Skiing after back surgery

[Marco]

I'm staring down the barrel of a disectomy and laminectomy with fusion this fall. Basically, it is a single level fusion (L4-L5) with decompression to alleviate the stenosis, and the fusion is required due to severe spondylolethsis. My surgeon, who is a nationally renowned spinal surgeon, says that after recovery, I will be able to do all the activities I currently do, along with all the ones I have had to give up.

 

Does anyone have experience or knowledge about returning to skiing after such a procedure? I am 54, and am happy when I get a few at 38, but more often I am knocking my head against the wall at 35. Will I be able to return to the same level of mediocre skiing after surgery? Any feedback is much appreciated!

[skibumm]

I had a three level fusion from L4-S1 because I shattered L5 in a snow skiing accident. That was three years ago on Dec 31st. It takes some time to feel 100% ok for me its more like 90% but it does not stop me from doing anything. There are times when I fall that I feel it and it scares me a bit. You will be much better because you are not actually missing bone. They had to remove my L5 al but completely.

[Chef23]

I have only had a micro-discectomy which was pretty trivial compared to what you are facing but I think if you do the rehab and get strong after the surgery you should be fine.

[MrJones]

Marco,

I believe that after a single level fusion you should have no problem returning to a high level of skiing. I would take the time that is needed for the fusion to solidify, mainly going with your surgeon's advice. You will have an excellent opportunity to rehab for an extended period.

 

When you do start back you might want to take the opportunity to try and make some basic changes in you skiing that will make life easier on your back. I recently have been trying to incorporate some things that Chet Raley is a proponent of and feel that this style of skiing is less abusive than what I have been doing for years.

 

Overall, I believe the glass is 1/2 full for you. Good luck!

[grab2go]

Not trying to plug Dave, but the powervest has helped me...

[ozski]

Good subject, I'm skiing much less right due chronic back pain. Physio says that structurally everything is fine but its still nasty pain when I get it wrong. Best of luck whatever way you go.

[cragginshred]

Marco, I work in PT and because I do not ski -38 my advice here is not always 'heard'. You seem to grasp the fact the fusions are never ideal and apart from your 'spondy' I would normally advise against it. I do not rehab many water skiers but can tell you one of the owners at my lake has a fused low back and skis hard into -35. The biggest thing I tell my pt's is 'do not rush the physiology'. You are looking at 6-8 months off skiing minimum but will definitely by ripping it up again!

Gentle stretching of the hip flexor, ham, piriformis, calfs are all key while doing ****'non aggravating'*** cardio and core strengthening. pm me if you have any questions!

Don

[6balls]

5 weeks from 2 level cervical fusion. I was told no skiing this season...ideally til next spring. Bummer but want to get the healing right because if it heals well I'm told no restrictions ongoing.

Now allowed to turn my head (avoid flex/extend), been back at work for 3 weeks, up to a 20 lb lift/carry restriction and can do upper body lifts in gym if don't cause neck strain or axial loading. Nothing overhead for now heavier than my hands n arms. Been working legs, riding stationary bike. Plan to hit the core hard over the recovery and perhaps build a stronger lower spine for future skiing.

[Marco]

Thanks for all the feedback. It has reinforced my decision to move forward.

 

@cragginshred - Your voice is important. Thank you very much for the input. I listen to what everyone has to say, regardless of skiing ability. Years ago, when I was teaching snow skiing, the head of the ski school once said to respect all of my clients regardless of skiing ability, because the one who might be struggling most may very well also be the best brain surgeon in the world. Everyone has their talents. That really hit home to me and I still think about it 30 years later.

 

@6balls - Good luck on your recovery. I was definately taking your situation into account when I decided to have the surgery. Heal well!

 

@MrJones - Thanks for the input. I am curious to hear about the techniques that Chet is talking to you about. I imagine it has something to do with low load skiing. If you have a chance, please elaborate.

[Rich]

I feel your pain, I too have spondylolethsis. I discovered I had it when I was 15. The combination of learning to barefoot that summer and highschool football workouts made me realize something was wrong. The doc at the time said that I should study hard because I couldn't make a living with my body. I did stay in phyical condition, however I had at least 1 back episode a summer for the next 35 years. I found Yoga when I was 40. Bikram Yoga at 50. 4 years ago I decided to do Bikram 5-6 days per week. Since then I have not had any back problems. I can ski thru 38 and have been doing that for 20 years. Bikram has been the best thing I have done for my body. I would also work on my psoais stretches. I would avoid surgury if possible.

