Stable Fracture to L2

[alanaos]

Hi

I fractured my L2 vertebre on Sunday in a skydiving accident. It's stable and no surgery is required but I'm in a back brace for thenext 6 weeks or so. Are there any exercises I can do to help build up my strength and/or relieve pain? Anything I should be eating or drinking or avoiding to help with recovery?

Many thanks

Alana

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[Canuck Physio]

Hi

I fractured my L2 vertebre on Sunday in a skydiving accident.
Is there further information that can be provided regarding the type of #, the incident angle in which it occured. The X-rays? Consultant reports?
It's stable and no surgery is required but I'm in a back brace for thenext 6 weeks or so.
Was it a compression #?
Are there any exercises I can do to help build up my strength and/or relieve pain?
Do you have access to physio? You should ask for a referral. Of course there is much that can be done, however, is standing up contra-indicated? Is there necessary precautions? Without this knowledge it is difficult to advise as you may need to remain in absence of gravity during exercise to alleviate extra spinal load compression
Anything I should be eating or drinking or avoiding to help with recovery?
Indeed, there are supplements shown in research to enhance bone recovery. One of them is calcium, vitamin D, amongst others. However, these are not to be mega-dosed. Just a little bit above the RDA would be useful, but needs to be combined with exercise for proper nutrient partitioning and utilisation.
Many thanks

Alana

as above Regards

[thomas bibu]

hi alana,

at the outset, sorry to know about your injury.

well, as far as there is no clinical signs of neurological injury, there should be no reason to worry at all.

i understand you are already on a brace which confirms immobilization of the segment. well, always log roll (move the body as a single segment) whenever you move in the bed to avoid pressure complications.

regarding standing, it is better to be on absolute rest at least for the first 2 weeks. the standing position is avoided because of the transfer, most often while moving to standing from sitting or lying there is a chance to bring in a torsional force to the spine which is contraindicated.

with respect to supplementation you may only if you have any other systemic illness. generally fracture healing of the vertebral body is good hence supplements are usually not necessary. rather drink plenty of fluids and take care of your dietary habits to avoid secondary problems like constipation etc.

well, movement is life and the principal segment of the human body is muscle so in order to avoid effects of immobility you may carry out mild to moderate spinal isometric exercises within the limits of your pain. please do not forget to add breathing exercises also to your exercise regimen.

last but not the least.. try to relate this particular phase positively. a positive mind has a very big role to play in healing.

take care & get well soon. feel free to contact in case you have any more queries.

cheers,

thomas

[alanaos]

Hi

in answer to your questions:

I haven't seen the x-rays but the consultant said that the fracture was across the larger part of the vertebre with the top part having moved about 2mm. It was incurred due to me falling back onto my reserve parachute (which was still packed inside my container - the reserve sits in the top part of the rig so it caused a sort of shelf for me to jar against). The force of this hitting my back produced a pretty clean fracture. It's not a compression fracture and there are no other neurological implications, plus my spinal cord has been unaffected.

The consultant had me stand and walk to the toilet the same day. I have an appointment with the fracture clinic next Tuesday and at the moment I'm only taking pain relief at bed time (I was only prescribed paracetemol and codene but I don't like taking codene due to problems with constiation).

I have been advised to rest as much as possible but I haven't been told not to stand. I have an apointment with the fracture clinic next tues and the only other problem I've noticed seems to be my left stiatic (sp) nerve causing me pain. I did also sprain my right ankle quite badly and I'm wondering if I'm compensating for this in ny way. I find that lying in the same position for too long also causes more aching and pain.

In short it almost feels like if I could get some movement going it might help but I don't want to risk anything. I'm a healthy weight and usually in good shape (so being unable to do any exercise is difficult for me anyway). I'm also vegetarian and never eat procesed foods.

Any advice much welcome as the hospital really weren't very helpful (they discharged me without even getting the physio to show me how to barrol roll or take the stairs).

Alana.

[Canuck Physio]

