>Health and Nutrition>Tibialis Posterior Tendonitis AND Lumbar Disc Herniation... Ugh.
Hi all- I've had a really tough go of it over the last six months. Last November, two days after completing a half marathon, I was diagnosed with pneumonia. I completed 10 days of antibiotics for that, and two days later, contracted influenza, which culminated in a second bout of pneumonia. I was extremely ill, and didn't manage to start running again until late January. I started running just 15-20 minutes at a time, and slowly ramped up the mileage over a couple of months. Then about a month ago, I started having symptoms of bilateral tibialis posterior tendonitis. I started having ART and PT, but was not responding at all. To make a very long story short, I have just been diagnosed with an L4-L5 disc herniation, which explains why I was getting no results at all from the PT for the tendonitis. The herniation (fortunately) isn't all that severe, and conservative management is what is recommended at this time.
I was just wondering if anyone out there has any experience with disc herniation and/or tib post tendonitis- what worked for you, how long recovery took, any unconventional therapies, etc. I'll do (almost) anything to get back to normal!!! So far, I have been having ART, traction, PT (with exercises to do at home), and I've been using my inversion table regularly. Any advice/experiences would be appreciated!
Back in the saddle, after three years off...
Goals- To stay healthy and uninjured...
I've had both, though not at the same time. Tendinopathies can be a pain but I got the most relief from Graston and ice/rest. If the pain in your leg is from your back, focus on the back only. Referred pain doesn't get solved at the location, just as the source.
As far the disc issue, conservative is always where to start. PT helped because I needed to figure out what caused the herniation in the first place - poor mechanics usually needs be to addressed. From there, the only other thing that helped was a cortisone epidural. That got me over the hump of being in pain so I could advance further in PT. And consider that once you have a herniated disc, there is no going back - so you'll want to look at lifestyle changes that keep your back happy.
The biggest help for me is a standing desk. It reinforces core muscles and always keeps me in a nice, back neutral position. Core strength and good posture are critical in keeping the back happy. And remember that 30 minutes of a core workout really can't undo 10 hours of slouching in front of a computer screen.
Also this book is helpful. There's a McKensie Institute as well, my PT was a trained therapist: http://www.mckenziemdt.org/
very strange that you ask that---my bad running year last year began with disk herniation (l4-l5) in june that laid me out for about 1 1/2 months of sciaticapain followed with PTT in the opposite ankle/calf that i couldn't shake for over 2 months…lets just say it was my most craptastic running year ever…saw a chiro for the disk and a pt for the PTT…Pt did a lot of graston on the calf to release the tendon and absolutely think that helped- had a lot of scar tissue there, while also giving me exercises /stretches for the calf. She thinks there's a definite connection between the disk and the PTT, all of which takes place in the non-stabilized core. I've been doing a lot of McKensie stuff on my own when in acute pain in the back and a lot of balance activities with the pt, and both issues have progressively gotten better.
Some of the stuff i'm doing:
1. calf raises/lowers on stair-1 foot at a time, drop to stretch, the stand on toes of both feet
2. 1 legged squats (for balance)
3. McKensie extensions for back
4. an exercise my pt calls the dead bug-on yer back, legs up then parallel to floor, lower 1 leg & opposite arm at same time
everything is connected and i hope yer PTT is kicked--think core.
Thanks you so much for the advice! Oski- I'm lucky in a way, I suppose- I don't sit at a desk for work. I'm in healthcare, so I'm on my feet constantly. Though I am absolutely certain that there are aspects of my job that contributed to the development of the disc problem, and there is plenty of room for improvement in my posture and core strength. And I ordered the book!
Six- My doc also has no doubt that the two issues are connected, though who knows whether the chicken or the egg came first.
Any thoughts on graston vs. ART? I have a wonderful ART practitioner, but I would be more than willing to change it up if people have had better results with graston. And yoga- I try to do yoga once per week on my own at home, but I've been nervous about it since this all started. I certainly on't want to do more damage!
My ptt responded very well to graston... Not so well to ART. ..maybe the amount of adhesions I had going on down there due to the imbalance ...the calf was downright crunchy
as for yoga, I highly recommend cobra pose as much as possible for your back...the mcenzie protocol mentioned before is pretty much the cobra pose with full re.laxation of the pelvis on the floor ...
I herniated a disk at the end of playing 2+ hours of racquetball. Apparently running as fast as you can, stopping very quickly as you bend over really low and hit the ball as hard as you can is a risky move.
I truly believe it happened becasue my core and back were not strong enough to keep my spine protected.
For me recovery has been quick, within 4 weeks I did not have pain and now 8 weeks later, I still see a Chiropractor, to keep things loosened up down there - But we are down to once every 2 weeks and soon not at all. (1st time I have ever seen one)
Much more important to me was at the Chiroprator's office was a great trainer. She helped me identify a lof of inbalance issues in my hips, glutes and quads. I met with her 4 times to identify issues and get different exercises. The 5th time I redid all the stretches and exercises to make sure my form was right and we made a short term and long term plan to keep me healthy.
At no time did anyone I was seeing suggest conservative management. They said I could do many activities all though treatment - Running if I could tolerate it, eliptical, stairclimber, weights, core. They did frown of my downhill skiing, but I promised I would not do jumps, bumps or agrressive turns as I skiied with my family ... heck I herniated it on a Thursday and I skied the Sat-Sun after.
But the biggest thing is I immediately was doing active things - stretching and strengthening to pain tolerance to help it heal and strengthen the area.
I found that the less active I was the more pain I had. Running or walking on TM at higher incline 5% plus seemed to have a lower impact
PS - I stopped playing racquetball, Volleyball and basketball - I am ready to start now 8 weeks later. I did avoide weight lifting for 3 weeks. I also did not run on pavement - either TM or trail.
I am fuller bodied than Dopplebock
PS - I have 2 routines that each take @ 1 hour to get through between stretching, core, back and strengthening. so I do each every other day - 3 times a week = 6 total days or hours a week. It makes it hard to fit in the running that I would like to do, but at this point getting healthy is more important that getting in running shape.
Conservative management means non-surgical interventions like PT. It doesn't necessarily mean you stop doing everything active. However, you obviously have to pick and choose what activities you want to continue with smartly based on your pain levels, etc.
I've never dealt with a disk herniation but I have dealt with ptt and ran a marathon with it (which is not fun). The only thing that really helps with it is rest, but at least for me, I do still have problems with it occasionally. It is not NEARLY as bad as it was then and the pain only lasts about a day, basically it just flares up a bit. In terms of keeping it from coming back, I went and saw a PT that does a lot of work with gait and he helped fit my orthotics to exactly what my feet needed. Don't have the same orthotics anymore, but it really helped take some pressure off of the tendon while it healed. I also changed the way that I ran. I went from running almost totally on my toes to running more forefoot.
For both of those, PT will be helpful. It takes some time but honestly, that is what it will take.
That is awesome that with all you have been through, you still want to keep running. Keep it up!