Strategies for Career-Limiting Chronic Back Pain

I love being active. When I am away from the desk, the computer, the phone and the conference room, I still dream of adventures into the ocean and up snow-scraped mountains. I exercise regularly because movement keeps me focused, smart and happy. I love the feel of my muscles after a good weight pump, the sublime serotonin boost after an early morning run in the rain, and the aggressive testosterone boost from interval training on my RP3 rower.

When work feels like too much work, activity is often just the medicine I need to keep going.

Until injury.

In November of 2018, I tweaked my back. In December 2018, I was admitted to the hospital with severe back pain and sciatica in both legs. I have a high pain tolerance, but this episode pushed me to my limit – a 9.5 out of 10. Movement would dull the pain sensations, but I couldn't sleep or be still without extreme pain.

My hope is that this recent experience can help someone else heal faster, boost mindset and reduce unneeded suffering.

If you know another working professional suffering from back pain, tag them below if you think they would benefit from the read.

If you want to heal – and heal fast – you must attack your injury: Do the work. Do the best you can. Keep experimenting. Keep learning. Reach out for help. Take the advice of others.

You will heal. The question is, how soon? How fast?

How? Why? Why Me?

How do you heal from back pain? This is one of the random questions I get asked as I travel around delivering my leadership training and consulting. I almost missed out on my Olympic dream in 2008 because of two herniated discs, and use this story to illustrate a time tested strategic philosophy: We must focus on what we can control, and ignore what we cannot.

Almost losing out on my Olympic dream because of a bad back felt tragic. It was depressing, defacing, doubt-inspiring.

But this recent, crippling episode felt even bigger. Why?

I have a young family. I have a mortgage, a minivan and multiple other bills to pay. Being self employed has its benefits, but this lifestyle does not have the backing of a union or a large organization. If I am injured and not working, I am not able to earn an income. Everything falls apart.

My mind was inundated with a thousand worst case scenarios. I love my work and my clients but I was terrified by the thought of sitting on another airplane, cramped in those tiny seats (that keep getting tinier!).

What happens if my back doesn't heal? Can I even fly again? Will I continue to get clients? What can I do to find a new path of work?

A New Normal

Healing requires us to create a new normal. When we’re healing we often want to get back to past feelings of health and strength. We have to look past the past and then put in the work to create a new paradigm.

The goal remains. It’s just that the route has changed.

My career goals are big. I’m launching my book this year. I’m working with my bureau partners to fill my calendar with speaking and training events. I need to hire new staff, update my marketing, increase my sales game, write a regular business column. And the list goes on and on...

I have had to let go of each of these goals, and my personal goals as well.

• How am I going to be a better businessman? Heal the back.
• How am I going to make more sales? Heal the back.
• How am I going to complete my administrative tasks? Heal the back.
• How am I going to edit, market and sell more books? Heal the back.
• How am I going to be a better father, husband, community advocate? Heal the back.
• How am I going to make 2019 a success? Heal the back.

Moving my back from a lower-level priority to THE priority has ensured a speedy recovery. (Although recovery from injury is never speedy enough...). My priority is to change habits and embrace a new paradigm that will make my back stronger, longer.

Six months from now, if I follow the best advice, my disc tissue will be healed. The bulges will shrink, and scar over. Pain will be completely gone, and full strength will return.

Motivational Mantra 

I will run again

I will climb again

I will go rucking again

I will row again

I will play soccer with my kids again

I will throw my kids in the pool again

I will dance again

Just not today.

Today I heal.

Surgery or no surgery?

I received a CAT scan, an MRI, spoke with four doctors and a neurosurgeon. I am a great candidate to go under the knife, and will get cut, if necessary. Let’s take a look at my situation and the facts. I’m going to get a bit more technical here, but I think this will be interesting for anyone reading this who is going through a similar situation.

L3-L4 - Broad, central protrusion, no stenosis

L4-L5 - Narrowed disc with noticeable degeneration, paracentral protrusion, extruded fragments, severely narrowed central canal (stenosis), thecal sac deviating to the left and posterior, narrowed right lateral recess, other lateral exit foramina are OK

L5-S1 - Disc degeneration, paracentral protrusion, mild foraminal narrowing on the right side

The surgeon could go into my spine, remove the protrusions, extruded fragments and open the canal space. Sounds like an easy fix, right? In the depth of pain, this was all that I wanted.

I can't sleep. I can't work. I can't play with my kids. Just fix my freaking back!

“I have operated on people with better backs than you,” said my neurosurgeon, Dr. Ian Fleetwood. “I have operated on people with worse backs than you. What the evidence shows is that the body is very good at healing itself. If you are showing progress, let’s hold off. You’ll probably heal quicker.”

The body has a remarkable ability to heal itself. The research is humbling. Countless studies show that in the long term surgical intervention has the same success rate as conservative, non-invasive therapy. This means, with the right mindset, therapy, discipline, practitioners and tools, your body could heal just as well – if not better – than if you have surgery.

