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fjellver06


Apr 14, 2010, 1:23 PM
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Herniated Lumber Disc
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Hi, I herniated right L3/4 this past January and after 3 injections and PT I finally had the a Discectomy last week and the surgeon took the extruded disc stuff off my nerve roots. Finally the leg pain is gone. Now recovering and wondering if and when I can go back to rockclimbing. Anybody else with herniated lumbar discs? Please advise.


onceahardman


Apr 14, 2010, 4:13 PM
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Re: [fjellver06] Herniated Lumber Disc [In reply to]
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Ask the dude you trusted to cut you open, he's done well by you so far.

Only if I rehabbed you could I give you an informed and responsible answer. Sorry I couldn't be more helpful.


fjellver06


Apr 15, 2010, 4:33 AM
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Re: [onceahardman] Herniated Lumber Disc [In reply to]
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Hey Thanks-good thoughts.
I do plan on asking him those and more questions, when I see him for my postop visit in 2 weeks, only after that can I start PT again.

Still... I am curious to know about others with lumber discetomies and their return to rockclimbing-how long berfore they led, best exercises, I heard pilantes is good, recurrence of disc herniation, etc.
Any advice is welcomeSmile


iron106


Apr 15, 2010, 5:41 AM
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Re: [fjellver06] Herniated Lumber Disc [In reply to]
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I am sorry you had to have the surgery. I would not let them cut me open. I always seemed to take as long to recover from the surgery as it did to do the same recovery without the surgery.

I suspect it would be some time before you should be climbing. Do your PT like your supposed to, not just at the PT sessions. It is your new workout. You will know when you are ready for climbing again. Don' t push it too soon. If you are a boulderer I wouldn't do anything you would fall on or Jump down for a loooooonnnnng time. Stick with TR and easy leads.

Do what you are supposed to with your recovery ask the doctor questions about pilates and yoga. Take it seriously and you will be out there soon enough.


airforceclmr


Apr 15, 2010, 5:55 AM
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Re: [fjellver06] Herniated Lumber Disc [In reply to]
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I feel your pain...literally.
Trashed my L3,L4,L5 and T10 in a parachuting accident in 05 and again this past summer. Numbness in my feet comes and goes. I still manage to get out on rock and ice each year, i just can't crank like the old days.


dlintz


Apr 15, 2010, 6:38 AM
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Re: [fjellver06] Herniated Lumber Disc [In reply to]
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It's been over ten years since I herniated my L5/S1 disc. I went through the same process as you...PT first followed by another aggravating injury which lead to a partial discetomy.

For me surgery was the right decision and I've had little trouble ever since except for occassional tightness, but then I'm 40 years old and age is slowly catching up with me.

I don't recall getting any hard and fast advice from my surgeon regarding when to resume climbing but as a precaution I stopped climbing for about 8 months. It was about that long before
I felt ready to get back at it.

Good luck with your recovery. I hope it all works out for you.

d.


Partner j_ung


Apr 15, 2010, 7:21 AM
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I'm about 6-7 months out from my operation (L4/L5). And I feel pretty good. BUT, I'm still fragile. I can get maybe one or two routes in before the muscles around the surgery site start to feel sorta tired. I also had a bit of a re-injury, when I pushed my PT a little too hard a couple months ago. I didn't re-herniate the disc, but I definitely aggravated the muscles around there.

If I have any advice for you, it's to take your time. I got to a point where I felt fantastic, so I started to really push my workouts. My re-injury came down to, literally, one rep too many. There was no warning whatsoever -- that's how fast it can happen. I also make sure to take my rest days to just lie around as much as possible. I never do anything physical more than two days in a row, because it seems fatigue is my biggest enemy. And as I just mentioned, I can't always tell how fatigued those muscles are by how I feel.

I have little doubt that I'll get back to climbing like like I want to, but I'm willing to let that be a year or more down the road.


Partner j_ung


Apr 15, 2010, 7:25 AM
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Re: [iron106] Herniated Lumber Disc [In reply to]
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iron106 wrote:
I am sorry you had to have the surgery. I would not let them cut me open. I always seemed to take as long to recover from the surgery as it did to do the same recovery without the surgery.

In some cases, such as my own, there won't be any recovery without surgery. My pain was intense. I couldn't climb, run, lift, walk normally, sleep more than an hour at a time or have sex. I was rapidly losing the use of my left foot. The herniated disc matter wasn't going to magically disappear on its own, so...

