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    Deconditioned due to back injury
    marieh9 posted:
    Hi, I have been sitting too much due to back pain. I have been walking now (slowly) 40 minutes a day. I do stretches too. But I can't yet bend or twist. I haven't been doing chores or other activities except finally doing dishes and helping with small things. How much activity can I start with to stop sitting so much without pulling a muscle (I have done this) and without too much pain to start with? I would like to do water exercises but I have a couple of problems: 1. I am not strong enough to get up and down the steps in the pool 2. I can't get by bathing suit on by myself due to bending being a problem and 3. I haven't been able to wash below the waist yet without pain. I need to do some starting exercises to get stronger to be able to do this obviously. Problem is also that I was injured by a physical therapist and then the second physical therapist had me do a lunge on the floor which made me pull a muscle because I was not strong enough to raise myself up. What are some suggestions to get started here. I am very motivated. I have no spinal problems (MRI negative, bone scan negative and have seen several doctors). It is not diagnosed but is upper buttock pain near the SI joint but the doctors (orthopedic surgeon, pain doc and physiatrist( all don't have a diagnosis. I have heard myofascial, possibly sacroilitis, or torn ligament. One said perhaps facet joint (pinched nerve) but the MRI is negative for that. So, given that info what exercises can I do to keep me from pulling muscles but get out of being deconditioned? Keep walking? Anything else?
    thanks so much
    Rich Weil, MEd, CDE responded:
    Hi Marie,

    I'm hesitant to suggest any exercises without being able to see you in person. Have you discussed with your doctor going to physical therapy? You probably wouldn't need a lot of sessions, but a careful evaluation by a therapist would allow them to prescribe safe exercises. I recommend you do that. You could also check out the Sports Medicine Community at for some of your medical questions related to your diagnoses.

    Take care,
    An_198519 responded:
    I agree with Rich; find a new (better:) physical therapist. As far as aquatic exercise, check with the Arthritis Foundation in your area. I know you don't have arthritis, but they have excellent aquatic programs, tai chi - which are gentle exercises, and walking programs. As far as the bathing suit goes - just wear a pair of loose, easy to get on shorts and a t-shirt. There are long handled reachers to help you get dressed and wash when you can't bend. And if you take an aquatics class, I'm sure someone will be able to help you in and out of the pool safely. Water exercises are a great idea.

    Congratulations on the 40 minutes of walking! That sounds really good. Sometimes nordic walking poles can help you take some of the weight off of a sore back. They also help develop some strength in the trunk muscles that support your back, and can improve your posture when walking.

    A back support or SI joint belt may not be a good idea for long term use, but it can be helpful in the short term to protect your back as you get moving around more. There is also an "aquajogger" belt that supports your back for water exercises.

    Just make sure you have someone, who knows about your back problems, coach you on the right water exercises for you. A physical therapist should be able to give you some recommendations and some appropriate exercises.

    Here is a link for some of the suggestions above:
    Hope that helps! Good Luck.
    marieh9 replied to Rich Weil, MEd, CDE's response:
    Dear Rich Weil,
    Thanks for your response. I mentioned above that I was injured by two physical therapists. Both did manual manipulation and both were Ph.D.'s in physical therapy and manual therapy. I am hesitant to go to another one. I am following the last PT's exercises and am loosening up some but still don't know how much to go forward. I went to a orthopedic surgeon and he said it was dynamic not structural, and the pain doctor didn't do a physical but said it was myofascial and the physiatrist had no clue and didn't give me any stretches or idea of exercises except do more and get up more. I just don't know how much to get up without getting too fatigued. I am doing a little more walking each day and keeping up the stretching. I feel no one wants to help me. So, I guess I just have to do more and hope that I do the right thing. I'll look at the sport med exchange. How much sitting is too much? I am starting to move more but it is slow progress. I just thought someone could mention something about how to get out of this sitting too much state other than walking. I want to get into the pool but I don't think I'm quite strong enough for the steps in the pool. Any ideas at all? i can walk up small steps.
    marieh9 replied to An_198519's response:
    Hi Anon,
    Where do you get the long handled reachers and washers? I can't seem to find those things. I also do stretches twice a day. It is hard but I'm making slow progress. I appreciate your help. I have been to two physical therapists and both injured me more. The first one did manual manipulation on the wrong leg and made me much worse than I was to start with. The second was also all hands on but he was too aggressive because I had been sitting for 2 months and he had me do a lunge on the floor and I couldn't get up with my bad leg (side) and pulled a muscle. He also did traction on that leg and it hurt and then bruised my ribs trying to do a correction of some sort. I do want to get the next stage and am now getting into the car and have driving a short distance but that hurts. Do you know if that is because I have been inactive and it causes pain when you move in different ways until you get used to it? I'll look up your site too. I need to get my life back. I think it probably is myofascial and I just can't seem to get anyones solid help. I do have one physical therapist that I trust that I would have to pay cash for (not on my insurance). He got me over this last time but I wasn't deconditioned then. So, I don't know if I'm ready for him. well, take care and thanks.
    debrazgalaxy replied to marieh9's response:
    Hello there Marieh~ I sure UNDERSTAND! I had become lazy due to not wanting to reinjure my self to a worse condition. But my mind couldn't take it anymore.
    BUT YOU are at a different stage in your journey friend.

