I’ve been pretty busy lately, so there hasn’t been much time for blogging – I’ve tagged a few subjects for future expansion in my drafts, being very much a reentrant blogger, but so far meat has only been added very sporadically to those particular bones. By the time I get around to filling in the detail, the subject matter will no doubt be considered ‘stale’, but maybe my particular brand of commentary might lend a modicum of life to them anyway.
I’ve deliberately avoided talking about my back for a while, for multiple reasons; firstly, that I suspect it gets a little dull to read, and secondly it seems that whenever I talk about it on this blog, it seems to get worse the day or two following. I’m not a superstitious man by any means, but it’s really quite uncanny; of course, it’s probably just because when it’s feeling better, I’m more likely to overdo something & injure it again.
So, with he appropriate caveats about what might happen in he next 2 days, the good news is that ever so slowly, my back is improving. After several months of following the advice of my physio to concentrate on stretching out and lengthening the muscles and tendons in my mid-upper back, to stop them clamping up and locking my back in enormously painful ways, I’m definitely seeing positive results. I now do about 1.5 hours of exercise and stretching per day, and go to the gym twice a week on top of that for something a little more strenuous. It still hurts moderately every morning and most evenings, and occasionally I get a more serious bout which requires me to take painkillers (usually the day after doing something unwise, or being too immobile such as when travelling for long periods), but overall, I can see positive results. Each month I seem to be a little bit better than the last – it’s not a fast process, but at least it is a process.
As you can imagine, it still plays havok with my daily routine, and I’m almost constantly frustrated at the amount of stuff I can get done these days. Years of sitting at the PC until 2am if that was ‘necessary’ led to a certain baseline expectation of how much I could do in a day. Now, I’m mostly a regular daytime beast, with a few extra hours at the weekend and the occasional evening here and there, so it’s quite different. But, I’m adjusting to it, such as learning to say ‘No’ to work offers that don’t feature highly on my personal priority list (which basically means that stuff that enhances Ogre gets top priority, things that use Ogre next, everything else brings up the rear, if at all), and time-boxing what I do in the community / forums – now, if I can’t do it in the time I have, it probably doesn’t get done (by me anyway), rather than the old situation of me just spending as much time as it took. I don’t like having to pass on work, or get slightly out of touch with some aspects of the community, but on balance it’s an acceptable sacrifice given the alternatives, no matter how guilty I might feel about it sometimes.
So, if I don’t talk about my back much anymore, it’s because it’s just on a very slow but seemingly steady road to recovery, which as you can tell, doesn’t make for very interesting blog posts 
It doesn’t mean I’m ‘better’ yet, and I’ve accepted that I’ll never be able to return to my old ‘all night coding marathon’ days, (revel in those while you can guys, but definitely think about giving them up before your back ends up like mine did) – but it’s probably time to stop talking about it now. My thanks to all those who sent their good wishes, and helped me out over this rather testing time.
May 24th, 2009 at 3:58 pm
Finally you learned the lesson tosay no to your favourite thing because of health. I hate saying no to favourite work but really health takes priority. I have myself have stopped sitting upto 2am (coincidentally I also sit upto 2 AM) and sleeping before 12 o clock. Actually the next day I feel more fresh. My back has again came back in good condition. I ahve succeeded in varying the activities I do. I now write my novel with pen in a copy instead of typing in PC. Latter I type chapters as they are completed. Also I work out mathematical algorithms code on paper first then I try them in PC. Also I make architecture for my game engine on paper. It is somewhat double work but actually it plays good with how I work and I get much needed variety.
I really wish that your back gets in really good condition soon. Keep posting the updates. Slow your path may be u will progress and soon we can celebrate your good health instead of just wishing for it to improve.
May 24th, 2009 at 4:01 pm
Also I got 3D Game Engine Programming by D H Eberley. It is really nice book. Thanks for pointing to it in OGRE manual. Knowing the name of good books is really important.
May 24th, 2009 at 8:20 pm
I actually like to know about your back problem being a regular follower of your blog as i myself am in a similar situation to yours..
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My back pain has been going on for the past 2 years and in times like now when i have exams or have to meet up with a certain deadline i myself have to take pills to control the pain..
But to tell you the truth you are lucky to know what is wrong with you as i live in Pakistan i have gone to the best clinic in my country and have got an mri done of my back all came back ok and the nut headed doctor gave me a very large dose of anti depressents which serve a side purpose of healing my back which ofcourse i quit after eating for a week as the pills make you go crazy
I do think ill have it checked if i ever get the opportunity to leave this country until then you are the only other person who i can relate to..
