Cycling with a long term back/hip issue
Discussion
Evening All
Wasn’t sure whether to post this in here or Health Matters, but as it is now ultimately stopping me from cycling thought it was more relevant in here.
Throughout my life (38 now) I've always ridden road bikes, early 2011 I started to get pain in my lower back and left hip. Roll on to 2014 I had a hip arthroscopy and a repair to the labrum.
Ever since then and throughout all my physio I kept complaining of tightness/pain in my lower left back and had ongoing physio. By 2015 I managed to ramp up the miles on the bike back to 100+ miles a week though I was in some discomfort.
It was recommended to me that I saw a chiropractor, I know they can get a bad rep, but they seemed ok. They advised I should give up riding my bike, which went against everything everyone else had said to me. As the pain was getting worse, I was starting to get desperate so I took their advice and stopped riding the bike.
This is where my problems really started, and I ‘ve never been able to get back to the point I was at before with my cycling, due to the discomfort and inability to go through that pain barrier.
Since then I’ve seen countless specialists. I’ve had MRI scans that have revealed an L5S1 with annular tear, though apparently this isn’t bad enough to need operating on. I’ve had nerve blockers, been prescribed gabapentin etc.
At this point I’m seeing an NHS pain clinic that was recommended to me rather than going the private route through my private medical insurance. My first appointment was in April, since then I’ve had one appointment where they injected my iliolumbar ligament, though this made no improvement.
However, what I’ve realized is now I’m in the most pain I’ve ever been in, and I’m the most sedentary I’ve ever been. I’m able to accept that I might never be pain free again, but there must be alternatives/better coping mechanisms out there that I can use to help deal with it.
Has anyone been in a similar situation? Or do you know of anyone that might be able to help get me back on my bike again?
Wasn’t sure whether to post this in here or Health Matters, but as it is now ultimately stopping me from cycling thought it was more relevant in here.
Throughout my life (38 now) I've always ridden road bikes, early 2011 I started to get pain in my lower back and left hip. Roll on to 2014 I had a hip arthroscopy and a repair to the labrum.
Ever since then and throughout all my physio I kept complaining of tightness/pain in my lower left back and had ongoing physio. By 2015 I managed to ramp up the miles on the bike back to 100+ miles a week though I was in some discomfort.
It was recommended to me that I saw a chiropractor, I know they can get a bad rep, but they seemed ok. They advised I should give up riding my bike, which went against everything everyone else had said to me. As the pain was getting worse, I was starting to get desperate so I took their advice and stopped riding the bike.
This is where my problems really started, and I ‘ve never been able to get back to the point I was at before with my cycling, due to the discomfort and inability to go through that pain barrier.
Since then I’ve seen countless specialists. I’ve had MRI scans that have revealed an L5S1 with annular tear, though apparently this isn’t bad enough to need operating on. I’ve had nerve blockers, been prescribed gabapentin etc.
At this point I’m seeing an NHS pain clinic that was recommended to me rather than going the private route through my private medical insurance. My first appointment was in April, since then I’ve had one appointment where they injected my iliolumbar ligament, though this made no improvement.
However, what I’ve realized is now I’m in the most pain I’ve ever been in, and I’m the most sedentary I’ve ever been. I’m able to accept that I might never be pain free again, but there must be alternatives/better coping mechanisms out there that I can use to help deal with it.
Has anyone been in a similar situation? Or do you know of anyone that might be able to help get me back on my bike again?
I too have had ongoing back pain for a number of years, but mine is mainly sciatic nerve based and goes down my legs. The days when I don't exercise were the days when it would play up the most and keeping mobile is the only thing which keeps it at bay.
I've recently started riding a road bike and find this helps me massively so I can see your reluctance to give it up.
It has taken me years to find someone who actually knows what they're talking about when it comes to back pain and i'm currently seeing an Osteopath and have honestly never felt better in terms of my back. He has explained how my having tight hamstrings and glutes is causing a pulling on my lower back muscles which sends them into spasm. He "adjusts" me once every few weeks and performs acupuncture and that's been working well for me.
Worth a shout looking round for someone good if you can.
