Recommend Fitness Advice for Closed T12 Fracture
Discussion
This is an interesting one and demonstrates that MTFU is not always the best course of action! And don't ignore the repeated requests from your wife to go to A&E.
8-weeks ago I was cutting some tree branches up the ladders when they slipped and I dropped 15ft onto the neighbour’s garden. Despite landing on my feet, I felt as though I'd over extended my back before banging my head! I gave it a few minutes and established everything still worked deciding the best course of action was to rest for a few days before getting my back mobile again going out for my daily 3.5 mile run followed by 10 mins of some HIIT stuff
Yes the back was a bit painful but I could work through it with the exception of sit ups as this really hurt a specific point half way up my spine.
Fast forward to last week and despite having some lumbar stiffness (not uncommon) the specific point in my back was still sore especially when it was pressed to the touch or against something hard like a chair. It felt like a spot/cyst. So I decide to go the GP, explain the circs at which point I'm told I could have a fracture and need an X-Ray. Yes they could book me one but it could be a few weeks before I got the results so I was 'encouraged' to go to A&E or the urgent care centre. I went to the latter and on being triaged there was some shock/concern I hadn't tipped up before now and apparently despite landing on my feet it's not the best-case scenario. I'm then sent for an X-ray. When the results are back I'm seen by a physio specialist nurse(?) and the duty doctor. The fracture is confirmed and that it is still 'unstable' - Apparently I'd been 'very lucky' as the soft stuff between the vertebrae usually pushes out to the side mine had gone inward towards my spinal cord! Doing all the fitness stuff over the last 7-weeks clearly hasn't helped! I'm then told to put on a gown and lie on the trolley/bed in a side cubicle and not move. I can't even get up for the toilet and ended up using the elephant's trunk!
About an hour passes when I'm collected by the MRI team and despite arching my back and touching my toes as part of the initial triage before the X-Ray I'm now on a scoop being transferred to the table for the MRI and portered down to the scanner. After it does the business I'm then scooped back onto the bed in the side cubicle being told this is going to go two ways pending what the spinal consultant decides when they've reviewed the imaging. It was either being sent home with rehabilitation advice or off in an ambulance to the spinal hospital across the city. Fortunately I was sent home.
Now other than the odd lumbar irritation which I usually resolve by stretching off I feel fine (can't really feel T12 soreness unless pressed hard) but I'm told I've got to avoid any sort of stretching and impact fitness so running and burpees/press ups/mountain climbers/sit-ups are out. And despite the 7-weeks post injury with no apparent healing, the new Day 1 for me is the day I was discharged. Whilst I've been told I can do some walking, if I don't do any sort of cardio I'm going to go stir crazy with a 6-12 weeks rehab period.
So what can I do? I'm thinking to get a good quality exercise bike that will automatically select resistance and not one of the cheap turn a knob type machines as sitting on the saddle and peddling should keep my spine aligned? Is this a good idea and is there anything else I can do? Despite being 61 I like to keep myself reasonably fit.
8-weeks ago I was cutting some tree branches up the ladders when they slipped and I dropped 15ft onto the neighbour’s garden. Despite landing on my feet, I felt as though I'd over extended my back before banging my head! I gave it a few minutes and established everything still worked deciding the best course of action was to rest for a few days before getting my back mobile again going out for my daily 3.5 mile run followed by 10 mins of some HIIT stuff
Yes the back was a bit painful but I could work through it with the exception of sit ups as this really hurt a specific point half way up my spine. Fast forward to last week and despite having some lumbar stiffness (not uncommon) the specific point in my back was still sore especially when it was pressed to the touch or against something hard like a chair. It felt like a spot/cyst. So I decide to go the GP, explain the circs at which point I'm told I could have a fracture and need an X-Ray. Yes they could book me one but it could be a few weeks before I got the results so I was 'encouraged' to go to A&E or the urgent care centre. I went to the latter and on being triaged there was some shock/concern I hadn't tipped up before now and apparently despite landing on my feet it's not the best-case scenario. I'm then sent for an X-ray. When the results are back I'm seen by a physio specialist nurse(?) and the duty doctor. The fracture is confirmed and that it is still 'unstable' - Apparently I'd been 'very lucky' as the soft stuff between the vertebrae usually pushes out to the side mine had gone inward towards my spinal cord! Doing all the fitness stuff over the last 7-weeks clearly hasn't helped! I'm then told to put on a gown and lie on the trolley/bed in a side cubicle and not move. I can't even get up for the toilet and ended up using the elephant's trunk!
About an hour passes when I'm collected by the MRI team and despite arching my back and touching my toes as part of the initial triage before the X-Ray I'm now on a scoop being transferred to the table for the MRI and portered down to the scanner. After it does the business I'm then scooped back onto the bed in the side cubicle being told this is going to go two ways pending what the spinal consultant decides when they've reviewed the imaging. It was either being sent home with rehabilitation advice or off in an ambulance to the spinal hospital across the city. Fortunately I was sent home.
