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  1. #1
    Longing for a Tail Wind Stickney's Avatar
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    Sciatica and Bike Fit

    All,

    I have been recovering from a bout of low back pain/sciatica for the past month. I am not entirely sure what brought it on, but I suspect cycling exacerbated the issue. At any rate, I am 6'2" and ride a 61 cm bike, with a 59 cm top tube. It is standard road bike geometry. I have now flipped the stem to raise the handlebars and that seems to help (riding a bit more upright).

    I was wondering if any others have battled similar predicaments and whether they were able to tweak their fit on a road or cross bike to ease back pain (if so, what worked for you?), or if you decided to shift to a hybrid or mountain bike.

    I am weighing buying a cross bike with a 57 or 58 cm top tube to try and get a more upright fit, or if I should just get a hyrbrid commuter.

    Thanks for any assistance you can provide,

    Alan

  2. #2
    Kaffee Nazi danarnold's Avatar
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    I stopped running ["From what?" Shut up!] a few years ago because of low back pain/sciatica. Started biking instead. No problems. Feeling great... until last week. Not sure what did it. Too much walking, standing and standing on the pedals up hills?

    So ... that's not very helpful, but I went to a physical therapist yesterday. Electro muscle stimulation and stretching exercises. Just finished a 70 minute ride and I'm ok so far. 'Course I'm sticking to the couch drinking gin & tonics the rest of the day.

    Hope this helps [both of us].

  3. #3
    Longing for a Tail Wind Stickney's Avatar
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    Yeah, I have been swimming and doing ab and back work, which is helping a bit. But, I think I have a chronic case (my father has this issue), and I suspect I may need to adjust my bike fit.

    Gin and tonics are a good option, been using Grain Belt Premium and red wine myself.

  4. #4
    Senior Member cod.peace's Avatar
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    Quote Originally Posted by Stickney View Post
    Yeah, I have been swimming and doing ab and back work, which is helping a bit. But, I think I have a chronic case (my father has this issue), and I suspect I may need to adjust my bike fit.

    Gin and tonics are a good option, been using Grain Belt Premium and red wine myself.
    I have a compressed disc in my lower back and have occasional sciatica when driving my wife's Honda. Riding my recumbent leaves me pain-free, except for driving said car for more than an hour at a time.
    old steel Specialized Hardrock

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    I'm not being a smart aleck but try carrying your wallet in your front pocket especially when sitting or driving.

  6. #6
    Longing for a Tail Wind Stickney's Avatar
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    Recumbents -- yeah, have seen a few items about that as an option -- not sure if I am ready for that. Do you have any knee pain or do you get used to that pedaling method with a bent?

  7. #7
    Longing for a Tail Wind Stickney's Avatar
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    Quote Originally Posted by dkmatdrum View Post
    I'm not being a smart aleck but try carrying your wallet in your front pocket especially when sitting or driving.
    Haven't had my wallet in my back pocket for 10 years, but that is a valid suggestion for others.

  8. #8
    FSM
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    sciatica

    I've been around the block a few times on this one.

    I've had sciatica off and on now for about 10 years. I got fitted for a new bike and that helped a lot. However, at the end of last season, I was lured to flip my stem for a more aggressive position. Not a good idea. While the bike performed well for me it put more strain on my back and eventually brought on a bout of sciatica. Since then I have found the sweet spot with a shorter stem with a downward angle. Bike is even better this way as I like the short arc turning radius.

    Along the way I found that it is better to tilt the pelvis inward (flattening the back) whenever I can. I have also sworn off hamstring stretches, which, given my particular disc problem, is very bad for me.
    Don't believe everything you think.

  9. #9
    Longing for a Tail Wind Stickney's Avatar
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    Quote Originally Posted by FSM View Post
    I have also sworn off hamstring stretches, which, given my particular disc problem, is very bad for me.
    Interesting -- my disc is part of the problem as well, and I used to stretch my hammies every night, have avoided it for a month and my back has been doing ok. Of, course, I haven't been riding, so my hammies haven't seemed tight.

