Practical Pain Management
#1
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Practical Pain Management
I've had a good winter and my fitness is the best in my short 8 years of cycling. The usual back issues have lessened as a result of working on the core, and improved strength has helped with others. The 30 pounds I've shed in the last 5 months has me feeling my best in several years. I do a host of stretches prescribed by my son the PT Doctor, to work on some trouble spots. But as the rides get longer, and I get older (age 60) pain becomes a constant companion. Back, neck, joints. No way around it, I need to managed my pain more effectively. What has worked, or not worked for you?
#2
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Started riding again in my mid-50s after being away from cycling for decades. I picked up a DF/Windsor Tourist and set it up way too heavy (carried too much "just for emergencies" stuff, a hold-over from riding in the late-70s).
The things that eventually did away with most of my back-related discomfort (after major injury and just getting older):
#1 - Switching to a recumbent. First I went with a trike, then a different trike, then a long-wheel-base recumbent (Easy Racer Gold Rush which uses an upright sitting position), finally got a short-wheel-base recumbent (Bacchetta Corsa which has a reclined seat where I lay back at between a 25% and 28% recline). My cycling evolution from DF to 3-wheeler-to-2-wheel-fast-recumbent illustrates moving from enduring & then just barely managing back pain to actually riding comfortably at tempo to doing long(er)-distance randonneuring than I'd ever expected to be able to handle. (When I first came back to cycling, I could barely handle 2 miles/ride even at a snail's pace. I've since ridden multiple 600km rides in under "official credit" times, not merely survived them.)
#2 - Learning to "spin" when pedaling rather than grind. Part of this is merely improving my pedaling technique but a large part is actually learning how & when to use my gears and shifting efficiently and appropriately with respect to the terrain. (I shift a LOT more now than 8 years ago despite my cadence being 20-25rpm faster.)
#3 - Deciding that stopping to stretch at the first sign of tightening up is NOT a bad thing. Rather, being able to finish long-distance rides comfortably, with to-be-expected amounts of muscle tiredness, not discomfort, is more important than making time/riding harder than my body can handle. Sometimes just getting off the bike and walking around for 30 secs is "stretching" for me; other times, more traditional stretches work better. I go with the flow.
FWIW, I'm now in my early 60s.
YMMV
The things that eventually did away with most of my back-related discomfort (after major injury and just getting older):
#1 - Switching to a recumbent. First I went with a trike, then a different trike, then a long-wheel-base recumbent (Easy Racer Gold Rush which uses an upright sitting position), finally got a short-wheel-base recumbent (Bacchetta Corsa which has a reclined seat where I lay back at between a 25% and 28% recline). My cycling evolution from DF to 3-wheeler-to-2-wheel-fast-recumbent illustrates moving from enduring & then just barely managing back pain to actually riding comfortably at tempo to doing long(er)-distance randonneuring than I'd ever expected to be able to handle. (When I first came back to cycling, I could barely handle 2 miles/ride even at a snail's pace. I've since ridden multiple 600km rides in under "official credit" times, not merely survived them.)
#2 - Learning to "spin" when pedaling rather than grind. Part of this is merely improving my pedaling technique but a large part is actually learning how & when to use my gears and shifting efficiently and appropriately with respect to the terrain. (I shift a LOT more now than 8 years ago despite my cadence being 20-25rpm faster.)
#3 - Deciding that stopping to stretch at the first sign of tightening up is NOT a bad thing. Rather, being able to finish long-distance rides comfortably, with to-be-expected amounts of muscle tiredness, not discomfort, is more important than making time/riding harder than my body can handle. Sometimes just getting off the bike and walking around for 30 secs is "stretching" for me; other times, more traditional stretches work better. I go with the flow.
FWIW, I'm now in my early 60s.
YMMV
Last edited by dual650c; 04-12-18 at 07:07 AM.
#3
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Gym work year 'round and stretches. Realizing that pain and then recovery from pain is part of getting stronger and more pain-free. Position. Relaxing on the bike. But I'd say the more important thing has been weight work in the gym, including dumbbells, cable work, squats, and back work. One hour twice a week all year except during summer, then only once a week. Also see: Riding Position Discovery
In my early 70s.
In my early 70s.
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#4
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As mentioned above, spinning more and less pushing big gears.
Constant attention to posture while riding. It's easy to drop your head/neck forward, or lift your head too high. Also, not hunching over or hunching up the shoulders (which often happens when dropping the head & neck forward). If I get lazy with posture while riding I'll pay for it.
Frequent breaks on longer rides. Get off and move around a bit. Stretch, bend, twist.
Daily stretching upon getting out of bed to stay limber between rides.
Enjoying the ride and less worry about speed, etc.
Constant attention to posture while riding. It's easy to drop your head/neck forward, or lift your head too high. Also, not hunching over or hunching up the shoulders (which often happens when dropping the head & neck forward). If I get lazy with posture while riding I'll pay for it.
