[Firerescuefin]

In dealing with my own spine issues, I am always struggling with the amount of activity that is healthy and promotes good spinal health. I was a competitive powerlifter and firefighter challenge (competition) participant for years, then became a competitive cyclist and triathlete...before my back said enough.

I have thought a lot about this as I have been going through the experiences associated with a spine injury, and through the research I have done/ observed others doing the same. I would think that a low tolerance for pain truly works against the spine patient. See if my logic make sense:

Injury takes place - Structures are compromised

Patient guards against pain or concern of future injury - Supporting structures become increasingly weakened, putting more stress on already compromised structures, resulting in more pain/weakness/dysfunction/degeneration.

Obviously, my level/type of activity (pre-injury) was not healthy (especially the powerlifting/competitive firefighting competitions). 3 months after microdiscectomy @ l4/5 I was still in a lot of pain (both sciatic and back). This was after going into the surgery as fit as possible...and the routine core excercises that my PT had prescribed during rehab. After researching additional PT protocols, I decided to go to a PT using the MEDX machines/protocol. My initial evaluation showed spinal musculature that was 40% weaker than the average male/my age/with my bodymass. To say I was suprised was an understatement. In someone with a compromised spine, you would like to see those levels above average. Now whether that is possible would be different depending on each individual case..and obviously there is some risk that would go along with that (My PT said she had seen 1 person in the 8 years using the protocol re-herniate). I currently am testing above average, but my pain levels increased initially before they decreased due to the inactivity and atrophy. Am I pain free, not even close. Is the pain less...yes, substantially. Am I more functional...Yes. Do I feel like I have done everything in my power to give myself a positive outcome/prepare my body for something more invasive, i.e. ADR...Yes.

I guess to build on what Mark was saying....the inter-relation of the psychological (perception of pain and disability) and physical components regarding spine injury are both incredibly complex and relevant in the life and possible recovery of someone with an injury.