Returning to roping from herniated disc injury

28 y/o male, I blew out my back about 7 months ago. L4L5-L5S1 herniated with impingement on exiting nerve roots. Its been a roller coaster ride of dynamic symptoms. Treatment plan involves anything to avoid surgery. PT and injections have helped relieve the major symptoms. I am starting to see the light at the end of the tunnel as I am beginning to have a few completely pain free days per week. 

I'm looking for advice on a harness that may provide me the best support for that lower back area as I plan to return to ease back into rope climbing. I'm guessing any big wall harness will likely serve me well. BD Big Gun and MM Cadillac seem popular. Anyone have experience with these or other options? 

Also, will gladly and gratefully accept any wisdom/tips from anyone with experience in a similar situation/injury ✌

I switched to a MM Cadillac, for the same reason. I had a herniated disc at L5-S1 and got the surgery. Honestly, the falls won't be the issue, the weird moves and hanging belays are going to be harder for you. 7 months after surgery I tweaked my back again after hauling a tag bag off a low anchor. You need to hip hinge and squat like a pro now.

The most important thing is to keep good form and keep doing PT. You don't lift heavy things without perfect form anymore. You also don't stand and sit with bad posture, or you'll pay for it. Get a back support pad for your car and your office, and any other place you sit for a long time.

Get the book "Back Mechanic" by Stuart McGill and read it twice.

I agree and relate to all your points. My life pretty much consists of core strengthening and retraining those neuro-muscular connections towards proper posture in all aspects of life. And I totally see that turning into a lifestyle post injury. 

Just ordered the book and looking forward to diving in.

Cheers to staying positive and getting out and back after it. I appreciate the help navigating my return to climbing and anticipating challenges on the road ahead

My injury occurred at work. I am a Paramedic and had been suffering intermittent slight to moderate lower back pain for the better part of 6 months before blowing it out (I had made a bad habit of working and pushing through pain for most of my life, which helps sometimes in climbing and exercising but not in this case.) We had a patient in cardiac arrest in the back of the ambulance and there was a lot of work to be done on this patient so my adrenaline levels did a great job of masking the injury that was manifesting as I was performing chest compressions, intubating, pushing medications. I'm also 6' tall so all of this was being done while leaning over with my full upper body weight hinging and torqueing on my lower back. Needless to say after the patient was transferred over to hospital staff and I walked back out to the truck it felt as though someone was holding a blowtorch on my back and I had trouble lifting my right leg. I went out on injury for 2 weeks until the symptoms relieved to the point I felt able to return to work. 2 weeks after that, a simple "sheet transfer" of a patient from chair to stretcher took me out of the game completely and now there was fiery needles all up the inside of my right leg and into my back. 

I started with physical therapy and had an MRI which showed the disc injury. My neuro surgeon advised me that 70% of these injuries can heal on their own without surgery. It just takes time, lots of time. In my situation of being a healthy fit young adult, he felt that I certainly fell into that category and referred me to a pain management specialist. The ultimate goal was to reduce inflammation in the joints which was causing the symptoms and pain, which was done with the steroid injections coupled with rest and PT aimed towards strengthening and supporting every muscle and neuro signal around the injury site. It has been a long road of doubts and wondering if and when my pain will ever subside and what it will take to ultimately achieve that. But I will say that it did somewhat feel like a lot of silly exercises and movements that did not feel like they were doing anything at the time but down the line I reached milestones where I sort of "woke up one day" and was able to do things that I previously could not. I have to say I wish I had taken my back pain more seriously before this experience and I will forever be a voice for anyone who is having chronic back pain. Listen to your body. It is the most important piece of climbing gear you own, besides tricams perhaps ;). Take care of it and it will take care of you. 

Here are some things that worked for my pain relief at home, which I wish would have done more of prophylactically and I firmly believe I would have been able to avoid the injury. 

*books/research *Youtube yoga/stretching videos aimed towards sciatica and herniated discs *foam roller *back support pillows *CBD salve *heat/ice *inversion table

Dan the Man wrote:

Also, will gladly and gratefully accept any wisdom/tips from anyone with experience in a similar situation/injury 

I herniated that disk as well, coincidentally at right about your age (turns out that lifting a heavy thing while your spine is turned is not a very good idea, even if you're young and healthy).  The good news for you is that at age 52 I usually go years between it bothering me and when it does it is only mild and for a couple days.  

The key is that you have to keep your core in really, really good shape - but you won't need anyone to tell you that because as soon as you start slacking your back will start barking at you.  It will probably take a good bit of experimentation and tweaking to find a set of 12-15 core exercises that are both challenging and don't aggravate the disk so you have a good sized grab bag to rotate through (if you keep doing the same ones long enough they'll become less effective so you have to rotate them out and back in again).   Swiss ball & bosu open up a lot of options so good to try those if you haven't already.  There's also a bunch of plank variants you can try; I find those to be much better for lower back than any kind of superman or front-facing roman bench exercises - hyperextension of the lower back is a no-go for me but ymmv so experiment (gently).  Make sure you find something that works for your obliques, those are really critical to prevent re-injury.  Any kind of twisty sit ups / medicine ball taps give me issues, so I move through a very flat L-to-R plane with no spine twist at all both standing with a dumbbell (one side at a time) and lying sideways on a diagonal roman bench holding a plate.  Again ymmv so experiment starting with just bodyweight.  

