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Feeling the pinch
File Photo<br>
Health, News
Anika Richards | Senior Editor | richardsai@jamaicaobserver.com  
September 4, 2015

Feeling the pinch

MOST Jamaicans would’ve watched with bated breath and fingers, toes and knees crossed, hoping that hurdler Omar McLeod would’ve pulled off yet another miracle in the men’s 110m hurdles final at the recently held World Championships in Beijing, China, to medal for Jamaica.

Though he hit all 10 hurdles in the semi-final, he was lucky enough to still run 13.14sec to advance to the final. However, that approach was not good enough to put him on the podium. McLeod did, in fact, hit the hurdles in the final, but his sheer grit and determination only allowed him a sixth-placed finish in a time of 13.18sec.

Following his purposeful dash to the finish line, McLeod disclosed on his Instagram page that he learnt after the semi-finals that he had a pinched nerve in his right lower back, which he said resulted in him hitting the hurdles.

“Honestly, every time I hurdle I felt severe pain in my right lower back, but then I’d just ignore it and say it’ll go away eventually,” McLeod said in his post. “The doctor told me that was the reason I was helplessly hitting the hurdles.”

The National Collegiate Athletic Association champion insisted that, throughout the season, his races were always well executed.

“Y’all know that throughout the season, majority, if not all my races have been somewhat flawless and clean, so I know that was questionable as to why or how could I hit all 10 hurdles in the semi-final,” McLeod reasoned.

“I just could not understand why I was awfully hitting hurdles like that,” he continued. “It really scared me!”

However, even after learning about his pinched nerve, McLeod was still resolute about giving his best in the final.

“But with all of that, I still wanted to go out there and represent my country to the fullest, knowing that I would still have a disastrous race,” the former Manchester High and Kingston College student said. “I tried my very best in the finals to just go out as hard as possible and try to hold on for dear life, and I’m tremendously proud of myself.”

If his hashtags are anything to go by, McLeod already has his sights set on Rio 2016.

“I really have to thank God that he brought me through this and I’m a living testimony of how great he is. ‘Never Give up!’ #RoadtoRio #ReFocus #GodisGreat #WarriorChild #Blessed #BackToTheDrawingBoard,” his Instagram post concluded.

Dr Paula Dawson, a US Board-certified physiatrist and the founder of the Rehabilitation Institute of the Caribbean, explained the nuances of pinched nerve in a recent interview with the Jamaica Observer.

“In the general sense, a pinched nerve is usually when the nerve root that is exiting the spine is impinged, whether by compression from a disc or an inflammation around the nerve root, causing pain in the distribution down the legs where that nerve would normally supply sensation,” Dr Dawson told Your Health Your Wealth.

She explained that each nerve has a special place on the body where it gives sensation to the skin as well as makes the muscles move. The nerves from the lower back will go to the legs, which will allow for the movement of muscles.

“Now the pain that you feel is the sensory, which is the sensation part of the nerve which is letting you know that the nerve is inflamed,” the physiatrist said. “The inflammation of the nerve root gives the nerve root pain, and nerve root pain is called radicular pain, also called pinched nerve in a sense.”

Outisde of the pain that is felt, other symptoms include weakness in the muscles that the nerve supplies, reflexes in the nerve root being diminished, loss of sensation or numbness, as well as in really bad cases, it can cause loss of strength in the legs, loss or control of the bowel and bladder, and numbness and tingling in the legs.

She pointed out that back pain is quite common and that with athletes, sometimes they are unable to differentiate the pain that is being felt.

“Athletes will tell you that they always have pain somewhere,” Dr Dawson told Your Health Your Wealth. “And people don’t realise how tough it is for athletes in their training. They will train through pain, so sometimes they feel the pain and they don’t even know it is pain, they think it is just training pain,” the physiatrist said, adding that lower back pain can be more common among cricketers, volleyballers and people who do a lot of jumping.

“Hurdlers, I suppose, because they are doing that continuous flexion (bending) and when you flex the body you put the disc under pressure,” Dr Dawson opined. “You put the back under pressure.”

She stated that therapy, medication, injection, and surgery are the four treatment options for pinched nerve.

“The thing with pinched nerve is that 90 per cent of the time, back pain which moves into the leg will go away on its own, and it is what you do that prevents it from coming back,” Dr Dawson shared. “And 80 per cent of the time they do come back.”

However, with the ever-present issue of banned substances at the fore of athletics, Dr Dawson explained just how athletes can approach treatment.

She said therapy is the first line of treatment and it could include different movements, stretches, and certain exercises that can completely resolve the pain.

If therapy fails, then medication would be next on the list.

“The medication that we normally give would be an anti-inflammatory like Advil, Ibuprofen… or Cataflam,” she said, adding that in some cases neuropathic medication might also be given to patients.

“I have athletes with pinched nerve and they are taking Neurontin, which is World Anti-Doping Agency-approved, meaning it is not a banned substance,” Dr Dawson explained.

If neither therapy nor medication works, then injections would be next, but Dr Dawson explained that the only injection that can be safely done under World Anti-Doping Agency (WADA) guidelines is an epidural steroid injection.

She said a special substance approved by WADA is used and is given in the joint or in the epidural space. Dr Dawson said, however, that if the same substance is given in the muscle or through IV, it is considered a banned substance.

“It really is just giving them the anti-inflammatory at the point where the nerve is located, whereas oral medication is taken systemically, so you don’t get the medication as concentrated to the point where the pinched nerve is as you do with epidural injection,” the physiatrist divulged.

And, surgery is usually the last resort.

She insisted, though, that strenghthening the core – which is the abdominals, the diaphragm, the pelvic floor, and the back muscle – helps to stabilise each segment where the discs are and it will prevent movements that will cause pain.

Though not familiar with McLeod’s specific case, Dr Dawson told Your Health Your Wealth that patients who have general pinched nerve, with correct rehabilitation and their compliance, medication to help them, and sometimes epidural injection, they can recover without going on to surgery.

In spite of the pinched nerve, McLeod was grateful to God for a “remarkable season” and thanked everyone for their love and support, admitting that making the World Championships team for Jamaica was his dream come true.

“I was already a winner in my book simply for the mere fact that I was able to make the finals and line up beside all these great hurdlers that I grew up watching and only aspired to be like,” he also said in his Instagram post.

US Board-certified physiatrist andfounder of the Rehabilitation Instituteof the Caribbean Dr Paula Dawson

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