I've recently started riding a road bike and find this helps me massively so I can see your reluctance to give it up.
It has taken me years to find someone who actually knows what they're talking about when it comes to back pain and i'm currently seeing an Osteopath and have honestly never felt better in terms of my back. He has explained how my having tight hamstrings and glutes is causing a pulling on my lower back muscles which sends them into spasm. He "adjusts" me once every few weeks and performs acupuncture and that's been working well for me.
Worth a shout looking round for someone good if you can.
Get back on the bike!
Actually, you might need to think in terms of an exercise bike to start with, so that you're not in too much of a forward position.
Use the bike for exercise as opposed to training. The great thing about cycling (static and actual) is that it allows you to exercise without impact or fear of over extension or over flex of any joint.
Regular exercise will rebuild your general level of fitness which will improve your overall condition. You will be able to control the effort(pain!) to keep within limits. Just the regular movement of the joints around your lower back will improve flexibility.
I had severe sciatica a few years ago - gabapentin had made me like a zombie, and I had got to the non-exercise/ can't exercise state. However, I remembered the exercise bike and made myself get on it. I built up slowly and was eventually ( a few weeks!) able to build up a sweat (I made sure that I took pain killers 20 mins before exercise).
I have now got to the stage where I ride out regularly. At 70 I'm now at the stage where I dare not stop.
Actually, you might need to think in terms of an exercise bike to start with, so that you're not in too much of a forward position.
Use the bike for exercise as opposed to training. The great thing about cycling (static and actual) is that it allows you to exercise without impact or fear of over extension or over flex of any joint.
Regular exercise will rebuild your general level of fitness which will improve your overall condition. You will be able to control the effort(pain!) to keep within limits. Just the regular movement of the joints around your lower back will improve flexibility.
I had severe sciatica a few years ago - gabapentin had made me like a zombie, and I had got to the non-exercise/ can't exercise state. However, I remembered the exercise bike and made myself get on it. I built up slowly and was eventually ( a few weeks!) able to build up a sweat (I made sure that I took pain killers 20 mins before exercise).
I have now got to the stage where I ride out regularly. At 70 I'm now at the stage where I dare not stop.
Thank you for the replies!
Yes I have had a (Retul) bike fit, that was after my surgery and back in 2014. I no longer have that bike anymore, but the new one was has been tailored to the same measurements. I have thought about getting another bike fit, but as I've still not got a proper diagnosis it is quite difficult. All i know is that the pain is on one side and quite acute in one area.
I did actually skim read this earlier and it gave me the urge to go get on my bike, I went out and did a leisurely 20 mile ride. 100% feel better for getting out on it, but still in a lot of discomfort from that area.
With regards to pilates, I do some stretching everyday though I probably need to up this a little and target them to the specific area. I'll take a look at some videos.
I do think that is good advice about an exercise bike, however I'm on a Roubaix at the mo and I don't use the drops so it is pretty relaxed/upright. I don't feel it is the bending that is giving me the issue, it seems to be the action of pedalling.
Yes I have had a (Retul) bike fit, that was after my surgery and back in 2014. I no longer have that bike anymore, but the new one was has been tailored to the same measurements. I have thought about getting another bike fit, but as I've still not got a proper diagnosis it is quite difficult. All i know is that the pain is on one side and quite acute in one area.
I did actually skim read this earlier and it gave me the urge to go get on my bike, I went out and did a leisurely 20 mile ride. 100% feel better for getting out on it, but still in a lot of discomfort from that area.
With regards to pilates, I do some stretching everyday though I probably need to up this a little and target them to the specific area. I'll take a look at some videos.
I do think that is good advice about an exercise bike, however I'm on a Roubaix at the mo and I don't use the drops so it is pretty relaxed/upright. I don't feel it is the bending that is giving me the issue, it seems to be the action of pedalling.
Where are you based? If in / around London, I was always more of a runner than a cyclist but after I broke my back in 2015 i really couldn't run any more and ended up going to performance pro on great titchfield street for both physio (initially) and then mobilisation / strength training / personal training. That, combined with an endurance bike and a bike fit and I'm pretty good. I find anything more than about 3 1/2 - 4 hours tough, and I am not the quickest, but am out and riding. Anthony Purcell - one of the directors there, is a keen cyclist and worth talking to. Its not cheap but it is worth it.