May 26th, 2009 at 10:09 am
@Umar: sorry to hear you have similar problems. Both doctors I’ve seen refused to refer me for an MRI because they said it wouldn’t help, since they were convinced I had no structural problems, just really unbalanced soft tissues, and it seems they were right. The trouble is, to fix the unbalanced muscles takes a hell of a long time, and it can be pretty painful so it’s demoralising. But, the only answer I found was to stick with my new exercise regime, every single day, regardless of the discomfort.
Everyone’s back is different, but if like me you have no structural problems, it’s really about regular modest exercise. For me, it has to be every day – if I skip it I always feel the effects. And, it took 3-4 months for it really to start having a persistent positive effect – before that, it was quite random and I’d often end up hurting myself. I still have to avoid lifting heavy objects or otherwise overstraining, but I’m starting to be able to live more normally again. It seems to be a combination of more flexible ligaments, more balanced core muscles (I’m no longer quite so dominant in the muscles that make you sit up straight), and mental conditioning – learning to relax (stress tenses everything up), learning how to retain muscle balance when sitting / walking etc. It’s really about re-learning a lot of things – I spent so many years rigidly sitting at a desk and not doing much else that I ‘forgot’ how to sit & move more naturally. Part of that was beacuse I did injure my back (a vertebra) about 5 years ago (I think I can trace it to a horse riding incident), and I think as part of recovering from that I developed an overly rigid posture which then caused this later problem.
I hope you find a way to improve your condition – my experience is that there are unfortunately no quick fixes, but I’m convinced that with enough dedication over time it’s possible to recover.
May 26th, 2009 at 3:56 pm
@Umar: Follow the advice of your doctor first, but obviously dont take any medicine beyond your capacity. Aphisiotherapist may be helpful.
Also you can try to come in neighbouring country India. Good doctors and health care is really cheap as compare to anywhere else, that is why India in becoming more famous for medical tourism in USA.
It is good and not expensive. Also Physiotherapist are also very good, if you are really not able to find good doctor there or cannot afford him.
My advice is to try doctors in Delhi, Banglore or Bombay.
It is difficult and expensive to travel to western countries.
May 30th, 2009 at 10:57 am
@steve: I am pretty sure i have a problem similar to yours as firstly the mri showed nothing and secondly when i eat muscle relaxants they seem to work so its certainly muscle related.. BTW i would like to know what exercises you do, i started swimming for several weeks but i had to quit it because once i was swimming in the deep water and i got a muscle cramp which almost drowned me so i have a feer of deep water and the shallows are dominated by kids in the summers.. i live in a small town where there is only one club which has a pool
.. neways i will start swimming from august when the kids are back in school and waters are much calmer 
..
..
And my problems started much similar to yours i sat on a chair all day and when i came home i didnt go out on walks or nething i stayed at home sitting in a chair and working on some project and all the exercise i got was weight lifting.. so im sure those 3 years of my life were the ones responsible for breaking my back and making my career
@kinjalkishor: Yea i am saving up right now so that i can get my back checked from a proper doctor but right now i am at a critical point in my career where im sure i cant go anywhere for almost a year.. if it all goes to plan in this year im sure ill be able to get it checked from singapore which has the best health care in asia as the company im working for is located in singapore.. even if it doesnt go to plan i will be able to afford to go to india and get it checked for sure.. right now all i can do is get a good chair for my back which i have and exercise which i do as much as i can..
May 30th, 2009 at 11:31 am
Well, my physio diagnosed my problem as mainly related to over-active Erector Spinae, so the most important thing was to avoid exercises that used those muscles. This is interesting because many back books will tell you to do exercises to strengthen these muscles, but mine are already too dominant. So that meant, for me, no back extensions or anything else that tensed those back muscles.
Instead, I had to concentrate on 3 things :-
1. strengthening all the abdominal muscles without straining my back. Traditional sit-ups put too much strain on the neck & back, so I was advised to do reverse curl-ups, and ‘leg passing’ exercises. In both cases you do them on your back and move mostly your legs, which if you don’t extend them too far doesn’t strain your back. Doing it gently and often is better than trying to go nuts.
2. relaxing & stretching the erector spinae muscles and associated ligaments in a sitting position. This is mostly breathing exercises to relax and slowly curling over, pushing out your mid-back to form an arch, and also twisting exercises. If your problem is like mine, you won’t be able to bend much to begin with, and when you do you’ll be susceptible to spasms which can be incredibly painful and which reactively tense all the muscles (making it worse). I had to teach myself to relax and disengage the muscles, but it took a *long* time before I could do it without lots of pain. The key is to do it twice a day when your back is most stiff (morning and evening, I do it after a walk in the morning because that loosens it up a bit), and just do it relatively gently, carefully straigtening up in between each time. It takes time – it’s only really now that I can do it without expecting a knifing pain in the back. It’s tough to try to relax even while knowing that it’s likely to spasm & hurt any minute, but over time it really helped.
