Thursday, February 12, 2009

Four Miles and a Doctor's Visit

I've been off the running circuit for a couple of days. For the past few weeks (ever since my ski weekend) my back has been bothering me. I never had back problems before, so this is a new experience. Unfortunately, my wife is an expert at back problems (she has a couple of compressed discs that she deals with on a daily basis). So, she "convinced" me to see a doctor to make sure there is nothing serious going on.

I wanted to make sure I saw a Sports Medicine doctor. I've read horror stories about folks seeing their doctors and being told that the solution is quite simple - stop running. I someone who sensitive to why folks like us run. I visited a doctors that we've used for two of my kids for various sports injuries in high school. I made my way to his office for a series of xrays and an exam. I was hoping that he would be understanding about my desire to run. Little did I know that he is the Medical Director for the Surf City Marathon!

Well, the bottom line is I have a condition called spondylolisthesis. It's more a condition than an injury. The bottom line is my L5 vertebra is not aligned properly with the S1. The pain I am experiencing is being caused by inflammation of the L5 nerve. For now, my therapy is wet heat (i.e., jacuzzi) 20 minutes a day, ibuprofen (600 mg three times a day), and a new stretch added to my stretching repertoire. I do this for 7 to 10 days and we'll reassess. The best news is that I am cleared to train with two conditions - no hills (up or down) and nothing longer that 10 to 12 miles at a time.

So, armed with the diagnosis, my wife had no choice than to let me go out for my easy 4 miler late in the afternoon. Things went quite well. Kept my heart rate right at 75% MHR. It felt good to get out on the trails again.


  1. So glad that you are back at it again! :) Congrats on the good diagnosis

  2. glad they didn't tell you to stop running, especially since we know that just isn't gonna happen. i think i could handle a prescription to the hot tub! have you thought about seeing a chiropractor at all? (just a thought)

  3. Glenn,
    Glad the run went well and that you're still running. Not everyone should continue sport while rehab-ing an injury, but the real art of sports medicine is making an accurate diagnosis and then assessing how to incorporate sport into the rehab process whenever possible, albeit sometimes at a lesser degree. Even incorporating only certain elements of a sport for a period of time is very useful for athletes. Continuation of sport always has to be a consideration. A health care professional making recommendations based on lack of a confident diagnosis or lack of experience with the condition may recommend a plan which is "too guarded" and may include complete cessation of sport unnecessarily. This can have severe consequences in serious athletes and beginner athletes as well. Most serious athletes view sport as a critical part of life and when that is put on hold it erodes other aspects of life. Beginner athletes may be gaining momentum toward a healthy lifestyle in a sport and complete interruption of that sometimes leads to just plain quitting. I have taught sports medicine residents and fellows that important concept for 11 years. Basically- "Make an accurate diagnosis you can hang your hat on and then figure out how to safely incorportate elements of a sport in the rehab process" That is part of what makes you a "sports medicine specialist". It takes knowledge, experience and creativity. You've got to be as fired up as the athlete you are treating about getting him/her safely back into action as soon as possible.

    As for the comment posted regarding chiropractic evaluation, rotational manipulations in the face of spondylolysthesis can make the condition worse, but an experienced chiropractor, physical therapist or athletic trainer can be very helpful in the short and long term management of spondylolysthesis.
    Best, Dr. Aish