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Skiing with Sciatica

skibum4ever

Angel Diva
So I've had sciatica symptoms since May and have been really suffering since the end of July. The final straw may have been the hard fall I took on my butt on our last weekend of skiing.

I started with PT which wasn't helping. After about a month of frustration and serious pain, I transitioned to a pain management clinic. This is not a clinic where pain killers are prescribed - just the opposite. It is a clinic which attempts both to provide relief and to fix the root cause of the problem. Sciatica has many causes and none of them are fun. They use PT, chiropracter, massage, acupuncture, TENS, and lidocaine shots. They do not prescribe any form of steroids or painkillers.

I finally had an MRI on Monday and will discuss it with my doctor on Thursday or Friday. A preliminary report shows damage in the L4/L5/S1 area of the back. Just what this means to my continued activity and even my coming ski season is yet to be determined. I have been frequenting Sciatica Forums rather than Ski Forums this summer. My weight is up and my fitness level is down. So I need to FIX this as soon as possible, and hopefully not through any sort of surgery, however non-invasive!

I've been doing better for the last week or so, and am cautiously optimistic that the pain will be reduced shortly to a level where I can function adequately. I have been hitting the gym and the pool, and have just started walking. I'm slow and I'm using a lightweight walker, but I meet a lot of very nice neighbors that way.

My question is - if you have successfully dealt with sciatica, how long did it take to cure and what did you do? If you are currently dealing with it, what are you doing? What is the root cause? How much physical strength did you lose while you were/are dealing with it? And have you skied with it, and how did you do? Did you do any special strengthening exercises in order to cope?

A lot of questions at this point. I hope that all who have been recovering during the summer are doing better, and that the snow gods are kind to all parts of the country this season.
 
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nopoleskier

Ski Diva Extraordinaire
I get Sciatica. have had it my whole life. it is the worst pain ever. I bought a teeter hang-up. an inversion table, My chiropractor in Fl introduced me to it to avoid over manipulation. yes, it hurts to use it but it works.
I have learned how to sit.. I rarely cross my legs, I try to never sit crooked. It flares up when I sit too much, sit crooked etc. I can't go to some places because the seats are set at an angle and I know I'll be crippled when I leave the show!

I actually find skiing helped me. yes I am still in pain but the stretching and joy I get from skiing seems to lessen the pain. (I do have a very high pain tolerance) I do exercises that I"ve learned from Dr.s and sciatica websites. they help a lot.

The hardest part is making your self do the exercises to stretch that nerve and relax the muscles that are chocking it because it hurts so much but I know that it will lessen If I do the proper stretches. I also learned that if you can have some one (Randy?) massage your bad leg/side all the way down to your feet until you have a strong pulse in your ankle sciatica lessens.

Keep stretching, and exercising See if you can find an inversion table, it truly is my lifesaver.

The only Pain meds I take is Aspirin although I did take Voltaran a couple of times when the pain was so unbearable I couldn't walk, sit, sleep, bend over but extended use can cause liver problems.

I wish you well and hope you find relief and look forward to skiing w/you at Mammoth!!
 

skibum4ever

Angel Diva
Thanks, @nopoleskier. Sorry for your pain, but good to know that you can ski with it. Make me more optimistic for the upcoming ski season. I actually bought pass insurance for Colorado, in the fear that I might never get there this winter. I didn't buy it for Mammoth because going to Mammoth is a given, and I will ski there as much as I am capable of skiing.

Last night I added my name and Randy's to the list of attendees at the Ski Diva get-together, so yes we will ski together in March.

I had an MRI and am awaiting a call from my doctor to interpret the results. If they say I need surgery, I will try to make it through this ski season without it, and reassess my pain and functionality next spring.

We had been looking at inversion tables. I actually tried one at a friend's house and thought it might so some good. Based on your recommendation, I will try to buy one in the next week or so. Thanks.

