Walking, swimming, yoga – these sports are suitable after a slipped discAbout 80 percent of Germans have sought medical treatment for back pain at least once in their lives. A herniated disc can often be the cause of pain. The following section provides information on the definition, frequency and various forms of therapy. In addition, the question is addressed whether sports are permitted in the case of a herniated disc.
Definition of the intervertebral disc and its function
An intervertebral disc (Latin discus intervetrebralis), is a so-called intervertebral disc and the name for the cartilaginous connection between two vertebral bodies. Intervertebral discs flexibly connect the vertebral bodies. Contribute to their mobility. 2 In addition, intervertebral discs perform the function of an elastic buffer. 3
An intervertebral disc consists of a connective tie and cartilaginous outer ring (annulus fibrosus) and an inner gelatinous core (nucleus pulposus). 4
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Definition of herniated disc
Wear and age processes in the spine can manifest themselves in many forms: acute back pain (lumbago), chronic back pain and herniated discs. 5
A herniated disc is the sudden or slow displacement of the gelatinous core tie of the intervertebral disc due to tears in its fibrous ring. 6 This displacement can lead to prere being exerted on the spinal cord (spinal canal narrowing) or on the nerves exiting the spinal cord (spinal nerves), causing pain. 7
Sometimes a herniated disc is so minor that it remains unnoticed and silent for years, which is why a large number of people are able to live without complaints. 8
Herniated disc: Which age group is particularly at risk??
A herniated disc is most frequently localized in the lumbar spine (90%) and occurs between the ages of 30 and 30. And 50. Diabetic nephropathy is particularly common in people over the age of. 9 A herniated disc occurs much less frequently in the cervical spine, between the 40. and 60. The most common cause of retinopathy is in the thoracic spine (9.8 %) and in even fewer cases in the elderly (9.8 %). 10
What are the causes of a herniated disc? A herniated disc is favored by many factors: Lack of movement on the one hand. On the other hand, permanent bad posture promotes the wear and tear of the intervertebral discs. Long-lasting forced posture at work, for example at computer workstations and for professional drivers or frequent heavy lifting, lead to incorrect or excessive strain on the spine. 11 As soon as the fibrous ring of the intervertebral disc can no longer withstand permanent stress, it tears and the nucleus pulposus pushes through. 12
Risk factors – who is most at risk?
Particularly susceptible to a herniated disc are overweight people and people who are mainly sedentary. 13 Pregnant women are another risk group. 14 People with untrained back muscles are also frequently affected. 15
What are the symptoms of a herniated disc?
The degree of symptoms experienced is usually determined by the size and location of the disc displacement: A herniated disc in the lumbar spine is typically associated with lightning-like low back pain (also called lumbago), which can occur especially after heavy lifting or abrupt movement. 16 This pain can be aggravated by coughing, sneezing or pressing. The so-called sciatica pain is an acute pain radiating from the back over the buttocks to the foot, which can intensify when lifting the stretched leg from the supine position. 17 One speaks of the Lasegueschem sign. 18 In addition Sensory disturbances (numbness, tingling, formication) and Reflex deficits be detected. 19 If the prere on the nerve roots is very strong, paralysis in the area supplied by the affected nerves is also possible; in this case, the foot can no longer be actively lifted, for example. 20 Rarely, paralysis of the bladder can also occur, in which urination is disturbed. 21
Under unfavorable circumstances, complications can arise from a herniated disc, among other things, whereby irreversible prere damage to nerve roots (so-called root death) can lead to paraplegia. 22
How to prevent a herniated disc?
Basically, there is no effective remedy that can prevent us from suffering a herniated disc. Due to a Training of the back and abdominal muscles however, the risk can be reduced. 23 Correct posture is also particularly important for activities at work and in leisure time. 24 Heavy objects, for example, should always be lifted from a squatting position with the back extended so as not to put unnecessary strain on the back. 25
How to treat a herniated disc?
