MRI results not good for S2's back....

Parent Cafe
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<p>One of the things McGill has done in his research with sensors on actual athletes is measure the muscle contraction plotted against spine loading. Forget that they load the spine repetitively, crunches aren’t even a particularly effective exercise because they isolate two small, relatively insignificant muscles in the abdomen. The real key to core strength and performance is developing the entire muscular structure around the abdomen. There are layers of muscles and McGill describes them as working like the layers of plywood to provide stiffness. So, isolating one or another isn’t really the goal.</p>

<p>Also, the purpose of these muscles is not to bend or rotate the spine. Just the opposite. These muscles stiffen and resist bending or flexing, protecting the spine under load and increasing athletic performance by allowing the maximum transmission of power generated by the hips and legs to the upper body. For example, if Tiger Woods did not have a super stiff core at the moment of impact, the power generated by his legs would not be transmitted to the golf ball.</p>

<p>There are entire books and programs on core training. I’ve been doing 10 to 20 minutes of core exercises, three days a week for two years, and I haven’t even done them all. However, if she wants to feel some burn in the abs, here are a few of my favorites. All of these are very advanced, so don’t even try them until you can do a comfortable 60 seconds of front plank and side plank without back pain.</p>

<p>[Stir</a> the Pot](<a href=“http://www.youtube.com/watch?v=kukmaW9CmSU&feature=player_detailpage#t=65s]Stir”>http://www.youtube.com/watch?v=kukmaW9CmSU&feature=player_detailpage#t=65s)</p>

<p>This one, from McGills video, is really tough. Especially if you roll the arms forward towards your head, creating a longer lever arm, and try holding that position. This will set your “abs” on fire. The failure point with this exercise is having the core strength to keep your back from dropping into an arch. So, any discomfort in the lower back with this (or any plank) is the end of the set).</p>

<p>[Stability</a> Ball Dead Bug](<a href=“http://www.youtube.com/watch?v=yIOscniTeCU]Stability”>http://www.youtube.com/watch?v=yIOscniTeCU)</p>

<p>This one is really, really hard and can be made harder by holding the position with the opposite arm and leg extended for a few seconds and/or by squeezing the ball harder between the knee and hand. This works the abs like crazy, but adds a serious anti-rotation element, all without flexing the back. Again, failure point will be inability to hold the lower spine. A folded towel under the lumbar to press against may help.</p>

<p>[Stability</a> Ball mountain climbers](<a href=“http://www.youtube.com/watch?v=t8D3CMqTuik]Stability”>http://www.youtube.com/watch?v=t8D3CMqTuik)</p>

<p>This can also be done with the hands on a bench, but the stability ball version is brutal, especially if you try to hold each knee drive for a second or two. The trick is that you have to squeeze the ball to keep it steady at the same time as maintaining a stiff core. I don’t do it with the ball against a wall as shown in this video, which would probably make it a little easier. I did this one in my workout on Wednesday and it’s still crazy hard for me, although I can finally do ten reps per leg without collapsing in a heap on the floor at the end. Again, core stiffness plus anti-rotation. Same caution: stop if you feel discomfort from the lower back arching (the idea is to slowly build core strength sufficient to keep the back from arching).</p>

<p>[Pallof</a> Press](<a href=“http://www.youtube.com/watch?v=YpvbR_Ah8_g&NR=1]Pallof”>http://www.youtube.com/watch?v=YpvbR_Ah8_g&NR=1)</p>

<p>This is one named after John Pallof, the physical therapist who practices at Mike Boyle’s Stength and Conditioning in Boston. This is one of many exercises designed to increase the strength of the core in preventing rotation. It can be done with a cable column (as shown) or rubber resistance bands. The key is that the force is coming from the side and trying to turn the body. The challenge is to use the core to prevent being turned. It can also be done simply holding the arms extended. Standing, kneeling on both knees, kneeling on one knee – all great variations. Start with a lot less resistance than you think you can handle. 30 to 60 seconds per side is tough. This will make the love handles burn.</p>

<p>[Beginner</a> core exercises](<a href=“http://www.youtube.com/watch?v=kCwsuPVZeZo]Beginner”>http://www.youtube.com/watch?v=kCwsuPVZeZo)</p>

<p>Again, all of these above are advanced to very advanced. If you’ve never done core training, they may be impossibly difficult. This little beginner video is where where I started.</p>

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<p>^^^^^^^^^Thanks, I-dad!</p>

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<p>As a person with degenerative disc disease, I have also suffered from herniated discs. PT is the way to go, but make sure you find one that is experienced with back problems. I was able to work through a large paracentral herniated disc at L5-S1. My PT focussed on core exercises, including “dead bug” mentioned above. </p>

