It would be nice to start this post with a clear statement of the problem. A diagnosis of a pinched nerve, sciatica, a lower lumbar misalignment, something clinical. Definitive.

I don’t have that.

What I have instead is a collection of symptoms.

Traditionally, I have had upper back issues, often tied to ribs being out. A good adjustment by the chiro, some massage release of tension, and I’m good to go. I had some back exercises to do, and when I did them, my upper back stayed okay. Then I would feel better, stop doing them, slump and slouch more, and bam, back to massage and/or chiro to get me going again.

In the spring of this year, something else happened. I didn’t tear anything, I didn’t move anything and feel intense pain, I didn’t fall, I wasn’t in a car accident. I just woke up one morning and the lower left part of my back was spasming a bit. I thought maybe I just slept on it wrong. In the past, I’d had pain there before but it was usually a “walking” discomfort…I would be walking along, and suddenly I’d get a tightness there. If I leaned into it, or stretched my thigh muscles and IT bands, it would lessen, and I could keep going. Weirdly, if I had my shirt tucked it and it was pulling somehow, the pain would get worse. However, this morning, I had no “cause”. It just hurt.

As the day went on, it got worse. Until early afternoon, I was trying to go to the washroom, stood up, and my whole lower back felt like it was in a vise. It was brutal, fast, unrelenting. I literally screamed. I couldn’t get it to stop spasming. I eventually had to have Andrea come down and help me. In the interest of full disclosure, and embarrassing myself to ensure I never repeat these issues, I needed her to help me wipe my own butt cuz I could not bend or reach. I got my pants and underwear on with help, and then I sat down in the basement on a bench. It seemed okay. Until I got up and tried to go up the stairs. It was brutal again.

I booked a registered massage therapist who refused to treat me until I saw my regular doctor and got some X-rays. The regular GP said it seemed fine, which was easy to say as it subsided to dull pain for the next two weeks. No need for an x-ray unless it didn’t respond to massage and osteopathy. Fast-forward another week, and I had another complete breakdown. It spasmed and I couldn’t stop it. It was excruciating, the worst pain I have ever felt. I couldn’t walk, I couldn’t breathe when it spasmed. We attempted an ambulance but when they came, they just had me walk out to the van rather than trying to put me in a gurney, and the ride to the hospital was more like a bus ride…I practically held on to a strap the whole way to steady myself, feeling every bump along the way. I know the next time to just take a taxi; it would have been way faster and more comfortable, damn the pain. I spent the night in the ER, about 8 hours for someone to actually look at me and get x-rays, etc. Nothing structurally wrong, got some meds, and generally got told I completely wasted their time. The only thing that really helped is that I had ordered a back brace from Amazon, and it was giving me enough support to function.

Over the last six months, osteo was helping for a while, and then it really stopped helping. Certain movements were more clunky and painful, so I’m mostly relying on release through Chiro right now, more about my upper back than anything. Hence the need for back rehab. The only thing that is going to work is a systemic series of exercises designed to stretch certain muscles and to strengthen others.

I have a long regimen to work through, divided into three main stages. Back rehab, let’s go.

Stage 1, initial exercises (November, December, January)

To start with, I’m supposed to do two sets of ten reps daily (or hold for 15-20s) within a pain-free range and only do what I can tolerate. There is an initial list of eight exercises but I’ll start with Group 1, then add Group 2, then Group 3:

1. Group 1
   • General Exercise 1 — Knee raises to chest (either alternating or together)
   • Lower Back 1 — Hip rocker A (side to side)
2. Group 2
   • General Exercise 2 — Knee rocking (laying flat on back, knees bent to 90 degrees, rocking side to side)
   • Lower Back 2 — Hip rocker B (forward and back)
3. Group 3
   • General Exercise 3A — Modified cat / cow exercise (smaller range of up / down motion to avoid pain)
   • General Exercise 3B — Modified child’s pose (“less deep” engagement, pose)
   • Lower Back 3 — Mackenzie side wall (elbow at 90 degrees, healthy side only toward wall)
   • Piriformis 1 — Ankle pull (Knee to chest, close hand on knee other on ankle, pull towards opposite shoulder, 3 reps, 10s hold)

That will likely keep me going until at least January.

