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SueCoo2
Mar. 24, 2010, 11:48 AM
No responses on this question in the other forum, so I hope it's ok to cross post it here. I really would like to be able to give him so hope. Here's the post:

One of my best friends who is an avid (rabid) polo player had back surgery late last year and is trying to gear up to return to his previous level of play. However, after the last two practices he is experiencing quite a bit of pain and is worried that he will not be able to play.

With Bruce's (Davidson) recent surgery http://brucedavidsoneventing.blogspo...p-in-road.html
I was wondering how many of you have experienced back surgery and what did you do to get back to your previous level of riding? Do you wear a brace, or do yoga or any specific things that assist you in managing your pain? Any advise or encouragement I can give him would be greatly appreciated. Thanks!
_____

tarynls
Mar. 24, 2010, 11:58 AM
Most of this will depend on a few factors: 1. what kind of back surgery? 2. how long ago was the surgery? 3. how much did the surgeon have to "fix" during surgery?

I ask these questions because I've had two spinal fusions. The first one,I had screws inserted in L5 and S1 with vertical rods connecting the screws. I had a block of bone taken from my iliac crest, chipped into pieces and laid along the rods to encourage fusion. 6 months after surgery, I was riding a very quiet horse for no more than 10 minutes at a time (mostly at the walk). It was a full year after surgery that I could do whatever I wanted on horseback.

The second fusion (L4-L5) was much more complicated as they removed the bottom (S1) screws from the first fusion, had to remove a ton of scar tissue that had built up in the foramen (holes in the vertebrae that nerves run through), plus add L4 screws, remove the disc completely, add a block of cadaver bone where the disc was and add rods plus a crosspiece between the rods.

I didn't attempt riding until 8 months after that surgery.

Perhaps your friend is doing too much, too soon? You need to listen to what your body is trying to tell you; if it's painful, back off. A lot of muscles and small nerves end up being cut during spinal surgery; it takes time to build strength in those muscles again. Perhaps your friend can ask the doctor about physical therapy geared toward strengthening the muscles he'd use during polo?

Good luck and feel free to PM if you like.

Taryn

ETA: My docs did not want me using any kind of back brace as they were afraid my muscles would become dependant on it. I never tried yoga or anything like that. It really takes time and GO SLOW!

whicker
Mar. 24, 2010, 03:52 PM
Hi Suecoo2,

Would your friend be willing to tell us more detail? There are many different back surgeries and it makes a difference which part of the spine is damaged. It also makes a difference with age and fitness. I assume that your friend has lots of determination, it is just that his body isn't getting the message.

For example, my DH had a cervical (neck) fusion for degenerated discs. He recovered in a matter of months with lots of P.T. He can not do all the things he did before, and he had to retrain his movements. He was able to travel and teach in an seminar or lecture hall in about 6 weeks.

He had lower discs repaired early this December. One was done with stem cells and is doing very well, no surgery.

The other exploded, and he went through 2 surgeries within a week and a bone infection. That disc required fusion. He is still a wreck. He is exhausted, trying to think clearly on meds, and frustrated that it is going so slow. He has P.T. 3 times a week, and the the P.T. thinks he is coming along quickly. He can drive and fly and teach, but it comes at a great cost. He doesn't have the reflexes back, that takes lots of P.T. to retrain the nerves and restart the muscles. He can't BLT; Bend, Lift, Twist. All the movements that go with a polo mallet.

If your friend can work with a P.T. who is a rider, the P.T. can develop exercises specifically for riding. There will be a lot of scar tissue that has to be released as well. Back surgery is a BIG DEAL. it takes time, lots of it, to come back. There are adaptations that we make to get to the prize of riding again, then more to develop the skills again.

I have broken my back 4 times, no surgeries. The last time was 4 years ago. I have done stem cell procedures instead and lots of consistant P.T. I have had to have a custom saddle made to support my back exactly. I am still in the process of getting enough careful flexibility to be able to sit the canter,or trot. I have different horses now, that take care of me. It is easier for me to avoid concussion and instead, 2 point or light seat. But my situation is not the same as your friend's, I hope.

It takes courage to face the amount of work it takes and to realize that when the body gives you warning pain to heed it. Very different from the usual plow through pain mentality that we, as athletes, have been taught. If you ignore the pain with a spinal issue, the nerves that control your lower body stop working. Being paralyzed, no feeling, no control, is not where you want to be.

There are a number of threads on backs on this forum. You or your firend can P.M. any of us for support or questions. We know what it feels like, and we care.

SueCoo2
Mar. 24, 2010, 06:01 PM
You all have been very kind. I am copying your comments to him and will post his responses. Again, thank you!:)

SueCoo2
Mar. 26, 2010, 08:59 AM
The recent surgery (Nov 2009) was minor in nature. I broke 5 transverse processes from S1 – L3 as a result of a fall (non horse related). I was told it was like broken ribs and the surgery only removed the chips that would never fuse.



Unfortunately, this way my third time having been diagnosed with fractures in my back. Other than the last, the first two were fractures in the S1 and L5. My orthpods have noted disk narrowing between those. The net result was that after the 2nd break in 2003, I was forced to give up marathon running and running in general. As an ex-college athlete, I had to find something to do so I would not kill my friend that started this post (also my paralegal and work wife) so my friends – both Susan and one other – suggested polo. I fell in love. All the action of football and I fell in love with horses. I have battled back strains, and by posting and 2 point and only casual cantering I have experienced no real disability/hindrance of my play.