I have long term back issues (had a fusion at L4/5 but continue to have life long pain and problems) and I find being sedentary causes me the most pain of all. As long as I keep moving and doing stuff it isn't too bad. Of course I have to be selective about what I do! I was MTB and road riding until last September for a few years, but started to cause me pain. Been working with my physio on identifying the cause - not there yet, but hoping to get back riding properly again for next year.
From my own experience, it's a case of identifying what does and doesn't cause the pain; if you can find a bike knowledgeable physio to work with, you might be able to tweak the bike to work for you - at least for some sort of riding. For me I have to have a relatively upright position on both bikes because too long and low and it causes me pain, numb legs, and all sorts of issues. But generally the advice with back problems is to keep mobile - don't do what is so tempting, which is to rest it, because generally I think that can make the pain worse.
What does the consultant (rather than the chiro) say?
PS - I also get the pain on one side and everything locks up. Possibly to do with some muscle weakness which is causing too much rotation of my hips when I pedal and putting other bits of me under stress. It's all complex and highlights how interconnected our bodies are! One small weird thing can cause so much pain somewhere else !
From my own experience, it's a case of identifying what does and doesn't cause the pain; if you can find a bike knowledgeable physio to work with, you might be able to tweak the bike to work for you - at least for some sort of riding. For me I have to have a relatively upright position on both bikes because too long and low and it causes me pain, numb legs, and all sorts of issues. But generally the advice with back problems is to keep mobile - don't do what is so tempting, which is to rest it, because generally I think that can make the pain worse.
What does the consultant (rather than the chiro) say?
PS - I also get the pain on one side and everything locks up. Possibly to do with some muscle weakness which is causing too much rotation of my hips when I pedal and putting other bits of me under stress. It's all complex and highlights how interconnected our bodies are! One small weird thing can cause so much pain somewhere else !
Just a couple of things:
1) Chiropractic is not mainstream medicine: https://en.wikipedia.org/wiki/Chiropractic. I wouldn't make a big lifestyle change on the advice of a chiropractor. In their defence, manipulation has been proven to help spinal pain in some cases, and yes, they do train for several years to do it (although it is not an evidence based medical degree). However, I would only take the word of a qualified doctor, and even then, compare it with your own personal experiences.
2) I have long standing back problems going back to my late teens (I'm 40 now). Over the years, like you I've found that the more I keep active, the less pain I get from my back. This applies to virtually any sport or activity that I do, other than the ones that give me instant back pain or are known for back problems, such as rowing with a less than perfect technique, swimming breaststroke or dead-lifting weights etc, all of which I avoid. My back pain is of the degree where if I do no activities and sports, within weeks I can barely stand for more than a few minutes and am in permanent pain. However, now that I've had a couple of operations to help with the pain if I keep very active then I am virtually normal, with only mild pain. One thing I would say with cycling is to alternate between handlebar positions regularly - this is best with drop handlebars, where you have three positions to choose from. Another thing worth pointing out is that some activities and sports are really good for your back. Everyone's back is different, but for me, swimming front crawl and SUP are best for my back, and if I do an hour or two a week of either the benefits are very noticeable. You may also find certain exercises are good for your back, although personally I've found that given a spare hour, I'm better off swimming or SUPing than doing Yoga, pilates etc. Everyone's different though - experiment!
1) Chiropractic is not mainstream medicine: https://en.wikipedia.org/wiki/Chiropractic. I wouldn't make a big lifestyle change on the advice of a chiropractor. In their defence, manipulation has been proven to help spinal pain in some cases, and yes, they do train for several years to do it (although it is not an evidence based medical degree). However, I would only take the word of a qualified doctor, and even then, compare it with your own personal experiences.