    If I was YOU... I would apply heat a few times a day and take anti inflamatory meds. You also should give in to muscle relaxants. I would also NOT walk while the problem is antagonized. The sciatic pain says that there IS compression on a nerve. Maybe just by the swollen muscles...but compression all the same.

    PLEASE hear me~ I am 48, female 5'10 ,150 lbs~ I had a discectomy and laminectomy in 98 DUE to doctors NOT believing my pain . Mine also started as muscle spasms which did what YOUR muscles are doing. You need to break the spasms so that your muscles do NOT wreck your spine. If you have foot problems , IT may be triggering your spasms. I no longer seek medical attention due to not wanting drugs or ANYMORE injections. My FINAL damage to my spine was by a chiropractor that did NOT bother to investigate why I had the problems. I was only in my early 30's so I was "to young to have a serious problem". What I had at that point was a bulging disc with bone chips and calcium deposits encringing on the nerves. ALSO 24 hr a day hip pain and left leg numb and foot drag. The manipulation is probably what blew my disc. SURE felt like it! I too was damaged further by PT after surgery... I DID try water arobics a couple of years after surgery, I was told NOT to swim as that stretched out the spine and would cause problems. The actual exercise in the water felt GOOD. Take an anti inflamatory like ibuprofin before going. What felt REALLY good was that I was making an effort to improve my situation instead of WISHING life was better. TAKE TIME TO HEAL!! OR you will set yourself up for a lot more agony in the future. GIVE youf SELF permission to rest. Your BODY is giving you early warning friend. LISTEN to it. Sincerely, Deb~ PS.. Did YOU have blood work to see if you had EXTRA muscle protien in your blood? They should check you for muscle diseases too.
    debrazgalaxy replied to debrazgalaxy's response:
    YOU STILL have HOPE for NOT further injuring your self Marieh~~ You really NEED to help yourself so that your future does not mimick many others that got further damage.

    more history... hoping you take time to heal!

    I was reinjured after several falls when my leg was not working properly... nerves to my leg were severed prior to my surgery. THEN in an assault which triggered worsening problem AND a problem with my cervical spine .
    I have actually came down to almost pain free for several months unlesss I do something wrong..which starts the whole muscle spasm,disc bulg alll over again. Like I said...I have become a lazy person due to being "careful" WHICH is not good for my emotional health. NOW I am determined to DO THINGS different in order to reclaim "ME" ..the busy "ME" !
    Two weeks ago I started going to a fitness center in order to do core strength training and leg strength training. Currently I do 35 minutes on the treadmill w/ a 3.0 ave mph. I also am using equipment that stretches out my muscles gently and equipment to assist with what feels like belly crunches and back stretches. I want to be adding exercise equip. as I continue . OK, background over (c:

