A back pain question from a triathlete

Question from a real patient:

Dr. Hyman,

My name is (deleted) and I’m a member of the (deleted) Triathlon Club. I noticed you are a sponsor and are very familiar with the athletic world who has worked with all types of athletes. I’m in my fourth year of racing Tri, which is remarkable due to a back injury in 2001 that resulted in a bulging disc. In 2006 I had a skiing accident that resulted in an avulsion facture of the L5 vertebrae. I was all healed up and good until a week ago when for some reason, a drive to Breckenridge aggravated my back. This resulted in crawling around for a couple of days. My back is very stiff and the pain is now tolerable. I want to consult your services in hopes of a speedy recovery to get back to training. Can you help me and how?

Answer:

A patient with this type of injury history is susceptible to aggravations of back pain. These may be severe and these may be minor. Since this patient had no pain radiating into his legs, and no other neurological symptoms, I was comfortable working with him. In this case, a simple move in the wrong direction led to a fairly significant muscle spasm. It’s likely that this person’s existing herniated disc received excessive pressure as a result of his posture in the car. This led to a painful guarding response that stopped him from skiing and doing further damage to his low back. After 2 – 3 weeks of treatment and some reasonable range of motion exercises, this patient should be able to return to full activity. His triathlon training should be normal, but core strength is definitely going to be a priority.

Note: This article is for informational purposes only. Don’t use it to diagnose yourself. See a qualified licensed health care practitioner.