[Marco]

@Rich - Unfortunately fusion is required due to the instability in my spine. I have already spent quite a bit of time and effort strengthening my core, which is allowing me to get through the summer. I haven't tried yoga yet, but maybe it is time to start.

 

Way to overcome your back issues to be one of the top skiers in Mens 5! I'll look you up to say Hi at Regionals at Laku. I'll be the guy wearing 3 back braces and going off the dock early in Mens 5 (unless I am able to knock down a 35 between now and then)...I hate being early off the dock!

[Rich]

Do Bikram... forget the surgury. Don't be paying for the doc's pool!

 

[Rich]

I just signed up for regionals, my ski site is dry, practice is limited. We shall see how Bikram helps my mind. Its all there anyway! LMAO!

 

 

[Rich]

western medicine treats the end... start from the beginning.

[Rich]

Bones don't cause instablity, weak muscles do,

tight psoais can contribute in a BIG way also.

[Marco]

As do stretched ligaments. I am not familiar with where a psoais is. Please educate me.

 

Sorry to hear about your dry ski site. Where in Cal is it? If you are driving out to ski in the warmup tournament, feel free to stop by our lake for some sets. We are an hour south of Grand Junction.

[Rich]

https://yogainternational.com/article/view/how-to-stretch-and-strengthen-the-psoas

 

[Rich]

here you go

[Rich]

stretch psoas

[6balls]

I would have avoided surgery if at all possible, but given most of my spinal cord was compressed didn't have any choice. Was told in the meantime prior to surgery "just don't fall down" to avoid ending up a quad. Also had a number of severely crushed nerve roots due to neuro-foraminal stenosis.

Don't even want to know what my lumbar spine looks like...been a problem since teens. My bro is having some success temporizing his with core work. @rich send me a link on Bikram yoga. My history is far from that as a comp powerlifter so philosophically very different but probably a road I need to explore with age...I'm also about the most inflexible person in the world so worth a look. Suggestions for how to start as a beginner would be cool, too. I probably can't do much of it just yet, but two months from now I should be cleared for all but heavy contact sports.

 

Thanks!

[Marco]

@Rich - Thanks for all the info. I am leaving now to drive 175 miles to ski in a tournament, so I'll review the information on stretching the psoais when I return tomorrow.

 

@6balls -I have severe stenosis as well, in my lumbar spine (and C2-C5 as well, but thats another story). Just the thought of eliminating the chronic pain is appealing. I hope your recovery is going better than expected!!

[Than_Bogan]

Psoas is huge for skiers. Few sports load them like we do. And the asymmetry of our stance makes it even more interesting.

[eddie_roberts_jr]

I had laminectomy/decompression surgery on Thursday @ L3/L4. I'm sore as hell at the surgery site but WAY better in several places in my back and hips. The doctor was pretty proud of himself and said it only took about 45 min. and came out perfect. I probably should have had it done at least 6 months ago. I can walk upright now!

[Marco]

@Rich - Thank you for the info on the psoas stretching and strengthing. I did the first go'round this morning, and can already feel the benefits! Like @6balls, I am pretty inflexible, and just a half hour of the stretches helped relieve tension in my back. I will definitely incorporate it into my daily routine.

 

@eddie_roberts_jr - Glad to hear your surgery is already showing positive results! I can only imagine what it must be like to be without the chronic pain after years living with it. I hope you have a speedy recovery!

[Patmaster]

@Rich, been doing Bikram since I turned 45. Changed my life (now close to 53), I even financed my own studio. Last year been diagnosed with spinal stenosis, which explained why I was so stewed up last season. Continued Bikram, however I find it hard to do it every day, especially if on a tournament. Glad to hear you swear by it, I'm also a big believer. Talked several skiers into trying, most did not stick. Once bumped into Natalia Brednikava near Orlando in a Bikram studio. She used it as a part of her rehab program. Not sure if she is now still a regular. Aside from skiing, Andy Murray was big on Bikram, but he had a back surgery last year. I wonder if he still does it. Anyway, it is one of the best quick-fix-it-all fitness routines I know. And if you are smart, you will not bend too much when it starts to hurt, but reap the overall benefit by sweating all the toxins out of your body.