2) I have long standing back problems going back to my late teens (I'm 40 now). Over the years, like you I've found that the more I keep active, the less pain I get from my back. This applies to virtually any sport or activity that I do, other than the ones that give me instant back pain or are known for back problems, such as rowing with a less than perfect technique, swimming breaststroke or dead-lifting weights etc, all of which I avoid. My back pain is of the degree where if I do no activities and sports, within weeks I can barely stand for more than a few minutes and am in permanent pain. However, now that I've had a couple of operations to help with the pain if I keep very active then I am virtually normal, with only mild pain. One thing I would say with cycling is to alternate between handlebar positions regularly - this is best with drop handlebars, where you have three positions to choose from. Another thing worth pointing out is that some activities and sports are really good for your back. Everyone's back is different, but for me, swimming front crawl and SUP are best for my back, and if I do an hour or two a week of either the benefits are very noticeable. You may also find certain exercises are good for your back, although personally I've found that given a spare hour, I'm better off swimming or SUPing than doing Yoga, pilates etc. Everyone's different though - experiment!
Edited by RobM77 on Wednesday 30th August 10:04
Thanks everyone for their input really helpful!
For me the most frustrating part about this whole thing is, having the original operation, recovering and getting my fitness to a higher level than it has ever been. Then being told to stop by someone (which was clearly the wrong advice) and never being able to get to anywhere near that level again.
I just think I need to be a bit more determined and try and get through that barrier.
Cheers for all advice, it is very motivating!!
williaa68 said:
Where are you based?
I'm in Oxford so getting to London to see someone isn't that much of an issue. I shall look these guys up.Usget said:
If it's the specific pedalling action which is hurting, is it worth trying a recumbent? Might be no better but it's a very different riding position and your back is more supported.
I don't actually think it is pedalling that brings it on, it is just being in the same position for a long period of time. The biggest issue is sitting at work, but I've resolved this as I've handed in my notice (there were other reasons too) with the aim of looking for a job that is a lot more varied.dreamer75 said:
From my own experience, it's a case of identifying what does and doesn't cause the pain; if you can find a bike knowledgeable physio to work with, you might be able to tweak the bike to work for you - at least for some sort of riding. For me I have to have a relatively upright position on both bikes because too long and low and it causes me pain, numb legs, and all sorts of issues. But generally the advice with back problems is to keep mobile - don't do what is so tempting, which is to rest it, because generally I think that can make the pain worse.
What does the consultant (rather than the chiro) say?
So what I know so far from 2 MRI scans is that I have a herniated disc with an annular tear at L5 S1, but not bad enough for surgery. The latest from the pain clinic was that they thought I had an Iliolumbar ligament issue, this was injected 2 months ago and made no difference. Awaiting my next appointment with them on October.What does the consultant (rather than the chiro) say?
RobM77 said:
2) I have long standing back problems going back to my late teens (I'm 40 now). Over the years, like you I've found that the more I keep active, the less pain I get from my back. This applies to virtually any sport or activity that I do, other than the ones that give me instant back pain or are known for back problems, such as rowing with a less than perfect technique, swimming breaststroke or dead-lifting weights etc, all of which I avoid. My back pain is of the degree where if I do no activities and sports, within weeks I can barely stand for more than a few minutes and am in permanent pain. However, now that I've had a couple of operations to help with the pain if I keep very active then I am virtually normal, with only mild pain. One thing I would say with cycling is to alternate between handlebar positions regularly - this is best with drop handlebars, where you have three positions to choose from. Another thing worth pointing out is that some activities and sports are really good for your back. Everyone's back is different, but for me, swimming front crawl and SUP are best for my back, and if I do an hour or two a week of either the benefits are very noticeable. You may also find certain exercises are good for your back, although personally I've found that given a spare hour, I'm better off swimming or SUPing than doing Yoga, pilates etc. Everyone's different though - experiment!
Yeah I totally agree, everyone is different. At the moment I see someone for Pilates, and I do exercises everyday. These do help a bit but I think my own exercise plan that I had before worked better, so might revert to that.Edited by RobM77 on Wednesday 30th August 10:04
anonymous said:
[redacted]
I remember reading about your issues, glad you are making good progress now. Seems to me that everyone is saying the same thing - need to get moving again.For me the most frustrating part about this whole thing is, having the original operation, recovering and getting my fitness to a higher level than it has ever been. Then being told to stop by someone (which was clearly the wrong advice) and never being able to get to anywhere near that level again.