IMO, my surgery was money well spent. I have little doubt that all of the above mentioned problems would be far worse right now, had I not done it.


iron106


Apr 15, 2010, 7:48 AM
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Re: [j_ung] Herniated Lumber Disc [In reply to]
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j_ung wrote:
iron106 wrote:
I am sorry you had to have the surgery. I would not let them cut me open. I always seemed to take as long to recover from the surgery as it did to do the same recovery without the surgery.

In some cases, such as my own, there won't be any recovery without surgery. My pain was intense. I couldn't climb, run, lift, walk normally, sleep more than an hour at a time or have sex. I was rapidly losing the use of my left foot. The herniated disc matter wasn't going to magically disappear on its own, so...

IMO, my surgery was money well spent. I have little doubt that all of the above mentioned problems would be far worse right now, had I not done it.

After surgery how were you? Did you recover on your own? or did you do PT? Also did you do the same PT before your surgery? I am not a doctor nor do I play one on TV however, I am willing to bet as many as 90% of back surgeries in the US are unnessary.


dlintz


Apr 15, 2010, 8:45 AM
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Re: [iron106] Herniated Lumber Disc [In reply to]
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iron106 wrote:
j_ung wrote:
iron106 wrote:
I am sorry you had to have the surgery. I would not let them cut me open. I always seemed to take as long to recover from the surgery as it did to do the same recovery without the surgery.

In some cases, such as my own, there won't be any recovery without surgery. My pain was intense. I couldn't climb, run, lift, walk normally, sleep more than an hour at a time or have sex. I was rapidly losing the use of my left foot. The herniated disc matter wasn't going to magically disappear on its own, so...

IMO, my surgery was money well spent. I have little doubt that all of the above mentioned problems would be far worse right now, had I not done it.

After surgery how were you? Did you recover on your own? or did you do PT? Also did you do the same PT before your surgery? I am not a doctor nor do I play one on TV however, I am willing to bet as many as 90% of back surgeries in the US are unnessary.

Well I certainly wasn't part of your 90%. Like Jay surgery was absolutely the best option. In the days preceding my surgery I couldn't even put my shoes on, push in my car's clutch, or sit for more than 15 minutes. No way in hell could I have waited for PT to fix me. Aside from post-op soreness at the surgery site all of my left leg pain was gone immediately after I woke up from surgery.

d.


Partner j_ung


Apr 15, 2010, 10:12 AM
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iron106 wrote:
j_ung wrote:
iron106 wrote:
I am sorry you had to have the surgery. I would not let them cut me open. I always seemed to take as long to recover from the surgery as it did to do the same recovery without the surgery.

In some cases, such as my own, there won't be any recovery without surgery. My pain was intense. I couldn't climb, run, lift, walk normally, sleep more than an hour at a time or have sex. I was rapidly losing the use of my left foot. The herniated disc matter wasn't going to magically disappear on its own, so...

IMO, my surgery was money well spent. I have little doubt that all of the above mentioned problems would be far worse right now, had I not done it.

After surgery how were you? Did you recover on your own? or did you do PT? Also did you do the same PT before your surgery? I am not a doctor nor do I play one on TV however, I am willing to bet as many as 90% of back surgeries in the US are unnessary.

Yes! I tried PT for two weeks, and it was getting progressively worse the whole time. I was starting to worry about permanent damage, so I went ahead and pulled the trigger. I have no idea what the ratio of necessary to unnecessary surgeries is, but I've never doubted that I made the right choice.


fjellver06


Apr 15, 2010, 12:57 PM
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Re: [j_ung] Herniated Lumber Disc [In reply to]
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I feel like you do that surgery was not optional.
I put up with 3 months of intense pain, especially in my knee, like a knife was stuck in it, I was turning into a cripple, despite constant PT and 3 injections. I gave the medical approach the best shot I could-ha ha. After the surgery the pain in my leg was gone and has not come back.

Thanks a ton to everyone who wrote back. Based on what I am hearing I plan on waiting at least 6 months before easy, TR type climbing. And to work hard on PT and an excercise regimen when able.
Walking is great for the spine and I plan on doing easy hikes when oked by PT and MD.


moose_droppings


Apr 15, 2010, 4:02 PM
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Re: [iron106] Herniated Lumber Disc [In reply to]
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iron106 wrote:
I am sorry you had to have the surgery. I would not let them cut me open. I always seemed to take as long to recover from the surgery as it did to do the same recovery without the surgery

Its been 1 year and 2 months with a herniated disk and tear at L4 for me. It isn't getting better, it's getting worse. Sometimes, like others have said, the only option is surgery. I managed to climb and work all the way through a degenerating disk at L5, hurt like the dickens but got through it. Not so lucky this time.