My doctors are both depressing me. Over the holidays one told me never to snow ski or ride a horse again because in my late 30s I have a back of an 80 year old. Sorry doctor, if that is your real name, that is not going to happen…FYI, spent 7 days skiing with the kids in Jan and made it until the last day before the back went out.



When I began training again this year (4 weeks ago) I probably went to hard. Working out 6 horses a session and began hot yoga twice a week to try and protect myself. After a week off for spring break with my kids, I worked out four relatively easy horses in an full arena to stick and ball. After the third horse I felt my back talking to me but ignored it. After 10 minutes on the fourth, I quit. I have experienced extreme pain and can hardly get out of bed. Knowing my body I have been icing by back constantly and taking anti-inflammatories (as well as vino and pain killers). I can feel it getting better, slowly. I am concerned about this season which is month away. Should I let my pros go…I am their only source of income? I am inclined to take it day by day and try and see how I feel next week.

Any encouragement/wake up calls/etc. are appreciated!

Thank you,

Charles

whicker
Mar. 26, 2010, 11:38 AM
Sue Coo2,
I am going to send you a p.m.

Your friend is discovering that the mind sometimes can't over rule the body. When it gets into spinal nerves, you drop in your tracks, in extreme pain. I don't think there is any kind of pain that is worse. However, the reason for the pain is very serious. Your friend needs to understand that he is dealing with something life altering, if he doesn't listen to his body.

My husband, also a lawyer, read your friend's email and he said, "He needs to understand that he may be practicing law from a wheel chair in the near future." In other words, this is serious, and he really needs to proceed with more caution than he has shown in the recent past.

I understand that he is a high powered lawyer, so I am going to put it in those terms. This isn't a parking ticket case. It is a high profile multiple murder case (he is murdering his nerves). He is the victim and he has some control over the outcome. He needs to understand all the different possibilities in order to shape the case for the best possible outcome. He wouldn't go in to court un-prepared I am sure.

The pressure on the nerve, if not released, will damage the nerve to the point that it stops working and can die. Then the area that that nerve signals will stop working. The muscles will wither, waste, and atrophy. Given some of the areas of the spine that are affected, they control the abdomen as well as the legs, and balance can be at great risk. Not being able to control the elimination process, (poop and pee) is a very real possibility.

It is also quite likely that he is going discover in the near future, that he will be starting to have balance issues, and fall. Sometimes, it is when walking and sometimes, for me, just losing the centering reflexes, (propreception), and go down. Occasionally, there are odd sensations as warnings. Not being able to control the front of the foot and having it drag, (foot drop) will cause tripping, too.

There are resources to help recovery. He needs to change his perspective to be able to do what it will take for the best outcome. He uses the analogy of football and that he is a tough athlete. No coach will let him in the game without sufficient rehab. And, he needs to look at those players some years later for their quality of life. I am suggesting some strategy is necessary.

tarynls
Mar. 26, 2010, 01:49 PM
When I began training again this year (4 weeks ago) I probably went to hard. Working out 6 horses a session and began hot yoga twice a week to try and protect myself. After a week off for spring break with my kids, I worked out four relatively easy horses in an full arena to stick and ball. After the third horse I felt my back talking to me but ignored it. After 10 minutes on the fourth, I quit. I have experienced extreme pain and can hardly get out of bed. Charles

WOW. I'd say your friend did WAY too much, WAY too soon. Working out 6 horses a session?

I'd have started LIGHTLY working ONE horse per day. Keep up that level of activity for a week or two, then take the horse to stick and ball for a FEW minutes. Keep that up for another few weeks, then add another horse in light work...etc, etc. When I say LIGHT work I'm talking about walk/easy canter (trot can be hard on the back), 15 min. max.

He refers to the surgery as "minor". There are no minor spinal surgeries. You still have to cut through nerves and muscles to remove the transverse processes.

The pain he's feeling now is likely due to the nerves - they're screaming at him to STOP!

I would suggest finding a different doc, preferably one that works with a pro sports team (pro football team would probably be best). What area are you in - I'm an orthopedic medical asst. and can help you find someone suitable (you can PM me this info).

Docs that work with pro sports teams understand the mentality that they MUST play, there is no other option. They tend to be more aggressive with physical therapy and can help him find a therapist that will work the same muscles used in riding in a controlled setting.

I will tell you I had my first spinal fusion at the age of 21 and the second at the age of 25. I'm 31 now and am doing well but I feel it's because I was very very cautious with my recovery.

Before the first fusion, I DID lose all the reflexes in my right leg (and subsequently couldn't drive a car as I couldn't pick my right leg up high enough to get my foot on the brake). I did start to have urinary incontence. Thankfully those issues went away after the spine was stabilized. Ten years later, I still have a permanent numb area, about 6"x8" on the outside of my right thigh. I still get goosebumps in odd patchwork-type patterns on both of my legs. All from nerve damage.

Also, my first surgery was done by an orthopedic surgeon that only did spine work. I was not free of pain until the second surgery (4 years later). The second surgery was done by a neurosurgeon. If your friend has not consulted with a neurosurgeon yet, now is the time.

Please tell your friend to take it easy!

wateryglen
Mar. 26, 2010, 02:10 PM
Ummmm...I'm thinking that polo might not be the best equestrian sport to pursue with his back issues right now.....too much twisting & odd bending involved with the concussive elements of riding. Bad combo IMHO. I'm sorry but maybe just riding a few horses without a mallet might be the way to go. Sometimes we have to make accomodations for what's happened to us; whether we like it or want to or not. Patience, time and wait & see. Might have to skip this season and just ride horses simply for awhile.