I’m just starting this thread to feel like I’m not the only one struggling (struggled) with back pain that’s getting in the way of training. I’m 32, have been training for about 3 years on the bike now, and have seen huge gains from TR. I was on my way to a US cat 3 upgrade before covid, used the lockdown to train harder than ever before (including strength and core), and was coming up on the magic 5 w/kg as recently as December. But that feels a long way away now… Since late Dec/early Jan I’ve been dealing with pretty bad low back pain. Who knows how it started, but there was a lot of snow to shovel around that time, so probably something there could have been an issue. I’ve combed the forums here for tips, I’m seeing a PT, and have been prescribed Opioids from my doctor and avoiding them atm. Trying to do all the right things (stretching and even more core work as prescribed by the PT), but it’s been a tough slog just being unable to train (edit: hard, I can spin easy without too much issue). More of a mental challenge than anything else, (not just training, not being able to play with the kids has been tough too). Doc and PT are thinking I just did something to discs, so more just a wait and see approach.
More just wondering how people have handled the uncertainy of low back pain. Give me a broken collarbone any day (ask me how I know, haha). That I can see, I can understand how long it will take to get back training, and I can plan. This, meh. Fast group rides are opening back up in my area, and all I want to do is get out there or know when I can!
super interesting stuff. I believe there’s a lot of validity in the idea that a lot of pain has a huge mental component!
One thing that has confused me in this process, I do wonder how much pushing through the pain is good/appropriate. As a super-driven personality, I’m happy to push through a lot of pain. Knowing when it’s getting worse is a challenge, and accepting when it’s getting worse is an art that I struggle with!
As a fellow back pain sufferer, I recommend not pushing through pain. I’ve learned the hard way that if I push a little too hard, can take days or weeks to recover. So I have learned to embrace sweet spot - I can usually do those without aggravating my back.
Sounds like you are doing the right things - seeing PT, stretches, etc. One other idea is to get a bike fit - you might be too aggressively positioned for what your back can currently handle?
You probably don’t want to hear this, but I had a very similar experience to you ~10 years ago at the age of 28 after about 10 years of riding and racing as a CAT3. I only truly stopped riding for about a 6 month period, but it was roughly 3 years before I felt “good”. It was a very long journey but I was motivated to come out the other side and stuck to the recommendations of a few key medical professionals and ultimately I’m still in a pretty good place a few years down the road.
My best advice I can give is take the situation seriously, but evaluate all advice very carefully. My situation was tricky because the pain did not manifest in the most typical sciatic nerve type pain or numbness in your leg. The best way I can describe it is muscle spasms in my low and mid back, and very painful “on fire” feeling generally throughout my lower/mid back area. I had some minor back pain for a few months but shoveling snow one day really put me in a lot of pain. I couldn’t really do anything.
It showed up on an MRI months later as a very slight disc bulge that was difficult to see but essentially pushed “forward”, i.e. toward my organs, not out to one side or the back.
The best way I can summarize my treatment was to control damaging motion while building the necessary strength to support the spine in a correct position. This meant stopping many forms of stretching that cause spine flexion that put stress on the injured disc. In reality, I probably did quite a bit of damage to myself at the beginning by trying to “stretch it out” incorrectly. My PT had me put athletic tape on either side of my spine from my ribcage down to my tailbone. This helped me feel immediately when I was flexing my spine so I could avoid any motion that did so until I was ready. The feedback was incredibly helpful.
I was given several exercises which seemed weird but were designed to support spine strength. I did a whole bunch of other stuff too, NSAID treatment of inflammation for 4 months, 2x cortisone injections, many PT visits, some swimming, easy riding, no running or other jarring movements, and lots of ice. It all helped, and like I said earlier, it was a long road. None of those things on their own would have made much of a difference, but the whole program got me to a much better place. I still have to be careful and know my limits but I’m able to do most things I want to do now. My PT described it like a position of financial bankruptcy. At some level I wrote a bunch of checks that I was not prepared for and it takes a lot of deposits and strategies to get the problem solved. I was also strongly encouraged to avoid surgery, which some physicians will go straight towards. I’m not here to give medical advice, just my experience. Surgery may be the only solution for some people. I’d say best of luck, but I don’t really think it has to do with luck, just a commitment to a good plan.
Thanks for sharing! This is what I was hoping to read, just some firsthand stuff about what it was like for other people. I hope to avoid surgery too, and think I can.
