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On July 8th, 2020, I drove 40 minutes in my car which has low, sort of crouched seats, to a dance class. I took an hour long dance class, then drove 40 minutes back home, where I practiced the choreography for another two hours.
The following day, my abdominals were in so much pain, I felt like I was going to cry. The pain was located at the top of the rectus abdominis (the six pack area), and felt like a stabbing, sharp, sometimes burning sensation. Never one to rush to the doctor due to having garbage health insurance that’s really only for catastrophic injuries, I decided I would just take it easy and rest.
Days later, it still wasn’t better. The pain didn’t seem to subside unless I was laying down, completely flat on my back. It especially hurt when I’d be in a reclined position like laying on the couch with my head elevated. It was beginning to be difficult to work at my computer, because regardless of whether I was laying down with my head elevated, or sitting at a desk, the pain in my abdominals was constant.
Since the pain was localized to the abdominals, I focused on the abdominals. I dove head first into learning more about the structure of the abdominals, trying to figure out if I’d injured the linea alba (the fascia that runs down the center of the abs), or if I’d torn a muscle. The pain moved around a bit - I’d often feel it on the lateral sides of the upper abdominals, and down the center of the abdominals. Sometimes I’d feel it lower, near my belly button, both laterally and about two inches about my belly button, in the center. I invested in a one to one master class with a core specialist to learn more and try to figure out if I was improperly bracing my core. While I did learn a lot, I learned that my core brace was fine, and that this was likely not from an improper core brace.
I started to go down google rabbit holes, and found myself looking at hernias, but I didn’t have any bulging, and the pain moved around a lot, so that didn’t quite fit.
Finally, seven weeks later, I felt enough was enough, and I went next door to my studio, where there’s a sports medicine doctor. She took a very thorough intake, asking when it started happening, what the quality of the pain was like, where it was, if it moved around, what helped, and what made it worse. (Nothing to my knowledge really made it worse, at that point it was still chronic pain unless I was laying down flat (‘flat’ being the operative word). She did a very in-depth exam, checking for an aortic aneurysm (!!!), checking for hernias, etc., but nothing out of the ordinary was appearing. The quality of the pain, she said, sounded like nerve issues since we are talking sharp, tingling, sometimes itchy, stabbing pain.
She suggested I get bloodwork done to rule out anything major, but when I went to get the labs done, I found out it would cost me over $850, so I decided I’d hold off on that for now. Like I said, my insurance is pretty garbage. She also recommended an MRI, but again, with the insurance I have, it’d be about $3,500 for an MRI of the torso area. Again, I passed on that.
Without those labs, she still started to work with needling the abdomen, and hooking the needles up to a STIM machine. She applied a laser for about ten minutes as well. She put a needle in each ear and the top of the had (that’s supposed to help you calm down and chill out) - she said stress was a huge factor, and that one of the best things I could do was try to de-stress. Meditation, deep breathing, and cold showers was what she recommended. Near immediately, I felt so much better, and had such high hopes this was a thing of the past.
WRONG. The pain was back a few days later, same as before.
I continued to see the doctor, and while she couldn’t say for certain what was going on since I couldn’t get imaging done or bloodwork done, she asked me to be hyper aware of whether any movements I did made things worse. I came in and reported that I noticed that any time I am in a rounded back position, like when I’m driving in my car, watching tv on the couch, laying with my head elevated, or even leaning forward and rounding slightly like when washing the dishes or brushing my teeth, I get these ZINGS of pain on the sides of my abdomen, still located to the upper abdominal muscles.
She said that since the pain seemed to increase whenever my spine was in flexion, and decrease when the spine was neutral or in extension, it sounded a lot like a herniation. I asked why I wouldn’t have felt anything in my back, because my boyfriend had a serious L4/L5/S1 herniation last year, and it was excruciating for him. Like, we are talking curled-up-on-the-floor type back and leg pain. So why wasn’t I like this? She said that my herniation was likely in the thoracic spine, which is actually pretty rare and often misdiagnosed.
