Member Case Study: Spinal Fusion and Triathlon Training

author : AMSSM

comments : 4

I've been struggling with a disk bulge for nine months with no let-up. I am seriously considering the operation. It would be nice to be even able to bike again let alone run.

Member question from kiwee

I've been struggling with a disk bulge for nine months with no let-up...I am seriously considering the operation. If you've had a fusion in your lumber or know someone who has I'd be keen to hear.  It would be nice to be even able to bike again let alone run.

Answer from Billy Haug, MD, CAQSM, CSCS
Member AMSSM

Disc herniations may cause pain that may or may not require surgical intervention. Initially, such injuries are treated conservatively with medication, activity modification, and at times, with epidural injections. 75% of people get better at three months and 90% are better at six months with no significant differences between surgical and non surgical groups at five years.  

When appropriate, discectomy procedures are usually well tolerated by athletes.  When lumbar fusion surgery is performed, the patient should be pain free, have no disabling neurological deficit, and exhibit evidence of bone fusion on x-ray films before resuming play.  Spinal fusion is not without long term risks since it shifts forces away from the injured disc/joint complex to above and below the level of fusion.  However, advances in treatments such as minimally invasive surgical techniques and in other technologies may lessen the biomechanical effects of spinal surgery and may even change postoperative restrictions.

For athletes, as for other patients, a regimen of stretching and strengthening the abdominal and back muscles is an important aspect of the recovery process.  Usually, return to sport comes within 6-12 weeks, but may be even earlier if healing and pain tolerance permits.  Your healthcare team will help guide you through the process.
When returning to triathlon, your progress should be tracked closely until you are fully reintegrated into your activities. Consistent counseling regarding the importance of proper bicycle fit, proper swimming technique, properly fitting shoes, and perhaps even custom foot orthotics cannot be overemphasized.

Billy Haug, MD, CAQSM, CSCS
Grand Forks, ND

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date: June 25, 2010