Cervical Disc Herniation and swimming

I have a similar neck problem & have coexisted with it for 27 years. Swimming is the very best thing, yes, diving is bad & using a board to kick is very bad- otherwise the inactivity & immobilisation therapeutic response only weakens your supportive neck muscles. I have religiously done light-weight shoulder shrugs & upright rowing free weights to tone & condition those same neck muscles for 27 years & have avoided what 2 specialists recommended- neck fusion c5-c6. You do not want that surgical procedure.

There is a fascinating article in the April 8, 2002 New Yorker entitled Knife in the Back by Jerome Groopman that I highly recommend you read, especially in light of your comment about seeking a timely referral to a neurosurgeon. It turns out that herniated disks are exceedingly common, both in populations suffering back pain and in those NOT suffering back pain. (I think this also holds true for neck pain.) Most cases resolves themselves on their own within six months. The reason: the stuff that acts as a shock absorber and squishes out of the herniated disk, pressing on nerves, etc., eventually gets reabsorbed. Moreover, despite the strong economic incentive to perform operations, the evidence for surgery being beneficial--especially spinal fusions--is extremely thin. Clearly this is a situation where "First, do now harm" should be the operative philosophy. I also recommend you get a referral to a topnotch sports medicine clinic. I'm currently doing research for an article I'm writing on the active rehab of sports injuries. The advice I have gotten from numerous sources is to find the athletic trainer of local professional, college, or high school athletic team and find out A) what doctor they recommend for injuries impacting sports performance, and B) what physical therapists they use to rehab their own athletes. You'll in all likelihood be given stretching exercises to remove strain and spasms from the affected area; and strengthening exercises designed to bolster the surrounding muscles, which will then do the heavy lifting as opposed to the joint itself. This may sound simplistic, but it's really a very powerful one-two punch. I know exactly how you feel when you say you're quite bummed out about this. But remember: the philosophy of sports med trained doctors is to help active people stay active. I would be shocked if you were told to avoid swimming or encouraged to undergo prolonged bed rest for your neck. The new credo, it seems to me, is "rest is rust." In terms of swimming, make sure you keep your head down--this will not only prevent pain, but make you swim faster. The old technique many of us were taught--water should hit the forehead so we can "hydroplane" during sprints--doesn't really work. You will have better body position and go faster if you look straight down. You might also want to work on your body role so that breathing will require less in the way of neck-alone contortionism. Also, I agree about throwing away kickboards for ever, and you might want to avoid any particularly provocative moves--butterfly and breaststroke both put lots of stress on your neck--until the area calms down a bit. Also check the ergonomics of your regular life--if your monitor, for instance, is too low or too high, this could aggravate neck pain--as could excessive typing, etc. Did you do anything in the last two weeks to trigger the current tingling and numbness? For example, volleyball spiking or tennis serving? Excessive typing or computer mousing? Anything? For what it's worth, I've had many of the same symptoms you mentioned--tingling, numbness, a kind of wooden quality to my fingers--and these all resolved after I stopped typing too much, bought an adjustible keyboard rest (so I can move the damn thing up and down at will and get some variety), and also got a "natural" style keyboard. I know the jury's out on the latter, but it definitely seemed to help me. I should also point out that I suffered greatly from sciatica on and off over the years, and I have no doubt that an MRI would reveal some heavy duty spinal irregularities in me. However, I've found these symptoms always go away eventually, and the more carefully active I am (that is, after the acute phase has been given a few days to a week or so to cool down), the less I am generally bothered by pains of this sort. See the thread on hip pain; it's a different injury, to be sure, but the discussion has some overtones you might find useful (including the psychology of sports injury.) Good luck, keep the faith, and I suspect your body will work itself back to health if you give it a chance.

I have had cervical neck problems in the past and find it is best to have a good swimming posture, head in alignment with the spine, keeping the head down, and looking down. I found using a front mount snorkel very helpful. Along the way I found out how much breathing (or lack of) plays in stamina in swimming. I swam way farther than I ever had before and never felt winded. The harder strokes were *** and fly because during the breathing the head is not supported by the water. A straight spine with no head bobbing or jaw thrusting to breathe is very important.

