Riding after severe lumbar disk hernia?

[Hawks_Nest]

Hey folks, haven’t posted in ages but I’m struggling with my current medical condition and thought I’d come here for some hope and wisdom. I’m a young professional, mostly teach vs having client horses but I do have my own young horse (6yrs old, was schooling 4th/PSG this fall).

I took three weeks off barn work (still riding) in November after a meniscus surgery only to severely herniate my L4-L5 disk just sitting on my couch. 6 weeks later after PT, rest, steroids, and chiro have done nothing I saw my MRI yesterday. I’ve been lucky that most of my struggle is weakness and tingling in my right foot, rather than the pain I had at onset but I’ve sat on my horse twice since this started, the first time a few weeks ago was excruciating if I did anything but walk. A few days ago walking was fine and it was able to trot and canter so a big improvement pain wise but I’m so floppy from the weakness that I could barely do anything anyway.

Based on my MRI I’m looking at surgery. It isn’t just the typical bubble in my spinal canal but more like a gross dribble of toothpaste almost down to my L5-S1 disk (before the mri they thought it was that disk that was the issue). I’m stuck in the awful place of not knowing if I can go back to barn work or if I should go to my backup plan of getting my masters/phD and working a “real” job and riding/teaching on the side.

Experiences? Advice?

[Piaffe11]

I feel for you OP.

Spring of 2021 I herniated my L4/L5 disc (5th time in 4 years), but it was way worse than I had before. Went to PT - wasn’t improving, but I could get by. Shooting pain down my legs and I couldn’t stand for more than 10 minutes. Eventually I lost feeling in my left leg and foot, much like you describe. I was still riding up until November (walking was difficult, but could manage trot/canter), but then it became too painful. Finally got my MRI January 2022 (I’m in Ontario and it’s a big backlog) and ended up having urgent surgery two days later. I’m assuming you are looking at the same surgery - laminectomy and a microdiscectomy all wrapped up in one.

Almost immediately after my surgery, my legs were back to normal and the pain was gone (outside of the incision of course). Recovery was actually quick. However, I did too much too early and re-herniated the same disc (confirmed by MRI) at my 4th week after surgery. My doc said it only happens 20% of the time. I was scheduled for another microdiscectomy in August, but started working with my PT and managed to get the disc back into place again three months later. It’s been a long road back, but I’m glad I didn’t do the second surgery. My surgeon said I could go right to fusing the joint, but that I would 100% have complications later in life because I am on the younger side (I’m in my mid/late 30’s).

I am back to doing all my normal things, but I constantly have to remember to do everything “properly” (aka have core engaged, lift with my legs, etc.). Strength is coming along slowly, but I do battle against constantly tight muscles and still have to figure out how to relax.

I am not going to give any career advice, but you can get back to where you were pre-herniated disc. I have just found that once it herniates, it is easier to herniate again so just be aware and make sure you keep up on your exercises.

Please keep us updated!

[Hawks_Nest]

Thank you I’m under 30 so this was all very overwhelming and not what I expected my knee surgery outcome to be. I’ll definitely update the post when I have an actual treatment plan in place etc

[Piaffe11]

I hope your surgery can happen sooner rather than later. Just take it easy if you can until then. When the disc is already pressing on the nerves so much, you just want to be careful it doesn’t hemorrhage or shift to press on the nerves any worse as that could cause significant damage.

If you are still in a lot of pain, talk to your doc about a nerve blocker (I took gabapentin). I also found sacral cranial therapy was helpful with the numbness (it’s a bit “out there” but it worked despite me not expecting it to).

[Bristol_Bay]

If there was no event that caused this to happen, then I would maybe go the grad school route and use the break from riding to develop a lot of core strength.

[rothmpp]

Obviously until you have the surgery and get through the PT, you’re not going to know what your personal results will be from the surgery.

SO had a laminectomy for a L4/5 hernia years ago. They tried the non-invasive management for about a month and he was miserable, I was miserable, and they pushed doing the surgery much faster than usual. I was at his appointment following the third round of injections that did nothing and I looked at the surgeon and said neither one of us were going to last - he couldn’t sleep which meant I couldn’t sleep.

