Ep 16: Strength, Lifting, and Recovery with Pain, Injury, or Even Back Surgery
Last year, I went under the knife for a microdiscectomy, a type of minimally invasive spine surgery where a portion of a herniated disc is removed using microsurgical tools.
In this episode, I share my story of what happened, how I dealt with low back pain in the context of health and fitness, the surgery and recovery process, and lessons I learned along the way.
I hope my story sheds light on some productive ways to think about pain and injury and even inspires you to consider multiple options when faced with a situation like this.
Medical Disclaimer
One last thing. I am NOT a medical practitioner and am NOT dispensing medical advice in this podcast. Everything I say is my personal opinion and experience. Do NOT use this podcast as medical advice to treat any medical condition. Consult your own physician for any medical issues!
RELATED LINKS
Book about dealing with pain through screening and corrective movements:
Rebuilding Milo: A Lifter's Guide to Fixing Common Injuries and Building a Strong Foundation for Enhancing Performance (by Dr. Aaron Horschig)Starting Strength article about "pin firing" for elbow tendinopathy:
Elbow Tendonitis: How It Occurs and What to Do About It
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Transcript
This podcast was transcribed automatically, so please forgive any errors or typos.
[00:00:00] Philip Pape:Welcome to the Wits & Weights podcast, for busy professionals who want to get strong and healthy with strength training and a sustainable diet. I’m your host, Philip Pape, and in each episode, we’ll examine strategies to help you achieve physical self-mastery through a healthy skepticism of the fitness industry, and a commitment to consistent lifting and nutrition.
[00:00:26]Welcome to episode 16 of Wits & Weights. Blasts year, I went under the knife for a micro diskectomy. This is a type of minimally invasive spine surgery, where a portion of a herniated disc is removed using microsurgical tools. And in this episode, I share my story of what.
[00:00:54] How I dealt with low back pain in the context of health and fitness, the surgery and recovery process and lessons I learned along the way. I hope my story sheds light on some productive ways to think about pain and injury, and even inspires you to consider multiple options when faced with a situation like.
[00:01:17] One last thing. I am not a medical practitioner. I am not dispensing medical advice in this podcast. Everything I say is my personal opinion and experience do not use this podcast as medical device to treat any medical condition, consult your own physician for any medical issues. So I want to take you back to what happened to get me to this point.
[00:01:39] So about 10 years earlier than the surgery. So this is around 2011. I was doing CrossFit and I had just been doing CrossFit for a few months at that point. And if you know anything about CrossFit, it's a lot of high intensity interval training combined with power movements combined with barbells. Uh, it's kind of a recipe for.
[00:02:02] Potential injury, especially if you're not used to it, especially if you're not trained and you're trying to throw around big weights. Um, and I'm not blaming CrossFit at all, but at some point I was warming up with very lightweights with a back squat and back then it was a high bar back squat. I didn't have very good form and I felt something pop in my lower back and I could barely stand up.
[00:02:24] And a lot of you have had low back pain over the years, whether you lift or not may have experienced something like this, it could have been. Reaching over to pick up your kid's toy. Uh, it could happen anywhere, but it happened. And I went ahead and got an MRI and discovered I had a herniated L five S one verb, which is very common.
[00:02:46] And in fact, Once you get to your thirties. Pretty much every human being on the planet is going to start having disc degeneration, bulging some sort of issue, and many don't have any symptoms, but it was very painful and I allowed it to recover. It took a few days. I got back to what I was doing before it happened.
[00:03:09] And this time I went to see a, an orthopedic surgeon, I think at the time. And the recommendation was to get a steroid injection in my spine. I did that. It seemed to make the pain go away. I didn't think about it anymore. And then I moved on with my life in the next 10 years, maybe five years, seven years later, something like that.
[00:03:29] It happened again. And this time it didn't happen. And I was, I was lifting. I was just, uh, doing some everyday activity. Might might've been getting in the car or getting up out of my seat and I felt it again. And this time again, I just went about my day. I got some rest and after a few days, it started to get better.
