Training with Ruptured Disc?

author : AMSSM

comments : 0

How to accommodate a ruptured disc in tri training

Question from Member bnsafe
"My wife had a ruptured disc a few years ago that she had surgery on. Then last year a motorist rear ended her and ruptured a disc and she had a hairline fracture on a vertabra. she went to PT and is not currently having any issues but she decided today she would like to start training for her first tri. Any suggestions for her?"

Answer from Deanne Eccles-Rotar MD
Member AMSSM

It sounds like your wife has had her share of challenges with respect to her back. After surgery for a ruptured disc there is usually loss of disc height and hydration essentially leaving the patient with a degenerative disc. After such surgery it would be recommended to begin rehabilitation and focus on maximizing core strength and improving pain free range of motion. Triathlon would be a nice sport because it is a great blend of cross training and a lot of time on non impact activity with biking and swimming. Running has more impact but the posture of the spine during running is less stressful on the disc than bending and lifting activity. It still requires a strong core with respect to abdominal, paraspinals, gluteal muscles and muscle balance with these and hamstrings/quadriceps. After a second trauma with a fracture and a second herniated disc it is very important for her to allow complete healing of the fracture and then progress through rehabilitation. Once she has regained full range of motion and core strength she can begin training. She should listen to her body and pay attention to tightness in the low back and maintain good flexibility in addition to the continued vigilance at core strengthening. I would recommend alternating impact days with non impact and monitoring these 3 parts of triathlon for any development of pain into the tailbone or gluteal area. This can mean that the nerve root is getting irritated and it would be beneficial to go back to the basic exercises from PT and cut back on the activity that caused the pain to radiate to that area. If despite this the pain continues to radiate into the leg then a visit to your physician is recommended. I would recommend working on a good level of base training in all three disciplines over a 3 month period. Then it would be a 2-3 month progression of interval/increased intensity training. She could then test out her training with a sprint triathlon. As long as the back pain is localized in the low back and lessens with warming up to begin training then it is ok to progress the activity. If the pain worsens during training or starts to radiate into the tailbone or gluteal area then a careful evaluation of what causes it to radiate should be done and then cut back on that part of the training and see if the pain can be managed. If that doesn't seem to be helping then taking time off of that would be recommended.

There is not a way to stop the disc degenerative changes from happening but by maintaining core strength, flexibility and overall health one can manage the symptoms and slow progression. Good core strength programs can include yoga, pilates, TRX and balance work. I think it is good to set goals in training and sprint triathlons are good because there multiple disciplines of training that can be done to maintain fitness without causing injury. I am happy to hear that despite the challenges she has faced with her low back she is continuing to pursue her own goals to overcome them.

Good luck in the training!

Deanne Eccles-Rotar MD
Dean/SSM Health Sports Medicine
Janesville, WI

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date: September 30, 2016