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Back pain counsel sought

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Old 05-20-18, 09:47 AM
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philbob57
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Back pain counsel sought

I've been riding since 2013, after a 12 year hiatus. I'm 73. Never fast, I just like riding, rode just over 1000 miles last year. I'm way overweight. I've done 11 rides this year, starting at 7 miles, 16 yesterday. That's a little more than I did last year.

I feel fine during the rides, but several hours after I get home, the lower 1/3-1/2 of my back hurts, from lower rib to lower rib across my back. I have a known L4-L5 disc problem, but this feels different. This is brand new this year for me.

Does this sound familiar to anyone? What did you do?

There's no need to tell me to see an orthopd ... if I don;t get something pretty specific from this query, I'll be making an appointment tomorrow or Tuesday.
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Old 05-20-18, 10:44 AM
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I'm a long time lower back sufferer. Over the years I've found tactics that alleviate the problem quite a bit. Those tactics involve stretching and exercises for back muscles. When the back begins to act up, there is a strong tendency for muscles to cramp or seize up which further throws the back out of alignment. If the stretching is done daily before the problem gets too far out of hand, those muscles will tend to loosen up. Exercise of the back muscles will strengthen them to help maintain alignment. Exercise also works for a troublesome knee that acts up now and then. To maintain the skeleton in the best possible alignment then, maintaining strength is crucial. I also see a chiropractor regularly to push things into place because discomfort sometimes gets beyond my own ministrations. Good luck.
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Old 05-20-18, 12:39 PM
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What type of bike do you ride? I have spinal stenosis (L4-L5) and my spine doc (who is a cyclist) said "good quality" road bikes are the best thing for my back. Leaning over the handlebars opens up the space between the discs and relieves the pressure. I have zero back pain after rides, long or short.
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Old 05-20-18, 01:16 PM
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72, also spinal stenosis, arthritic facets, thin discs. Best thing for my back is to work it until it hurts, rest it until it doesn't, repeat. Talk to your doc about what stuff you shouldn't do. I particularly like gym work: barbell squats, back machine, horizontal rows, lat pulls, that sort of thing. I ride a road bike with low bars, lots of reach, and keep my back straight on the bike by rolling my hips forward so that it's straight from the top of my shorts to my neck. I also stretch but find the strength work to be key.
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Old 05-20-18, 03:43 PM
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You may be too stretched out (and, possibly bending over too much)-- maybe try lowering the seat and bringing it forward about 1/2 cm at a time and see how that goes. Raising and bringing back the bars may help too.
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Old 05-20-18, 03:56 PM
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While some here might offer helpful information it's no substitute for a medical opinion.
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Old 05-20-18, 03:58 PM
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Thanks. I expect it's time for some professional physical therapy, for which I still need an MD's prescription here in IL. My last sciatic nerve episode was too long ago for me to remember the exercises I did. My wife has some back exercises from PT. Depending on how long I have to wait for an appointment, I may try some on my own.

My bike is a 1973 road bike with dropped bars, 12 cm Nitto Technomic (very tall) stem. I'll talk with my doc. I have a 7 or 8 cm Technomic, but it is a major PITA to change stems with quills.
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Old 05-20-18, 04:13 PM
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I have similar pains and the cause of mine is due to weak core\stomach muscles. I do not have any disc or vertebrae issues. I’m able to keep my pains away and under control using a combination of stretching like Berber describes but most importantly adding simple exercises that improve abdomen muscle strength. Sit-ups ang leg lifts help. But a simple action I’ve recently found that helps as much as anything is consciously sucking in my stomach muscles as far as I can every time I think about it. It’s interesting how a simple iso exercise like that helps me. I’ve been doing it a lot lately and so far so good.

When I get a back pain I cannot stand straight up but can do most anything somewhat bent over, like riding a bike. However I usually have to take a break from golf for about 7-10 days before I can swing pain free.

I pieced all all this together after consulting with an orthopedic physician, so I have sought professional advice. I wanted to make sure I didn’t have disc issues.
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Old 05-20-18, 09:04 PM
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Originally Posted by jppe View Post
I have similar pains and the cause of mine is due to weak core\stomach muscles. I do not have any disc or vertebrae issues. Iím able to keep my pains away and under control using a combination of stretching like Berber describes but most importantly adding simple exercises that improve abdomen muscle strength. Sit-ups ang leg lifts help. But a simple action Iíve recently found that helps as much as anything is consciously sucking in my stomach muscles as far as I can every time I think about it. Itís interesting how a simple iso exercise like that helps me. Iíve been doing it a lot lately and so far so good.

When I get a back pain I cannot stand straight up but can do most anything somewhat bent over, like riding a bike. However I usually have to take a break from golf for about 7-10 days before I can swing pain free.

I pieced all all this together after consulting with an orthopedic physician, so I have sought professional advice. I wanted to make sure I didnít have disc issues.
72 y.o. I know just how you feel. That is, how I used to feel until I got it fixed. I don't have a blown disc, only thin discs which compress the nerves exiting the spine, one vertebra with a compression fracture, lumbar stenosis, and arthritic facets (MRI). I think the fracture came from carrying an 8/4 X 12" X 12' green oak plank back when I thought I was a human crane.

My fix: For the first year, go through all the exercises in Tom Danielson's Core Advantage, doing one every day and devoting enough days for each of the graded exercises that it takes a year to get through them all. For the years since the Core Advantage year, I've done the following periodized strength training exercises in the order shown below. These PDFs are for both myself and my wife, and the dates at the top are for our cycling season, peaking in July. We do strength training twice a week for improvement, once a week for maintenance.