<p>Lifting should definitely be on hold, at LEAST for the forseable future. Also, he should avoid sitting as as much as he can. And, surgery should be a LAST resort, when everything else has failed, and the pain is intolerable.</p>

<p>Since your son has youth and health on his side, he should do fine with PT. AS for the sport, I’d probably defer talking about that until he is over this medical issue. I wish him the best in college and in health.</p>

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<p>I’m hoping you can take the “threat” of having to live at home instead of away at school off the table. That may make it difficult to make the appropriate decisions regarding taking care of his back.</p>

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<p>After years of soccer, D1 had an un-diagnosed stress fracture in her lumbar spine that caused it to slip signficiantly leading to severe spondylolisthesis and a double spinal fusion at the tender age of 19. Which is probably why they were so worried about the stress fracture in the spine. It is very common in linebackers, gymnasts and I guess now soccer players.</p>

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<p>Why the threat to move home then? Would it be more of a financial hardship to stay on campus playing or not playing football?</p>

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<p>There’s no money for football, but we only live 20 minutes away. He originally went to school further away so he lived there, but he hated it so he transferred here this Jan. Financially it makes more sense to live home, but we wanted him to continue to play football and the schedule sort of justified the expense. </p>

<p>Without football it is a bit extravagant to live on campus. His older brother stayed home, went to CC, and just transferred and commutes to the same school. The 2 kids across the street commute…But there are some from his HS who do live on campus. </p>

<p>Living on campus was originally a carrot so he would do well in school and keep playing. It was sort of like we know he loves to play, but every now and then there is the thought of quitting so he can have more time with his buddies. He doesn’t need more time out with them, the responsibility and accountability of football seemed better than more party time. We didn’t want him to choose the easy way out by doing comm college like some of his buddies. CC is good for some, and for some it is the easy way. </p>

<p>The subject hasn’t come up yet about moving home without football. It’s a discussion my hubby and I have yet to have. It seems unfair to S1 who would have liked to move out this year. We did consider it for him, but he didn’t want to do a school apt with people he doesn’t know. (we were robbed 2 years ago by people my boys knew) and I wasn’t going to pay for part of an apt for him and his girlfriend. His non-student friends can’t afford to move in with him.</p>

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tx5athome, S2 also had a double lumbar fracture – linebacker with 8" growth spurt in 15 months. The ortho told us it tended to happen with gymnasts, linebackers and kids with major, rapid growth spurts.</p>

<p>The docs and PT told S2 to build the core. He played two more years of football, though was not first team. He found karate helpful during that time (once he got clearance from the doc) and continues to do it today.</p>

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<p>UPDATE: I don’t remember if I posted that the family Dr. (DO)originally said it was his sacro-iliac joint that seemed messed up. He did an “adjustment” probably like a chiro would do and it felt better for one day. He tried it again a day later, no help, sent us for MRI which revealed the disc and sent me in a tizzy.</p>

<p>Went to the orthopedist (MD) and lo and he behold, he says he thinks the MRI is over-read, yes, there is a disc but S2 has no symptoms of it and the MRI also doesn’t say it is bothering the nerve. Says that most of us have them and we just don’t know it (I agree, though not necessarily at 18).</p>

<p>He tested him by moving, pressing, reflexes, etc and announces that he thinks it’s his SI joint. I was floored, same diagnosis as the family doc! Family doc had only sent us for the MRI to rule out a stress fx, he had thought it was the SI all along.</p>

<p>Ortho gave a cortisone shot with lidocaine in the SI area, if the lidocaine stopped the pain then it would confirm the SI as the source of the pain. IT STOPPED HURTING! Son stood up an bent over and had an amazed look on his face that it didn’t hurt. That was only temp relief and it hurt for a few more days (partly from the trauma of the shot–they inject and move the needle and inject more etc.) Went to the 2-week checkup and S2 announced it hadn’t been bothering him lately. WOW! </p>

<p>He has a nasty sore throat/headache that the Dr says is virus now to start spring break, but his back is better. Ortho gave him no restrictions except to ease back into things. OK to play football, he explained his rationale why and it made sense. I am feeling much better now that he is ok and not seriously injured.</p>

<p>Just wanted to update. Yay!</p>

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<p>Don’t know if this is helpful, but when I hurt my ankle and got MRIs, my parents who were doctors read them and seemed much more concerned than I. For the most part, radiologists comment on everything they notice and most of the time it sounds really bad to an untrained eye. For a surgeon or doctor, not needing surgery is always good news, regardless of the extenuating circumstances. If the dr. says he needs to go out for a while, he really should heed those words. I couldn’t play soccer for 3 months, and am recently back in training. But sometimes, giving your body a rest is actually very helpful. I feel better than before and am playing much better, so good luck with everything but make sure your S knows that he will be back, he just needs to rest and work for it when the time comes.</p>