[Patmaster]

@Marco, any updates? Did you go for surgery or did you start doing yoga? I was advised surgery a couple of days ago - have difficulties coming to terms with that!

[JoeMac]

I had c5-c6 fused 4 years ago. Tried to go back too soon. And was set back due to the muscle atrophy I had sustained from the injury. After the first setback I got a power vest and have used it for the last 3 years. At the end of this season I am finally able to ski without the power vest. It has taken me 3 years to strengthen my left shoulder back to about 80 percent of what it was. I still use a unilateral shoulder brace. I think it is critical to continue doing the exercises that the physical therapist shows you forever!!!! I think that if I had started doing those exercises from the beginning, I never would have had to have surgery. I know I didn't have lumbar injury, but I know a lot of skiers that have. I have seen those types of injuries end their skiing. For the lumbar having a strong core is critical. I would focus on that all off season. Hope that helps

[skibumm]

I had no choice on surgery as I had a vert that was crushed and in 20 pieces. I was walking on a treadmill (in my turtle shell) 1 week after surgery. I was not allowed to do anything but walk for 4 months. I did not do any formal PT at all. I am the type that hates to sit still and I kept asking about PT and the response was that he wanted to keep me from doing things as every appointment I would ask if I could do something like swimming or biking etc. I was in very good shape before the accident. Finally he allowed me to bike and even lightly jog on a treadmill. After 6 months I was back in the gym working out. I lift for strength (even though I am a puss still) but since my surgery I have run 5 full ironmans and 4 halfs. I have a stretching routine that I do twice a day and Yoga twice a week. I was 46 when I had my accident and I really have no ill effects from the surgery. I can't put my palms on the floor like I used to able to do but I am more limber than most still. Plus I have a cool scar.

[6balls]

@joemac i had C4-5 and C5-6 done June 5. Was on exercise bike by day 3 post op and within a few weeks light free weights though no shoulder work. Kept after legs throughout. Now back to pushing heavy upper body and have one shoulder workout under my belt. Did some smith military press, lat raise and shrugs for sets of 20. Getting away with heavy curls, heavy bench and flies, weighted dips, and tricep press downs. Core every a.m.

 

Today legs n back. I haven't pushed back (lats) real hard kinda like the shoulders hoping to dial back and shoulders up slowly now. Like you each time I started to advance my neck muscles would get sore...I think mainly they are just out of shape from disuse. Just before the 3 month mark I hit tennis balls with my daughter and was stiff/sore for 2 weeks.

 

Was tempted to ski in practice at skiwatch tourney as feeling good but glad I didn't...they tell me not to ski til spring and my back/shoulders are not in shape. I am now bringing a rope to the gym and doing some static leans in ski position as well.

 

I think the hard thing about these neck procedures is I started feeling pretty good pretty quick...but it wasn't ready to "go" yet.

[Marco]

@Patmaster - Good timing for reviving this old thread. I am going in for surgery on Monday. Unfortunately, yoga would not help the instability in my spine, or the stenosis, so surgery is my only option. My surgeon said that after surgery (and recovery) I will be able to start doing all the things I had to give up over the years due to my back. I'm sorry to hear you may need surgery also. Keep in mind that medical techniques have advanced drastically over the last several decades, and full recovery is the norm, not the exception.

 

@JoeMac - Point well taken on taking the PT seriously. I learned that during my rehab from a major shoulder rebuild several years ago. I spent 2 hours a day for 7 months doing my exercises, and that shoulder is better than new.

 

@skibumm - That sounds like a major injury. How did you crush your vertabrae?

[skibumm]

@Marco‌ I was snow skiing (coaching some under 16 big mountain skiers) I hit a cliff a bit too hot and over jumped where I should have landed and landed on a much less steep location. So I landed a 60 ft cliff and came to a stop too quickly without enough angle to dissipate the speed. The compression of the spine basically burst the weakest link. Moral of the story stop doing stupid stuff before you turn 46 as your body will betray you.

[Patmaster]

Thanks for the comments guys. If anyone had a good (or bad) experience with arthroscopic surgery of the lower back (stenosis), I'd be particularly interested to hear...

[Patmaster]

@Marco, keep us updated and may you be on water sooner than you expect!

 

[Marco]

@Patmaster -Have you made any decisions on your course of action with your back?

