Horseback Riding: Managing a herniated disk

Horseback Riding: Managing A Herniated Disk

The following is an edited version of a Q & A I did for the October 2009 edition of Dressage Today.

Question: 

I have been suffering from back pain due to a herniated disk but would like to continue with my riding lessons. I heard riding might help alleviate the pain. Please give me your thoughts on that.

Answer:

The answer depends on several factors. If the pain is recent and intense and made worse by sitting, in general, it may be best to wait until the pain has subsided before resuming riding.

If you are experiencing a recent onset of pain, it is a sign that the inflammation is quite active in the area. Further attempts to “ride it out” may lead to a more severe situation.

But, if the pain has persisted for a longer period of time (a minimum of four weeks), is not made worse by sitting and generally feels better with activity, then consider getting back into the saddle.

Many riders who have chronic lower-back spine disease actually feel better with riding. This is supported by what we know about stimulating the lower spinal muscles. The very deep, lower spine muscles are subject to weakening because of fatty replacement of muscle. While we do know that this fat is not a weight-related issue, the cause that leads to these changes is unclear.

Does the lack of activity, or injury or trauma, such as a herniated disk, initiate the conversion of muscle to fat?

The disk, which sits between the bony segments of the spine, or vertebra, acts like a water-filled balloon with a tough outer casing to provide spacing and shock absorption between the vertebrae.

But the disk is not the only pain-producing structure in the spine. Even if you have an obvious herniated, or bulging, disk that can be seen with diagnostic imaging, such as MRI (magnetic resonance imaging), it still may not disclose the real source of the pain.

Technology, while a wonderful tool, is often not the determining tool for understanding and solving a problem. Be wary of any doctor who simply looks at these images and concludes the origin of your problem. This knowledge only comes from a thorough history and examination.

Maintaining healthy deep, lower spinal muscles can be quite challenging; these muscles, which are essential for correct dressage performance, are typically difficult to strengthen with standard gym activity. They require specific targeted exercises, sometimes on specialized equipment. It turns out that riding is an excellent way to stimulate these lower muscles, however, dressage in particular, is even more effective as a result of its’ additional focus on balance.

Another way to stimulate the deep, lower spinal muscles when not in the saddle is to sit on a device called a stability disc, a circular, air-filled disc that encourages you to move your pelvis while sitting. It’s an excellent way to strengthen and tone these muscles. And it fits nicely in a chair, at home or at work, and is great for travel.

Another factor to consider for riding is your own body structure. No one is perfectly symmetrical. In many areas of life this may not be critical, but in dressage body structure and balance can mean the difference between adequate and outstanding performance.

Common areas to analyze for balance include the two sides of the pelvis, or the hemi-pelvis. Some people have a smaller hemi-pelvis, which could require a build-up of the saddle features. Characteristics of the hemi-pelvis are determined by X-ray and biomechanical analysis.

Limb length discrepancies could also require an adjustment in the saddle.

Lower-back problems rank as the fourth most costly chronic disease after diabetes and heart conditions. Fortunately, lower-back problems do not threaten your life as other diseases do, and there are effective options to stabilize and improve your condition.

For example, I employ a treatment called myofascial trigger point dry needling, a method of effectively balancing dysfunctional and locked muscles. Muscles can become locked but cannot unlock by themselves, even with therapeutic forms of treatment, such as massage, ultrasound, and electrical muscle stimulation. Dry needling is not acupuncture but a western-derived approach to treating sick and injured muscles.

Finally, listen to your body. If the activity you are doing is increasing your symptoms, then you should stop it temporarily. Thus, your pain level may require suspension of your riding until the situation is stabilized. Even if a doctor gives you a go, if your body says ‘No’,  listen to it. It is whispering signals to you, and you should respect them.

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