Frequent breaks on longer rides. Get off and move around a bit. Stretch, bend, twist.
Daily stretching upon getting out of bed to stay limber between rides.
Enjoying the ride and less worry about speed, etc.
#5
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Just doing pushups helps me a lot. One thing that has helped me is shoulder rolls. You can do that on the bike, I suggest doing it one shoulder at a time so you don't crash.
https://www.pinkbike.com/u/yoga15app...shoulders.html
https://www.pinkbike.com/u/yoga15app...shoulders.html
#6
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This (last) weekend was the PA randonneurs flèche, and most of the teams rode from Saturday morning to Sunday morning. Saturday was clear; some high clouds set in early in the evening but cleared by morning. The moon set a bit after midnight.
All this made pretty perfect conditions for watching a meteor shower and, luckily, there was a meteor shower peaking right about then. So as we rode through the night, I kept my head up, looking this way and that as i watched the sky as much as I could without endangering myself, then looking back at the road, repeat. Repeat...
Result: I never got a sore neck at all.
I saw two meteors. But otherwise this strategy was a success.
All this made pretty perfect conditions for watching a meteor shower and, luckily, there was a meteor shower peaking right about then. So as we rode through the night, I kept my head up, looking this way and that as i watched the sky as much as I could without endangering myself, then looking back at the road, repeat. Repeat...
Result: I never got a sore neck at all.
I saw two meteors. But otherwise this strategy was a success.
#7
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Vitamin I
(Ibuprofen.)
(Ibuprofen.)
#8
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#9
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I found it more effective than hillbilly heroin after breaking my ankle.
However, it is worth noting it can cause kidney damage and even heart problems, so care, restraint and moderation are advised.
However, it is worth noting it can cause kidney damage and even heart problems, so care, restraint and moderation are advised.
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Stretching on the bike, varying positions constantly, and intelligently timed rest breaks help a lot. As does maximizing sleep as much as possible around events. During very long rides I much prefer a shot of whiskey or a cold beer over anything else. One or two over the last few hours of a long ride really seems to take the edge off. I don't otherwise partake but something about a little nip during a rest break makes getting back on and peddling into the night so much easier.
#11
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I bring 4, 5, and 6mm allen wrenches with me in case my body tells me that a cleat, saddle, or stem isn't quite in the right place. Sometimes you don't realize that until you're out on a really long ride.
#12
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I tend to have a strategy of discomfort management rather than pain management. I think long distance riding revolves around the ability to prevent small discomforts from becoming large or leading to actual pain. Hands, butts, shoulders, feet, knees... I try to pay attention to small signals and fix them before they become larger.
Sometimes I feel like Data from ST Next Generation running continuos diagnostic checks on various systems while riding.
Once the unchecked discomfort becomes pain often the only treatment is rest. And Ibuprofen
Sometimes I feel like Data from ST Next Generation running continuos diagnostic checks on various systems while riding.
Once the unchecked discomfort becomes pain often the only treatment is rest. And Ibuprofen
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I'm going by memory, but I think ibuprofen during exercise increases the heart risk, so please double-check this. It might be more beneficial after (or maybe before). Having said this, my wife finds it gives tremendous relief if she takes it just prior to the ride (for an arthritic hip).
#15
Junior Member
I have found that 600 or 800 mg ibuprofen and 750 acetaminophen is effective up to a 7 or 8, respectively, out of 10 on my pain scale. I have found that taking the pain medication proactively before the pain begins is more effective than reactively after it has started. YMMV
I would also suggest BioFreeze(or something like it with Menthol) before you ride, and then reapply after 5-6 hours. Menthol has the benefit of zero side effects, apart from the false temperature change sensation it produces.
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I used to believe in just toughing out post ride joint pain but working with people who have Arthritis has caused me to rethink allowing my knees (in particular) to go through repetitive unchecked inflammation cycles. If they feel like they are unusually sore or stiff at the end of a long day, particularly on multi day rides, I just pop some Advil. My medicine kit basically just contains Advil and Tylenol (non codeine) for headaches.
#17
~>~
An ounce of prevention as they say:
From season to season a review of bike fitting and LD kit, enough seat time for re-adaption to the machine and weekly power work in the hills and HIIT intervals for speed can mitigate discomfort on the longest rides preemptively by being fit, well-fitted out and capable of getting up and over and done w/o undue stress.
Re-wrapping bars, replacing shoes/cleats before they are sloppy worn and testing those and any new kit thoroughly on endurance rides can eliminate those unpleasant surprises of a seam that's in just the wrong place after hour three or contortions using a jersey with hard to reach pockets.
-Bandera
From season to season a review of bike fitting and LD kit, enough seat time for re-adaption to the machine and weekly power work in the hills and HIIT intervals for speed can mitigate discomfort on the longest rides preemptively by being fit, well-fitted out and capable of getting up and over and done w/o undue stress.