  10. #10
    staring at the mountains superdex's Avatar
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    I'm 6'2" and ride 58s --the bike may be too big, stretching you out. Is the angle formed by your torso and upper arm greater than 90*? --what about the amount of vertical distance from saddle to handlebars? ("saddle to bar drop") --a decent starting place is even (no drop).

    Are you sure the bike fit is causing the sciatica? I had a nasty bout with it at the end of last winter, and I had to stay off the bike for a good couple months. It was caused by some inflammation not related to the bike, but man, did being on the bike exacerbate it....

    Also, exactly how are you doing hamstring stretches? Standing and bending over to stretch them does NOT stretch your hamstrings. They are too busy contracting to hold you up. The hamstring stretch my PT made me do is to lay on my back and with a towel hold one leg in the air, pulling it into a vertical position and holding it there. She said it takes 30 seconds for the muscle to relax, so her guidance was 1 minute to stretch, but if I wanted to actually change the length of the muscle I have to hold for two minutes....

  11. #11
    FSM
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    hamstring stretches

    Stretching my hamstrings stretches the ligaments which allow the discs to bulge. That's how it was explained to me by my PT who was looking at my MRI. I found that the hamstrings can seem tight, not because they need stretching, but because the sciatic nerve is being impinged and is firing.

    This is the trap that I fell into a couple of times now (but never again). When the hamstring was tight, I thought the best thing was to stretch it, and that was followed by further inflammation of the nerve, which caused the hamstring to feel tighter which led me to stretch, etc..... Several of the physical therapists in the practice that I was visiting said that the never stretch the hamstring for the very reason. I cycle about 200 miles a week and play racquetball four or five days and I don't stretch at all! Just warm up and down. My friend who is manic about stretching is in constant pain.
    Don't believe everything you think.

  12. #12
    Kaffee Nazi danarnold's Avatar
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    Quote Originally Posted by superdex View Post
    I'm 6'2" and ride 58s --the bike may be too big, stretching you out. Is the angle formed by your torso and upper arm greater than 90*? --what about the amount of vertical distance from saddle to handlebars? ("saddle to bar drop") --a decent starting place is even (no drop).

    Are you sure the bike fit is causing the sciatica? I had a nasty bout with it at the end of last winter, and I had to stay off the bike for a good couple months. It was caused by some inflammation not related to the bike, but man, did being on the bike exacerbate it....

    Also, exactly how are you doing hamstring stretches? Standing and bending over to stretch them does NOT stretch your hamstrings. They are too busy contracting to hold you up. The hamstring stretch my PT made me do is to lay on my back and with a towel hold one leg in the air, pulling it into a vertical position and holding it there. She said it takes 30 seconds for the muscle to relax, so her guidance was 1 minute to stretch, but if I wanted to actually change the length of the muscle I have to hold for two minutes....
    This is almost the same thing my PT said, 20-30 seconds minimum. I'd been holding stretches for 5 sec max. There's a lot of guess work going o.n with this stuff. My understanding is that this impingement on nerves can be for a variety of reasons in addition to things related to spinal disc issues. In my case, the PT thinks it has to do with lack of upper back flexibility and inflammation and spasms of the lower back muscles. I do know that once the muscles get aggravated, they stay that way for a while.

  13. #13
    Senior Member cod.peace's Avatar
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    Quote Originally Posted by Stickney View Post
    Recumbents -- yeah, have seen a few items about that as an option -- not sure if I am ready for that. Do you have any knee pain or do you get used to that pedaling method with a bent?
    My knees are pain-free. The bike has to be adjusted, of course, but since you can't stand to pedal you learn to spin instead of mash the pedals. Spinning preserves the knees. Since the seat is supporting your body the trunk can relax, and the way your pelvis is attached to your spine makes for a therapeutic effect when you pedal. Well, at least it does for me.
    old steel Specialized Hardrock

  14. #14
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    Although I had back surgery (double laminectomy) when I was 25 (29 years ago!) and according to the surgeon, I'd be back in for another surgery on the third damaged disk within 5 years, I began riding a road bike for therapy. My old Austrian PT and Dr. were dead set against it, but I felt better and continued to ride to this day.