robsaque, Yes, I've experienced a similar situation, with tingling and numbness in one arm. That was back in '87, so it's hard to remember all the details. It lasted a long time and I checked with several doctors. At first they thought it might be carpal tunnel, since I worked at a computer all day long. Turned out that the disk giving me problems was at c6-c7, plus they said I had spurs and narrow spacing between disks anyway. I ended up having a cervical fusion. I was told I should quit swimming. I didn't and still do it to this day and plan to continue. In the process of figuring out what I had, and the rehab afterwards, I learned some things that hopefully will prevent any future problems. The biggest thing for me is posture. I have always tried to have decent posture (even before the problem started) but I'm not perfect at it. Let's face it, it is a major effort to keep it perfect all the time! Anyway, I was talking to another swimmer, who is a physical therapist and he told me I was letting my chin jut forward, like most people do. I didn't quite believe him initially, but as I started paying more attention, I realized he was right. I even got a little scared awhile after my surgery, when my OTHER arm started to tingle. So I paid close attention to my posture, and the tingling went away. Whenever I start to get lazy about it, my body reminds me and then I get better about it again. I didn't quit swimming, but I have adjusted my stroke. I make sure my head is in line with my body on freestyle (which is my primary workout stroke), so my head isn't UP. I look down and only a little forward. I also try to make sure I roll enough so I don't have to turn my head much at all. I breathe both sides. My arm recovery is slightly lower than it used to be. I don't kick much with a board, but I do it some. It is tiring for my neck. I wouldn't recommend it for you, especially while your disks are out of whack! I did a lot of kicking on my back, with my arms at my side, when my arm was tingling. If you keep your head in line with your body (not too far back and not too far forward), that should be good for your neck. I would also be careful of being on a stationary bike (or ANY bike) - what position is your head in? I guess if I were you, I would be very aware of anything I was doing and the position it puts your head/neck/shoulders in. I often wonder if I could have avoided the surgery, but I'll never know. I have no intention of having another, though. That's not to say the surgery was bad - I had a good experience.

Dear Robert, I herniated my C4-5 disc on May 25th. I was mowing the lawn and suddenly my left should and the left side of my neck spasmed and locked. Overnight, the pain became intense and my symptoms spread to the right should and neck and the upper back. I went to the emergency room where they took x-rays. The ER physician diagnosed a neck sprain and sent me home with muscle relaxants and painkillers. Over three days the symptoms responded to rest and medication. I could function again but the cramps and pain where still there. I was also suffering from sharp stabbing pains in my neck. I followed up with my personal GP who proscribed more rest, stretching and more medication. We discussed swimming and he recommended that I restrict my activities to backstroke and kicking. I went to one swim practice that week. I was convinced that swimming would help break up the knots and help me get better. I didn’t last 45 minutes. After one week of this therapy my neck and shoulder had not improved so my GP ordered an MRI for the next Monday. Naturally, since the MRI was scheduled, my symptoms improved over the weekend. I swam about 2500 yards that Sunday. I felt I was out of the woods and on my way to recovery. Tuesday morning (now two weeks from the initial symptoms) my GP called me early in the morning. He faxed me my MRI report. I had a large extruded disc herniation that was midline at C4-5 and compressing the spinal cord. My GP insisted that I see a “neck specialist” right away. My GP indicated that I could be at a very high risk for significant damage to my cord and restricted my activities to just working and sleeping. I made an appointment with the Orthopedic Spine Surgeon he recommended. The earliest appointment was three weeks out. Since my GP had me scared to death, I called every neurosurgeon in town until I finally secured an appointment for the next afternoon. After examining my films and me the neurosurgeon told me I needed a cervical discetomy and echoed my GP’s statements about the risks. He told me that he didn’t do surgeries anymore but he could recommend a couple of people. One was the surgeon I had already scheduled. I mentioned that I had an appointment with this doctor in two weeks. The neurosurgeon told me that was too far out, and the longer I delayed surgery the worst my situation could become. He walked down the hall and had them move my appointment up to Monday. The five days were agonizing. I spent the majority of my time researching Cervical Disc fusions and calling every medical professional I knew. Almost everyone recommended that I see a neurosurgeon – not an orthopedic surgeon. I discovered that there is a group of surgeons (mostly orthopedic) that consider themselves to be “spine specialists.” They have restricted their practice to treating spinal injuries and have completed fellowships. They do more than surgery. They also provide rehabilitation and physical therapy. The gentleman I saw Monday was a spine specialist. He told me no surgery and to resume my normal activities (but no bungy jumping, parachuting or roller coasters). He said surgery was a LAST RESORT and that I had made a remarkable recovery in a short time. Needless to say, I had fully prepared myself for the worse and this news was a bit shocking. I got a second opinion from another “spine specialist” who repeated the same advice – no surgery, resume swimming, and manage your activities according to your symptoms. Both spine surgeons told me that the disc might be reabsorbed and that we should “watch it” but don’t live in fear. I’m back in the water and I feel great. I still have occasional pangs and “flashes” of numbness but I’m getting better. I learned a few things that I would pass on. 1) See a spine specialist. They have different philosophies. They are more accessible that neurosurgeons and can offer many forms of treatment. 2) Get a second (or third) opinion. 3) Swimming is great therapy. Because I’m a swimmer, I have recovered faster. 4) Pay very close attention to your posture. I damaged my neck because I spend hours on the phone, hours on the computer and I read in bed. All these activities put undue stress on your cervical vertebrae unless you pay very close attention to your neck. Good luck, Michael

