First, a little background. I am a 40-something professional with a wonderful family and a full-time job, and I have been active all my life. Growing up I always played and participated in various sports - soccer, baseball, basketball, lacrosse, tennis, skiing, etc., and started lifting weights in high school. After college, as my career interests took off, my athletic endeavors were put by the wayside a bit, but I always tried to continue training and lifting weights to maintain a base of strength and conditioning that would allow me to continue to participate in whatever physical pursuits I wanted, and also just to not suck at life in general (and, probably, so I could eat more too...but that's a separate discussion). This waxed and waned over the years a bit, depending on what was going on in my life at the time (work, grad school, new puppy, new baby, etc.) but I have never strayed too far from some sort of athletic pursuit.
About 9 years ago, my yearning to return to competitive sports grew big enough that I could no longer ignore it, and I started playing lacrosse again in a very competitive post-collegiate club league, mostly with guys 10 years younger than me. In order to keep up, I began training hard - lifting, running, sprinting, agility work, etc. - and it began to pay off for me. My play improved and I got in some of the best shape of my life. Around 2007, while searching for training info online, I accidentally discovered CrossFit, and started experimenting with it on my own. I soon became hooked and began building my own basement and garage gym - barbell, bumper plates, rower, jump rope, squat rack, etc. - so I could do the WOD's from the main page, and from various CrossFit affiliates who posted their WOD's online. I mostly trained on my own, learning from countless videos and Journal articles, and supplemented my knowledge and experience with drop-ins to various boxes on my work travels. In 2012, a new box opened up right near me, and since that time, my wife and I have become regulars in the box as we have jointly come to know the great sense of community and friendly competition that a box brings (in addition to greater levels of fitness, PR's, etc.) I became an L1 in January of 2013 and began coaching at our box shortly thereafter.
Following the completion of the 2013 CrossFit Open and my first taste of CrossFit competition, I began to participate in the competitor training program at my box and began to increase the workload (and wear and tear on my body). My weights increased, I hit some new PR's, and my metcons improved further. I was enjoying the heck out of it, aside from the increased soreness. Within a few weeks of starting the program, however, I began to experience some occasional pain and tingling down my left glute, hamstring and lower leg following my training sessions, and with extended periods of standing and walking. Initially I thought it had to be something relatively routine - muscle strain, ligament strain, piriformis syndrome, etc. and tried various stretching and massage to alleviate the pain. Nothing really made much difference, but since it was intermittent and I could still work out without any weakness, I plowed ahead in my training. As the next few months wore on, the pain got increasingly worse and I began to experience numbness and tingling, and walking for any distance and standing still for more than a few minutes became painful.
After a visit with a local chiro (mainly for another orthopedic issue) and his mention that I might have a bulging disc, I began to do some research online and came across some sites like Fix Your Own Back and others, and began to try McKenzie press-ups and other exercises to see if perhaps a disc was indeed my issue. After a couple of weeks of trying the press-ups with no change in my pain, I figured it was probably time to get it checked out by a doc.
Following an exam, my sports medicine doc ordered up some imaging to see what was going on in my spine, and in addition to severe disc degeneration at my L5-S1 level, what the X-ray and MRI also showed was a bit unexpected:
"Bilateral spondylolysis at L5-S1 with grade 1/2 anterolisthesis of
L5 on S1 causing severe left and moderate right neural foraminal
narrowing."
narrowing."
In layman's terms, at some point in my life, the back half of my L5 vertebra cracked at the connection to the front half (spondylolysis) and separated from the front half, causing the front half to slip forward some 25-30% (spondylolisthesis) . Since the disc between L5 and S1 is the only thing holding the segments together, it takes a lot of abuse and has been pretty worn down over the years. The decrease in disc height and slip of the vertebra had resulted in a lot less space for the nerve roots that run down the legs to exit the spine. In other words, a severely pinched L5 nerve root. Ouch.
I was pretty surprised to see these findings on my MRI, especially since, aside from a couple of back tweaks/spasms over the years, I had never had any other back or leg symptoms and couldn't recall any big traumatic events that would have created such a break. According to the doc, I've probably had the spondylolisthesis since I was a kid and just didn't know it. But all kinds of questions began to flood my mind - was I only now suffering symptoms due to years of sports, CrossFit, weight lifting, etc.? Could I have prevented it? Would I be able to continue with CrossFit and my other activities? What kind of treatment will I need? Will I need surgery?
The reality is that I'll never know what caused the spondy specifically, but it's not likely I could have prevented it in any meaningful way at least in my youth. Has weight lifting and increased levels of training made it worse? That's hard to say. I do believe that I probably have accelerated the wear and tear on my discs from weight training, but on the flip side, the training has made me much stronger overall and thus better able to function even with degenerative changes in my back. Not to mention that imaging results don't always correspond exactly to symptoms, so the degeneration may not have meant much absent the spondy finding.
I have come to believe that there are mechanical aspects of movement, especially in weight lifting, that can be focused on and improved to minimize chances of causing a spondy, especially the overemphasis on lumbar (hyper)extension when setting up for lifts, and perhaps if I had known some of this earlier, I might have minimized the damage, though it's really hard to say for sure. I don't think I hyperextended when I lifted prior to this, but since I don't have much video evidence to review it's all speculation at this point. Anyway, it may have been invevitable in my case. (By the way, cues such as Posterior-Pelvic Tilt, as suggested by Tony Gentlicore, and Kelly Starrett, can help address the hyperextension issue and could potentially reduce the risk of injury over the long haul. No guarantees, but it likely couldn't hurt.)
In my next post I'll go into my initial discoveries and experiences after being diagnosed.
#crossfit #weightlifting #spondylolisthesis