As in many things, it depends.


reno


Apr 16, 2010, 6:33 AM
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dlintz wrote:
iron106 wrote:
j_ung wrote:
iron106 wrote:
I am sorry you had to have the surgery. I would not let them cut me open. I always seemed to take as long to recover from the surgery as it did to do the same recovery without the surgery.

In some cases, such as my own, there won't be any recovery without surgery. My pain was intense. I couldn't climb, run, lift, walk normally, sleep more than an hour at a time or have sex. I was rapidly losing the use of my left foot. The herniated disc matter wasn't going to magically disappear on its own, so...

IMO, my surgery was money well spent. I have little doubt that all of the above mentioned problems would be far worse right now, had I not done it.

After surgery how were you? Did you recover on your own? or did you do PT? Also did you do the same PT before your surgery? I am not a doctor nor do I play one on TV however, I am willing to bet as many as 90% of back surgeries in the US are unnessary.

Well I certainly wasn't part of your 90%. Like Jay surgery was absolutely the best option. In the days preceding my surgery I couldn't even put my shoes on, push in my car's clutch, or sit for more than 15 minutes. No way in hell could I have waited for PT to fix me. Aside from post-op soreness at the surgery site all of my left leg pain was gone immediately after I woke up from surgery.

I've got the same story, only it was my neck, my right arm, and I did try PT (and a couple epidural injections, even.)

I don't know where he got the "90%" number.... IMHO, he's full of shit.


iron106


Apr 16, 2010, 7:08 AM
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Re: [reno] Herniated Lumber Disc [In reply to]
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reno wrote:
dlintz wrote:
iron106 wrote:
j_ung wrote:
iron106 wrote:
I am sorry you had to have the surgery. I would not let them cut me open. I always seemed to take as long to recover from the surgery as it did to do the same recovery without the surgery.

In some cases, such as my own, there won't be any recovery without surgery. My pain was intense. I couldn't climb, run, lift, walk normally, sleep more than an hour at a time or have sex. I was rapidly losing the use of my left foot. The herniated disc matter wasn't going to magically disappear on its own, so...

IMO, my surgery was money well spent. I have little doubt that all of the above mentioned problems would be far worse right now, had I not done it.

After surgery how were you? Did you recover on your own? or did you do PT? Also did you do the same PT before your surgery? I am not a doctor nor do I play one on TV however, I am willing to bet as many as 90% of back surgeries in the US are unnessary.

Well I certainly wasn't part of your 90%. Like Jay surgery was absolutely the best option. In the days preceding my surgery I couldn't even put my shoes on, push in my car's clutch, or sit for more than 15 minutes. No way in hell could I have waited for PT to fix me. Aside from post-op soreness at the surgery site all of my left leg pain was gone immediately after I woke up from surgery.

I've got the same story, only it was my neck, my right arm, and I did try PT (and a couple epidural injections, even.)

I don't know where he got the "90%" number.... IMHO, he's full of shit.

OK I can see i might be in trouble here. I will provide more specific information but it may take some time. Just a couple of thoughts first.

1. Back surgery fails to look at the reason why it happened and prevent that. Lets say you have a slight imbalance in your gait. Over the course of 20-30 years you will develop a back problem because of this imbalance. Then you go to the doctor and surgery may fix it. However, if you correct the gait you will not need surgery and you will not need it in the future. It is like giving a liver transplant to an alcoholic. Back surgery GENERALLY fails to look at the route of the problem.

2. Look up failed back syndrome. For a good portion of people it dosen't work.

I believe that the neck may be a different and have not helped or had any neck problems.

Also I did make up the 90% number, but I am going to stick with it being a high number.


onceahardman


Apr 16, 2010, 2:56 PM
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Re: [iron106] Herniated Lumber Disc [In reply to]
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In reply to:
I am willing to bet as many as 90% of back surgeries in the US are unnessary.

It depends on how you define "unnecessary".

200 years ago, there was no such thing as back surgery. So in some ways, one could argue that none are "necessary", as in, necessary for life.

Western medicine treats chronic pain problems poorly, in my opinion. I have seen some very successful back surgeries, where constructions workers have returned to heavy lifting, full time, and could palm the floor without pain. I have also seen many (more) who ended up depressed, and addicted to painkillers.