Do you know the cause of your sciatica?
 

beckylh84

Ski Diva Extraordinaire
I had herniated L5/S1 pretty severely this previous winter. Luckily mine was bad enough that surgery was the only option, so there was no decision making or screwing around with conservative treatments - I had foot drop and lost feeling in my leg, so I got the surgery and it has been a life saver. I was in the OR 4 days after the initial consult. Best thing I have done. I was walking 2 miles/day by 7 days post-op and had doubled that 2 weeks out and skiing 6 weeks later. Mountain biking like nothing ever happened. Post-op I was struggling with SI joint syndrome. That took a ton of patience, PT and bi-lateral SI joint steroid injections. My PT introduced me into dry needling and that has helped tremendously to keep muscles relaxed. It's like acupuncture but better. Then core, core, core along with upper and lower body. I'm careful with how I sit and how I lay. When I bend at the waist, I just squeeze that core tight. I always make sure whatever I do, movement dynamics are spot on. I try to walk as much as I can, but that's been a challenge lately with my ankle. My PT thinks that my ankle issues are likely leading to a finicky lower back. I also like to go to a place called iFloat. These pods with super concentrated Epsom salt water. You're totally weightless and just float there for an hour. I like that because everything just relaxes.

Earlier in the summer to get my strength back I worked with a strength & conditioning coach. No personal trainers - find someone who has experience rehabbing athletes. My guy was an ATC and strength coach for the football team at the local university. He was expensive, but worth it.
 

veronicarella

Ski Diva Extraordinaire
I tried a non-traditional method. It was recommended to me by someone who also had sciatica. She has been pain free for many years - I think she said 8 years(?). I was desperate to try anything, so I tried the AtlasPROfilax treatment in May, and have been pain free for the past few months. There are some information and (mis-)information online, which didn't reflect my experience. It was a gamble for me to try it, but again, I was desperate for pain relief, and I'm glad it has worked for me, so far so good.
 

nopoleskier

Ski Diva Extraordinaire
Thanks, @nopoleskier. Sorry for your pain, but good to know that you can ski with it. Make me more optimistic for the upcoming ski season. I actually bought pass insurance for Colorado, in the fear that I might never get there this winter. I didn't buy it for Mammoth because going to Mammoth is a given, and I will ski there as much as I am capable of skiing.

Last night I added my name and Randy's to the list of attendees at the Ski Diva get-together, so yes we will ski together in March.

I had an MRI and am awaiting a call from my doctor to interpret the results. If they say I need surgery, I will try to make it through this ski season without it, and reassess my pain and functionality next spring.

We had been looking at inversion tables. I actually tried one at a friend's house and thought it might so some good. Based on your recommendation, I will try to buy one in the next week or so. Thanks.

Do you know the cause of your sciatica?

I've never had MRI, my Dr. said sciatica is so common many causes.. I know I aggravate mine by sitting too long or sitting crooked. Flying long distance sometimes gets me. I probably have had it from old falls, when I was younger the phrase "no pain, no gain" was the mantra in training.. not good now that i'm 60,, I should have saved my knees and not put so much stress on all my joints. I did a lot of heavy weight lifting and think that could have contributed to compression on my joints?

Thankfully my sciatica comes and goes. it's gone right now, I know immediately when it's starting to happen so now I immediately stretch and watch how I sit. I hope you can find an inversion table. Teeter hang-ups was the original.. here's to no pain!
 

nopoleskier

Ski Diva Extraordinaire
I tried a non-traditional method. It was recommended to me by someone who also had sciatica. She has been pain free for many years - I think she said 8 years(?). I was desperate to try anything, so I tried the AtlasPROfilax treatment in May, and have been pain free for the past few months. There are some information and (mis-)information online, which didn't reflect my experience. It was a gamble for me to try it, but again, I was desperate for pain relief, and I'm glad it has worked for me, so far so good.

I'm checking AtlasProfilax out. thanks for the tip!!
 

