know of a barefoot runner with spondylolisthesis (vertebra slip)?

Do you know of a barefoot runner with spondylolisthesis (vertebra slip)?

I just hit a marathon season "altering" situation. Around 12 days ago, I was hit with extreme lower back pain (unable to stand nor walk for more than 10 minutes without intense pain) after having done a week or so of heavy lifting. Pain/discomfort started slow and became progressive over the course of a few days. I had an MRI - Grade 1 spondylolisthesis (vertebra slip) of L4-L5 ... and I am sure heavy labor in my younger years contributed to my current "degenerated spine."
I meet with a back doctor on Wednesday to go over the MRI. Yesterday, I started barefoot walking and today I was able to go 25 minutes of brisk barefoot "cat walking" with no pain. I have no idea of a recovery time line, but I do know that barefoot running has taught me how to move gently/lightly and has gotten me going again.
Yes, I would love to dialogue with any barefoot runners out there with this issue to learn!
---
MRI REPORT:
~ The MRI shows a Grade 1 spondylolisthesis of L4-L5 with a decrease of the ring in the T2 sequence and reduction of the liquid.
~ The L5-S1 also shows a decrease of the ring.
~ The bilateral image also shows a spondylolysis of the L4 vertebra with a slight widening of the L4 – L5 ring and a slight protrusion of minimal character of the L5-S1.
~ The images do not show any significant anomalies of the “sponginess” of the vertebrae body.
Conclusion:
~ Spondylolisthesis of a Grade 1, L4-L5 with associated dislocation & spondylolysis bilateral L4.
~ Slight protrusion of L5-S1 disc ring.
 

Attachments

  • canary feet mri .jpg
    canary feet mri .jpg
    50 KB · Views: 7
I don't suffer from it but I've taken care of several patients post operatively who had it bad enough to require surgery. A reasonable and realistic goal would be to slow the progression of the slippage for a long as humanly possible, or to stop its progression all together. I would put a hefty focus on building and maintaining the entire core and use perfect technique while doing the exercises. It can take 6 months or more to really improve your core if you are truly doing the exercises correctly. I'd recommend lifelong maintenance with those exercises too. Once healed, I would also use picture perfect technique while lifting things of any weight. The reason it is slipping is because some of the nearby supportive tissue (muscles and ligaments, etc) are weak and overstretched, or maybe even a little torn. You must be very cautious and pay a great deal of attention to pain and any numbness or tingling from the waist down. If the slippage worsens the l5 vertebra will start to pinch nerves and nerve roots. You don't want to deal with that. Symptoms from a pinched nerve root can be very obvious or manifest as something as vague as pain on the bottom of the foot or pain in the calf area. If the pinched area is bad enough for long enough it can cause permanent neuromuscular damage. Bad news! Not trying to scare you, just trying to inform. Hopefully conservative care takes care of it but I wouldn't push the running -- or any activity for that matter -- until the symptoms subside. The jolting effects (even while moving gently) of it could easily exacerbate your symptoms. Treat your recovery as though it were a fracture and you should be safe. Good luck!
 
Si barefoot, thanks for your reply! Are you a nurse, PT, etc.?

"A reasonable and realistic goal would be to slow the progression of the slippage for a long as humanly possible, or to stop its progression all together."
----
I have been reading medical journals non-stop since this incident occurred and it seems that most people try the "non-invasive route" first, but slippage eventually occurs and surgery happens within 10 years of the initial diagnosis ... a losing battle. It seems the negative of surgery is the risk, much longer recoup/rehab time, decreased mobility, etc.
"I would put a hefty focus on building and maintaining the entire core and use perfect technique while doing the exercises. It can take 6 months or more to really improve your core if you are truly doing the exercises correctly. I'd recommend lifelong maintenance with those exercises too."
----
Yes, what I have seen is that this a situation that I will face for life now and I need to accept a new norm ... and that might not include marathoning any more ... and I am "just" 42 years old. :(
"Once healed, I would also use picture perfect technique while lifting things of any weight. The reason it is slipping is because some of the nearby supportive tissue (muscles and ligaments, etc) are weak and overstretched, or maybe even a little torn."
-----
I have always felt (possibly I am deceived) that my core is strong and I am 5'8" 136lbs, so it makes me think it is torn.
"You must be very cautious and pay a great deal of attention to pain and any numbness or tingling from the waist down. If the slippage worsens the l5 vertebra will start to pinch nerves and nerve roots. You don't want to deal with that. Symptoms from a pinched nerve root can be very obvious or manifest as something as vague as pain on the bottom of the foot or pain in the calf area. If the pinched area is bad enough for long enough it can cause permanent neuromuscular damage. Bad news!"
----
... that is the tough one, as I am very active and not used to taking things easy ... do I just feel achy from muscle compensation for my back, of is it nerve pinching - no idea. I have been really trying to self evaluate for numbness or tingling and initially it was thought that I had a right glute tear near my spine with the way the pain was. A nerve pinch? I also feel some dull sensation at the front top of my foot where the foot & leg touch between the ankle bones. It is soooo hard when training to know what is the normally soreness and twinges of training and what is a nerve pinch, especially in the longer race training. It makes me want to bite the very big bullet and do a non-fusion surgery, so I can rest better as I assume it will stop slippage and potential nerve pinching (but still would have pain & mobility issues).
"Not trying to scare you, just trying to inform. Hopefully conservative care takes care of it but I wouldn't push the running -- or any activity for that matter -- until the symptoms subside. The jolting effects (even while moving gently) of it could easily exacerbate your symptoms. Treat your recovery as though it were a fracture and you should be safe. Good luck!"
-----
Scare me, yes, but it is sound advice from what I am reading from the research. THANK YOU! I think the best is to drop the season and focus on rebuilding me from zero ... even if surgery is the best option. THANK YOU again!!
I am not a moderator, but maybe this topic of barefoot running and doctor/medical issues threads.
 