<p>Edit: congrats on the update :D</p>

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<p>MRIs show a lot of things. But what they don’t show is the pain a patient is feeling. Many of us, if we were to do an MRI of our backs, would show deformities but we are completely asymptomatic. In addition, there are a lot of baseball players who would show up as having deformities in the labrum of the shoulder, but have completely no pain…</p>

<p>MRIs should be used to confirm the diagnosis, but just basing everything on the MRI should not be done…</p>

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<p>How many MM’s is the disc protrusion at level L4-L5, if any, as noted on the MRI report?</p>

<p>Is he experiencing any pain that is shooting down either of his hips and legs? Is he experiencing any foot numbness or walking with a “dropped foot”? This can develop later and he should closely monitor any changes.</p>

<p>I would get a consultation with a Neurosurgeon and not just an Orthopedic surgeon. A Neurosurgeon may also want to send him to a Neurologist, if he develops any burning or numbness down the road.</p>

<p>I’m in complete agreement with mini on this one. I have had herniated discs on two levels, L4-L5 and L5-S1, including back surgery. Your son should drop this sport now so he doesn’t have to pay later. Good luck to him.</p>

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<p>jshain, He NEVER had any pain shooting, radiating, numbness or tingling. It was centered in his lower back and slightly off to the right. 2 docs said it was his Sacroiliac causing the pain. The shot in his SI area caused the pain to stop immediately. I believe after the lidocaine wore off the pain was there for a few more days, but 2.5 weeks later has gone. This leads me to believe the pain really was from his SI. </p>

<p>The MRI didn’t note how many MM’s and only said that L4-5 was right parcentral disc herniation without canal stenosis…mild right lateral recess narrowing without nerve root impingement. L5-s1 disc bulge with foraminal narrowing encroaching but not impinging on exiting L5 nerve roots.</p>

<p>I will still be considering what his future holds. For now he will participate in spring practices because they are mainly conditioning, no pads or hitting. </p>

<p>I wondered whether a neuro would be willing to view his films and give some opinion as to whether is it “over-read” especially since he has no disc symptoms. If he hadn’t had the SI pain we would never have discovered the discs. How many people truly have discs like his and never have symptoms?</p>

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<p>A lot of people…</p>

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<p>hops_scout,
I’m just curious where you get your perspective on this? have you had the problem or are you in the medical field?</p>

<p>It’s really hard to know what is the “right” thing to do.</p>

<p>The Dr. had no problems at all with S2 continuing to play football. I do believe a lot of people have the same problem and may never know it. The problem is that we DO know it, but we wouldn’t have if not for the SI pain, which sort of leads me back to the fact that many people do have it and never know it until they go looking for some reason.</p>

<p>I used to work in automobile claims and this makes me really realize how many people probably cashed in on discs they had all along…We always knew that happened to some level. I wonder if study has ever been done on asymptomatic people to see how many have issues they don’t know about.</p>

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<p>I’m an athletic trainer. I deal with sports-related injuries on a daily basis.</p>

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<p>Thing is: that automobile accident caused that individual to go from asymptomatic to symptomatic so now it needs to be treated. I don’t have the research on-hand, but Stuart McGill out of Canada has done significant research on the spine and they have done studies looking at how many people had asymptomatic disk issues…</p>

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My surgeon said something like 50%.</p>

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<p>I’m not sure if anyone specifically mentioned SWIMMING, but it can be an excellent way to strengthen the core as well and can be less traumatic on the spine.</p>

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<p>College, High School or private?</p>

<p>I finally got google to give me some results on the issue of positive MRI w/o symptoms. It’s a little reassuring to know that a “bad” MRI can be “normal.” It probably explains why some of us have a bout w/back pain from time to time.
[The</a> Truth About Herniated Discs - Rebuild Your Back](<a href=“http://www.rebuildyourback.com/herniated-disc/pain.php]The”>The Truth About Herniated Discs - Rebuild Your Back)
[Positive</a> MRI in asymptomatic people](<a href=“http://www.chirogeek.com/000_MRI-Abnormalities_Asymptomatic-Pats.htm#bottom_line]Positive”>http://www.chirogeek.com/000_MRI-Abnormalities_Asymptomatic-Pats.htm#bottom_line)</p>

<p>As far as the auto claims, I agree that it can cause it to become symptomatic. There are, however, unscrupulous patients, doctors, and lawyers who will make false claims and if they are very lucky they get one of these “positive” MRI’s and claim they now have permanent pain. They may not really have any pain, but who can prove it?</p>

<p>That’s another debate for another place!</p>