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Today it has been exactly a month since I have been released from the hospital, where I was admitted with spondylodiscitis and stayed for ten days. It was a pretty ugly condition, there was septicemia on the second day of admission, of the four teams that assumed my case (pain management, infectology, orthopedics and finally psychiatry, thanks to a major screw-up by orthopedics), orthopedics was the only one that stood out as incompetent. They were utterly unable to handle an athlete and had, among them, a team member with issues with athletes.
The result is that my orthopedist and I are now working from scratch, somewhat tackling as to where to go from each point. From the six month immobilization, never lifting again and the black magic spells of the hospital orthopedics team and my desire to lift tomorrow, there is an infinite array of possibilities.
What we know for sure is that the L3 and L4 vertebrae suffered partial osteolysis and the disk is gone. The predicted outcome is an ankilosis – a fusion of the vertebrae – and final bone healing. It is hard to know exactly how long this will take: there is still debris in the inter-vertebral space, which is closing as fast as can be expected, I guess.
How much stimulus to put on the injury, how often and with what intensity, are unknown variables. There is not a single published paper about spondylodiscitis on a strength athlete.
I actually started benching a few days after leaving the hospital. I was aware that the bone was obviously soft and all care was required. Everything hurt then. My strength was gone and a 75-78% load felt heavy.
Since then I benched every week and my strength improved about 20% – or rather, my ability to recruit muscles to exert strength. Feeling the strength coming back to my body is close to the best sensations possible. It is like life being pumped back into me.
But what should I do for recovery? Certainly some isometric training (plank), pushups and leg raises. It took me a while to admit that this is one of those rare occasions when machines are useful. I decided to go for it.
I am known as one of the most radical advocates of free-weights-only training and the expressions and jokes I made about machines became popular on the internet. I expect to become the joke myself after this article. I don’t mind.
Yesterday was my first training session at Wynner Gym, which belongs to my friends Felipe and Nathalia. We’ve been friends for almost 10 years now and I have my powerhouse (my own home gym) for three years.
Our first task was to establish the right range of motion so as not to allow for hip retroversion on the leg press. I did it with a friend who is a strength and conditioning coach there. It looked more or less like teaching your kid how to park a car: “go… go… no, that’s too much, go back. Yes… now just a little bit more… that’s it!”.
May the gods forgive me, but I even used the leg extension and leg flexor machines.
I know better than to think any of this will help me in anything for the squat or the deadlift. The reason I need to do this is because my brain is screaming for squats and I can’t give it to it. I need to provide something, no matter what, that resembles movement and strength, will silence my brain and help with inactivity soreness.
I never read about this. I think I might just have invented the expression. But no powerlifter is a stranger to it: you spend too long away from a lift, you start feeling a certain weird soreness. That is what I call “inactivity soreness”.
When my doctor asks me about the pain, and it has been intense on some occasions after I left the hospital, it is never irradiated pain. There is no neurological commitment. It is only referred pain, especially on tendon insertions. The worst is the quadratum (the part of my body the most suffers from inactivity), then gluteus medius and when the pain reaches a high intensity, the right quadriceps insertion. Everything on the right side.
Today I used the machines for pulling movements. The interesting fact is that I arrived at the gym with some soreness, didn’t take any pain killer and the pain was gone after I finished my workout. Innactivity soreness dealt with?
So, no, I am not immobilized. And no, the vertebrae have not collapsed due to my refusal to use the corset all the time. Even the stupid hospital team didn’t reach consensus concerning that: some said it should be used all the time, some only when moving around. And two thought I needed a hard structure corset (one of the most stupid ideas for a patient who already has lumbar rectification). I’m doing none of this. “My team” agreed that the corset should only be used if preventing pain, as in long car drives where there might be too many bumps.
No, I do not recommend anyone healthy to use machines. Even people with minor injuries should not use machines. But a spinal injury is a case in which it makes sense to be very careful when rehabilitating for core efficiency. Until safe, it is wise to protect the spine by minimizing spinal mobility.
Here are some references (storify allows me to update the references without having to edit the article)
There is some evidence from the literature concerning widespread pain and local soreness caused by inactivity. Whether these have any physiological relation with the inactivity soreness athletes feel when a few days to some weeks without training is unclear.