really sick of being trapped in this particular version of my body. I've tried to streamline my diet (both compositionally and in terms of raw caloric intake) to offset the reduced exercise and intensity, but I'm feeling physically boxed-in and frustrated by the inability to get the kinds of endorphin-blazing, heart-pumping, muscle-shredding, mood-lifting outdoor exercise I used to enjoy by doing hill sprints and sand sprints and stair runs and all those other intense and delicious leg-based activities.

Under the circumstances, what are my options for really kicking my body into high gear while also dealing with a (possibly permanent) reduction in my capabilities? It pains me to realize that I've become one of those slow-moving, inflexible, prematurely old guys with A Bad Back™ at age 40, but here we are.
posted by mykescipark to Health & Fitness (8 answers total) 3 users marked this as a favorite
Oh my gosh, I'm so sorry you got sent to a chiropractor for this instead of someone who can help with long-term goals. Are you able to afford a couple sessions with a physical therapist, especially a sports-medicine oriented physical therapist? They will be your best resource for figuring out exactly what you can and cannot do and advice for exercises and whatnot.
posted by brainmouse at 10:46 AM on June 26, 2017 [3 favorites]

I spent my life with chronic back pain since I was a teen (similar spot in my back) and felt like exercise always aggravated it. I second the other commenter - physical therapy got me 99.5% pain free and I can do all kinds of exercise now. I never thought I could feel this good! If you can go, it is worth the investment. Also, aside from that suggestion, if you have access to a pool or body of water, swimming is a good exercise that is low impact on your back.
posted by beyond_pink at 11:48 AM on June 26, 2017

Working at a standing desk does wonders for my lower back pain. It's free (I just stacked up some boxes and books until I had everything at the right height) and worth a shot while you're finding a good fitness program. If you have a desk job, that is.
posted by dawkins_7 at 1:39 PM on June 26, 2017

Can you swim? I don't know if the twisting motion would be OK with your back. If you can, I think it's the most efficient calorie burning way to spend your time.

It'll take a few weeks until you get your swimming specific muscles to a level where you can get your cardio vascular system to work hard, but when you get to that point even a 20 or 30 minute hard session (no bludging at the ends!) will burn a lot of calories.

I know it's not seeing the outdoors as much as running / cycling, but you can train for open water swims which are a different type of adventure.
posted by trialex at 4:18 PM on June 26, 2017

Nth seeing a PT. Also check out Dr. Stuart McGill's stuff, for personal reference. (He's legit - the back guy, afaik.)

Until you get your back into a better situation (which I think can probably happen, to some degree, via PT/Dr. McGill!), I'd stick to the bike, and do 20-30 minutes of HIIT, if possible. Any interval you want - 8 seconds on, 12 off, 30:30, 60:60... 60:30 - that should give you a boost. There are tons of interval apps out there - I use this one [for Android] and couple it with a great playlist of happy-making songs.

The main thing for weight loss is diet. If you like food (like I do), it sucks to not be able to rely on lots of cardio to burn it off (I know from personal experience :/), but if you can't go that way, all there is is eating less (while keeping protein high to spare as much muscle as possible).
posted by cotton dress sock at 7:32 PM on June 26, 2017 [1 favorite]

it still feels weak, like a balsa wood carving that's been shaved into a narrow hourglass shape.

ah yes. mine was like a cinderblock perfectly balanced on a single pin so that if I tipped my body a millimeter too far over in any direction, the pin would snap and my torso would fall off my pelvis. they should make a list of these sensations for doctors' reference, much more informative than the 1-10 pain scale.

always always trust the sensation of structural weakness over and above what anybody tells you about which motions are and are not allowed. That terrible feeling that something is in the wrong place, which is different from pain, is the ultimate authority. that is the reason I run on a treadmill several times a week but never do yoga and NEVER get on a bike -- you can ride your bike because it doesn't make your back afraid, but I shun all forward bends because for me they are the enemy.

that is a long way of saying, not that you should go running tomorrow and jar your spine a bunch until you need fusion surgery, because that's a real risk apparently, but that I did, and do, and every so often it bumps around the thing that makes my left shin go numb and then I stop for a while. but I still do it and it's been several years since the acute stage of my two moderate herniations and one big one with nerve impingement. and I never did have surgery and I am mostly fine and can even sit in chairs sometimes.

the thing about all back recommendations and back treatments is that no matter what you do or don't do, you can just wake up one morning feeling all right again after three years for no reason. so although I would like to say chiropractors are terrible and they definitely can give you a stroke if they touch your neck and all that, a doctor-recommended one is better than a really bad PT who doesn't listen when you tell them what hurts if it's not what they've been taught is supposed to hurt. competence in all these professions is distressingly individual and unpredictable, almost independent of qualifications.

if you can or want to swim, definitely do it now before you tear your rotator cuffs from overdoing the only weight lifting exercises that feel safe on the back. it makes you feel like a damn idiot to have both a broken back and broken shoulders at the same time. and I'm not even 40 yet. but like I say, I still run and it hasn't ruined me much more than I already was. and if you want to do something physically stupid, you can always find a doctor who will tell you it's perfectly safe.
posted by queenofbithynia at 8:15 PM on June 26, 2017

I saw this today, and it might be helpful: The $100 billion per year back pain industry is mostly a hoax. The author mentions Dr. McGill, who provides a video showing the basics of back care (including the three best exercises.

Sorry about your buddy.
posted by Johnny Wallflower at 7:59 AM on June 27, 2017

Definitely find a McGill based PT. And you are probably lucky in that your lack of insurance kept you away from things like epidural injections that have been shown in peer reviewed study and study to do more harm than good but are such a cash cow for doctors that they get pushed on everyone.

If you need an MRI, drive down to Mexico and get one on a new high res machine for well under $1k. Once you have the film's you can get them read for a few hundred bucks at places like Steadman Clinic and John's Hopkins.
posted by fshgrl at 12:26 PM on October 29, 2017

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