Advice Please--Recovering from Low Back Pain
 

I ride several thousand miles a year, and at the age of 51 finally had an injury that has kept me off the bike for over a month. Apparently, I have a lower back injury known as a disc bulge. It's not herniated but it did lead to some pretty painful events over a several month period last fall. Ultimately, I've seen both a doctor and a chiropractor. After three weeks of following a stretching and related exercise program, I'm feeling pretty good. Not quite ready for the bike, but close. (By the way, I never had a back problem before, and was dubious about chiropractors. But I feel like this guy pretty much knows what he's doing. At least my back feels better, and I haven't re-injured it as I did when I was trying to manage the situation on my own).

However, I'm being told that in the future I should limit my bike riding to twice a week. That, of course, is simply unacceptable. I'm not sure what my next step should be. Find a sports medicine doctor? Most of them seem to focus on running and don't know much about backs. Set up my own self-care program? If so, what? Find a chiropractor whose focus will be keeping me on the bike?

If anyone's been through something like this I'd sure like to know what worked for you. I'm considering a higher, shortr stem and maybe even switching to a more forgiving road bike--a Lemond Big Sky for example. Thanks!

Hi,
been there, done that. Ok, here's my experience. This is going to take TIME. How long is up to you and your back, but you will progress as your body heals. Push too hard and it's one step forward and TEN steps back. Got it?

This breaks down into quieting, healing, strengthen, adapting.
The first thing is getting symptoms under control to interrupt any inflammation process that might be going on. I'm sure you know about RICE, but have you bought a couple really big cooling pads from a medical supply house yet? I found a daily soak in a hot tub
worked wonders, took me a couple weeks of going every day. But after that, I started to get better. There are other approaches, that's just what worked for me.

Now, let's assume the worst is over. So now we can start therapy (if the doc prescribes it) or light exercise. Here you really need a professional to set you up with a exercise regime that matches your needs.

Next.. you have licked the worst and you feel ready to hit the gym. Set up an agonisingly slow schedule and stick to it. A couple weeks of rowing with one plate (about 10 pounds), then a couple weeks with a second plate. That sort of thing. There are a lot of back exercises. EVENTUALLY you wll be able to do a number of them. But for now stick to a couple your Doc or therapist has said was ok. I'd work your abs on a machine, like a Nautilus. WHen you can do 80 to 100 pounds on the ab machine start doing incline crunches. They exercise the stabiliser muscles like crazy.

I eventually got the the point where I could do Roman Chair exercises, and a rowing exercise designed to stress the lower back. I don't even want to discuss the specifics of those yet.
That is likely 6 months to 2 years away, depending on how long recovery takes.

I like the idea of getting a more forgiving bike. You could also consider a seat with supension. I have been using a Brooks Flyer.
But I would spend a few months working towards recovery before doing even that. You could try spinning classes. You can get noise
deadening earplugs for $1.67 in the Walmart hunting department.
You will know why I mentioned those if your spinning class is anything like mine.

I know the situation looks bleak, but I was worse off. But I brought myself back, and hiked and backpacked and went skiing for years afterwards. You can do it, too.

Thanks! This is helpful. I'm actually pretty hopeful of making a good recovery, as are the docs. Evidently, this is a relatively mild case. Although, it did put me completely out of commission for several days at a time. I can't imagine what a herniated disc would do to someone. Ouch!

I've done chiropractors and neurosurgeons, and they made a lot of money repairing me.
However, I finally got steered by a Nurse Practitioner, who had a bad back himself, to a Physical Therapist who practices the Feldenkrais Method.

Moshe Feldenkrais developed a program of becoming more aware of how we use our bodies and learning new ways to move, work and play that don't constantly re-injure the body.
He specialized in stroke and head injury patients, but the method works very well for aging atheletes and normal aging people.
I would compare it to the gentlest yoga imagineable.
I now consider regular yoga and chiropractors way too violent.

A Feldenkrais practitioner does the normal seven years of undergrad and postgrad training, and then undergoes and additional four years of training in the Feldenkrais Method.
Most Feldenkrais practitioners actually mix and match therapies according to the needs of the patient.

Two years ago I could't sit cross-legged on the floor.
I suffered regular back spasms that sometimes required hospitalization, and I would spend days laying on the family room floor, incapacitated by pain.
I now commute 15 miles a day, like clockwork.

A Feldenkrais Physical Therapist costs a lot of money.
My insurance company really wanted me to do it, though, and paid for it all.
They had already paid for two back surgeries and Feldenkrais has a better statistical record than does surgery and chiropracty.
If a person doesn't have insurance, the Feldenkrais folks sell a series of self-instruction tapes for about $65, and, if a person listens to them and does what they say, it works.
They just help the patient discover for himself what he does that causes the pain, and it helps him discover alternative ways of doing the same thing, without pain.
No mumbo-jumbo or mysticism.
After one figures out the how and why of his pain, and the alternatives, it all seems so obvious.

Just do a search on Feldenkrais.
Almost any community with more than four physical therapists will have a Feldenkrais practitioner.

I have a herniated disk and it got so bad 4 years ago that I could barely walk. Each step was excruciating with sharp pains radiating down my left leg to my foot. I quit riding for a couple of months because it hurt to move my leg. To this day, I still can't ride my mountain bike even on smooth paved streets.

Now I have a back pillow strapped to the seat of my recumbent and commute every day. Riding the bent doesn't help or hurt my back but at least I am able to ride any time I want. If you do not have a bent you should try a couple of them. If it hurts -- stop. If not, keep going.

I'm 53; degenerative discs have been my biggest health issue for the last 8 years. I'll second the recumbent bike suggestion. I cannot find a sitting up position that will work for me for any length of time, even on a bar stool, but 80 to 90 miles a week on my recumbent bike doesn't hurt my back at all.