Hi

in answer to your questions:
Hello again
I haven't seen the x-rays but the consultant said that the fracture was across the larger part of the vertebre with the top part having moved about 2mm.
This is the body of the vertebra
It was incurred due to me falling back onto my reserve parachute (which was still packed inside my container - the reserve sits in the top part of the rig so it caused a sort of shelf for me to jar against). The force of this hitting my back produced a pretty clean fracture. It's not a compression fracture and there are no other neurological implications, plus my spinal cord has been unaffected.
This sounds like a wedge facture, although not a compression fracture it may influence the joint space. Was there any prolapse/disc bulge?
The consultant had me stand and walk to the toilet the same day.
How did that go? Did you use any aids?
I have an appointment with the fracture clinic next Tuesday and at the moment I'm only taking pain relief at bed time (I was only prescribed paracetemol and codene but I don't like taking codene due to problems with constiation).
During your visit to best enhance your recovery please ask for a referral to a hydrotherapy physiotherapy class. You will lose muscle, strength, cardiovascular fitness during this time. I highly recommend that in order to enhance recovery (you appear to be fit previously) to continue to work on your fitness, and really there is no reason not to.
I have been advised to rest as much as possible but I haven't been told not to stand.
It would be nice to know exactly what was said. However, please do not confine yourself to bed rest. Complete movements as tolerated. If you are confined to bef for whatever reason try to move your upper limbs as much as possible. A stretching programme would be useful as well.
I have an apointment with the fracture clinic next tues and the only other problem I've noticed seems to be my left stiatic (sp) nerve causing me pain. I did also sprain my right ankle quite badly and I'm wondering if I'm compensating for this in ny way. I find that lying in the same position for too long also causes more aching and pain.
by the virtue of the aches and pain, your body is telling you that it needs to move about. Try moving a little bit every few minutes. It only takes minutes for muscles to mal-adapt into spasm.

In short it almost feels like if I could get some movement going it might help but I don't want to risk anything. I'm a healthy weight and usually in good shape (so being unable to do any exercise is difficult for me anyway). I'm also vegetarian and never eat procesed foods.
Once again, the clinic appointment is nearing and hydrotherapy may be the best bet for yourself. Without knowing clearly the implications of the # it is difficult to say what you can/can not do. But there is no reason your upper body can not be utilised to maximise your fitness in the meantime.
Any advice much welcome as the hospital really weren't very helpful (they discharged me without even getting the physio to show me how to barrol roll or take the stairs).
Please bring this up with the consultant, be adamant that you require physiotherapy.
Alana.

As above regards

[alanaos]

Was there any prolapse/disc bulge? - There is no prolapse or disk bulge

The consultant had me stand and walk to the toilet the same day.
How did that go? Did you use any aids? - no aids were needed and my ankle hurt more than my back. I can now walk around very easily and find I don't need any pain relief during the day

During your visit to best enhance your recovery please ask for a referral to a hydrotherapy physiotherapy class. You will lose muscle, strength, cardiovascular fitness during this time. I highly recommend that in order to enhance recovery (you appear to be fit previously) to continue to work on your fitness, and really there is no reason not to. - I did do some very gentle yoga stretches on my legs yesterday which eased my siatic pain. I am finding that the more I move around the better I feel as long as I keep my spine pretty straight and rest after (I went for dinner with the girls last night and there was no problem apart from a little achine towards the end)

I have been advised to rest as much as possible but I haven't been told not to stand.
It would be nice to know exactly what was said. However, please do not confine yourself to bed rest. Complete movements as tolerated. If you are confined to bef for whatever reason try to move your upper limbs as much as possible. A stretching programme would be useful as well. - The advice given was pretty random and by different people. The consultant seemed to think I was fine to move with in my limits - the nurses insisted on wheeling me to the toilet even though it was no problem to walk. I can do most things for myself (including tie my laces - due to the yoga I've previously done)

I have an apointment with the fracture clinic next tues and the only other problem I've noticed seems to be my left stiatic (sp) nerve causing me pain. I did also sprain my right ankle quite badly and I'm wondering if I'm compensating for this in ny way. I find that lying in the same position for too long also causes more aching and pain.
by the virtue of the aches and pain, your body is telling you that it needs to move about. Try moving a little bit every few minutes. It only takes minutes for muscles to mal-adapt into spasm. - I couldI'n't agree more! Staying still seems to cause the most pain. I've also been doing lots of stomach tightening exercises when on my back to try to kep my core strong (not crunches - just tensing and releasing) and I find leg raises helpful but worry that this may be too uch (even though it doesn't hurt).

In short it almost feels like if I could get some movement going it might help but I don't want to risk anything. I'm a healthy weight and usually in good shape (so being unable to do any exercise is difficult for me anyway). I'm also vegetarian and never eat procesed foods.
Once again, the clinic appointment is nearing and hydrotherapy may be the best bet for yourself. Without knowing clearly the implications of the # it is difficult to say what you can/can not do. But there is no reason your upper body can not be utilised to maximise your fitness in the meantime.
Any advice much welcome as the hospital really weren't very helpful (they discharged me without even getting the physio to show me how to barrol roll or take the stairs).
Please bring this up with the consultant, be adamant that you require physiotherapy. - I will insist on physio and even if they can't offer m hydrotherapy I'll ask the physio to show me exercises I can do in my gym pool.
Many thanks for your advice. It's god to hear that someone else agrees complete bed rest isn't always the best course of action. I'll keep you posted on progress and let you know what the consultant says.


A. x
Alana.