[00:03:49] So fast forward to 2021. It is, I think the end of March. And again, I am warming up with my back squat and you might think there's a common theme here. Oh, the squatting is causing your injury, which is not the case at all. And even the doctors and surgeons will say, you know, we don't know what causes this.
[00:04:08] Everyone has some sort of degeneration in their spine, but for some people that just gets a little worse than others and a particular event along the way. Good causes. My wife and I both think maybe there was a snowboarding accident 10 years earlier that caused this where I effectively flipped over a few times.
[00:04:27] The edge of my board smashed into my lower back, who knows the point is last year I had the pain again, it was severe. And again, it was warming. With a lightweight on the back squat. And I could barely move. I had to lay down. I couldn't walk for like two or three days. This time, the pain wasn't going away as significantly, meaning I still had some pain and it started to radiate down into my left.
[00:04:57] Well, if anyone's familiar with this symptom, you've heard of sciatica. The, the idea that something is impinging on your nerve that goes down your leg and it results in some level of pain. And for some people it's worse than others. And for some folks that goes all the way down to your toes. For me, it went down to roughly my ankle.
[00:05:15] Um, and it sort of progressed over time, but over about a six week period, I had this pain now, initially I went to get an x-ray nothing. Uh, then I went to the orthopedic surgeon and he said, okay, well, the first thing we need to do is send you the physical thing. So I went to physical therapy and did that for about three or four weeks.
[00:05:40] I did everything to the letter and nothing helped. And the physical therapist even said, yeah, I think you need surgery. So then finally I was cleared for an MRI. The MRI showed that the herniation that I had had over all these years had gotten so severe that it bulged out into the canal where it impinged on.
[00:06:00] The nerve. So he said, all right, you need surgery. You definitely need this surgery. Now, before I get into the process of planning for, and then the surgery and then the recovery, because I think there's some important lessons there for folks, especially if your lifter, I want to take a step back and talk a little bit about.
[00:06:20] Pain in general, especially for those of us who lift those of us who exercise and there's different levels of pain, right. There's soreness, which is, could be the delayed onset muscle soreness also called Dom's where you either have you either have soreness in the workout, right. Immediately from the pump, the burn, whatever.
[00:06:41] And then you, or you can have Dom's where you get it a day or two later. And you know, you know, the feeling when you've done some heavy quad workout and. Maybe it's a new movement for you. Maybe it's an extremely intense weight compared to what you're used to, uh, or maybe even just, uh, biked 20 miles. And you know, you hadn't ridden a bike in a year and then the next day you just can't walk well, that's soreness.
[00:07:03] Right? And I think we're all familiar with that. And we know that that goes away, you know, fluids and hydration, electrolytes, all that tend to help. There's all, all tricks that people learn over the years. That's soreness. So let's put that aside. That's manageable pain. That's part of lifting get used to it.
[00:07:20] Then there is something like tendinopathy, and this is. Uh, pain, swelling, inflammation in attendance. For example, I'll give you one that affected me and affects a lot of lifters. And that is golfer's elbow. The medical term is medial epicondylitis, and this is where you get pain on the inside part of your arm, right?
[00:07:45] Where the up the bicep attaches to the forearm golfer's elbow, because people who swing a lot of golf balls, get it. But. I've also seen it quite frequently with those of us who back squat heavy when you don't have a very good grip on the back squat. And your hand is overextended to the point where you're basically supporting the bar.
[00:08:09] With your forearms and with your elbow. Uh, and ideally when you do a, especially a low bar back squat, your arms should simply be there to lock the bar to your back and your body does the work, your legs do the work. But if you have a poor grip, you can definitely develop pain eventually on your elbow known as golfer's elbow.
[00:08:30] Now, for something like that, traditionally people thought, well, I sit and take ibuprofen, and now we know that icing is probably not the way to go and that we need to. Use the tissue that is having the problem. So that is kind of what your father or grandfather used to say. Just walk it off. Basically you have to move the injured area and find some sort of pain, free exercise or tolerable exercise that will accelerate the muscle repair and the generation and limit scar tissue.
