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Severe c7 forminal stenosis with nerve compression

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  • Severe c7 forminal stenosis with nerve compression

    Hello doctors,

    I'm looking for some guidance here. Symptoms have been on and off for about 2 months. Had some numbness for a few weeks but that went away. Last two weeks I have some right tricep weakness that developed after trying to OHP. I went to the orthopaedic and they wanted me to have an MRI that shows I have severe right C7 foraminal stenosis with nerve compression. Also have herniation on C6 and 7. Ive gone through two doses of methylprednisolone. Almost no pain and tricep weakness is a little better. Still pretty weak though.

    Im going back to see him in one more week to follow up.

    I went to the neurosurgeon to get a second opinion and he said I could have surgery at some point but he would like to see how this pans out if there's any Improvement first. He told me not am emergency situation and i have some time.

    the problem is I'm not really sure what to do in the meantime. The neurosurgeon said I could work out but nothing over my head. The orthopedic surgeon didn't seem to care what I did. And then a chiropractor friend said don't do anything because deadlifts will blow out your back.

    so I'm wondering should I be trying to still do some lifting or should I stop? kind of confused getting different suggestions. And obviously want to avoid surgery.

    Last edited by Angione78; 04-23-2019, 02:41 AM.

  • #2
    Hey, sorry to hear about the weakness you are experiencing. If it has been two months you're still in the initial phases of regaining your triceps strength. Luckily we have some good redundancies built in to where we can work through issues like this and regain strength. Obviously the chiro is wrong as if there is one treatment that is guaranteed to make you weaker it is doing less. I would have no problem with you going overhead but this is an instance where I do heavily advocate for some isolation work. I do this for two reasons 1) it gives you at least a subjective perception of the side to side weakness i.e. if kickbacks are an 8 on one side and a 4 on the other you probably have some work to do. 2) this is an area where I tend to advocate for really training to failure. Most times when doing an exercise like a triceps pulldown the sensation isn't necessarily the typical muscle burn but more an empty feeling. I would start getting this in a few times/week.

    Also, in regards to overhead pressing specifically I would not advocate going heavy for a little while. I would say still let RPE be your guide but this is an instance where I would take the weight a little lighter due to that empty feeling mentioned above. Until you can reestablish some good strength via some isolated work on your triceps I would err on the side of caution for overhead press more from a safety standpoint.


    • #3
      I have recently been in to see the ortho due to excruciating pain (now much better, but still rough) in my left arm and shoulder. Additionally, I have numbness in my index and middle finger and significant triceps and chest weakness on the left side. Ortho sent me in for an MRI on my neck and the conclusion was "Large left paracentral/proximal left foraminal disc extrusion at the C6/C7 with caudal extension resulting in moderate left-sided canal stenosis and sever left neural foraminal stenosis compressing the exiting left C7 nerve root." The report also noted that the disc extrusion is "effacing the ventral CSF space, contacting and flattening the ventral left aspect of the cord..."

      I have been trying to train through his using a 3-4 day Hyper program and GPP. I can barely bench at all (bar is ok, 95 lbs. is iffy for a few reps, 135 is tough with my right going way up and the left not able to push much. When it first happened, I could not push a 35# DB off my chest for a flat chest press. More recently, I have been doing a little OHP and BP with whatever weights I can handle. I supplemented a little DB chest press, using 85# on my right and 30-35# on my left (so I would see atrophy on both sides as much). Same with triceps work - one arm rope extensions or DB kickbacks, but with significantly different weight on the right versus the left.

      Should I modify this approach at all? My triceps are a bit stronger, but just a bit. I am only 3 weeks removed from the onset of the excruciating pain symptoms. I am scheduled to see the neck ortho next week.

      Thank you for your input.

      Here is the weight difference on a hammer strength machine between my right and left...

      Click image for larger version

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      • #4
        So, I want to start by offering some personal perspective here. I had a similar episode to this 6.5 years ago, but in my quadriceps in regards to weakness. I had the fortune of having strength tested my quadriceps on an isokinetic dynamometer (re: REALLY fancy strength testing device) just prior to the injury so I had baseline numbers. Prior to the injury I was kicking out 240# with my right leg and 230# with my left. Four weeks after the injury I was at 230# on my left leg and 68# on my right. I'm stubborn so I tracked progress over time and it took about 3-4 months before I felt normal walking around and going up and down stairs and even then I was somewhere around 120# on my right leg for strength. At three weeks I would highly suspect there to still be a huge difference side to side in how you are feeling. What I noticed is that if I got on a knee extension machine I could get some reps then it would just feel "empty" like I wanted to kick more but it just wouldn't go, completely different than the normal muscle fatigue feeling of failure.

        I say all of this because your situation sounds very familiar and the picture of your hammer strength machine would have been analogous to what mine looked like for a knee extension machine. I think you are fine to continue training and the hypertrophy template is okay. That being said, you are likely going to have to adjust a lot for how your symptoms are feeling. Don't loose hope though, it does come back. I was pulling low 500's within a year of it happening and even though I still have a quad deficit I'm squatting acceptable weight (maybe not by Jordan and Austin's standards but what am I gonna do, not train?). You will get there. It's hard not to be frustrated and you are ENTIRELY justified in being frustrated. The more you look at it as a process and comparing yourself to where you were a few weeks ago versus a few months ago, the more you'll start seeing yourself getting back to normal.


        • #5
          Thanks for the perspective. It does seem the pain is better and holding at more of an endurable baseline (ibuprofen helps). But the week was continues to be pronounced. Are things like chiropractic spinal decompression and/or physical therapy shown to help the disc reabsorb any quicker? Or regardless of treatment, it’s just a time thing and the body will just heal when the body heals?

          i am going to a neck specialist since the MRI showed the herniated disc was pushing slightly on my spinal cord. Since I don’t have any symptoms from this, my guess is he will simply say to give it a month or two to continue healing and see what happens next.

          With your quad injury, did you have significant pain? If so, what pain management did you use? I am just dealing with it with a little nsaids to assist.

          Thanks again!


          • #6
            I have some encouragement for you all hopefully. I had a very similar C7 injury last July and I actually posted on these forums a couple of times looking for advice. I initially had lots of pain that resolved over a couple of months. Derek gave my some really good advice. I was tremendously frustrated by the weakness for several months. It took me some mental adjusting to focus on getting back to baseline and embrace the process of rehabbing my weak side, but I was able to get there. A consult with Dr. Ray was helpful for me too. I'm really happy with my training now and I'm continuing to gain strength in my weak side. If you are feeling defeated by the loss of strength (like I was) hang in there, it will improve.
            Last edited by EY07; 05-22-2019, 08:56 PM.