hi all. well, i'm not sure if i had the exact same problem. but i think it's related. i basically went through all the same phases and symptoms that have been described here, ending with a visit to the neurosurgeon and mri machine. the report: for someone who's 27, it's a more unusual condition. a form of stenosis i believe it's called. my c4/c5 disks were impeding on the spinal canal and intially, pinched my nerve and my right arm became useless with compromised neck range of motion in back. had they seen it in the beginning, they might have operated. but because of my age and 3 months of physical therapy, i have healed mostly, though i'm still building without therapy now. no surgery. my question: unfortunately, i was preparing for an upcoming big meet in november. i'm no star by any stretch of the imagination, but i'd been making good progress until i'd lost 3 months of decent swimming. even now, i haven't joined my workout group cause i'm probably not ready for the same intensity. but i've had almost a couple months of some solid consistency. conditioning, relearning and adjusting my stroke. i still intend to compete, regardless of results. so the longwinded question ends with - are there things i should just really avoid? can i in fact still dive off the blocks? my old coach mentioned that diving with proper streamlined form, with your head natural and guarded by your hands and arms is supposed to stabilize you, and should prevent jarring. it should be ok. i used to do the jerky pikey dives where i could just burst forward, particularly for breastroke, which is my specialty, actually. so now, i'd like to hear from all, professionals and first-handers, alike, what i really should avoid. am i crazy for even competing again. i'm a little creaky, but i don't know if this means i should not. i'm planning on going to a test meet (test for me, that is) in between, just to see what my new compromised times would be. any advice for breastroke is also appreciated. thanks very much

Be on the look out for hunched shoulders from your swimming. Swimming is pretty much a chest workout and the pecs tend to overpower the back muscles. This gets us to posture and the familiar swimmer's hunch. I work on this constantly trying to even it out. I had pretty severe cervical problems that were related to restriction in the C6, C7 area. Got an adjustment from a physical therapist, loosened up my upper spine area. Thereafter I have kept up with it through stretching. The pain went away and hasn't returned even though I swim just about as much. Sp be aware of the kyphosis and do what you can to balance out the strength. For me it means not going from the pool to the bench press machine and making the imbalance worse.

Mister - You should consult closely with your doctor. I have not had any problems swimming or competing with my C4/C5 herniation. My doctor thinks the swimming is good therapy for my neck and I'm also a breaststoker but, a disc herniation is very different from Spinal Stenosis. Good luck, Michael

Just a quick, 2nd hand observation on the surgery aspect – a swimmer in our club who was a US Squash Champion in the 1960’s (a sport hard on the body) had some vertebrae fused and has regretted it. He swims now because it is the ONLY exercise/sport he can do without problems.

Unlike many of the posters, I indeed had a C4/5 Anterior Discectomy and Fusion with bone graft and plating on May 18, 2009. This was a result of several injuries incurred over 25 years. Long story short, my symptoms were so severe in the end I had no choice. I swam right up until the month before surgery and picked up right away about 30 days post op with the blessing of my neurosurgeon. All is well so far but in retrospective I may have waited a bit too long. I have some cord symptoms and nerve root symptoms that may never go away. I think the fly and breaststroke are out forever as are kick boards. Anything with neck extension is out. Freestyle is all good. In the balance I think swimming has been great for avoiding surgery, and once I had no choice a great rehab venue. By the way I favor neuro guys. I have operated with both(as a scrub nurse for 20+ years) and the neuro guys seem to be more proficient. Just make sure you find one that operates with his brain not his checkbook. Regards Spudfin