Obrules15

Ski Diva Extraordinaire
I had herniated L5/S1 pretty severely this previous winter. Luckily mine was bad enough that surgery was the only option, so there was no decision making or screwing around with conservative treatments - I had foot drop and lost feeling in my leg, so I got the surgery and it has been a life saver. I was in the OR 4 days after the initial consult. Best thing I have done. I was walking 2 miles/day by 7 days post-op and had doubled that 2 weeks out and skiing 6 weeks later. Mountain biking like nothing ever happened. Post-op I was struggling with SI joint syndrome. That took a ton of patience, PT and bi-lateral SI joint steroid injections. My PT introduced me into dry needling and that has helped tremendously to keep muscles relaxed. It's like acupuncture but better. Then core, core, core along with upper and lower body. I'm careful with how I sit and how I lay. When I bend at the waist, I just squeeze that core tight. I always make sure whatever I do, movement dynamics are spot on. I try to walk as much as I can, but that's been a challenge lately with my ankle. My PT thinks that my ankle issues are likely leading to a finicky lower back. I also like to go to a place called iFloat. These pods with super concentrated Epsom salt water. You're totally weightless and just float there for an hour. I like that because everything just relaxes.

Earlier in the summer to get my strength back I worked with a strength & conditioning coach. No personal trainers - find someone who has experience rehabbing athletes. My guy was an ATC and strength coach for the football team at the local university. He was expensive, but worth it.


I had a large herniation at L5/S1 as well and had foot drop/loss of feeling/weakened bladder control and had surgery within 5 days of MRI. However I also have SI joint problems and occasional muscle spasms due to alignment problems which are well/easily addressed with chiropractic/alternative therapies (and wouldn't be a problem if I kept up every 3 month appointments instead of waiting). I think the big thing is to know what exactly is causing the problem because different things work for different problems.

To the OP, what kind of damage does your MRI show? Is it bone narrowing or disk herniation or degeneration and loss of space? That all has a huge effect on what will work. Many pregnant women get sciatica and carpal tunnel because of the near universal soft tissue swelling that you get so definitely it makes a difference if it's a soft tissue problem or a bone problem.

Laying/sleeping on the floor and using a SacroWedgy helped me when it was an alignment problem but the SacroWedgy made it worse after the disk herniation.
 

santacruz skier

Angel Diva
I'm about your size and had lower back and sciatica pain for about two years. Finally had MRI which showed two bulging discs in the L4/L5 segment and an annular tear. Lots of PT and treatments from physiatrist (didn't help) but believe it or not, it has kind of gone away. I'd say it's 90% better... My back ached at night and didn't feel great skiing. No drugs other than the cortisone and epidural.
Exercise helped and yes lower back pain running down my leg.
Do lots of PT - it really does help.
Good luck
 

Obrules15

Ski Diva Extraordinaire
First, and important, I am not an orthopedic surgeon, a chiropractor, or a physical therapist! This is not official advice. My official advice is to talk to your doctor.

Best way to envision the disks is as jelly donuts. Think of what happens when you smoosh the top, the sides bulge, and if you smoosh too hard the filling comes out through the fill hole on the side. Bulging is equivalent to protruding, herniation is when the filling comes out through the hole.

I see a few separate problems causing your symptoms, reading the report. You have extra bone growing into to spaces where the nerve roots need to travel (hypertrophic facet disease)-causing crowding-which leads to pain.

You also have loss of space (which leads to crowding and pain) because the cushions between the bones are dried out and collapsing (dessication and loss of stature). You also have small areas of the collapsing disks which are protruding into the spinal canal.

Of the three discs that are a problem, the top one has a 2mm protrusion, the middle one has a 4mm protrusion, and the bottom one shows a 3mm protrusion. Nothing is completely herniated. The middle disk has a small hole in it (just like the jelly donut fill hole) but nothing is coming out (no herniation). To put this in perspective when I had to have my emergency surgery I had 14mm of disk herniating into the spinal canal, so as scary as this sounds it's not that bad.

If I had to GUESS I'd say you've had the bone problem and mild protrusions for some time BUT the fall caused worsening protrusions and the annular tear (hole).

As far as I know (this is not Medical advice) nothing can be done to fix the extra bone problem (maybe surgery, but I'm not sure). On the other hand the protrusions, desiccated disks and annular tear (without herniation), provide opportunities for improvement.