Clicking on the PDFs below will download them to your computer for viewing/printing with Adobe Reader or similar.
Gethin Fundamental Tuesday.pdf
Gethin Fundamental Thursday.pdf
Gethin Momentum Tuesday.pdf
Gethin Momentum Thursday.pdf
Norwegian Strength Training Prep Tuesday.pdf
Norwegian Strength Training Prep Thursday.pdf
Norwegian Strength Training Comp Thursday.pdf

The main thing is that this all worked marvelously well. I still get some back pain from long periods of bending over, but only off the bike, and the pain goes away within minutes of straightening up. I regularly do hard long distance rides, though only up to doubles now. Besides cycling, I backpack, run, and ski Alpine, cross-country, and backcountry, all with no back problems now.

For the rationale behind the Gethin exercises, see Body by Design. For the Norwegian exercises, see In season strength.pdf

Both books mentioned above are also available on Amazon.
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Old 05-20-18, 09:38 PM
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Maybe try stretching after your ride. That works for me.
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Old 05-21-18, 05:40 AM
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Originally Posted by RonH View Post
What type of bike do you ride? I have spinal stenosis (L4-L5) and my spine doc (who is a cyclist) said "good quality" road bikes are the best thing for my back. Leaning over the handlebars opens up the space between the discs and relieves the pressure. I have zero back pain after rides, long or short.
Many years ago, when I presented with sciatic nerve pain, my Chiropractor said the same thing. But, in my case we were talking about motorcycles. He said the leaned in position on a sport bike was the best thing.
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Old 05-21-18, 05:44 AM
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Recently, I started getting back into the gym. I am 72 yr. old and in pretty good shape. But, I couldn't do a sit-up thanks to the stiffness and pain in my lower back. It wasn't about my core, if we are talking about abs. I can do leg raises all day long. It was about the unused muscles in my lower back. I stated doing bridges along with leg raises. I also started doing squats. In a couple weeks all the aches went away. Not saying this is someone else's issue but something to try and it's easy.
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Old 05-23-18, 05:03 PM
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Originally Posted by philbob57 View Post
Thanks. I expect it's time for some professional physical therapy, for which I still need an MD's prescription here in IL. My last sciatic nerve episode was too long ago for me to remember the exercises I did. My wife has some back exercises from PT. Depending on how long I have to wait for an appointment, I may try some on my own.

My bike is a 1973 road bike with dropped bars, 12 cm Nitto Technomic (very tall) stem. I'll talk with my doc. I have a 7 or 8 cm Technomic, but it is a major PITA to change stems with quills.
I have one bike with a unique quill stem that doesn't require stripping the bar to install. It has a four bolt clamp over the top, which completely detaches. Unfortunately it's of limited use. It's a non-standard wider diameter stem, and has practically zero reach -- it's shaped like a fist, with perhaps 1/2" to 1" reach beyond the stem. It came with my Globe Carmel comfort hybrid. Makes it easy to swap handlebars though. I suppose the design would be considered too ungainly on a classic road bike.

Swapping to a shorter stem really helped on my road bike (an '89 Centurion Ironman, mostly stock). With the original long stem I was much too stretched out (almost 135mm end to end, 110mm c-t-c). I could just about manage up to 50 miles before neck and lower back pain stopped me. (Back and neck injuries from 2001, cracked six vertebrae, two in each major section of the spine, and splintered the C2 which took years to fuse naturally -- the C2 appears to be fused now, but is thickened and feels like it's grinding occasionally.)

A few weeks ago I switched to a shorter stem sent by a member on the C&V forum. I think it's around 80-90mm ctc. Huge difference. Not only more comfortable on my neck and lower back, but more efficient. Rather than forcing me to sit more upright and less aero, I could more comfortably bend my elbows to tuck and still feel balanced. Best of all, I could stand to sprint or climb short, steep hills and feel much more balanced and efficient.With the longer stem I was too far forward of the pedals -- it felt like I was forcing my feet backward, losing power and straining my lower back. With the shorter stem my legs felt better centered over the pedals, transferring my weight more efficiently without straining, and without lower back pain.

I was anxious to try the shorter stem immediately, so I stripped only the right side of the drop bar -- tape and brake -- and left the bar bare on the right side while I tested the bike. I also wanted to be sure of the bar angle and brake lever alignment before sealing it up with good bar tape. I even lowered the stem another 1/2" and it was still comfortable. It was so much better I just kept riding it with the bar unfinished for a week or so.

It was surprisingly comfortable with just thin padded gloves. The shorter stem was so much better balanced I had less weight on my hands, so I didn't really need the padded bar tape I'd purchased.

Unfortunately I got in only a few 20-30 mile rides before I was clobbered by a car while I was riding my hybrid. Broke my shoulder, so I'm off the bike for several weeks or months. But the shorter stem felt so much better I'm sure I could have managed 50 miles or a little more without discomfort.
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Old 05-25-18, 05:16 PM
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Thanks, all. I resurrected my old PT exercises and stretches, and I've ridden more. No back pain after my last 2 rides.
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Old 05-26-18, 04:18 PM
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Originally Posted by philbob57 View Post
Thanks, all. I resurrected my old PT exercises and stretches, and I've ridden more. No back pain after my last 2 rides.
Pretty much what I was going to recommend - make an appt with your PT and explain the problem. I've discovered that as I age, they are just about the most important medical support I need for day to day issues. A good PT is worth their weight in gold.
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Old 06-23-18, 11:31 AM
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Lots of good advice re seeing medical professionals. I just posted this reference on another thread. I personally think its a great resource for building core strength that contributes to overall good back health. https://www.amazon.com/Foundation-Re.../dp/1609611004
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