 

Well, I'm now 10 days post op and am starting to feel the payoff. The first week was pretty miserable, highlighted by my 4 hour drive home from the hospital after 2 nights in the hospital. But now the pain is under control. and I have actually had moments of being 100% pain free for the first time in a decade. Can't wait for the pain of surgery to go away so that is the norm instead of the exception.

 

Planning on rehabbing like crazy (once cleared to do so) so next season I can focus on setting new PB's since my back will not be the weak link any longer. Getting back on the water next summer in great shape is the thought that will motivate me to rehab like never before!

[Deke]

@Marco‌ it must have been miserable if it took 4 hours to get back from Durango. Glad to hear things are getting better now. Keep that positive attitude!

[Marco]

Thanks @Deke - The roughest part is over, now every day is better than the last!

[6balls]

@marco follow the rules and when it's time to work into things again move slow. It will feel better in terms of pain than your muscle atrophy is ready to handle until you have a chance to rehab the muscles. When you begin to push them, they may balk a bit but you want them strong again to support your repaired spine before pushing it. When they balk back off a little and re-approach slowly.

 

I will be 6 months out in a few weeks. Have been building up slowly and steadily since they free'd me up about 3 months post-op for all but contact sports (and skiing where I could fall and take a blow). I ramped up more quickly in areas that didn't involve my neck and more slowly in areas that did (lat work, overhead work, shoulder work). I'm pretty much full tilt in the gym now and building. Every morning is core work (and stretching) to shore up my low spine which has not been operated on but is crap while slurping my coffee. It's making a difference in my back pain and I feel more solid...I really hope it helps my durability come ski season.

 

The gym is 3-4 times a week and again at this point, I'm full-tilt in terms of intensity (I get pretty intense in the gym). I'm able to play with really heavy weights for sets and am quickly building heavier and more reps. Fun to feel like my old self again...but I'm nearly 6 mo's out so be patient.

 

Having said that...I don't think I would want to suddenly jarred by wake or a fall, or take a short-line slack hit right now. I did a heavy set of flat fly dumbell presses the other day to exhaustion and after lowering them, let 'em drop on the gym floor and the subsequent jarring to my neck when they hit the floor was not fun. Felt like I had rigid spine with no shock absorber at my surgery site (which is kinda true) and it set off the neck muscles for a few days. Wasn't terrible, but got my attention...so as much as I'm really pushing the gym I don't feel like skiing is in the cards until spring. That will be almost one year and my surgeon said 1 year to mature fusion. At least at that point if I do something that fires it up I know it's stable and I just irritated it...not likely to do any damage.

 

Good luck and again, be patient (it's really hard to be patient)!

[Marco]

Thanks for the information @6balls - I was going to connect with you to see how you were coming along after 6 months, but you beat me to it. I'm sorry to hear that it is nearly a year to full fusion. When I decided to have the surgery, my surgeon (reportedly one of the best in the country) told me that I could be back to full activity, including skiing, after 6 months, which puts it at the middle of April. I have no intention of hitting it too early, so now I guess I need to mentally prepare myself for missing a good part of next summer, rather than risk re-injury by going too early.

 

Glad to hear you are ramping it up in the gym. I am committed to being sedentary for 8-12 weeks until I get out of my brace, and I can only imagine how atrophied my core is going to be after 2-3 months of immobility. Hitting the gym in a few months is something I am really looking forward to. As it is, I am limited to walking a mile a day, no more, no less. Hopefully that changes when I meet with my surgeon for my first post op meeting next Thursday.

 

Thanks again for the information and advice!

[6balls]

@marco I'd be clear with your surgeon about what skiing means to you, but also the type of skiing you do. This is not riding around behind the boat.

 

If you told him ok, we at times take excessive temporary loads (500-1000 lbs would be my guess...used to break ropes 800-1000 tensile, handles, too) whether it's an over-turn that goes well in the end but took too much, or an overturn you survive bent over taking the load but get to the other side with a chance, to the slack then get bent over and don't get the next ball at 38, to the I want credit for full buoy or out the gates slack hit. I don't feel I'm ready for any one of those right now, and arguably those would be harder on the low back than neck.

 

If after you lay it on the line your doc still says go for it at 6 mo's...it may be a difference of opinion on when it's really mature. I was honest with my doc about my lifting, skiing, and personality type. He basically said do this right and I have no greater risk than any other normal guy on the starting dock. He really cautioned me not to screw it up once I started feeling well because as much as he's really good at the initial fix, he can make no guarantees about the repair if I blow it by going back too hard too soon.