I would worry that chiropractic manipulation could put enough pressure on the disk that it could herniate through the tear. I herniated my disk bending over installing a router so I would use a healthy dose of caution in anything you try. I am actually a huge fan of chiropractic, but in this case I'd worry.

The fact that your disks are dried out and smooshed provides the best chance of non-surgical improvements. Treatments that are non traumatic, take pressure off the disks, and are hydrating would seem to be most likely to work (don't know if they will but they'll address the actual problem instead of treating pain). Definitely do NOT use the Sacrowedgy.

I know of a few things you could think about trying, first would be an inversion table. I think someone else on this thread had good results from inversion. It's non traumatic and would decrease the pressure on the disks and allow them to hydrate. The second is a belt that my orthopedic surgeon gave me which kind of stretches the spine to take the pressure off the disks. I've also read about stem cells transplants for this kind of thing but I don't know how well they work and they're not covered by insurance.

If you focus your research on expanding the height of your disks and keeping them hydrated I think you'll find some things that will work really well.

Good Luck.
 

santacruz skier

Angel Diva
Best way to envision the disks is as jelly donuts. Think of what happens when you smoosh the top, the sides bulge, and if you smoosh too hard the filling comes out through the fill hole on the side. Bulging is equivalent to protruding, herniation is when the filling comes out through the hole.
Exactly what I was told by my physiatrist! But he said with PT etc, the jelly can be pushed back into the donut where it belongs... I think mine did as the pain as finally diminished (unless sitting for long periods of time). Also I am very careful how I bend, squat, turn, etc....
I think the PT will really help, but you have to be patient. I wasn't particularly patient. I just wanted it to go away.
 

Obrules15

Ski Diva Extraordinaire
Exactly what I was told by my physiatrist! But he said with PT etc, the jelly can be pushed back into the donut where it belongs... I think mine did as the pain as finally diminished (unless sitting for long periods of time). Also I am very careful how I bend, squat, turn, etc....
I think the PT will really help, but you have to be patient. I wasn't particularly patient. I just wanted it to go away.

I was just doing some reading and it looks like PT builds up the adjacent muscle & improves circulation which helps the disk stay hydrated, which are longer term fixes, but take time. Inversion seems to be more of a short term fix for the pain as it increases disk height mechanically, but it won't permanently fix the problem (though there's debate). Seems like a combination of PT and Inversion would get the best result as one works in the short term but doesn't last, and the other one has more lasting results but takes a while to kick in.
 

skibum4ever

Angel Diva
Many thanks, @Obrules15. How did you get so smart about these issues? That's a fabulous analysis.

We bought an inversion table and will start using it soon as it has not yet been delivered.

I have been going to a Pain Management clinic and chiro is one of their biggest recommendations. I will discuss this report with them on Monday.

We have a trip planned in October and I'm wondering if getting an epidural just before might help the pain for a couple of weeks.

OTOH, I seem to be getting better. I was able to bowl today without pain meds and without pain. I can walk short distances. I'm cautiously optimistic, because it sounds like sciatica sometimes improves, then roars back.

Thanks for all your comments, everyone. Please keep them coming. If I get any sensible input from my doctor on Monday, I will post an update.

@Obrules15, what is your belt called? Sounds like something I should look into.
 

Obrules15

Ski Diva Extraordinaire
I believe it was the Air Traction Belt. Not entirely sure. As to inversion, it might need to be to greater than 60 degrees to show significant benefit.

As for your Sciatica coming back, you now have enough information to know that it will likely get worse with dehydration (other types might improve w/dehydration so it's important to keep in mind your particular problem), prolonged standing, and at the end of the day (we all lose around 0.75" in height daily due to disk compression and regain overnight), so I wouldn't be fearful, just thoughtful and aware. It's not random, mostly it just feels that way when we don't know enough.

As for chiropractic, many people with Sciatica will benefit, however most people don't have a disk with a tear. You've already got a hole in the disk, the wrong type of pressure might just cause your disk to get the squirts. Definitely discuss it with your pain management center and make sure they understand you have an annular tear and no herniation. Same with the chiropractor if you go, there may be less twisty things they can do. When I get a back adjustment (I waited until I'd healed after surgery) they usually do a pretzel twisty thing to me which just doesn't strike me as the best move for a weakened disk.