I just think I need to be a bit more determined and try and get through that barrier.
Cheers for all advice, it is very motivating!!
anonymous said:
[redacted]
Whilst quite a lot of your post is quite valid, and covers much of the basics, this statement though is b
ks. The body is an amazing thing, although it's also not a miracle worker. The requirement for surgery is dependant on the condition, in your case, essentially a minor prolapse of the disc. Whilst debilitating and highly annoying, they stopped surgery for these as much as they could 25 years ago, as you've mentioned they settle down over time.To provide some context, I started having back issues at 15, 3 years of misery, temporary bouts of paralysis and more drugs than you'll find in an inner city, it was finally diagnosed at the National Orthopaedic centre. I have 6 lumber, with one disc fully missing, one partial - at 18 I had L4-L6 fused. Post op, I had no issues from this procedure, except due to my metabolism at the time, it took 12 months to fuse, rather than 6. This made it very strong.
I went back to spending copious hours in a swimming pool, cycling, gym etc. At 21 I prolapsed L6/S1, at this point I gave up swimming. A lot of pain is the result of inflammation, it often occurs days after (as you mentioned) by bending awkwardly to empty the dishwasher - mine was always cleaning the wheels on the car!
I'm now 46, and have managed this since then. Mainly good days, a few bad - that's when the drugs get you through. Work with your body not against it. I'll agree to disagree on the posture part, as that is also dependant on the individual, and can vary day by day.
In all of these types of conditions, the important thing is to have a strong core, not to just focus on the front. If you need the drugs to get you up to do it, so be it, they're just an enabler to get you well again. As I type this, I cannot remember having to take any this year, so far, so good.
I think you know when surgery's needed - I've had two and it's transformed my life for the better. Almost house bound, to biking, skiing, flying and all sorts. I have the rumblings of a new issue (previously L4/5, now possibly another level) and I'd have the surgery earlier than later this time, to avoid the accompanying issues which were caused by me delaying for so long.
Having said that, there are risks with surgery and it's a not a decision to take lightly, as you say it can make things worse not better.
Having said that, there are risks with surgery and it's a not a decision to take lightly, as you say it can make things worse not better.
anonymous said:
[redacted]
There's probably no way of knowing. I've had back problems since my teens, but I didn't take up road cycling until I was 30, and I found out that cycling actually helped my back. It probably depends what inherent geometry your back has when not on the bike; for me bending forward on a road bike pulls my spine back into shape! I do tend to stick to 1-2 hour rides though; over 2 hours is very rare for me. The only real ache I get on my road bike is from my neck and shoulders on long rides.As Rob said. The only thing I've learnt about backs & bikes, is that the long low stretched out usual road position puts a lot of strain on the lower back. I can feel it within minutes so have a shorter and more upright position on both bikes. But who knows! Backs are some sort of mysterious enigma!
After 2 spinal steroid injections, 2 discectomies and a stripping of the scar tissue from the sciatic nerve; I have some history in this space - and a lot of pain memories. Although a lot of those are hazy from the drugs and the wine self medication.
I find keeping my core muscles helps a lot, also ensuring that my back muscles are well stretched and used as well as my stomach. It helps avoid them going in to spasm.
My weight has drifted up and needs addressing as that is clearly a causal issue for straining in unexpected ways.
I love cycling (commuted in Edinburgh and Milan by bike) but these days it is touring pedalling rather than competitive pace. It does massively help both my mental and physical well being.
Sorry for the waffle and hope you get yourself fixed up; it can be utterly soul destroying.
I find keeping my core muscles helps a lot, also ensuring that my back muscles are well stretched and used as well as my stomach. It helps avoid them going in to spasm.
My weight has drifted up and needs addressing as that is clearly a causal issue for straining in unexpected ways.
I love cycling (commuted in Edinburgh and Milan by bike) but these days it is touring pedalling rather than competitive pace. It does massively help both my mental and physical well being.
Sorry for the waffle and hope you get yourself fixed up; it can be utterly soul destroying.
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