Now other than the odd lumbar irritation which I usually resolve by stretching off I feel fine (can't really feel T12 soreness unless pressed hard) but I'm told I've got to avoid any sort of stretching and impact fitness so running and burpees/press ups/mountain climbers/sit-ups are out. And despite the 7-weeks post injury with no apparent healing, the new Day 1 for me is the day I was discharged. Whilst I've been told I can do some walking, if I don't do any sort of cardio I'm going to go stir crazy with a 6-12 weeks rehab period.
So what can I do? I'm thinking to get a good quality exercise bike that will automatically select resistance and not one of the cheap turn a knob type machines as sitting on the saddle and peddling should keep my spine aligned? Is this a good idea and is there anything else I can do? Despite being 61 I like to keep myself reasonably fit.
I'd maybe suggest a cross trainer over a bike chap (ideally without using the arm holds as they require ipsilateral limb movement rather than contralateral), but you need to be careful with anything you just try to do yourself. I'd also suggest trying to find a specialist rehab person to help guide you, if you can afford it. Someone like David Grey Rehab or similar as an idea of the sort of person to look for.
Finally, as frustrating as not being able to work out is, in the grand scheme of things a few months out is not the end of the world. I have personal experience of this with some nasty (non training) injuries and have seen a few older gym bro guys come back from heart issues and strokes. Took them a while but they're back at it fully now (get regular bloowork if you're going to use PEDs or have done for any length of time in the past guys). It's harder on your mental health than your physical body, so I wish you well chap and fingers crossed for a full and speedy recovery.
Finally, as frustrating as not being able to work out is, in the grand scheme of things a few months out is not the end of the world. I have personal experience of this with some nasty (non training) injuries and have seen a few older gym bro guys come back from heart issues and strokes. Took them a while but they're back at it fully now (get regular bloowork if you're going to use PEDs or have done for any length of time in the past guys). It's harder on your mental health than your physical body, so I wish you well chap and fingers crossed for a full and speedy recovery.
Obvious and only correct answer (assuming that you like walking, pissing & pooing without the use of mechanical aids) is to ask the spinal consultant who reviewed your MRI.
Are they going to see you in clinic at some point?
You'll need follow up imaging to keep an eye on your central spinal disc bulge.
Are they going to see you in clinic at some point?
You'll need follow up imaging to keep an eye on your central spinal disc bulge.
Thanks for the advice. The irony is I feel absolutely fine and all functions work as intended with the exception of some lower lumbar aches with standing for long periods and not really different to what I used to get pre injury.
I've been advised by the GP to take vitamin D and whilst there's no history of osteoporosis in the family and my fracture is from a significant trauma I'm about to have a DXA bone density X-Ray. Once this has been done and whether or not this prompts a follow up with the GP I'll ask about referall at least for some physio.
The only 'info/advice' I've been given is this: Follow the Green pathway
I've also been warned about Cauda equina syndrome which does sort of put a damper on doing anything rash, as uncontrollably filling my pants doesn't sound too clever!
I've been advised by the GP to take vitamin D and whilst there's no history of osteoporosis in the family and my fracture is from a significant trauma I'm about to have a DXA bone density X-Ray. Once this has been done and whether or not this prompts a follow up with the GP I'll ask about referall at least for some physio.
The only 'info/advice' I've been given is this: Follow the Green pathway
I've also been warned about Cauda equina syndrome which does sort of put a damper on doing anything rash, as uncontrollably filling my pants doesn't sound too clever!
It's all about mechanism with bone fractures.
They've given you the wedge fracture leaflet (slow gradual bone collapse frequently seen in osteoporosis), but your injury is more akin to a burst fracture in terms of the mechanism (sudden high trauma with likely over extension via 15ft fall onto both legs).
Gentle movement.
Don't do stuff that makes it hurt.
Play the long game.
They've given you the wedge fracture leaflet (slow gradual bone collapse frequently seen in osteoporosis), but your injury is more akin to a burst fracture in terms of the mechanism (sudden high trauma with likely over extension via 15ft fall onto both legs).
Gentle movement.
Don't do stuff that makes it hurt.
Play the long game.
OIC said:
It's all about mechanism with bone fractures.
They've given you the wedge fracture leaflet (slow gradual bone collapse frequently seen in osteoporosis), but your injury is more akin to a burst fracture in terms of the mechanism (sudden high trauma with likely over extension via 15ft fall onto both legs).
Gentle movement.
Don't do stuff that makes it hurt.
Play the long game.
Noted thanks and I'd agree this is a burst, not degenerative. I've got the DXA X-ray tomorrow (yes Sunday) evening. When the results of that come through I'll contact the GP to discuss specific physio. They've given you the wedge fracture leaflet (slow gradual bone collapse frequently seen in osteoporosis), but your injury is more akin to a burst fracture in terms of the mechanism (sudden high trauma with likely over extension via 15ft fall onto both legs).
Gentle movement.
Don't do stuff that makes it hurt.
Play the long game.
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