Stage 2, ramping up (February, March, April)

February is where I start to do a bit of growth, not just getting it back to where it should be already. I should be able to drop a few of the initial exercises though as I start to add in the new ones.

1. Group 1
   • General Exercise 2 — Knee rocking (laying flat on back, knees bent to 90 degrees, rocking side to side)
   • General Exercise 3A — Modified cat / cow exercise (smaller range of up / down motion to avoid pain)
   • Lower Back 1 — Hip rocker A (side to side)
   • Lower Back 2 — Hip rocker B (forward and back)
   • Piriformis 1 — Ankle pull (Knee to chest, close hand on knee other on ankle, pull towards opposite shoulder, 3 reps, 10s hold)
   • Glutes 1 — Standing Glute Pulses – backwards
   • Upper back 1 — Doorway pushups
   • Hamstring 1 — Straight leg raise (strap around ball of foot, pull up with leg straight until feel stretch)
2. Group 2
   • Quadricep 1 — Straight leg raises (45 degrees, slow and controlled)
3. Group 3
   • Glutes 2 — Standing Glute Pulses – side out (abductor)
   • Upper back 2 — Upright row (not until all lower back pain is gone)
   • Quadricep 2 — Toes on board, toe raises

Stage 3, strengthening legs and knees (May, June)

By the time I get to Stage 3, I should have most of the regular exercises down, and then I’ll have to decide if I’m going towards mostly Bowflex exercises (which I feel are really good for the upper body, but a little more complicated for the lower body), or repeating stage 2 with some additions from the list below of lower body work.

1. Quadriceps:
   1. Abduction raises, bottom bent 90 degrees, foot horizontal
   2. Adduction raises, bottom straight and raised inward pass back leg that is raised for stability
   3. Heels on board, vertical squat, knees over toes (not out or in) — 10 reps … can use chairs to push back up
2. Knee strengthening: VMO –> https://www.youtube.com/watch?v=HekbzjpXI0gb
   1. Stretch / engage teardrop muscle, tense, hold for 10s, relax for 3s
      1. Variation: Put towel under thigh to raise the leg
      2. Variation: Wear heavy boot
      3. Variation: Use resistance band
   2. Wall sit with an exercise ball behind your back
3. Advanced knee strengthening: VMO –> 10 options…https://www.youtube.com/watch?v=b3sQaKOjCl0
   1. 1 leg squat — on a box, or on a lower box
   2. Band resistance squats (pushing the bands outwards with thighs)
   3. Power band side steps/walks … Band around ankles, help hip stabilisers
   4. Power band leg extension backwards … behind thigh, start knee bent, extend leg to push back
   5. Hip abduction, adduction — sideways away from you (narrow, wide), towards you (wide, narrow)
   6. Box steps — step backwards., to side
   7. Box assisted squats — sit, stand (use lower box later)

Onward!

I have some cardio and upper body stuff to add to the plan with the Bowflex, but most of what I need to do is the exercises above to fix my back. When I get that under control, I can expand outward. But I can’t keep dealing with ongoing spasming and pain. It’s just too limiting. And, reluctantly, I have to stop using my back brace as a metaphorical crutch. It helps, but it is not a cure, just a temporary, well, crutch to lean on. It gets me through bad days, just as taking the anti-inflammatories does. And I need to stay on top of the meds while I’m doing the exercises.

Onward, as I said. Except I know this is not a simple “do it” type item for my to-do list. A simple checkbox or schedule won’t cut it. I need some extra help / enhancements and in fact, I’m going to combine seven to help me stay on track.

I will use the checkbox, scheduling, quantity (min 1 set per day), chain tracking, public announcement, formal accountability (reporting every two weeks to my chiro), and a simple yet large reward…my reward will be that if I can get my back sufficiently rehabbed in time for my birthday in June, I’ll reward myself with starting the process to choose a kayak (trying different types, renting different places, etc.).