I agree that too many surgeons cut too quickly. I know that PT doesn't always "work" on patients. Sometimes, it doesn't work because of poor compliance by the patient, sometimes because the PT doesn't know what he's doing, sometimes for reasons which will remain unknown. NOBODY gets everybody better.

My opinion is, lumbar surgery should not be considered unless unbearable pain is experienced CONSTANTLY below the knee. (below the elbow for neck pain). Pain which is intermittent may still have a mechanical cause, and therefore there is a chance that mechanical treatment might be successful.


reno


Apr 16, 2010, 5:04 PM
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onceahardman wrote:
My opinion is, lumbar surgery should not be considered unless unbearable pain is experienced CONSTANTLY below the knee. (below the elbow for neck pain). Pain which is intermittent may still have a mechanical cause, and therefore there is a chance that mechanical treatment might be successful.

My neurosurgeon (who, incidentally, also did the spinal surgery for Pvt. Jessica Lynch after she was rescued from being a POW in the first years of Iraq: http://www.bnaneuro.net/...rMarciano_Rocky.html ) used motor function loss as his measure. Paraphrasing here, but he said "If it was just pain, that we can manage other ways. But you're losing the function in your right arm, so I think surgery is your best bet."


onceahardman


Apr 16, 2010, 6:56 PM
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reno wrote:
onceahardman wrote:
My opinion is, lumbar surgery should not be considered unless unbearable pain is experienced CONSTANTLY below the knee. (below the elbow for neck pain). Pain which is intermittent may still have a mechanical cause, and therefore there is a chance that mechanical treatment might be successful.

My neurosurgeon (who, incidentally, also did the spinal surgery for Pvt. Jessica Lynch after she was rescued from being a POW in the first years of Iraq: http://www.bnaneuro.net/...rMarciano_Rocky.html ) used motor function loss as his measure. Paraphrasing here, but he said "If it was just pain, that we can manage other ways. But you're losing the function in your right arm, so I think surgery is your best bet."

Yeah, I should have specified more...I was really talking about what is usually considered elective spine surgery...if you have a progressing drop foot (or hand), or loss of bladder function secondary to a spinal injury, you are really looking at a medical emergency, as opposed to just pain. Thanks for keeping me sharp.


reno


Apr 16, 2010, 7:03 PM
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onceahardman wrote:
reno wrote:
onceahardman wrote:
My opinion is, lumbar surgery should not be considered unless unbearable pain is experienced CONSTANTLY below the knee. (below the elbow for neck pain). Pain which is intermittent may still have a mechanical cause, and therefore there is a chance that mechanical treatment might be successful.

My neurosurgeon (who, incidentally, also did the spinal surgery for Pvt. Jessica Lynch after she was rescued from being a POW in the first years of Iraq: http://www.bnaneuro.net/...rMarciano_Rocky.html ) used motor function loss as his measure. Paraphrasing here, but he said "If it was just pain, that we can manage other ways. But you're losing the function in your right arm, so I think surgery is your best bet."

Yeah, I should have specified more...I was really talking about what is usually considered elective spine surgery...if you have a progressing drop foot (or hand), or loss of bladder function secondary to a spinal injury, you are really looking at a medical emergency, as opposed to just pain. Thanks for keeping me sharp.

No worries. Wasn't trying to correct you... just wanted to offer one surgeon's metric for surgery vs. not.

I guess I didn't pick up what you were trying to say. It's all good.


fjellver06


Apr 16, 2010, 9:00 PM
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Re: [moose_droppings] Herniated Lumber Disc [In reply to]
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I feel for you.
Since this happened to me I've done a lot of reading about discs and backs, I am no expert.
But, this might help.

Basics of a disc: the pulposus is encased in a annulus, growing of these cells stops after puberty. With time Everybodys discs shrink as the pulp ages and loses elasticity. This puts pressure on the annulus and eventually alot of disc annuli crack-physics and the pulp is released. MRIs show 50% of all people, past 40, have signs of past and present herniated discs-fact, check it out. But many folks don't have pain or symptoms because nerves aren't always affected. It is only when the nerves are compressed and enflamed by the pulp are we symptomatic.
There are other causes too-tumors, stenosis,etc.

When I first herniated, my PCP said ride it out, "in 8-12 weeks you'll be better 70% do", gave me a script for narcs and PO steroids(both shown to be worthless). After a week I could not walk or work he agreed on an MRI. Still 3 out 10 people do Not get better and studies show that only 70% of lumbar discs actually reabsorb after One year, not 8-12 weeks. I have talked to alot of people who did medical managenent and have significant disabilites.