    I went through years of PT that really didn't work for me. One exercise was a 'press up" where you lay on your stomach, keeping hips on the ground and pressing the upper torso up similar to half a push up. Every single time I did this, I'd end up in severe pain and couldn't move for days. I've found that most stretching and excercise just tend to make my back hurt more. While riding my bike, it would feel better, so I rode more and more. Don't get me wrong, there were times it did hurt (Death Rides, centuries, etc.) and I'd have to get off the bike, lay on my back and pull knees to chest. This is the one thing that helped my back the most. I even did 10 years of Chiropractics that would seem to help and keep things straight, or so I thought. Now that I have stopped the Chiro routine for the last several years, I have noticed NO pain or performance issues. I even started riding dirt bikes again the past 7 or 8 years and always continued to ski. I just stayed away from bumps & jumps to help insure there would be no issues.

    The key was to really pay attention to the body, make subtle changes and see what works and what doesn't and don't be afraid to try alternative therapies. I've talked to many that swear by accupuncture, Chiropractics, etc. Make sure you are fitted properly to your bike by a good shop. Making changes in riding such as standing every 50 rpms on hills, move the pelvis forward as recommended earlier and when going down hill, keep your feet level and using your legs, keep most of your weight off the pedals to help take up the road shock.

    Hope this helps and shows you that there is hope and you can get through it and still ride without extreme changes.

    Good luck!!

    Bergie

    By the way..........I never had to go back for that "other" surgery that they expected me to have!!

  15. #15
    Insane Bicycle Mechanic Jeff Wills's Avatar
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    Quote Originally Posted by cod.peace View Post
    My knees are pain-free. The bike has to be adjusted, of course, but since you can't stand to pedal you learn to spin instead of mash the pedals. Spinning preserves the knees. Since the seat is supporting your body the trunk can relax, and the way your pelvis is attached to your spine makes for a therapeutic effect when you pedal. Well, at least it does for me.
    Ditto. I've been riding recumbents since 1991 (and hanging around recumbent bike people since the '70's) and the technique is as Cod describes. My spine is a pile of carp, but I've ridden pain-free for many years.

    I've been tempting fate lately- I have a couple uprights that I've been experimenting with. So far, so good, but my neck is sore at the end of a ride. I think that's the muscles waking up.
    Jeff Wills

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  16. #16
    Bicycle Repair Man !!! Sixty Fiver's Avatar
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    I have a back that is perma-farked with a nerve root lesion at the L4 / L5 and the only time I am not in some degree of pain is when I am riding and even then it has been a matter of finding that perfect fit.

    I can't sit upright on a bike for any amount of time and I can't get into too aggressive a position as although this relieves pressure on the nerves in my back it compresses the disc.

    From day to day my fit requirement changes as some days a more upright position feels better and on others I am dropping those bars down a fair bit... having a number of bikes helps and just about all of them have quill stems so they can be easily adjusted up or down as needed.

    A threadless stem can also be set up so it can be adjusted or an adjustable stem can be used... Ritchey makes an excellent adjustable stem.

    Sciatic pain has many causes and is a symptom of another issue that could originate in the spine, glutes, or piraformis and knowing where the sciatica stems from is the first step in dealing with it.

    I had some additional piraformis related pain and doing stretches for that relieved a good percentage of my pain, hamstring stretches aggravate my back, back arches are a no go, and the knees to chest stretches are also beneficial.

    Regular physio, ultrasound, traction, and interferential treatments are a steady factor in my life as this is also very beneficial.