The other thing I have had good luck with is a spine-specific muscle relaxant called chlorzoxazone (brand names Parafon Forte and Lorzone).   I use this as soon as possible when I tweak it, and usually one or two doses is all I need.  When I tweak it the problem is that the first thing my body does is tense up the muscles around it, which just jams the disk into the nerves, which causes the muscles to tighten up more and it's a death spiral.  The clorzoxazone acts as a circuit breaker for that, so the earlier I use it the better.  If (when) you tweak yours, you may want to give that shot and see if it works for you.  The good news for me is that it doesn't knock me out at all, I can take it and still get work done (although you don't want to take it and drink unless you enjoy waking up feeling like someone rolled your brain in ground glass).

Good luck with it - if you have gotten to pain free days already with just PT and time you should be fine.  Def avoid surgery if at all possible.

Dan the Man wrote:

I had made a bad habit of working and pushing through pain for most of my life, which helps sometimes in climbing and exercising 

Yeah I am that guy too.  DON'T DO THIS WHEN TRYING A NEW CORE EXERCISE.  Trust me on this one.  If it hurts, stop immediately and try a different movement.

I'm a little puzzled by the idea that any harness will make a difference because of offering back support?  Let me back up...

I had a few herniated disks in my 30s/ early 40s, went through PT each time yada yada yada.  I only had two terrible herniated disk episodes since then, although I do have degenerative disk disease in my cervical and lumbar areas.  I am very careful to do all my maintenance exercises, to avoid the things that are super hard on the disks, and to be aware of the warning signs (very important).  In all that time, I've never found climbing per se to be at all a factor in my low back flaring up.  I can climb as much as I want and my low back is fine.  The hardest climbing related activity for my low back is driving (for road trips), and descents (esp over big talus) with a heavy pack on (bending).  The worst activity for my low back is gardening! 

What makes all the difference to remain pain and injury free for me is the maintenance exercises, esp core/plank, and proper stretching.  Hamstring stretches are critical and I do a lot of hip stretching exercises as well. Hamstrings every day!  Hard to do when on road trips but I spend at least 15 minutes a day on these.  Of course as you already know, proper body mechanics are critical. But that is easy to train - once you have that awareness it becomes pretty automatic.  The worst thing is sitting for too long.  The last major flareup I had (pain, sciatica etc) was after I drove home from an Idaho road trip 12 hours in one day.  That was stupid and I paid for it with 2 weeks of fragile/pain.  I don't use a back support in the car, but I do sit on a doughnut pillow which helps a lot.  Before that, the only other bad flareup was a simple overuse injury.  I had just bought a new house and was doing a ton of all day active days with constant movement.  Anyway, good luck with maintaining your back and avoiding repeat injuries.

I've had back issues last year - not herniated disk but locking up upon rising from seated/lying position on most days for a few months. Seizing upon getting from the toilet was the most... somehow humiliating for me. I mean if I can't even take a proper shit without ending on all 4 on the ground with my pants around my ankles...  Muscular issues causing the imbalance/compression for me.

I had similar issues to those mentioned by EJN - hanging belay not great, weird moves not great (avoided steeper stuff for the most part). One thing not mentioned that helped me a lot was to use belay glasses. Not using glasses meant I tended to lean backward, or ended up in slightly off/weird position, and there was a positive correlation between seizing up & belaying a lot during the day. Once I started using glasses the issue improved significantly. Might sound like an insignificant postural improvement but I swear it made a big difference.

Oh and another thing - if you're not into yoga, with may be a good idea to give it a try. I personally picked it up as I couldn't run anymore (flared up my back issue like crazy). I cannot 100% tell if yoga itself helped (or just PT stuff I was doing along with time, and/or less running for a while). However my anecdotal understand of my body as it relates to back issues:

• Softer/easier yoga focuses a lot on body awareness, especially as you move. I am much more aware of my body positioning now than ever before, and yoga as a lot to do with it. Even when I don't consciously try to move in a specific way (e.g. say just picking up a sock on the floor), it seems I tend to botch the mouvements a lot less. I generally feel like I move better.
• It brings you to move in ways you naturally may not be inclined to do. I think we all have our muscular imbalances, and muscles groups we tend to favor even when they're perhaps not the best for a given job. By having to follow postures you may not be used to, you gain awareness of stuff you just don't use a lot. That has helped me as well.
• Most yoga routine involve a decent amount of core work. I find it generally doesn't focus on strength a lot, however it does build tonus & help with stability. It's also less boring (imo) than just doing crunches or whatever.

phylp phylp wrote:

I'm a little puzzled by the idea that any harness will make a difference because of offering back support? 

My thoughts are more padding plus more surface area will equal more weight distribution and more back support for a more comfortable belay/whip. 

And more enticement to buy more cams to fill more gear loops and do more climbing ;)