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“Dear Mark,   I have a dilemma. I have a worn-out back, actrosis, edema, degeneration and 2 bulges l4-l5 and l5-S1. No nerve damage according to EMG and no entrapment according to MRI. Occasionally loss of feeling right toes, right leg and / or right buttock. They say it is radicular or something. Not treatable. Now I want to do some exercise myself despite the pain The pain clinic recommends Mensendieck / Cesar exercise therapy and stop everything else.

The physical therapist and manual therapist I go to in recommend medical fitness. The neurologist says that both are not scientifically substantiated. With exercise therapy I have to stick to the schedule they indicated, said the pain clinic and I am not allowed to garden. However, this is impossible since I have a 1300 m2 garden. So I tend to opt for medical fitness. But I’m unsure. Can you advise me?”

Hi Marco,

Excellent question and very understandable that there is some confusion when two different specialists give you advice which is directly opposite.
I think I can definitely get you started, let’s take a look at the points step by step.

MRI

In my opinion, the results of your MRI are promising. No nerve damage is the most determining factor. Things like degeneration and bulges sound scary, but nowadays we know that they are very common, even with people without complaints.
In the 40-50 age group, 68-80% of the population has this! And those are people without complaints, so they are not even aware of it! These factors therefore do not have to pose any restrictions at all.

Medical Fitness

I agree with your Physical Therapist in this area. Exercise programs that have been compiled with care generally have a tremendous influence on the complaints picture. It is important to find a therapist with a sports background who can look closely at the movements that are required during gardening. It would be even more ideal if he / she can drop by to see the garden and get an idea of ​​how you are moving there.
Once this is clear, the necessary movements can be simplified to a level where the practice does not cause any complaints. From this point on, the program will be adapted to more and more resemble the activities during gardening. With good guidance, this should be all right.

During the build-up period I would recommend getting help for the garden. This can be a salaried person, but there are often also interns or volunteers who are happy to lend a hand. This way you can temporarily relinquish the difficult things yourself and for someone else this can be a very valuable learning period!

I hope this helps. If you cannot find anyone in the area, it is possible to request online guidance from us.

Kind regards,

Mark Chen