Tag: health

Video version:

I will describe my still ongoing struggle with foraminal stenosis (narrowing of the cavity by which the nerve root exits) and spondylolisthesis (vertebra slipped forward; in my case “grade 1”). It might help someone who is currently suffering with something similar know what to expect, though, of course, each case is a bit different.

Though I’ve had back issues “off and on” for decades, things came to a head in mid to late 2000 (during COVID). I had learned to live with tingling in the bottom of both feet. But then, I developed stabbing glute pain (like being stabbed with an ice pick) which came on during longer walks. It started to come on at 3-4 miles, and over time, at 2 miles, then at 1 mile; then at 1/2 a mile. The technical term is neurogenic claudication .

I felt knots in my glute and thought it was piriformis syndrome. I sought out physical therapy and received it in the summer of 2021. The stretches and strengthening appeared to help. But I still could not walk a complete mile without pain; it was walk, stretch, walk, stretch, etc.

Eventually, I laid off of walking, but by February 2022, the pain came on so suddenly that I could not even walk 1/4 of a mile without stabbing pain. Walking between buildings on campus was painful.

I went to the walk in clinic at Midwest Orthopedic (Peoria, IL) and was assigned to Dr. Lilly.

The diagnosis was “degenerative disk disorder” and I was prescribed lumbar physical therapy.

It helped quite a bit; I was then able to progress to walking up to a mile with moderate to mild pain. But symptoms persisted enough to warrant an MRI:

The worst appeared to be the anterolisthesis (spondylolisthesis where the vertebra is slipped forward) of L5, with some minor problems in L4-L5 and mild stuff at L3-4 and L2-3.

I was referred to a surgeon (Dr. O’Leary) who said I didn’t need surgery yet, but suggested an injection, which I got on June 17. I steadily improved, but was far from perfect when we met again on August 9. At that time, he released me, saying “you’ll know when you need me for surgery” and encouraged me to continue with self PT, activity management, etc.

And it worked, to a point, as you can see. I was able to steadily improve my walking until I made 137 miles in December, 2022.

2023 looked like this: (note: I got COVID in January 2023 and it took a couple of months to recover; In 2024 I got 152 miles in January and 137 in February.

So, things improved a great deal. BUT I am NOT “what I once was.”

Current reality: I am managing a chronic condition. It does flare up on occasion, often due to a mistake on my part (trying something I shouldn’t have tried), illness (COVID flared it up a bit), sitting too much, etc.

But: no pain medicine. I got off of Naproxen (two 22o mg tablets twice a day) in November 2022, got back on it when recovering from COVID, and haven’t had any in about a year.

My life adjustments:

1. I lost weight. I had gained to 207 lb in the fall of 2021 and steadily lost back to the 185 that I am now. Since I carry much of my fat on my midsection, this helps relieve some of the pressure.
2. Daily PT. I learned some exercises from my physical therapists and from other sources (listed below) and I go about 20-25 minutes worth every day. There are some exercises I do daily and a few that I rotate in and out. These are designed for MY condition.
3. Walking modification: right now, I do about 4 intentional exercise/training walks a week; these are usually 5K-10K in range and are done at 13:30-15:00 minutes per mile. On occasion, I’ll powerwalk a 5K (33-35 minutes) or go for 8-10 miles. BUT if I do that, I’ll take an easy few days afterward. Also: I vary courses. I do a hilly course 2-3 times a week (sometimes hiking trails); flat the other days. And on the days that I don’t powerwalk, I do a couple of 1-2 mile commuter walks at 16-17 minutes a mile. About 1/3 of my 30-35 miles a week is this type of easy “street walking”
4. Walking modification: I sometimes make mistakes or get setbacks. Instead of panicking, just cut back to something comfortable and rebuild.
5. Walking posture: I found a posture that works for me. I try to tuck the butt and tilt my pelvis forward, and NOT go “Into extension” (arch the back). That is tricky on hills.
6. Weight lifting modifications: pull ups, I try to avoid extension (arched back) and keep my knees bent and forward a bit. And I’ve learned: try not to raise the chin but instead look over the bar. And I’ll sometimes do single reps, and keep the sets typically 5-7, though I sometimes try for 10.
7. Weight lifting modification: bench press: I keep my feet on a chair. That decreases my strength by 10-20 lbs. AND I notice if I press my butt into the bench; I get the tell-tale slight nerve pain. I HAVE to take the arch out of it.
8. Weight lifting modification: high incline press instead of overhead press; try to keep the butt from sliding forward.
9. Weight lifting modification: trap bar deadlifts; focus on form (body not too far forward), brace by breathing into the belt, and keep the weight to something I can handle 5-10 times. NO MAXING OUT. When done right, my glutes get a good pump and walking afterward is pleasant.
10. Weight lifting modification: NO DEEP SQUATS, especially with weight. It is better for me to keep a narrow stance, stay shallow and hip dominant and either use a trap bar or something that does not cause compression. I am still working this out.
11. Swimming: I ended up stopping swimming; I liked to do the crawl and I arch my back (extension) when I do that. I know drills can possibly get me out of that, and I might try again, but for now, no swimming.
12. Life modification: lumbar cushion for the couch and office chair, and a standing desk attachment for teaching.
13. Life modification: frequent walk/stretch breaks while doing desk work.

Anyway, that is where I am at the start of year 3 of recovery.

Resources

I’d like to stress that, in my case, professional help (physical therapists and doctors) were essential. Things started to turn around for me when I was properly diagnosed with a lumbar problem. But these helped me:

Life and PT exercises:

Great resource for spinal stenosis and neurogenic claudication:

This is a good explanation of spondylolisthesis (Dr. Furlan’s channel is good).

Weight lifting modifications:

A great exercise that I include daily;

I do these crunches: very useful:

Even though the McKenzie press up is not usually prescribed for stenosis sufferers, I do have disk bulging so these do help, TO A POINT:

My daily PT routine:

McKenzie press up (gentle) see above.
Glute bridges (other leg in a figure 4 piriformis stretch position

The quarter crunches with straight legs (shown above)

Dead bug.

Glute bridge with toe tap

Bird dog

Kneeling hip flexor stretch with rotation

Banded clam shell

Glute bridge with banded abduction

Psoas March

Monster walks (lateral, and forward/back)

Note: I’ve had to replace the bands a couple of times. You can see the difference between a new loop that I use for the banded (monster) walks and one that I’ve used for a year:

Life: do you really WANT/need surgery? Tough advice here: