Musicians' Health Collective

Musicians' Health Collective: Supporting the health of musicians

Help! I have a herniated disc!

At the beginning of a yoga or movement class, I'll usually ask if anyone has any injuries, pain, etc., and one of the most often reported injuries is "disc issues."  This is a huge and somewhat amorphous category of diagnoses, but let's take a look at the intervertebral discs and how they operate.  

Each of our vertebrae are "padded" so to speak with discs, that permit the sliding, gliding, and rotation of each vertebral body.  The disc structure is like jelly filled gummies (almost a gusher, if you know those) in which a tough outer layer of fibrocartilage surrounds a softer, gelatinous core.    The outer layer is the anulus fibrosis and the inner layer is the nucleus pulpous.  Diverse spinal movements compress the discs (in a good way) and allow for displacement and recoil of the disc back to the initial position.  In addition, discs are a critical part of the length of our spinal column, accounting for 1/4 of the height of the spinal column.  As we age, our discs may remain healthy and buoyant with movement, or become compressed, dehydrated, and we may shrink in stature.

Top view of a disc, with the spinous processes pointing down.

Top view of a disc, with the spinous processes pointing down.

A herniated disc (the terminology can be confusing: I've heard slipped disc, bulging disc, disc issues, and other words describe similar, if not the same, and sometimes different things) is when the disc ruptures, the middle "filling" spills out and may compress the spinal nerves.  A bulging disc usually means that the disc is displaced laterally, but is not ruptured.  Both conditions may cause pain, especially when they most often occur in the lumbar spine (low back).  A herniation in the cervical or thoracic area may be more precarious, given the amount of mobility in those regions of the spine.  In addition, many disc issues are caused by a traumatic incident, such as a car crash, bike accident, sudden fall, or other abrupt movement.

The good news is that not all disc issues cause pain and that chronic low back pain can be positively impacted through different movement and non surgical treatments.  Eric Goodman, a chiropractor and movement teacher, created a movement methodology called the Foundation Method which looks at the large scale structural misuses of the spine and hips.  A good physical therapist will help identify which movements are not helpful for the spine (stretching away from the herniation may exacerbate the condition), and which muscle deficiencies may be present.  I find that the lower body (foot muscles, calves, hamstring, psoas and glutes) play a huge role in back pain, movement quality, gait, and other movement activities.  In addition massage and self-massage may help support the surrounding tissues as the body adjust to new strains and loads.  

Resources:  Katy Says Podcast on Bones

Breaking Muscle: Lifting with disc issues

Breaking Muscle: Myths about Disc Issues

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