    I ALSO want to know if the doctor can tell me the best equipment to use is to achieve core strength with my damage being in the sacral and cervical areas- The 'S' area has scar tissue and narrowing~ and if I swell up or stretch too much...I never KNOW what I will compress as the swelling goes down. My first day of trying the equipment caused 4 days of normal muscle pain and my 'c' area bulge came out. I went back ANYWAYS and and my bulging went AWAY . UNless a person has bone on bone problems...which I had prior to my surgery... I truly think that more of us with back problems should at LEAST TRY exercise to see if it DOES work for us. The alternative is to never know if we could HELP ourselves back to healthier bodies and mind sets~ Deb~
    marieh9 replied to debrazgalaxy's response:
    Hi and thanks for your reply and info. I had written a long letter and it just disappeared. This computer does that. Anyway, I do use heat and Ibupropin and Tylenol. I can't use Ibupropin everyday as it hurts my stomach. Celebrex doesn't work as well and I can only take it about 3 days in a row then I get insomnia from it. I don't have sciatica. My pain is in my left upper buttock near the SI joint in one spot. My MRI bone scans are negative. Which muscle test is it that you were talking about and what does it check for? I seem to think walking is the best for me overall and stretching. I am just trying to drive but that hurts because I can't get my seat reclined. I think each new movement hurts for a while then my body stretches or whatever and it starts to get better or used to the movement. I would never go to a chiropractor I do not believe in their abilities. I have heard more people getting injured than helped by them. I'm sorry you had these bad experiences. You have been through A lot! My goal is to get to 1 hour walking and get strong enough to get into the pool to get in and out of the pool that is. The problem with PT's is that there is no regulation and no accontability . So, my manual therapist did manual manipulation on the wrong leg and caused great pain. I have no way to prove this. It doesnt' matter now I have to go forward and get better. I hope I can do it. I had the same injury three years ago and got through it with physical therapy and a cortisone injection. The pain just went away after about 7 months. Since exercise helped before I have to believe I can get out of this in a similar way. This time because I was reinjured a couple of times it is taking longer and I got decondtioned. So I am slowly working my way out of this but it is hard. I still don't have a solid diagnosis but 80% or so of back pain (non-spinal) is not diagnosed. My MRI and bone scan were normal and I just went to a physiatrist too and she didn't have a clue. She just said do more stretching and get moving. I wish I had more specifics everyone is trying to cover thier butt and won't give advice since there is no solid diagnosis. I think the closest one maybe myofascial pain. I don't know whether to try accupunture or have myofascial release since I am not really diagnosed for sure with that. The two PT's said I have SI joint dysfunction and the doctors don't agree with the PT's. The orthopedic surgeon said it is not spinal it is dynamic. I am going to a neurologist in two weeks to rule out MS (though I don't have those symptoms) I hope it isn't that!!! I was told by the pain doc (though he didn't give me a physical) that I had myofascial. My family practise doc thinks either myofascial or facet joint degeneration that hasn't showed up on the MRI yet. Well, take care. I just need to get driving, and be able to get independant again. I haven't been able to get my pants on or wash myself below the waist. I did in the past and it hurt. Now I am not sure when to try and how to know when you can stretch without injury. Very frustrated.
    debrazgalaxy replied to marieh9's response:
    Tight muscles need rest and something to relax them, so that you can resume activity. My problem started like yours, From 1993 to 98~ and my sciatica started as hip and buttoks pain, before it went down my leg. IF you have compression on the nerves then damaging them permanently is a possibility. That is why I say to rest and relax them.
    My spine literally turned part way, pulling to the right, and then curved after not getting the muscles to relax for a few weeks.

    Also~Have you had any bloodwork to see if your body chemistry is in ballance?
    Perhaps you are lacking something which with out it...causes muscular contraction?
    Muscular dystophy is in my family, so I have had protien levels checked in the past to check for muscle break down.
    An_198520 replied to marieh9's response:
    To find the long handled reachers and washers just type in "hip kit" in and you'll find several choices.

    You really are in a catch 22. You need help to progress and yet the "help" you have gotten hasn't been helpful! You did mention that you have had a positive result with a physical therapist in the past, but that you'll have to pay cash. If it were me, I'd make at least one appointment with him to get his advice on what to do next. It really does sound like you are doing all the right things - stretching and walking.

    The physical therapist that you trust can answer questions like which stretches and which stabilization exercises you should do, and how to progress them. Also, he may be able to show you someway to release the spasms on your own and how to make yourself more comfortable sitting in the car. If he thinks you are ready, he can show you how to strengthen your leg muscles (without aggravating your back) so you can get in the pool. Or he may know of a pool program where they have one of those chair lifts. And since he has helped you before, maybe he can help you make sense of what is going on and what to do to get better.
    Best of luck.
    Rich Weil, MEd, CDE replied to marieh9's response:
    You could try chair exercise videos. Check Collage Video and Armchair Fitness at What that would do for you is strengthen your upper body, and that will help you do things like get out of the pool by holding on to the handrail.