His may have been from lifting wrong, or more likely, after he had a terrible complication from a botched open appendectomy that resulted in the surgical site herniating TWICE, he was overcompensating for the hacked up abdominal muscles and herniated his lower back.

He has fared very well since then, but continues to be very careful so as to not injure his back again.

Were I you, I would wait until post surgery to make any huge life decisions. Unless you were already considering a career change, which in that case, at least working out what it would take to attend grad school while you recover would be useful.

[SBrentnall]

I herniated L4/L5 and L5/S1 in 2015, with sciatic nerve root compression and paralysis of the back of my right leg.

Before you opt for surgery, try spinal decompression. It’s non-invasive and you can still do surgery if it doesn’t work for you.

I did 2 months of spinal decompression and several months of PT, and was showing at 4th level a year later. The paralysis went away after about 2 months, although I still have a narrow strip down the back of my leg with no feeling. I just have to be careful when I’m shaving my legs!

[theresak]

After I threw my back out, sciatica started along with tingling in my foot. The sciatica and tingling remained for almost exactly 6 months and then one day I realized it was gone.

Throughout all of that, I worked with PT and continued with core strengthening, gentle stretching, cardio, and riding. I worry about doing surgery because my mom had a disc surgery and it relapsed less than a year later, which is really common.

I still have to be careful and certain things (and riding certain horses) make my back feel “tired.” I think it’s really that my core gets fatigued and I start using my back more and then I’m in a risky spot to aggravate things. I have to stay on top of that, take NSAIDs when it happens, and do lots of gentle stretching of my hamstrings, piriformis releases, and rolling my IT band. My personal horse does not upset my back at all (although I’m mostly posting the trot on him still); however there is one horse that I have to make sure I ride first or only him because he really makes my back tight the next day.

[IdahoRider]

I had a spinal cord injury at L-4/L-5 and can’t feel from the waist down. I will NEVER ride like I did before my injury. But I do ride. I take lessons and enjoy my barn life just as much as I did before.

Once you get the pain addressed, it is a question of staying as supple as possible in your own body. Spasms are common and that might be a day you don’t ride.
Sheilah

[floppyammy]

I’m not trying to hijack the OP’s thread, I had actually been considering starting my own in the “Riders with Health Issues” forum. But I am finding the responses on this Dressage thread really helpful.

OP, please tell me to go pound sand if I am infringing on your thread. But I would love to have some input on my (less serious but similar) situation as well!

A week ago I was diagnosed with an L-5/S-1 hernia, which I gather is fairly common. In fact, I suspect I have had it for at least 4 years. However, I recently managed to make it very, very angry and ended up in the ER in serious pain. They did a great job, patched me up and sent me on my way and I have been pain free for about a week. I do have residual numbness in my left calf and foot, which I read can take up to 6 months to fully resolve.

My question is, how quickly is it reasonable to get back in the saddle?

[theresak]

@floppyammy

My question is, how quickly is it reasonable to get back in the saddle?

I found as soon as I could figure out how to get into the saddle and able to relax my butt cheeks, I could at least walk around. What happens is I try to protect my back by clenching everything up mounting and if my muscles are still so tight I can’t relax my butt or thighs, I’m not going to get any benefit from riding. The walking motion of the horse actually helps loosen the hips and low back a bit.

What really would make my back seize up was putting my leg on for a canter transition and dismounting.

[SBrentnall]

@floppyammy

My question is, how quickly is it reasonable to get back in the saddle?

I had complete paralysis of my right leg, so it took longer, but I was in the saddle after two months, once the major inflammation went down.

I couldn’t actually ride and my right leg flopped around, but I could get on at the end of my trainer’s ride and walk around for a few minutes. Even that was hugely helpful to the healing process, both from a physiological and a psychological viewpoint.

I started doing a little more while still doing spinal decompression and PT. A year after my injury, I was showing 4th level.