 

Having said this...my surgery was June 5. I plan to ski at ice out as usual in MN which will not be a full year...likely a good 10 months and I always start the year free skiing which should afford no hits and no falls, followed by some time at 28 off which again should be relatively risk free. 11 months post-op will start getting busy on the water and hopefully pretty durable.

 

Good luck in your recovery. I think your surgeon will given you honest answers if he really understands the intensity and if he has the great reputation that he does...I'd listen. Make sure the core is ready, though.

 

 

[Marco]

Thanks @6balls - all really good points! I have not had the opportunity to get too detailed in explaining to my surgeon the loads involved with shortline slalom. Me pre-surgery time with him was very limited, but I did tell him I competed in slalom waterskiing. He asked at what level, and I told him at the national level, and that's when he told me 6 months, but I don't think he grasped what that really meant.

 

I am going in for a follow up in a few days, and will definitely get more detailed in my description of the sport. If needed, I'll compare it to other activities that he may be able to more readily relate to, like bump skiing or even contact football. Maybe I'll show him video of shortline skiing too, but I don't think the forces translate visually.

 

Regardless, I will not come back before the the time is right. The decision to have surgery was 10 years in the making, so If I have to sit out another summer, it will be a bummer, but not the end of the world. Thanks for all your advice!

[Patmaster]

Back to the thread guys, with two opinions and another epidural shot to buy some time. Both doctors suggested flexible implants, no fusion. Could you guys recommend some specialists? I want to get several opinions, US and EUROPE. I will only get one shot to do this right!

[6balls]

@patmaster if they are confident in their recommendation, they should know some docs who do the desired procedure well.

[Marco]

@Patmaster - I'd be happy to put you in touch with my surgeon, who is reportedly one of the best spine surgeons in the country. If you are interested, let me know and I will PM you his contact info. He and I never spoke about flexible implants, presumably because I was not a candidate for them, but I'm sure he is well versed on all the latest procedures.

 

I just met with him for a 2 week follow up yesterday, and I was very clear with him about the forces involved in short line skiing, and he still maintained that although people heal at different rates, it would not be unreasonable for me to get back on the water this spring after 6 months, and start the process of "ramping up" into short line skiing. I'd be happy just staying at -28 for a few months if it meant I could get back on the water in May!

[6balls]

@marco buddy of mine who had surgery one month after me was cleared to start skiing with cervical procedure similar to mine. I have no doubt I could "ski" right now but would be nervous about pushing it. Cool that you doc will turn you loose...go slow at first.

 

I'm lifting in the gym really hard and really heavy right now...getting away with that ok.

[Marco]

@6balls Knowing that everyone heals at a different rate, my return to the water will be driven by not only what my doc says, but how I feel. It would be stupid to risk further injury just to get a few more months on the water. Glad to hear you are getting after it in the gym! I'm looking forward to when I get the approval to start to work out, so I can begin to gain back the 10 lbs of muscle I have lost since the surgery.

[Patmaster]

@Marco, please send me the details re your surgeon. If you prefer, my e-mail is sdp@online.be

[Marco]

@Patmaster - email sent

[jdk99]

For what it's worth...as a skier and neurosurgeon, I will share this: there are no objective data that specifically address course skiing in someone who has had lumbar fusion with dynamic or adynamic instrumentation. Which is to say, all we as MD's can give you is our best informed opinion on the matter. Unless someone is a skier, it is difficult for him to truly understand the forces involved...particularly those that occur in bad OTF fall.

 

My rec to a patient undergoing Lspine fusion would be to wait a full year for aggressive short line skiing. The skiing itself doesnt worry me as much as the potential for a bad fall. Reasonable perhaps to return at 6 months but only at sub max levels so as to avoid the fall potential.

 

 

[Marco]

@jdk99 - Excellent advice, especially relevant coming from a neurosurgeon that also skis and understands the forces involved! Thank you for your input, which I will heed, along with @6balls perspective. Having no plans to go to Nationals this year, I have no reason push it. I will be happy just to be on the water with my friends skiing at my easier line lengths, if I feel up to it when the time comes. My decision to have surgery was 10 years in the making, and i will not jeopardize my recovery just to get back on the water or shorten the line a few months earlier than i should!

[Patmaster]

@jdk99 any thoughts on stabilizing implants that are used to stabilise the spine after decompression surgery, and that avoid fusion altogether?