Timeline

For your interest, here is a brief timeline of my back injury. I call back pain my “Demon”. When my demon shows up, he starts with a whisper. If I instantly lean into therapy, the demon leaves.

2002 - Tweaked back doing an improper squat (without weight coach supervision) while training with the Canadian National Rowing Team. Out from training for two weeks.

2003 to 2007 - Various episodes of pain where I was able to keep training, or reduce volume and keep pushing hard. I embraced the following mantra, which I still do for high-performance athletics: “If you are not flirting with injury, you are not pushing hard enough.”

2008 - Major back episode. L4-L5-S1 showed bulging and herniation. I could not row. I could not train. The only way I could be without pain was to walk or lie on my back with knees elevated. I fought through a strong depression of hopelessness and doubt. I leaned into conservative therapy and hit this pain episode with everything. I was back rowing in six weeks, and training at full Olympic volume by eight weeks. I will describe what has worked for me below.

2008 to 2010 - Various episodes of pain, but nothing that stopped me from moving. I was detraining from Olympic volumes, learning the difference between training and exercise, and adapting to desk work.

2010 to 2018 - No major problems as a weekend warrior and adventure athlete. I have happily participated in and completed 100-mile bike rides, 50-mile runs, 40-mile rows, all with no major problems. My biggest issue came in 2015 when I was rear-ended by the distracted-by-texting driver of a pickup truck and had to go into manageable therapy for eight weeks. I had minor back pain when I rowed across the Atlantic Ocean and around Vancouver Island in 2012-2013, but nothing major.

2018 - I tweaked my back lifting heavy logs on the beach, then exacerbated the injury with an improper deadlift, then by a row at my 2008 Olympic reunion. This niggle compounded in severity due to my heavy air travel schedule. I leaned into therapy, but the back got worse. On Christmas day, at the behest of my neighbours and wife, I visited the emergency room to get scans and receive drugs for the pain.

Deep Pain Healing Regime

While in deep pain, our first goal is to manage the pain. The body will heal if you can be patient and give it time. This is what I did to speed the natural healing process and manage the pain.

Pain Medication

Tylenol. A general analgesic to relieve pain.

Diclofenac Potassium (Voltaren Rapide). This is a non-steroidal anti-inflammatory drug (NSAID) to reduce swelling and flare-ups. Eat with food to reduce likelihood of getting stomach ulcers. I often take 2-3x the recommended daily dose for 2-3 days to calm down a flare-up, but this strategy didn't work this time.

Notes: I will take ibuprofen (an NSAID similar to diclofenac) for lesser flare-ups, but it is not advised to mix different types of NSAIDs. I did not take any muscle relaxants this flare-up, because the pain was ‘discy’. I felt the pain in my spine and sciatica, and not in the general region of the back.

Gabapentin. Helps treat neuropathic pain. This medication synergizes well with diclofenac and morphine. I found that this medicine made me depressed, gave me suicidal thoughts and reduced my intelligence. Needless to say, when the pain became more manageable, I was motivated to stop using this drug, and tapered off usage after three weeks.

Morphine. When the doctors first prescribed this med they cheered for me. “You get to get high!!” We all laughed. Yes, morphine helped, and felt good, but you’d have to be living under a rock to not know about the opioid crisis. I tapered off this drug after about two weeks of use.

Ointments

Rub it in where it hurts

CryoDerm, RockSauce Fire, Tiger Balm. All three are high in menthol, which helps numb pain. Each of these ointments has their own special recipe of ingredients to treat pain and inflammation.

Voltaren Extra Strength Gel - A topical application of NSAID diclofenac.

Supplements

Vitamin C - I take a very high dose of stomach-friendly Vitamin C to help with wound healing and collagen utilization.

Omega 3s - Again, I take as much as my body can handle to reduce inflammation.

Curcumin - A natural anti-inflammatory. Adam O’Mera from Purica hooked me up with a good supply.

Purica Recover - Packed with complementary substances to boost healing and joint care. This supplement includes grape seed extract (aids in wound healing), MSM, Glucosamine, Hyaluronic Acid, among others. Another gift from Purica and Adam O’Mera.

Branch Chain Amino Acids (BCAAs) - Ensuring that I have a full suite of repair tools available for my back.

Collagen - A raw material needed for tissue healing.

Inositol - Helps to alleviate low mood states and depression.

Body System

Rest - Go to bed early, wake up late. Move as slowly as possible. Take breaks throughout the day. Don’t push through the pain.

Sauna - Sweating helps the body clear toxins and keeps the muscles limber. This is a good place to stretch. I will spend 20 minutes in the sauna, then come out and stand with the cold shower blasting on my low back.

Cold Plunge - Activates the full body and boosts the immune system. I will spend 10 minutes in 8°C water one to two times per week.

Tools

Localized Hot/Cold packs - Increases fluid flow in the wounded area for healing.

