If you know me or have read some of my blog posts, you probably notice that I use the same few words often: awesome, super thankful, appreciate, honored, lucky, proud and grateful. I probably need to broaden my vocabulary, but I really like these words and this is how I feel about everything in my life. I am a simple person, I don’t need much and I look for the good in all situations. I am thankful for my family and a profession that I am very passionate about. I don’t care much for fancy things, but I do care about making a positive difference in other’s lives and I get to fulfill that daily as a dad and a Sports Chiropractor.
This past week I was reminded of how much I appreciate the ability to move
I often tell people that before I was a Chiropractor I was a Chiropractic patient. At the age of 20 I suffered a devastating lower back injury from falling forward during a set of heavy back squats. One of the reasons that I decided to become a Chiropractor was to learn how I can help myself overcome constant excruciating lower back pain. What I have learned and applied about musculoskeletal rehabilitation has me feeling better in my 30’s then before I hurt myself at 20.
The most severe pain since my initial injury when I was 20
This past Tuesday I felt my lower back twinge during my lunch break work out. I went back to work, but woke up Wednesday morning with severe lower back pain. The pain was so severe that it felt as if my muscles were going to rip my spine out of my body. I was forced to fall to the floor and could not move for several minutes. My friends and family saw me in a tremendous amount of pain Thursday at Christmas Eve dinner, but 24 hours later when I saw them for Christmas the pain was gone. The pain had passed so quickly they asked me how I could be nearly crippled one day and close to 100% the next. Maybe it was a Christmas miracle or maybe what I did to recover was a perfectly appropriate recipe to cure an intense acute back spasm and that is why I should share it with you. When I injured myself when I was 20, I was in horrible pain for an entire year. What I’ve learned both academically and clinically since my injury at 20 has led me to feel almost no pain just 48 hours after my pain started again.
This is how I think of it – Put out the fire
Initially, I know that the injury is so painful because of inflammation and edema. Inflammation is not a mistake; it creates pain so that your body can tell your brain that something is wrong. Inflammation is not the enemy that it has been made out to be. I think of inflammation as the firemen and the construction workers coming to put out the blaze and rebuild the area. I believe that when there is an injury we should leave inflammation because it has the workers coming to rebuild the area. When we rid the body of inflammation it leads to poor healing and scar tissue. Scar tissue is tissue that does not perform as well as the initial tissue; it does not stretch well and it is likely to be re-injured when the area is used at a high level of demand. When pain is not severe I always leave inflammation to do its job and I try to stay out of the way.
I do believe in using different things to rid the injured area of edema and swelling because it congests the area and slows healing. Swelling and edema can be thought of as the garbage that is left after inflammation has come to put out the fire and rebuild. I do have one exception to leaving inflammation and that is when you are in severe pain you’ve got to do what you’ve got do to get rid of it.
Severe pain trumps all
Movement helps to heal but when you are in severe pain you cannot move. Getting rid of pain, even if it is just temporarily blocking it with medication, is productive to healing because it allows you to move. Movement is a very important part of healing because it helps prevent deconditioning (weakening of the area) and it pumps swelling and edema out of the injured area leading to quicker recovery.
Because I was in so much pain in this situation I went to see an Orthopedic friend who gave me trigger point injection shots as well as a prescription for Vicodin. He joked with me and said that my back actually bent the needle during the injection because my Chiropractic body was rejecting his poison. I respectfully believe in a team approach and I am very thankful for his help and for medicine, when appropriate. The injection was not noticeably helpful right away. It actually increased pain and pressure in the area, but I expected this due to the soreness from the needle. When I got home I applied ice, medicated and rested. I rarely ice because it shuts off inflammation and sends the workers home, but because pain trumps all and ice is excellent at numbing a painful area I used it as often as possible.