If you are interested in getting this checked out you will need another MRI, it pays to find a good pain doc. The pain doc can help you get another MRI and help finding the best neurosurgeon in your area. Remember steroid injections and Any treatment you can think of to treat herniated discs do Not work! In fact only low impact exercise has been shown to help hernaited discs. But, I think the new microdicsectomy procedures, like I had, are slick and effective. In a microdiscetomy/laminotomy they make a small incision in your muscle take a small piece of bone and using a microscope they remove the extruded pulp, they usually take out any loose and dead pulp in the disc too. You do Not want a laminectomy or fusion this is where you get chronic pain in your back. A microdiscectomy is only for debilitating leg pain &/or weakness, bladder, bowel dysfunction.
Whew, I hope this helps. I'll give you my email if you want. Ed


onceahardman


Apr 17, 2010, 6:30 AM
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In reply to:
you will need another MRI,


A word about MRIs...I have seen studies showing as high as 39% false positives for MRI, when compared with discogram, which is really the "gold standard" for diagnostic accuracy. More invasive, difficult, and expensive, though. MRIs are wonderful, but when nearly 4 out of 10 are misleading, well, you can see why some "uneccessary" surgeries are done. I have personally seen surgery justified in cases where all symptoms were right sided, and the MRI showed a left sided herniation. Not surprisingly, those patients were no better after surgery.

In reply to:
Remember steroid injections and Any treatment you can think of to treat herniated discs do Not work! In fact only low impact exercise has been shown to help hernaited discs.

This statement is internally inconsistent. Low imapct exercise IS effective in many cases. To say there is no treatment that works, and then to say there is a treatment is illogical.

EDIT: interesting relevant paper:

http://www.ncbi.nlm.nih.gov/pubmed/8747239


(This post was edited by onceahardman on Apr 17, 2010, 6:42 AM)


kateross


Apr 19, 2010, 1:40 AM
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Don't go back to rockclimbing about a year. Start a little training (physical exercises) after 6-7 months.

_____________________________
http://herniateddiscsurgery.net/


(This post was edited by kateross on Apr 19, 2010, 1:46 AM)


fjellver06


Apr 20, 2010, 5:32 AM
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I've been trying to find accuracy % for MRIs without much luck-no numbers. But, everything I did read said MRIs of spine pathology are "very accuarate". With knees and other joints-"less accurate".
By the way discograms are Very invasive as they involve a Doc sticking a long needle into the middle of your disc.

Yes, that "internally inconsistent statement" was poorly written. I should have said that retrospective studies have shown that only 2 things help herniated lumbar discs symptoms resolve: exercise and time.
This includes PO and epidural steroids, NSAIDs, Narcs, all Rxs, inversion tables and traction, Physical Therapy-I was shocked by this one-certainly seemed to help my muscles stay strong, even surgery-although I don't think you can compare people with severe motor-pain-bowel-bladder dysfunction And those that had alittle leg pain.


fjellver06


Apr 20, 2010, 5:36 AM
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I am curious as to where you came up with "about a year".

Are you speaking from personal experience. If so, I would love to hear your story.


onceahardman


Apr 20, 2010, 6:51 PM
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For heaven's sake, fjellver, you must not have tried very hard. Try googling "lumbar MRI false positive", which yields nearly 8,000 hits, including this:

III.Pitfalls: Coincidental Findings in pain free patients
A.Asymptomatic Under 60 years old
1.Bulging disc: 33%
2.Herniated disc: 20%
3.Unexpected XRay finding: 0.0004% (1 in 2500)
B.Asymptomatic Over 60 years old
1.Degenerative changes: 100%
2.Bulging disk: 80%
3.Herniated disk: 33%
4.Spinal stenosis: 20%
C.References
1.Boden (1990) J Bone Joint Surg Am 72:403
2.Boos (1995) Spine 20:2613

from here:

http://www.fpnotebook.com/Ortho/Rad/LmbrSpnMr.htm

But there are many many other examples. It's a well known "dirty little secret".


Also, when you say exercise works, but PT doesn't...that is a non-sequitur. Exercise (billed as "therapeutic exercise") is perhaps the most common treatment modality employed by orthopedic PTs. Could you please show a link to where you found that?

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Forums : Climbing Information : Injury Treatment and Prevention

 


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