3. Just generally getting more exercise. At first I just did brisk walks, now I go to the gym too and major on aerobic rather than weight-bearing exercises. I’m not looking for strength, but general balance in the muscles. Cross-trainers seems to be the best for this. At first I’d be in lots of pain the day after the gym, now I tend to just be very stiff & sore, which passes after doing my daily morning exercises.
That’s what has worked for me, but it did take quite a few trips to the physio to actually figure out what the core of the problem was in my case. I had assumed ‘back strengthening’ exercises like extensions would help (you see these in back self-help books), but in fact they were probably making things worse in my case. Because of the secondary effects it probably took about 3 months to get a handle on precisely what helped and the physio definitely helped with that. Having said that I went to a different physio before that who didn’t help at all – in fact he told me the opposite. So it’s all about finding an exercise regime that fits your individual needs, and a physio or particularly a sports injury specialist might help you with finding that, rather than a general doctor.
What’s hard is that initially, the results seem a bit random – I know I was often very stressed out because nothing I did seemed to consistently work, and even when I made progress it seemed to evapourate at a moments notice. It took a few months of gradually increasing exercise, every single day, to start seeing more predictable results. I think finally deciding to put my health first, and fit everything else around it rather than the other way around, even if that meant doing less, was crucial.
I hope you can find a similar way through. I’m such a stubborn bastard that it required an ambulance trip to hospital, strapped to a stretcher and not being able to move without screaming, to finally make me stop trying to ‘just cope’ within my normal workload and change my approach. Don’t let it get to that stage!
May 30th, 2009 at 4:09 pm
^ That is really informative steve thanks a million for this post.. i actually took note of my problem when i read your post about you going to the hospital before that i had given up on my back as the mri had nothing and the doctor gave me anti depressants and said they will fix me up, the simple solution to life itself :/.. And now that you say it i will actually try and look for a sports injury specialist cause i think i might be able to find someone of that sort.. I think ill experiment with different exercise regimes and start digging up till i find a good physio to point out the problem..
actually the biggest problem of all is the frustration as you must have witnessed yourself.. i have a bad back problem which acts up on its own accord which restricts me at times to even pick up a pencil if i drop it and there is no one who will tell me whats wrong with it and how to fix it.. i mean ffs we are on the brink of finding a cure for cancer and you cant fix a broken back..
May 30th, 2009 at 5:36 pm
Yes, I totally understand the frustration – it’s not knowing what is helping or hindering, and as a person that works with logical things, not having a clear route from cause (doing particular movements & exercises) to effect (how much pain I was in over time) was maddening. Because it takes so long to improve, and because there are regular ‘blips’ when you overstrain it, it’s hard to figure out whether things are working or not. In the end I tried to filter out the ‘blips’ and focus on being consistent with what I was trying do, for at least a couple of weeks at a time, and look for even small improvements. A diary helped, to try to identify things that caused the ‘blips’. It’s boring, but having a very regular daily / weekly routine really helps to trace the good & bad things to build up a picture of what you need to be doing more/less of. Having to be super-aware of exactly how you’re moving every single day rather than just being on autopilot is a real bore – I know, I did it for months. But it’s necessary to isolate & identify the problem. I’m actually quite pleased that in the last 2 weeks I’ve had periods of time where I really felt I could just move naturally again, without excessively concentrating on exactly what angle I was putting my back and other joints in! It’s the kind of thing you take for granted until you have an injury like this.
May 30th, 2009 at 6:14 pm
Hmm again the diary advice is very good indeed.. that can really help me and would also encourage me to stick to the routine.. Thanks again man..
June 4th, 2009 at 10:03 am
@Umar Mukhtiar, It is very right tobuild a career, but you need health to use your hard earned money and most important to live happily.
Keeping a record of everything while boring is immensely helpful so as to isolate the cause,and keeping a strict eye on diary is also equally important.
Donot wait till your condition becomes worse and as steve said u are forced on hospital bed. Get wise soon. Learn from others fault.
Get health first and then work. No Health, No Work ever.
Singapore is also expensive. What really matterrs is good doctor or physio at affordable price wherever it maybe. I am certain there will be some in Pakistan too.
If steves account didnot opened your eyes, here is my own, My sleep was always disturbed every night due to back pain, which actually put me to right track of rest and exercise. Donot wait and suffer. Take right steps as soon as possible. Donot try to cope, instead try to eliminate the problem. Also I waited one month fruitlessly for a minor eye surgery, and coped and suffered. After surgery it took another month and now I can see very good like old days. Waiting was really bad. I really laugh now at why I waited so long so as to aggravate the problem.
More waiting , more suffering.
Give health first priority.