I did this until about 6pm when my sister in-law and licensed massage therapist, Jackie DeMaio, came to the rescue. Jackie gave me a 30-minute-deep tissue massage on the injured area. I expected to be in pain the next day because I had a severely acute injury, added injections and a deep tissue massage in the same day, but I expected to feel much better the day after that.
As expected Thursday morning – worse pain than Wednesday
As predicted, Thursday morning was incredibly painful and even worse than Wednesday. Any time that I activated my lower back muscles to the slightest degree I experienced excruciating lower back pain that had me pleading to the man upstairs. Although I had severe pain I felt that this was a turning point. Throughout the day I iced my lower back at every occasion I could. I also was forced to bedrest which I am usually against, but in this circumstance I looked at it as giving the spasms a chance to relax. Another thing that helped tremendously was my father in-law giving me a cane. The cane was a great way to get me up and moving while giving me something to lean on and reduce the spasms in my lower back. On this day I also added proteolytic enzymes to digest inflammation and a Marc Pro device, which uses H-wave stimulation to pump out edema and swelling. I also performed Graston Technique (instrument assisted soft tissue mobilization device) on my lower back as part of my recovery formula. By the afternoon I was miraculously able to walk well with the cane, but I would still feel the spasm if I was standing for too long or moved too quickly. I kept drinking a lot of water, iced often, medicated and went to bed.
Friday Morning Miracle!
I woke up the next day expecting to have some pain but I only had a faint trace! My kids were great the night before and were wishing for Santa to make me better and not to bring them any presents! Was this a Christmas miracle or did I put together the correct combination of things to help overcome a severe crippling spasm?
Throughout the day I kept getting better and eventually was able to ditch the cane. I was even able to hold 2 of my children at the same time when they were tired at night and I had to bring them to my car. I still have some minor tightness in my back, but I think the success came from getting rid of the inflammation and edema as quickly as possible. So after going through this fast recovery I think it is okay to break the rule of leaving the inflammation there if you are in severe pain. Also, I believe that by resting the injury I was significantly able to speed up my healing. If I were to keep pushing my limits I would probably take a step forward and then a step back. I was able to rest the provoking activities which helped me to progress quick. So, here is the list of what helped to heal me so fast.
• Trigger point injection – Anti-inflammatory right into the affected area. Left me sore initially, but I believe it helped a day later.
• Vicodin – Helped to reduce some of the pain while my body was healing. I am completely aware that pain killers are widely abused and not used correctly. I usually do not promote them and I have never taken them before but in this situation they did get rid of some pain. This helped me to become more active which I believe is pro-healing.
• Ice – Helped to numb the area because I was in so much pain. Usually I do not like ice, but it is an excellent way to numb an injured area. I will only ice if I am in severe pain.
• Rest – Avoid provoking the area and let the muscles relax. If you keep provoking the injured area, you will not gain progress in your healing.
• Cane – Moving is extremely critical towards healing. A cane helped me to reduce the strain on my lower back while giving me the opportunity to move.
• Proteolytic Enzymes – These enzymes are a natural way to digest inflammation and edema. I noticed my biggest improvement after I started these on Thursday.
• Massage – I understood going into the massage that I would come out worse for about 24 hours. This is due to increased inflammation from the pressure on the injured muscles. However, the next day it incredibly accelerated the healing process.
• Marc Pro – This device helps to pump out edema and swelling. Definitely was a huge part of this fast healing.
• Positive thinking – Telling myself that this is temporary and it will pass.
I always believe in taking the positive out of any situation that life can throw. This experience reminded me of how lucky I am to have the ability to move and get up and go easily. To be able to move freely without limitation and pain is a gift and something that we should never take for granted. It also has reminded me to listen to my body more and that I need to do things to recover better from exercise so problems do not build up. Hopefully by sharing my story I have in some way helped you to understand what our body needs to recover quick and strong from a severe acute injury. If you have any questions please do not hesitate to contact me by email or call my office.
Stay healthy my friends,
Dr. Todd Rodman, DC, CCSP