[00:09:05] So going back to the example of golfer's elbow, You know, I had it for quite a while and I tried all these different things, stretching. I'm scraping. I tried the ibuprofen, I tried the IEC and I tried heat and finally came across a recommendation, I think, through the starting strength community of. A high number of chin-ups, you know, doing, doing a few reps, um, maybe at 30% of your max.
[00:09:33] So if you could do 10 chin-ups you go ahead and do two or three and you do it like 20 times, and then you. A break and do it again. So you do three sets of that, and then you do this every few days. Now I don't have the precise, um, regimen. You can look it up. The point is it forces you to do a movement that exercises that tendon, and you, you kind of feel a little bit of the pain as you're using it, but it's.
[00:09:59] So the point where you feel like you're making it worse, uh, if anything, you're, reinflating the tissue, so to speak and helping it to heal and avoiding scar tissue. Right? So that's just kind of a tangent. I wanted to take on some of the types of pain that are not, um, not a real acute injury or something that is more severe.
[00:10:17] Now I wanted to talk about a book that was actually very helpful to me called rebuilding Milo by Dr. Erin Horshack and the subtitle is. The lifters guide to fixing common injuries and building a strong foundation for enhancing performance. And I'll include a link to this book in the show notes, because if you are having any sort of pain, okay.
[00:10:41] Back pain, hip pain, knee pain, shoulder pain, elbow pain, ankle pain. He has chapters on all of these and it takes you through. The specific sub injury types that you might have within each of those. So if you have low back pain, you know, is it herniated disc or is it something else? It takes you through movements you can do to screen for the specific pain and identify it.
[00:11:04] And then corrective exercises, including loaded. Because using barbells using dumbbells, using strength related exercises to address injury can be an important part of rehab. And it helps you change how you work out in the short term to get around the pain, but facilitate healing. Uh, and this author, you know, he's one of the ones that recommends against icing for injuries and sore muscles, and instead, you know, using movement to heal.
[00:11:35] And in some cases you have to load. The effected muscles. You just have to, through some form of moderate lifting, it could be body weight, or it could be loaded. Um, and this lesson has paid off for me throughout this whole process. I'm going to get to that in a bit. When I talk about the. However, if nothing works and the pain gets worse, that's where doctors come in.
[00:11:58] I lived with this, for this condition for about 10 years. It bothered me off and on, but it wasn't a big deal. It wasn't until it actually got worse and just would not get better. Then I finally took the next step now, before taking that. There are other things you might consider. Some of those are recommended in the book that I mentioned, rebuilding Milo.
[00:12:18] Um, but others are, are things that might work for you. For example, some forms of pain. Are for lack of a better term mental or psychological they're associated with some form of stress or underlying trigger that leads to chronic pain. And I definitely explored that for my condition, but then it turned out my condition was just an acute problem that could easily be fixed by surgery.
[00:12:43] But I also know individuals who dealt with pain. It was stress-induced. Didn't know where it came from. All of a sudden they felt a pop in their back and they were in pain. They would have to lay on the floor with their legs up on a chair. And this might've gone on for years and dealing with the mental side of things often helps for, for some of these conditions.
[00:13:03] So consider that, and then. Also consider of course the physical therapy, the mobility, the stretching, the massage, all of those things. Um, in addition to of course, the loaded movements and exercises that work around the pain. So all of these things could be solutions before you go to the point of involving a physician or a surgeon.
[00:13:28] Hey guys, I just wanted to thank you for listening to the. If you find it valuable, you'd be doing me a huge favor by sharing it on social media. Just take a screenshot, share to your Instagram story or Facebook, please tag me so I can personally thank you. And we can talk about what you found helpful and how I can improve again.
[00:13:47] An incredible thank you for supporting the podcast and enjoy the rest of the episode. All right now. Go ahead and talk about the process that I went through, which some of you may, may relate to. So I mentioned that I had the injury and. Lead to pain radiating down my leg. It wouldn't get better. I went through all of these steps, physical therapy, MRI, and then I finally scheduled the surgery.