    You could also check out exercise tubing for resistance exercise. Tubing is inexpensive and versatile (you can do lots of exercises with them even in a chair) and a great way to get started with resistance exercise. You can start with a set of four for about $20. They come in colors to denote the tension. If you order them make sure to order the strap that allows you to attach the tube to a door, and if you want to work your legs, ask for leg straps. Here are some vendors that sell them.

    Here's a site with great videos

    As for how much to do, listen to your body and don't work through pain. As you move more your muscles will start to strengthen, and your stretching exercises will make your muscles looser so there is less pull on the joints.

    Also have a look at "The Back Pain Helpbook," by James Moore, Williams Flexion exercises, and the McKenzie exercises for your back. -


    I hope that helps. Take care. Rich
    marieh9 replied to Rich Weil, MEd, CDE's response:
    Thanks so much for all the info. I will look into all of it. I do work through pain though. I wouldn't be moving at all if I didn't. But I am listening to my muscles and how tight they get. If too tight I don't increase my distance or try anything new. I do notice that the pain is only in one single spot near the SI joint. So, since my spinal tests are negative I'm thinking it is down to a few things (maybe). SI joint problem, myofascial trigger point (a single one from a previous injury) or a pinched nerve that hasn't shown up on MRI yet. But, last time PT helped and a cortisone shot did temporarily and finally after getting stronger I quit all exercise and maintain normal activity and it went away. So I feel exercise is the key but I just don't want to over do it. Thanks for listening.
    marieh9 replied to An_198520's response:
    I will look up the tips you said on Amazon and such. I have been thinking about a consult too with that physical therapist. I did start doing the bridge exercise (just 5 a day and small lifts) I seem to be hurting more this week. I don't know if it is from trying to do more overall like getting into the car hurts and driving really hurts. I am atrophied so I assume that is why. I hope this will pass. The stretching has helped and my hamstrings are reallllly tight.I like the chair lift idea in the pool but want to be guided by someone as to not overdo it. I have always been an athlete until this happened so I hope to get back to at least hiking and travelling and living without pain! I had to give up tennis and jogging due to tendonitis in both wrists from repetitive work, and then I got mild osteoarthristis in the hips. But the doctors don't think this has anything to do with the one single painful spot. Thanks for all your help.
    Rich Weil, MEd, CDE replied to marieh9's response:
    You're welcome. Good luck.
    marieh9 replied to Rich Weil, MEd, CDE's response:
    I need the luck and more.
    I have another question. If you are atrophied does it cause pain when you start doing a new exercise or chore. For example I have been shown how to get into my car to drive by my last physical therapist so I don't think getting into the car or closing door hurts me too badly but sitting in the car and driving hurts. I don't hurt as much when I sit in the passenger seat because I can recline the seat. I can't reach the gear and key etc. if I recline the seat at all while driving. I hope that if I do this activity enough it will improve. I also need to start bending. I have an exercise ball and was shown how to lean against the wall and squat a little. I haven't done this lately but want to start with an exercise that helps me bend. Is there any other exercise that can help with that or do you have a suggestion? Since I can't bend it is hard to put pants on. I can cross my legs while sitting but I can't reach my left foot much as I'm very stiff. I am not sure what stretches would help with this. How do you know when it is safe to go to the next stage? Is it your pain level or feeling that you can move better? I was initially so locked up when I was injured in April that I couldn't lift my left foot without a lot of pain to get into the shower. I think I must have torn a ligament. But anyway I mentioned now I am walking about 45 minutes and stretching. I now can wash myself in the shower but can't reach the peri and vaginal (V) area (sorry I have to be graphic ha ha). I couldn't wash my buttocks before and now I can. So the stretches are working. But to wash the V area a woman generally needs to be strong enough to bend some and squat. I was doing this before April but would get stabbing pain after. Is there any stretch that I can do to reach this area or shall I just keep it up? I am doing the lay on back with knees bent and rock knees slightly side to side (20 times), two sets of 10 pelvic tilt, one set of 10 of knee to the chest, one set of 5 (30 sec. hold) pyriformis and two sets of ten stomach and kegal tighten. Any suggestions are helpful. I am only going as fast as i can where my muscles tighten I slow down or don't increase. My goal is of course to get back to normal chores and so forth, driving, and then get to the pool to do pool therapy. I don't feel I am strong enough to do the pool therapy since I can't pull up the bathing suit or shorts and my husband has been helping with all this. It is so hard. i am used to being an athlete.
    thanks for any suggestions or help.

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