She said she should treat it like a herniation and see what happens. She continued to needle my abdomen and my thoracic spine. Based on where my pain was, she thinks the herniation(s) are between T8 and T10. She also added cupping to my treatment, including both the cupping of the abdomen and the back. She also had me go on the traction machine, which we wound up stopping after a few rounds because it wasn’t feeling great for my neck. She prescribed McKenzie Press Ups, and a bunch of other spinal extension movements as well as core strengthening movements, and said to be extremely mindful to reduce or completely avoid spinal flexion (any kind of forward folding with a rounded back), and see how it goes.
She mentioned being mindful of things like brushing my teeth and leaning over the sink, tying my shoe, etc. These are activities of daily living where we’re in spinal flexion without thinking about it.
By this time, I was getting up at 5:15am and leading an online meditation class at 5:20am. The near constant physical pain was taking such a toll on me. My morning meditation practice, once something I genuinely enjoyed and something I felt I greatly benefited from, became something I felt like I had to do for other people (I was leading it live on IG and filming it for my App). I felt so depressed not being able to workout, practice yoga, or dance - all things I loved so much as a form of mental health management and physical activity. I felt constantly exhausted from the nagging physical pain, and it was seriously affecting my mental health.
At the same time, we had also just moved, and we got some very difficult news about someone in our close circle. It just felt like a tremendous amount of stress that was weighing very heavily on me. The doctor had mentioned that stress was stress. While buying a house and moving was ultimately a source of happiness for us, it was still a lot, and it was still stressful. She kept underscoring the importance of trying to de-stress. So with that in the back of my mind, I pressed pause on trying to get back into my pre-quarantine routine of getting up at dawn to start the day. I decided to listen to my doctor and my body, and just try to get better sleep. I ended the live meditation sessions and started to just meditate for me. I started journaling again, to just get things out on paper, which felt a lot better than holding them in. I tried to breathe deeply and slowly throughout the day, not just when I’m meditating. I started to incorporate a ton of spinal extension exercises throughout the day, as well as foam rolling, as my doctor recommended.
Now, 14 weeks later, things are feeling a lot better. I don’t feel 100% better, but about 90% better. Sometimes I’ll catch myself rounding my back, and I won't feel the stabbing zings of pain at all. The pain is no longer down the center of my abdomen, but more localized to the lateral sides of the upper abdomen. I’ve been able to resume working out, and so long as I am hyper-diligent about avoiding spinal flexion, I feel really good. There are a few moves I avoid, like RDLs and rowing because I just feel like every time I do those, my abs act up. I don’t sit on the couch very much, and it no longer hurts when I lay on the bed and use a pillow (although I typically don’t use a pillow to support my posture, this is just when I forget). I can lay on my side and not feel pain.
I’ve also noticed that my right TFL is inflamed, and has been for the last two or three weeks. It feels really good when I use a lacrosse ball around T12 against a wall, right where the psoas inserts. That offers a lot of relief.
While I’m not out of the woods yet, I do feel hopeful that life will return to normal. In fact, this past weekend I was able to go to dance class! My first one since July. I was careful to avoid too much spinal flexion, and ended up having a great time. About 45 minutes into the class, I had to take a little break, but it felt so good to move again.
I learned so much from the process of understanding and healing my injury; it inspired me to create an Ongoing 6 Week Back Strength and Stability Program to help others with back issues build strength and feel better in their bodies. Our first round is going so well, and the next round of workouts starts November 17th. If you’d like to join us and gain access to the workouts and a mid-point community check-in, you can sign up here.
UPDATE - December, 2, 2020
I feel 99% better! I am back to doing RDLs, taking dance class without having to avoid spinal flexion or take breaks, and the only thing that really aggravates my abdomen is sitting for prolonged periods of time, so I try to get up every 30 minutes or so and walk around. I ultimately feel so thankful for this injury because it has taught me so much about the body and has better enabled me to help my custom program clients with their herniations. The Back Strength and Stability Program has been so successful and so many people are reporting feeling much stronger, more stable, and with less pain. I feel so grateful!