I Shoveled My Back Out

[00:00:00] Welcome back to Untold Physio Stories Podcast. I'm one of your hosts, Dr. E, with Modern Manual Therapy and Edge Mobility System.

[00:00:07] And every year, since I live in Buffalo, New York, I release a video on how you should shovel snow.

[00:00:16] Pretty specific on this, I say that you should lunge forward, accept weight on your leg, and then rotate on your opposite leg, and not on your forward leg, rotate on your back leg.

[00:00:27] So you're rotating on your hip, tense your core to protect your spine when you're rotating on your hip.

[00:00:37] When you're lunging, you lunge down, get weight on your front leg, and then lift up using your legs and less using your arms and your back.

[00:00:46] And I know some of that is unavoidable, but at least it minimizes it.

[00:00:49] Also, you take frequent breaks, do lots of backward bends, and that's kind of what I post every year.

[00:00:54] Sure. So I'm sure you guys have seen the news to date this podcast.

[00:01:01] There has been about three and a half foot of snow in Buffalo over the Thanksgiving week.

[00:01:07] And then just this past week, we got maybe another six to 12 inches, depending on where you live.

[00:01:13] So I woke up yesterday not really feeling that great.

[00:01:17] A lot of my family either has like a cold or a cough, and I woke up kind of feeling achy, like really, really mild flu-like symptoms.

[00:01:25] My head hurt, but I didn't really have a fever.

[00:01:28] I had a bunch of appointments, and I wanted to kind of rush and shovel the heavy, wet snow as quick as I can before my first appointment.

[00:01:39] So I get out there. Of course, I'm cold, not warmed up or anything.

[00:01:43] I'm shoveling, and I'm rushing, and I'm not necessarily doing the things that I say, especially the twisting part.

[00:01:50] But at one point when I got to lunge and really quickly, you know, kick the shovel in with my front leg and bend forward quickly,

[00:02:03] I had an episode of what most lay people would call throwing their back out.

[00:02:09] I didn't throw my back out. I shoveled my back out.

[00:02:11] It was pretty sharp.

[00:02:13] I mean, it wasn't a 10 out of 10, but it was central, lower lumbar pain, and it was about an 8 out of 10, and it really kind of took my breath away.

[00:02:23] So I immediately stopped.

[00:02:25] I mean, I knew enough not to continue going, and, you know, I hobbled, and this is actually caught on my Nest Cam.

[00:02:33] I hobbled between the two vehicles because I was behind my truck.

[00:02:37] I hobbled between my wife's truck and my truck, and I tried some backward bends.

[00:02:41] I was maybe able to get to neutral.

[00:02:44] I'd have to recheck the camera, but then that actually made it a bit more painful.

[00:02:48] I ended up having to use the shovel like a cane.

[00:02:52] And, you know, a few years ago, I'm pretty sure I podcasted about how I prevented an onset like this after shoveling for at least 7 1⁄2 hours.

[00:03:02] When we got that 7 1⁄2 feet of snow, it was pretty much one hour per foot after my truck had been buried.

[00:03:13] And I did similar things, but then I didn't actually have the acute onset that took my breath away and made it almost me unable to walk.

[00:03:24] I mean, I crawled into the house pretty much, and I immediately got prone on elbows.

[00:03:30] Prone on elbows helped quite a bit, but my extension was super blocked.

[00:03:35] It relieved quite a bit of the pain, but every time I tried to extend, I pretty much had zero extension.

[00:03:41] So I laid in bed, got on my H-Wave eStim device, and laid like that for an hour.

[00:03:49] That relieved it quite a bit.

[00:03:50] I was able to extend maybe 20%, 30%.

[00:03:53] I took it easy the rest of the day.

[00:03:55] I actually did end up taking some...

[00:03:59] I broke my fast earlier than normal.

[00:04:01] I had some oatmeal and took some ibuprofen because also I had, you know, at that point, my flu-like symptoms were not feeling.