One thing I have learned to guard against while riding: when you are really pushing it on the bike, there is a tendency to tense up all over, even the muscles you aren't using, including back muscles. If I let myself do that for any length of time, my back will hurt. These days, whenever I'm riding hard, I make sure to do all the work with my legs, and keep my back relaxed.

While the recumbent bike doesn't seem to hurt my back, it doesn't help it, either. One thing I have found that does seem to help is exercising and stretching with a video from the University of Michigan Health System called Health Abs and Back. You can get it online for just $11, including shipping, at: http://www.med.umich.edu/pmr/spine/video.htm. I do the exercises after every ride (four days a week).

I have herniation in L4/L5 and L5/S1 that I've been dealing with for 25 yrs. (current age 51) I had to quit running (no more marathons) and am always on the hairy edge of major episodes but have discovered I can ride (and really crank) all day long with no back problems at all (lucky in this regard).

I've tried everything and am convinced the best thing after an "episode" is to keep moving. The very worst problems for me have always occured when I try to rest and immobilize for any period of time at all. The longer I immobilized, the worse it got. And a couple of those were really bad (weeks of horrendous pain that made me wonder if life was worth it). Now I ignore all episodes and continue with normal movement as much as possible (no back stress but plenty of walking). The difference has been miraculous. I stay very active and still play golf (but don't carry anymore).

Dbq wrote:

"...plenty of walking..."

That has worked for me, and my therapists have said the same thing.
However, with really bad spasms, the kind where my family had to call an ambulance, walking did not present itself as an option.
The same with ruptured disks.

The bulged disks, the ruptured disks, and the back spasms represent symptoms and not a cause.
Stop fixing the symptoms: find out what causes these symptoms and do something different.

Dbq went on to write:

"...weeks of horrendous pain that made me wonder if life was worth it..."

I've heard that from other people and thought it myself.

what ever you do , don't stop ridding. I happen to believe that you will recover. I am not a doctor, nor have I had this problem. But, maybe you should consult a sports doctor like you said.

What helped my back problem the most was walking a lot and sleeping on the floor. Warning: Sleeping on the floor may be hazardous to your marriage.

I've had back probelms in the past as well. Completely blew a disk out. Surgery not an option. I was put on a regimin of back exercises and was told to walk as much as possible and cycle on smooth roads. Wasn't allowed to be anywhere near my horse for about a year. After a year I was cleared for light trail riding. I was told the regenrative process takes about 5 years total. Now well beyond that 5 years I can cycle, ride my horse, and do a number of other things, BUT if I hit a bump on my road bike I still get that "twinge" that tells me there was pressure on some nerves. This spring I switched to a recumbent. Best move I ever made. Now nothing hurts, not even my back. Even hitting a pot hole does not bother my back in any way. I think there is a lot to be said for recumbents.

'bent Brian

Bud Baker wrote "While the recumbent bike doesn't seem to hurt my back, it doesn't help it, either."
That is very good news.
Hey Bud, I live just up the road in Euless Bud and just had a rebent built for me by AD Carson.
I'm 57 with the usual lower bike pain that I have to deal with also and miss my riding. I have MTB sitting in front of me right now with clean tires, so that tells you I don't ride it much.
I recently joined a local Ft.Worth bike club (FWBA)because they have lots of rides and maps and I hope to put lots of miles on the recumbent as soon as it gets delivered in a week or so.
If you ride during the week or weekend maybe you and I can join forces some times, I want to take on the Ray Roberts area the group rides on the weekends and later on if that works out the MS150, we'll see
So Folks abandon those wedgies if they are stooping you from getting out anymore, recumbents can be had for under $500 now days because of bikesmiths in garages and small shops getting their products out on the market for us. It's a great time to live.

jman

Just curious - is this related to the "Alexander Technique" - it sounds similar.

Tried you suggestion, and my wife didn't seem to mind a bit.....

jman,
It was me who replied to you when you posted in the FWBA email list. Glad to hear you'll have your bike soon. I ride 4 times a week, and would love company on any of them. I do 3 weekday afternoon rides, and a longer weekend ride.

When I'm not fishing a bass tourney, the weekend ride is the FWBA ride at Joe Pool Lake out of Lynn Creek Marina. This is a slow pace ride that invites beginners, and it's a great group of folks. The pace is a bit slow for me, but there's always 2 or 3 faster riders who take off from the front of the group, so I usually join them. There are lots of stops and conversation. Lunch after the ride at the Oasis with this group is always fun, too, a real education for a newbie like me. I only live 5 miles from there, so I ride my bike from home to put in a few extra miles.

Two of my weekday rides are easy pace rides that I start from home, and cover some of the same roads. As often as not, these rides are with my wife on our EZ Tandem. The other weekday ride, I'm not very good company; I make two trips across the Joe Pool dam, and the only time my heart rate drops below 160 is when I stop to turn around. I do this ride away from traffic so I can concentrate on pushing myself, rather than watching traffic. All three of the weekday rides are just 17 miles or so, although I plan on making them longer once daylight savings time shows up (I don't get home until 4:00 pm, and riding in the dark in winter just doesn't sound that appealing to me). I haven't tried doing the rides the same day every week, considering the unpredictable weather, and short sunlight hours this time of year. I may change that too after the longer days arrive.

I remembered you were building a bike; I didn't realize adc was doing the building. He seems like a very knowledgeable source on the BROL forum (does he post here too?), and I just discovered (re-discovered?) his site this week. Drop me an email, and do your best to at least make one of those Saturday rides. I know you'll enjoy that one.

Oops... I'm guilty of rambling on, and hijacking another thread. Sue me. :)