Re-wrapping bars, replacing shoes/cleats before they are sloppy worn and testing those and any new kit thoroughly on endurance rides can eliminate those unpleasant surprises of a seam that's in just the wrong place after hour three or contortions using a jersey with hard to reach pockets.
-Bandera
Last edited by Bandera; 04-25-18 at 02:35 PM.
#18
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Thread Starter
An ounce of prevention as they say:
From season to season a review of bike fitting and LD kit, enough seat time for re-adaption to the machine and weekly power work in the hills and HIIT intervals for speed can mitigate discomfort on the longest rides preemptively by being fit, well-fitted out and capable of getting up and over and done w/o undue stress.
Re-wrapping bars, replacing shoes/cleats before they are sloppy worn and testing those and any new kit thoroughly on endurance rides can eliminate those unpleasant surprises of a seam that's in just the wrong place after hour three or contortions using a jersey with hard to reach pockets.
-Bandera
From season to season a review of bike fitting and LD kit, enough seat time for re-adaption to the machine and weekly power work in the hills and HIIT intervals for speed can mitigate discomfort on the longest rides preemptively by being fit, well-fitted out and capable of getting up and over and done w/o undue stress.
Re-wrapping bars, replacing shoes/cleats before they are sloppy worn and testing those and any new kit thoroughly on endurance rides can eliminate those unpleasant surprises of a seam that's in just the wrong place after hour three or contortions using a jersey with hard to reach pockets.
-Bandera
#19
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Thread Starter
So a little update here, as I've done a couple 300K rides since the first post. Including the first, where we experienced low temps, 75% headwinds and finished in sleet/snow. Veteran Randonneures called it the toughest 300k they experienced. Back problems have waned. Still there, but for now anyway, fading into the background. Ankle pain is taking it's place around mile 160 +/-. Expected in my compromised ankle (severe childhood injury and 3 surgeries in the past few years) but not in the good one. Blah, blah, but bottom line still working on the motor and to a lesser degree, the machine. And trying to dial in the proper pain medication regime to take the edge off. Like I stated earlier, on my last brevet, I took 600mg Ibuprofen six and 12 hours in. Thinking on my upcoming 400K to begin before the ride, like evening meal the day before, and continue through the ride day, while adding some Tylenol into the mix. All about lessening the inflammation I think. We will see how that goes.
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wind makes it tough. One thing to consider is training to increase your cadence. I know this is one issue I have always had, and spent a lot of time on the trainer this year working on it. But my average cadence slows down over the randonneuring season. Possibly belaboring this too much, I have a "smart" trainer, so as your cadence slows, the resistance increases. It's really good feedback for how much power depends on cadence. The slower you pedal, the more stress you put on joints.
#21
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Thread Starter
wind makes it tough. One thing to consider is training to increase your cadence. I know this is one issue I have always had, and spent a lot of time on the trainer this year working on it. But my average cadence slows down over the randonneuring season. Possibly belaboring this too much, I have a "smart" trainer, so as your cadence slows, the resistance increases. It's really good feedback for how much power depends on cadence. The slower you pedal, the more stress you put on joints.
#23
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I turned on my cadence meter for the first time in years and was shocked at how hard it was to maintain 90, let alone hit 100. Used to be easy.
#24
Senior Member
I got a professional bike fit after I bought and set up my second bike, which I had set up based on personal experience from riding my first bike. By then I had been riding centuries every month for a couple of years. The bike fit basically only confirmed what I had figured out by myself about what worked for me.
I've been around a lot of cyclists younger than me (I'm around 57) who frequently have issues with knee pain (which is also what stopped me from keeping up running), but on the bike that's never an issue for me. I think it's because I don't mash up steep hills, both my bikes have very low gears and I spin while seated. If a hill is too steep even for that I'll walk.
With regards to back pain, I got a sore back when I still wore a back pack on long rides instead of carrying stuff in saddle bags or front bags. These days I only really get back pain from working too much on the computer and bike rides actually help improve it!
My #1 pain issue is from sitting for too long, even with a Brooks saddle. If I make a conscious effort to stand up regularly throughout the ride, not just at the end when it's already painful to sit, then it becomes bearable.
I've been around a lot of cyclists younger than me (I'm around 57) who frequently have issues with knee pain (which is also what stopped me from keeping up running), but on the bike that's never an issue for me. I think it's because I don't mash up steep hills, both my bikes have very low gears and I spin while seated. If a hill is too steep even for that I'll walk.
With regards to back pain, I got a sore back when I still wore a back pack on long rides instead of carrying stuff in saddle bags or front bags. These days I only really get back pain from working too much on the computer and bike rides actually help improve it!
My #1 pain issue is from sitting for too long, even with a Brooks saddle. If I make a conscious effort to stand up regularly throughout the ride, not just at the end when it's already painful to sit, then it becomes bearable.
#25
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I don't want to get back into the habit of looking at the computer all the time, but occasionally using the cadence sensor still helps by reminding me I need to keep spinning.
A high cadence is easier at the beginning of a randonnee than at the end!
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