Neoprene Back Wrap with Magnets - Magnets are said to increase circulation in the area. Neoprene back brace helps support the core. When my back was really bad, it helped to wear this brace at night. When my muscles relaxed in bed, the pain would be almost unbearable. The neoprene brace kept my core tight and back feeling better.

Kinesio Tape - Taping the muscles around the back gives pain relief and stimulates the nerves to create more healing.

Inversion Table - hanging upside-down by my ankles decompresses the spine and allows me to say in a raspy voice “I’m Batman!”.

Chin up bar - hanging from a bar with my hands decompresses my spine.

Travel roll - Keeps my spine curved while travelling or sitting to reduce pain.

Hyperbaric Chamber - High levels of oxygen to speed healing. One day, high on my pain medication, I felt my blood pressure drop while in the hyperbaric chamber. My adrenaline kicked in and I had a panic attack. I discontinued use until after I weaned off of morphine and gabapentin.

Silicone Cups - Helps to increase circulation in the inflamed area, and stretch the surrounding tissue.

Exercises

For the first two weeks after my flare-up, I did very little exercise. As the pain subsided, I kept introducing physical work in 20-30 minute segments. When an activity would increase pain, I would back off for a day or so, then resume activity. Move it or lose it!

• Water Running - helps decompress the spine, movement helps to increase circulation for healing
• Pole walking - activates core muscles, increases cardio output
• Light Elliptical - lower impact
• Light Cycling - keeps movement in the low spine
• Light Stretching - work to find movements that do not impact pain
• Light TRX - core stability and engagement
• Light Ball work - stretching spine and core work
• Deep breathing - stretching spine and boosting mental health

Mental state

Staying positive and optimistic is key to a successful healing regime. My wife, Rebecca Sterritt, has always been my number one confidant, helping me through periods of restlessness, doubt and negativity. Here are some other tools that worked.

• Positive visualization - visualize the discs shrinking away from the nerves and healing
• Meditation - Transcendental meditation, reminding myself that I am safe, healing sounds from friend and performance coach, Bob Babinski
• Verbal Acknowledgement - Vocalize and celebrate small moments of pain-free living, or when a strained movement becomes less painful.
• Attack subconscious blockages - When pain arises, ask yourself "Am I running away from a deeper emotional pain? Is this physical pain blocking a larger psychological pain from work, family, childhood?"
• Limit social media - It can be helpful, but can also be toxic. Know your limit, stay within it.
• Positive conversations - I will share with concerned friends the actions I am taking to heal. Sharing proactive behaviours out loud helps to reinforce positive habits, behaviours and mindsets.
• Reaching out to friends - Ask friends for help who know how to heal
• Breaking the cycle - When I start wallowing in self-pity and doubt, I reach out to a positive friend who will have a good word to say
• Notes of healing - Post notes around my office and house that remind me that I am healing
• Journaling - I am presently enjoying the Stoic Journal by Ryan Holiday and Stephen Hanselman
• Writing - Writing this article has made me feel more positive. Knowing that my experience could help others feels great. Also, my confidence is boosted when I see all the proactive action I have taken to cure my pain.

Therapists

Because of this flareup’s disc-y nature, this most recent injury did not require massage for healing. I have seen and experienced relief with Osteopathy, IMT and other modalities. Below is what has helped me get better, and continues to aid my improvement:

Chiropractor - Decompression, laser work, adjustments. Thank you, Mike Murray.

Physiotherapy - Hip mobilizations. McKenzie Protocol. Balancing & core engagement exercises. Thank you, Greg Spooner

Acupuncture - Less is more. Too much acupuncture can exacerbate the flare up. Space it out. Thank you, Erin Alexander.

Body Talk - Energy healing. Thank you, Susan Stenson.

A New Paradigm

?At Work

I use a standing desk

I use a wobble chair

I use a kneeling chair

I use squishy pads under my feet

I have an ergonomic chair

I have an ergonomic screen

I take stretching breaks

I take walking breaks

For Exercise

I will lose 22 pounds (10 kg)

I am committed to core work (TRX, ball work, bodyweight exercises)

I am committed to more mobility and flexibility (Especially, hamstrings, psoas, hips, piriformis, calves & lats)

I will continue to hate yoga AND do it

I will learn more ELDOA moves

I will learn to swim

I will keep plunging in cold water every week

I will keep going to the sauna to sweat and stretch

I will never do heavy squats or deadlifts again

I will no longer mover massive objects to the point of failure

Final Thoughts

An injured back can be a real pain in the butt. Having chronic pain is horrible, disruptive and distracting at the best of times. At the worst of times, it's a complete mind-twister. It interferes with your ability to earn money and provide for others.

What’s most important is to stay committed once the pain subsides, then returns. Listen to the little signs. It's easier to calm a whispering demon than a screaming devil.

Pain is a very strong motivator for change and action. Keep trying new things. Keep innovating and experimenting. Create your new paradigm of health.

What has worked for you in the past? What would you recommend to me and others seeking healing and relief from back pain? Please share in the comments below.