[00:04:09] I was feeling that anyway.

[00:04:12] It wasn't necessary for the back pain, but more for the flu, and I wanted to kind of calm that down and mitigate that as well.

[00:04:20] I, again, took it easy for the rest of the day.

[00:04:22] I pretty much laid in bed, on and off, two applications of the H-Wave about an hour.

[00:04:28] I was able to start some mild trunk rotation.

[00:04:30] I had my wife do resisted trunk extension on me.

[00:04:34] Initially, when she tried it, I was able to push maybe what I would call a one or two out of five, you know,

[00:04:42] without having a dynamometer measure the amount of force I was able to push extension and standing in a stride stance.

[00:04:47] That's one of the things I noticed on patients with the most chronic low back pain.

[00:04:52] They couldn't push at all, which really led me down my rabbit hole.

[00:04:57] If you followed me recently on social media, I posted some stuff about extension strength and extension isometrics for chronic low back pain.

[00:05:05] There's a good amount of older evidence, but it doesn't mean that it's not worthwhile or worth your read.

[00:05:11] So I've been working on being able to hold extension isometrics for up to a minute, working on that extension endurance.

[00:05:20] But it was definitely the pain that probably inhibited my extensors.

[00:05:27] I mean, I wasn't in a lot of pain, but I just could not push into extension at all.

[00:05:33] So retesting that by the end of the day after these two applications of H-Wave and a lot of rest and actually canceling all my appointments for that day, rescheduling them.

[00:05:41] I was able to push quite a bit harder.

[00:05:43] I can extend maybe about 50%.

[00:05:45] I'm still quite a bit blocked.

[00:05:48] It's the next morning already.

[00:05:49] I'm standing at my work station, my battle station at home.

[00:05:53] But I really wanted to talk about mainly how I mitigated this.

[00:05:59] If I had gone to work, if I had kind of insisted on seeing my patients and not losing revenue,

[00:06:09] I feel like I would have been at where many patients get at where they just try to continue with their day instead of actually taking time to themselves.

[00:06:18] With the rest, also resting from flu-like symptoms.

[00:06:24] And I really attribute a lot of that pain modulation to the H-Wave.

[00:06:28] I think that thing is great.

[00:06:29] You guys should look into it.

[00:06:30] I don't work for them.

[00:06:32] I don't have any kind of agreement that if I promote their devices that I get paid any kind of affiliate.

[00:06:40] But it's been quite a blessing for not only some recurrent low back pain that I've had in the past.

[00:06:46] I've talked about that in the past.

[00:06:47] But also for some patients that have been really stuck and I couldn't get them loading until I slapped a couple electrodes on them, turned it on high, and then actually tried the loading strategies.

[00:06:57] I don't use it passively.

[00:06:58] You know, I was walking around with it yesterday as well, trying some flexion and extension movements, and it's great at modulating pain.

[00:07:04] There's a difference between that and the TENS.

[00:07:06] So really, the moral of the story is if you have a flare-up like this, try to get into extension.

[00:07:13] I think one of the big things that helped was me lying prone for a bit and then getting prone on elbows as soon as I can.

[00:07:20] And then working on extension isometrics and restoring extension as much as possible.

[00:07:25] That is key, especially with an acute onset of low back pain where the mechanism of injury or what triggered the whole response was flexion.

[00:07:35] It's nine times out of ten, it's going to be some sort of flexion and twisting.

[00:07:38] You might need a unilateral load, but like a side glide or a rotation if you have unilateral issues.

[00:07:44] But for me, it was central and lower.

[00:07:46] And I've never experienced anything like that before.

[00:07:48] I didn't have any radiating pain, no buttock pain, nothing into my legs.

[00:07:51] It was just central, low, and sharp.

[00:07:54] So I hope this helps you guys out.

[00:07:56] If you have any comments, questions, and if you first time listen to the podcast, you haven't done it yet,

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[00:08:08] And as always, you guys have a great day.