Returning to running after a disk injury - JP Fitness Forums

Kamal Singh · 05-01-2007, 11:10 PM

Hi,

Wanted your advice on returning to running after my disk bulge injury at L4-L5, happened in late Nov 2006. I have been going through rehab with a Paul Chek back specialist who has me doing core work on a Swiss Ball, spinal stabilization etc, who recommends 'walking' for exercise! By when do you think it would be okay to resume running again. I am talking running on a mud/grass track and not a treadmill.

Thanks

Kamal

UConnJulie · 05-02-2007, 07:07 AM

Generally I tell my patients who want to resume running that if they are painfree and compliant with their back exercises (McKenzie, stabilization, etc) and lower extremity flexibility that they can resume running/jogging but really limit the time/distance that they run initially. In other words, stop before you start having pain. And limit running to once or twice weekly for the first month gradually building up from there. We might start with a time of 5 minutes and slowly increase as long as they stay painfree and don't neglect the corrective exercises.

Disc injuries are compression injuries, and the compressive forces you body experiences are much higher during running than walking. You want to be sure that things are well healed before introducing that compression to the spine again.

But then again, if you are running in mud, you probably aren't going that fast ... and the compression would be less

(We played a charity game of Ooozeball - volleyball in the mud - when I was in college ... it was a challenge to run in that stuff!!)

bryanc · 05-02-2007, 07:54 AM

Our rehab protocol for returning to running after any injury is a walk/run scheme. Basically, you divide your running into 5 minute chunks. The first progression is to run for 30 seconds, walk for 4 minutes, 30 seconds. We generally recommend no more than 6 "chunks" though (for 30 minutes of total activity). Frequency of walk/running is generally 3 times a week. We caution against more, but that judgement call is a decision that is made between the physician, the athlete and their coaches (if there are any) based on their current state of fitness, and severity of injury. If it's less than 3 times a week, the you will not likely progress every single week. And that's okay because there's no concrete schedule in this program. The goal is to return you to running, period; not to return you to running at the cost of your health.

After a week, you get to increase your running time by thirty seconds, again, provided you have not experienced pain or other 'injury symptoms'.

You can increase your running time by 30 seconds a week, for a maximum activity time of 30 minutes until you're running for 4 minutes 30 seconds, and walking for 30 seconds. At this point, you can start to increase your total time if you want to, by adding an extra 5 minute chunk. So, as an example, if you've reached the 4 minute 30 seconds run, 30 seconds walk, the following week, you can run for 30 minutes and then add on another 5 minute chunk of 4 minutes 30 seconds run, 30 seconds walk.

You can scale this progression up or down as you require, but have a low threshold for regressing to a previous "chunk" scheme or not progressing to a more advanced "chunk" scheme if you're not sure if you're ready to move on or if you have symptoms.

Additionally, it is not recommended that you modify the walk/run ratio within a workout unless you are having pain. This recommedation is there so that you do not try to advance yourself more quickly than you should be because you feel that you can always increase your walk portion if you start to experience pain.

You should be pain-free throughout all of your walk/runs.

The rationale behind this protocol is that most of our athletes, after having sustained an injury that has required them to stop play/activity/training, require both acclimatization to the activity itself as well as cardiovascular re-conditioning (since they have de-trained through their injury and recovery period). It is a gradual return-to-play protocol with a self-regulatory component that allows the player to progress in accordance to their specific symptoms, thus ensuring that adequate, but not over-loading of the injured structures is occuring for optimal rehab and return to play.

Kamal Singh · 05-02-2007, 10:13 AM

Thanks for the prompt replies Julie and Bryan. Shall keep your suggestions in mind. Thanks once again.

Kamal

Kamal Singh · 05-11-2007, 02:02 AM

So would you recommend the recumbent cycle and the elliptical mchine in place of running.

Thanks

Kamal

UConnJulie · 05-11-2007, 05:46 AM

I'm not a big fan of the recumbent cycle ... I think running is fine, but when starting you need to intersperse it with a lot of walking and really limit your total time out as Bryan suggested. Gradual progression is the key, as is listening to the symptoms that you are experiencing/not experiencing.

Kamal Singh · 05-11-2007, 09:44 AM

Thanks Julie. I am goling bonkers not being able to work out. When you go from 6-8 per week of training to at the most half an hour week, withdrawal symptoms are pretty bad

. Its been six months of rehab, and no gym, no dojo, no track Jeez. Sorry, I know I shouldn't be indulging in self pity.

Thanks once again

bryanc · 05-13-2007, 08:56 AM

If you want to cycle on a stationary bike, and you can do it symptom-free, and it will save your sanity, then go ahead. I think the recumbent bike puts your back in a weird spot given your injury. The eliptical would basically be artificially 'cheating' with additional running.

If you want to just walk, and you can do it symptom-free, then you can walk 'til the cows come home if you want to. (By the way, cows never come home on their own).