    My issues are a result of an accident although this is something that will happen to many of us as we enter our 40's.

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    Your back pain is most likely from either an active or latent triggerpoint (a tiny and very nasty knot caused by injury to a msucle) in your middle back. The pain in your lower back is probably referred pain from the middle area of your back. The good news is if you find the trigger point, you can massage it away by working on the point several times a day over a couple of weeks and by building up the damaged muscle. Check out this triggerpoint locator to help you find the cause of your pain:

    http://myofascialtherapy.org/symptom-checker/
    http://www.myofascialtherapy.org/myo...apy/index.html

    Find out more about trigger points by googling. It is very surprising that not more people know about them, I saw various high end foot doctors for two years, was unable to cycle and spent hundreds before a friend alerted me to a trigger point in my calf that was causing my foot pain. After I located it, the pain was gone in a week. Keep in mind that muscles make up between 36-42% of body weight, so it's normal that things go wrong but it helps if you know how to diagnose yourself...if you don't find a triggerpoint, however, then you know it's something else. So nothing to lose!


    Good luck.

  18. #18
    Senior Member Wavy's Avatar
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    A Dr of Acupuncture cured my sciatica with a few treatments.

    Chiropractic helps, as does regularly hanging upside down on an inversion table.

    The best thing was getting a top shelf podiatrist to make casts of my feet for orthotics. Walking with properly aligned feet/legs/spine makes a huge difference.

    Now if I walk barefoot for a few days I feel that familiar twinge. So at nite I roll my hip, thigh, and lower back around on a hard rubber ball. Hurts like crazy, then no pain the next day.
    “Next time you're in your car, at 80 Kilometers per hour, strip down to your underwear and jump out. That's what it's like to crash in a professional bike race.” - Jonathan Vaughters

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    I went to a physiatrist (a physician that specializes in rehabilitative medicine) to deal with disc pain. Had a few sessions in "Back School". Learned why and how to achieve proper posture and maintain the curvature in my spine - exact opposite to the curvature that would be the result of an aggressive position on a bike. Did physical therapy to increase flexibility of glutes and hamstrings. So I learned to control the pain with proper body mechanics and flexibility. I was told not to cycle. But, after an initial layoff of about 2 years, I started again with a less aggressive setup. I have now been riding at least 10 years with rare flare-ups.

    Now, as long as i maintain that natural curve, I am pain free. My handlebars are just below my saddle height and I tilt my pelvis slightly rather than bending my spine.
    Last edited by pennstater; 07-28-10 at 06:14 AM.

  20. #20
    Senior Member ecovelo's Avatar
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    Professional bike fit finally helped what I call my "screaming SI joint", on my road bike. I did all the reading/researching on "bike fit" - felt like an expert on paper - but really didn't achieve proper bike fit until I visited a pro, and could intuitively "feel" how I should be riding my road bike. The bike, it turns out, needed only minor adjustments (seems I'd made hundreds of adjustments myself!) to make a huge difference riding. I am at the opposite end of spectrum from you however, as far as body type goes - very short. And bikes built for us shorties have extreme angles (seat tube, etc.) in order to clear the top bar - so traditional "bike fit" information from the internet, does not always apply. I wonder if it is similar in the opposite extreme for taller riders?

    All excellent points mentioned above... proper stretching, PT, core strengthening, cross-training (swimming) will all help - and for me... truly understanding the physical nature of my injury, I've learned to "visualize" (for lack of a better term) how my injury is affected by each of my body positions, before the extreme pain sets in.

    Good luck! Cycling is so great when I'm hurting.... and it's extraordinarily fabulous when I'm not!
    [SIGPIC][/SIGPIC]
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    I am not, associated, affiliated, nor in any way responsible for any of the creative and informative material, (and incredibly beautiful pictures) posted on the EcoVelo blog/website. (I chose my username before I was ever aware of the website).
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