As to my analysis of the issues, that's definitely one of those lucky life experience gifts paired with many years of work/study. I am actually a Clinical Associate Professor of Ob/Gyn at Temple School of Medicine but I didn't know anything about this topic until I was having all of my herniation issues (limping/pain/loss of sensation/loss of bladder control) and the ORANGE CRITICAL WARNING MRI report popped up on my computer. It's amazing how fast I learned an ungodly amount of information about my least favorite subject. Apparently facing neurological damage and permanent loss of bladder control is highly, highly, motivating.

Seriously though, none of this is from a medical perspective, it's my research into the traditional and alternative medicine aspects of the issue, so take it with a grain of salt and do your own research and ask tons of questions. From my research you are actually in a great position to knock this out.
 

santacruz skier

Angel Diva
@Obrules15 currently I see a personal trainer and am doing different chiropractic treatments called sports chirotherapy. No adjustments but it feels like acupressure as the chiropractor uses his elbow and "Kneeds" the muscles in my back and knee area (after injury in March I have avulsion fracture to ACL and flap tear meniscus!)
Would sports chirotherapy help @skibum4ever ? I think it helps me but at first I was petrified of it.
 

Obrules15

Ski Diva Extraordinaire
@Obrules15 currently I see a personal trainer and am doing different chiropractic treatments called sports chirotherapy. No adjustments but it feels like acupressure as the chiropractor uses his elbow and "Kneeds" the muscles in my back and knee area (after injury in March I have avulsion fracture to ACL and flap tear meniscus!)
Would sports chirotherapy help @skibum4ever ? I think it helps me but at first I was petrified of it.

I think so, and even the AtlasPROfilax sounds good.

There are definitely types of chiropractic which are less scary for this and I even got traditional chiropractic after the herniation, but before my surgery, which helped with the muscle spasms and low back pain (and might have prevented my herniation if it was at all due to muscular hypertension). However, when talking to my orthopedic surgeon (OS's do tend to be biased against chiropractors, so maybe take this with a grain of salt) he mentioned that his last patient had herniated a disk as a result of a botched adjustment. Thus my fear.

I'm definitely pro chiropractor, I saw one for the first time when I was 14, and try to go regularly. It's just not all of them are good, and it may take time to find one who is (and who has an appropriate understanding of the issues) so if you are seeing someone for the first time when you've so clearly got a big vulnerability (a not herniated disk with a hole)..............

I've been evaluating alternative treatments for my mother for 25 years and my perspective is that if it's not harmful, might as well try it, especially if traditional therapy is not working. In this case my fear is that a bad chiropractor could make things so much worse (cause herniation!), why risk it until and unless everything fails.
 

skibum4ever

Angel Diva
Thanks to all who responded. You gave me a wealth of good information, plus hope for my active future.

I received 2 cortisone injections last Tuesday - in the SI joint (sacroiliac) and in the Piriformis muscle. Since then I have been improving. I'm sleeping better and my pain during the day is much less. I know that cortisone is not a cure, but it will allow me to become more active, to start strengthening the surrounding muscles/tendons/ligaments, and to work toward my goal of being able to ski this winter.

I will continue to update my progress, and hopefully there will be actual progress to update.

To all who are healing, remember that it is a journey. Take it easy but persevere.

Think snow!!!
 

skibum4ever

Angel Diva
Today was my first day skiing. I was really scared of what might happen, but it went OK. I took 6 low intermediate runs, then rested, then took 4 more runs. Only minimal pain.

Tomorrow morning I hope to get out fairly early and try some slightly tougher runs while I and the snow are still fresh.

Then after Thanksgiving I have to seriously consider getting into ski shape. Time to use the Skier's Edge and get a little more aggressive at the gym.

I can also ski myself into shape, though I'm not sure that's the best plan.

Now I have one more thing to be grateful for. Happy Thanksgiving everyone!!!
 

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