[00:14:14] Well, throughout those six weeks, I took the advice of in, in the book, I was talking about rebuilding Milo and I continued to work out because I realized. Continuing to squat deadlift and all the other movements. If I was able to do them without making the pain worse, it was a, probably a good thing, not only for preventing scarring and keeping me moving, but for staying strong.
[00:14:41] So here's the thing I had only been doing. I'll call intelligent strength training for maybe not quite a year and a half at that point. And I had gotten stronger and stronger, stronger in terms of my maximum production, meaning all my lifts were going up, uh, but also increased muscle mass. You know, I like to do some power building, throwing some accessories to go along with my, the big lifts.
[00:15:05] And I would say that is like my number one piece of advice for those of you listening who want a. Much less painful, quicker, easier recovery. If you ever do get injured, if you ever get injured and you ever have to deal with surgery or anything like that, having been strong and fit to begin with, we'll give you a huge head start.
[00:15:28] And you see this with older folks who fall and then they break their hip and because they're weak, the other things break and then they can't move. Uh, and then the recovery takes longer and then they get an ammonia and then it sort of cascades. There's this cascade of issues from one to the next to the next, you start taking different medications.
[00:15:48] You know, I know I'm painting a grim picture, but you've heard it all before. So being strong and fit. Going into the potential for injury gives you a big advantage. So I wanted to mention that I kept working out. I didn't just give up. I knew my surgery was coming, but I kept doing all the movements that I could do.
[00:16:07] Right then I had surgery. And I went in, I had general anesthesia, the surgery probably took half an hour. As many of these things do. There's a lot of buildup, a lot of forms you have to sign. There's a lot of medication involved and then the surgery takes 30 minutes. And then I woke up. Now, keep in mind for six weeks.
[00:16:28] I had been effectively laying down on my back most of the day or working out because it was painful to stay. And to walk. And that was very limited. We tried to go on a hike and I actually had to stop every two minutes to sit on a log, to lay down on a log because I couldn't walk. I couldn't just stand around because the pain would start to radiate.
[00:16:53] It would feel like tingles in my leg and it would get worse and worse and worse until my body was like, you gotta lay down. But of course I could work out because that kept me moving. I could ride a stationary bike cause it can be moving very interesting. So here I am recovering from surgery. I wake up and.
[00:17:10] All of a sudden, I feel that there's no pain because the pain was always there. Even when I was laying down, I could feel something in my life and it wasn't there. And I was like, ah, that must be the pain medication. And they said, no, let's try to get up and walk. So I got up and I stood, no pain walked around, no pain.
[00:17:25] All I could feel was a little, a little bit of throbbing in the back where they had cut me. And over the next few days, as I recovered, that was really the only pain I had. So to speak was from where the incision was made, which is to be expected when you've been cut open and given a bunch of drugs and sewed up.
[00:17:42] That's fine. But I was able to walk again without pain. The issue was fixed. And that's not the case with everyone who has back pain. I know that back surgery can be playing the odds, so to speak, depending on what type of issue you have, especially if you have to have a, you know, a fusion or some sort of more invasive surgery than I had.
[00:18:06] I I'm pretty, I consider myself lucky in that regard. That it was an easy issue with a fairly easy fix, but it was still surgery. And so I had to take some pain meds for the first few days and I was encouraged to get up and walk whenever I want it to. So I took that advice. I won't say it to the extreme, but the fact that I could walk again, after not walking for six weeks, all of a sudden walking was my favorite new thing in the world.
[00:18:33] And we are talking may. In new England. So the weather was perfect. It was in the upper sixties, sunny, nice breeze, beautiful walking weather. And the first few days, you know, my wife and kids went out with being, I was like a, like a little old man, you know, kind of shuffling along, but I was walking and then by day three or four, I was had no problem walking, pretty good distances.
[00:18:58] And I realized that I loved walking. Took it for granted much of my life to that point and that I would now be an integral part of my movement going forward. Well, little did I know. How beneficial walking is for your mortality, for your overall health, for fat loss for giving you more room in your diet.