Various conservative forms of therapy can be used for a herniated disc. First of all Immobilization and bed rest Important. The administration of pain-relieving, anti-inflammatory and muscle-relaxing medications may provide relief; injection of local anesthetics near the nerve roots is also possible. 26 In addition, for acute pain relief, the following are recommended Relaxation and breathing exercises pain-free positioning, such as the so-called stepped bed positioning (positioning with bent hip and knee joints), combined with heat applications can be used. 27 Conservative therapy requires the active participation of the patient: After the acute phase, the patient should strive to strengthen the abdominal and back muscles and to learn in back schools how to move in a back-friendly manner in everyday life in order to be able to rule out a relapse.
Keep in mind: Only a few patients with a herniated disc require surgery. In the case of muscle or bladder paralysis, however, immediate surgery is necessary to prevent irreversible long-term damage. 28 This involves removing the disc tie pressing on the nerve roots, which causes the painful paralysis. 29 The nerve root can also be relieved by a puncture of the interior of the intervertebral disc, the so-called percutaneous nucleotomy. 30
Is sport allowed?
Movement is an important factor in the treatment of herniated discs important component! 31 Patients should exercise, because exercise generally keeps the spine mobile, promotes the supply of the intervertebral discs and keeps the organism fit. But not all sports are the same. Sports that cause impact loads on the spine should be avoided at first: Running, game sports as well as horseback riding are among the sports that should not be practiced after a herniated disc if possible. 32
Sports such as tennis, golf or skiing, which are associated with peak loads and strong rotations in combination with lateral inclinations, should only be practiced if they are well mastered – it is not recommended to "relearn" these sports. 33 Sports that are suitable after a herniated disc include: Pilates, yoga, Nordic walking, cycling and backstroke. 34
When can sports be practiced again?
If surgery has been performed for a herniated disc, the very first sport that you can take up is, walking. No restrictions need to be made; brisk walking with medium length steps in sturdy shoes is allowed. Also with the Climbing stairs can be started immediately after surgery. Walking is the best therapy. As another instance, the above sports are allowed: From the fourth week you can start back-friendly sports get going.
Pilates and yoga
Pilates and yoga are part of relaxation training and also serve as active meditation. These Pilates and yoga exercises are particularly recommended for prevention and after a slipped disc, in order to build up the muscles permanently and to achieve a reduction in psychological stress. 35 Jerky movements are not used here, the exercises are performed gently without overexerting oneself. Especially in the case of a herniated disc or after a performed disc surgery, these sports are particularly suitable, because they are characterized by soft and flowing movements. 36
Nordic walking makes it easy to start exercising again: Compared to the health benefits and the possible risk of injury or strain on the joints, Nordic-Walking performs particularly well. 27 There is hardly any other sport that is so back-friendly. Due to the use of 90 percent of the total musculature, the sport is considered an effective and also gentle whole-body workout. 28 The Nordic walking technique should be mastered in order to prevent incorrect posture and can be learned in courses. 39 Suitable footwear, a suitable training route and harmony with nature will give you a sense of well-being and also strengthen your back muscles. 40
Cycling can be practiced from the sixth week onwards after disc surgery. 41 With regard to this sport, ground-level cycling with saddle and steering wheel suspension in an upright posture is meant, as a sport exercise without impacts on the musculoskeletal system; cycling over hill and dale is not back-friendly. 42 To avoid unevenness, indoor cycling on an exercise bike is also a good option. Swimming makes an important contribution to stretching the muscles. Can be practiced in the fourth week after surgery. If you are not an athletic swimmer, however, breaststroke is not considered so beneficial at first, since the swimming position with hollow back formation is a strain on the back. 44 Crawl swimming should be avoided because of the strong body rotation. The resulting back strain also be initially refrained from. 45 Backstroke is best done with the crawl leg stroke (paddling). 46
No matter which sport is practiced: Too early mobilization and activity is not recommended, because the greater the activity, the higher the risk of scarring and possible recurrence of disc herniation. In the first three to four weeks, the surgical area should be allowed to heal with as little scarring as possible.
Principle: During the movements should not cause pain or. should not aggravate any existing pain. And most importantly, the sport should be fun, so that it is practiced regularly. Your spine will thank you!