I've been a nurse for 14 years and have a decent background in neuro. Aching pains in your back is just muscular (a good thing). Nerve pain is sharp and stabbing or can feel like a strange blend of numbness and burning or can feel kind of like how it feels when your leg or arm falls asleep. I doubt you'll have any lasting neuro involvement with the slippage only being a grade1. There may have been some transient nerve irritation with the initial injury, but that won't have any lasting effects. Just watch out for those types of symptoms down the road. Surgery should always be the last option. Sometimes that last option is the only option (true emergencies) but I doubt that will be the case for you. I'd personally be leery of a surgeon who wants to operate right off the bat. Statically most people end up needing surgery down the road but I'd bet the vast vast majority of folks never rehab and maintain themselves properly.

I doubt your build dictated why or what happened. People of all sizes have this happen to them. If I were a betting man I'd say you don't move from your hips and core, especially when lifting stuff. This is another topic worth mentioning. You could have a really strong core but if you aren't using it while you move you really increase the chances of getting hurt. Just like strengthening the core, learning to move from the core takes a long time. You basically have to train your brain on how and when to engage your core as you do things. Many people do core exercises wrong because they don't know how it feels to do it right. People will do a plank exercise and support themselves with their arms and legs, and not their core. It often times takes 6-8 weeks with the help of a good professional to get people on the right track, and that is when the patient plays an active role in getting better (practicing the exercises at home). Too often patients only do their exercises during their sessions, and never at home, and then never do anything else one the therapy is over. They may be pain free for a while but their system is just as weak and susceptible as it was before. You have a good chance of a good recovery if you really do things right (part of that is finding a good clinician) But, as I said in the earlier post, that is a hard thing for people to do.
Change is likely inevitable for you, but again,if things are done correctly, you will end up healthier and happier. Most of the changes that need to happen will involve undoing the wrong way of doing something and replacing with a bio mechanically more advantageous way of doing the same thing. This is where going barefoot fits in. It is one thing that can work towards helping the bigger picture but there are many other things that need to happen as well. It's not impossible but it will be hard. Many view monumental change like this As a journey. A big long never ending journey full of ups and downs (the ups should out number the downs by a long shot ;-) ).
 
si barefoot, you are the best!! THANK YOU for taking the time to write & encourage!!

No, I am not feeling nerve pain (thanks for describing it) and all groin area functions are working fine too. :)

My thought on future surgery, was my age, understanding this to often be a 60s thing, not forties.

THANK YOU again!
 
I just talked with the doctor and friend who was passing through the Islands for a race and gave me a quick examination and his feeling is that the spondy is a long term thing that I have and the pain is actually radiating from the SI joint, but they didn't MRI that! :( At least I now know I have a spongy issue to work through and maybe SI joint.
 
The orthopedic doctor looked at my MRI & me yesterday. He believes my back pain to be coming from
~ isthmic spondylolisthesis (vertebra slip that occurred due to a stress fracture when I was younger)
~ the symptoms from these stress fractures tend to develop in adulthood
~ disc slippage is 5-10% and he does not anticipate additional slippage or surgery

He did a number of tests to determine that my SI joint is not injured.

I will start rehab this week (strengthen & stabilize the area) and I can go back to normal life & sports as pain allows. I visited the chiropractor this morning and he has come to the same conclusion. I go to a "physical therapy" doctor tomorrow and she will set me up for a rehab program with a PT.
 
Just by way of follow up, I have gotten the input of at least 5 doctors (from chiropractors, orthopedic, sports medicine, family doctor, rehab doctor, etc.) and the weight of opinion was that ...
~ I suffered a stress fracture when younger which caused the vertebra slippage (ith. spondy)
~ normal disc degeneration (and over doing with poor lifting technique) created my current situation
~ sports like running will not worsen my condition/slippage and pain should be my only brake to how much I do
~ my core is already strong enough, but I will continue to work on my core and I need to focus on good body mechanics at all times and activating my core

Three books revolutionized my thinking and processing of endurance sports and my back situation which I have been reading during the last few weeks ...
~ Indian Running (classic from the 1980s) and Geronimo: Leadership Strategies of an American Warrior, which both had the message that the ability to work past discomfort & even pain are what made Native Americans amazing endurance athletes.
~ Healing Back Pain: The Mind-Body Connection, which Barefoot Dan Lutes from Indiana recommended, focused on the psychological/mental aspect of pain and our ability to overcome & remove pain.

Results: I have trained gingerly with care and was able to pace my wife through a marathon this last Sunday without almost any back pain.


THANKS for all your input and ready get back to the thoughtful paced process of transitioning to barefooting.