[00:19:18] All these things I've talked before about on this podcast. And I think I've posted about it. Um, but I think walking's the best form of cardio. So throughout this process, I realized that movement in the use of the tissue is key to your recovery because every day as I would get up and walk around and really move as much as I could, I felt less and less pain, more and more mobility.
[00:19:40] Things started to come back. And after only about a week, I got cleared by the doctor to start lifting lightweights. And then after about a week after that, I said, Hey doc, could I, could I go heavier? And he's like, You know, you can go a little heavier for you. And I said, oh, for me, you mean relative to what I can lift.
[00:20:00] Yeah, go ahead. And that kind of gave me license to start progressing again on. The lifts that I loved, you know, the back squats, deadlifts RD, ELs bench, press, everything. You read a lot of stories about how people have microdiscectomy that they're done back squat and they're done dead lifting forever. Uh, and that's sad.
[00:20:19] That's really sad because a year ago today I'm actually recording this exactly a year ago, uh, to the surgery. I don't know how many times I've squatted and deadlifts since then, since then, but it's just making me stronger. I love doing it. There's no problem with it. When I had my final checkup with the doctor, he said, you know what, I'm not going to tell you not to do anything because you're probably going to do it anyway.
[00:20:42] And it's probably not going to cause issues anyway. So go ahead. Enjoy your life. So I did, and I started to progress on my lifts again, and then. In July, we were coming back from a trip to Maine and it was the day we were driving back. So thank goodness it wasn't while we were up there. And I started to have a pain in my stomach, which developed over several hours to check myself into the hospital.
[00:21:07] I had appendicitis. So only two months after having surgery for my spine, I had to have an appendectomy. So they cut me in the open in the back. Then they cut me open in the front and interestingly, the recovery was pretty similar. Um, there was pain, you know, from recovering from the incision. I couldn't lift anything.
[00:21:27] Warren you getting a hurting enough, you do it, but I still walked a lot. And then I quickly resumed light-weight lifting as quickly as I could. I didn't wait. I didn't want to wait because I knew that movement is healing. It helps avoid scar tissue and you just have to progress in it. Um, I don't want to say slowly, but smartly and here we are.
[00:21:49] One year later. And I would say that I'm healthier than ever. And there were quite a few lessons that I learned from this whole process. The first, as I already mentioned, being strong is better than being weak. If you're strong going into an injury, you can recover better from that injury and you don't have the cascade of issues that other people experience.
[00:22:10] Number two recovery from most types of injuries requires movement and use of the effected area. Even if you have a surgery or you have a broken bone or whatever, generally, you're going to be advised to rest. You should always follow your doctor's advice, but there are cases where you can rest too much and actually prevent the affected area from healing sufficiently.
[00:22:35] So consider all the possibilities is what I'm suggesting. Don't just take one opinion, take multiple opinions and just realize that there are multiple options than the conventional, you know, staff feet and just recover option. And then the third thing is that at least for the injury. The spinal injury with the micro diskectomy.
[00:22:55] I'm not prevented from doing any particular lift, just because of that. And in fact, I would argue that doing your deadlifts, your squats, your accessory movements, they all strengthen your back and having a strong quote unquote bad back is preferable to having any weak, bad back. That is your back muscles are going to support that spine.
[00:23:17] And would you rather have a. Set of muscles, such that the spine is more easily susceptible to getting injured, especially the older you get, or would you rather have strong muscles that can support your back? Because it wasn't the squatting that caused my injury, but the squatting, the deadlifting make me stronger to prevent future injury and to support myself going forward.
[00:23:41] So that's my story. I wanted to talk about injury pain. I wanted to share the book rebuilding Milo. It was very helpful. Talk about some different options for recovery and rehab and encourage and inspire you to get back under the barbell. Keep lifting, stay consistent, you know, nutrition, walking in those things are all part of this, but loading those weights, getting stronger, developing muscle will better equip you for the future.
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