Check out the book Multifidus Solution. About 10 years ago, I ruptured L3 in the gym with sudden excruciating pain and subsequent weakness and loss of muscle mass in my left leg. I did all of the prescribed PT exercises, and the exercises outlined in this book. ( The author is a PT). I have no pain today, albeit I’ve shrunk about an inch in height. Age (66) may be a factor there.
I’ve issues with L4 & L5, have a protrusion in one and a bulge in the other. I went through a period of 7-8 years where I was having serious spasms every 6 months where I couldn’t budge for a few days. It mostly doesn’t get in the way these days though thankfully. In the past decade I’ve only really had one bad episode of spasming, occasionally get a stiff back but nothing too bad.
The most important part for me is to just keep mobile. I’m mostly chained to a desk for the day so need to get up and move every now and again.
Core work is great for prevention but I find that if you’re already suffering it can make things worse in the short term. I find larger functional movements better, even just squatting or deadlifting with little or no weight. Anything to help the glutes fire a bit and take pressure off the back muscles - they engage the core as well but without stressing the back to the same extent as the core exercises.
Aerobic exercise where I’m rotating helps a lot, swimming is great. Running actually fixed my last bad bout which was a couple of years ago after I got badly run down (lack of sleep tightens everything up for me). I find it helps in prevention but is a bit riskier as a cure - can make or break you.
Edit: I wrote all that and didn’t address the mental aspect😅. I confess to not being a great patient, I find it very difficult as well. With pretty much any other injury you can do something but the back just affects everything. To take a positive from it - I mentioned I get it when I’m run down. It might be that you honestly need the break as frustrating as that is. Take the time to recover and catch up with family (covid secure of course) or other neglected hobbies, you’ll be raring to go by the time you get the all clear👊.
Hey appreciate the physical component of advice as well! Interesting that running helped, I’m a software developer so pretty guilty of long stretches without moving when I get over focused. I did get an adjustable sit/stand desk and that helps too, but the pain is certainly worse on work days.
Mine is also something with the L4/5, I was positive for lack of reflexes or something
Two time discetomy patient checking-in with my two cents;
1). Dont fuck around with back pain it can end up being debilitating
2) Watch the opiods and painkillers - goes without saying at this point but they create some serious long term issues, they also mask a lot of stuff. Use when needed but dont develop as coping mechanism. Pain is your body trying to tell you something is wrong
3) Start a pain journal, 1-10 how you are feeling each day. This will become helpful as things progress and it ties to #2
4) Get to the root problem as quickly and prudently as possible. Imaging is important to rule things out. You can waste a lot of time on PTs and magic treatments like injections, but unless you know what problem you are trying to solve it can all be for nothing. Sorting out whether you truly have a “sore back” or are dealing with bulged disc or nerve impingment is really important for how you treat things.
5) Find a healthcare “team” that you trust and is looking out for YOUR best interest. Too easy to find PT’s, chiros, etc. who just want to prescribe you more visits because that is int heir interest. Find doctors you trust, and if you dont get new ones
6) dont play through the pain. It only makes things worse. But stay mobile, focus on stretching and mobility because if you stop it will compound issues
Happy to answer any questions, but i dont want to prescribe or solve issues as they are very individual.
Have you had back X-rays or CT scan or MRI? I wouldn’t accept a diagnosis of I think it might be a disc. You should see someone who has a sports medicine background. Currently I have SI joint arthritis. It doesn’t bother me on the bike but snow shoveling and weight lifting can put me out of commission for a week.
I’ve been dealing with some discomfort in my lower back. It bothered me a lot in 3 specific situations:
Doing heavy high bar squats.
Walking and standing a lot (2h museum type of thing)
3-4h into a ride with a lot of climbing.
Went to a highly regarded ortho (non surgical) specialized in spine. The guy looked at the MRI and told me basically that if I lift again my spine would explode. I ended firing the silly doctor and decided to take control of my destiny with:
Lots of core + glutes strengthening
Lots of heavy LOW BAR squats and deadlifts
Lots of stretching of the hip flexors…It turns out this is the culprit. I spend too much time seated in front of computer.
My only advice is not to let this thing demoralize you and don’t let anybody tell you your spine is weak and your disks are damaged for good. Even if something is wrong there, you’ll be surprised at the body self-repair mechanisms.
In terms of the imaging piece I was actually pretty discouraged that my insurance rejected my doctor’s mri order as not medically necessary since, to paraphrase them, I’m relatively young and not a good candidate for surgery at the present. Took me two weeks of waiting to get that letter in the mail, and it’s going to be a while more till I figure anything out on that front. But I’m with you, I want to know what’s going on! As does my doctor, as does my pt.
I assume you are located in the USA based on your comment, is going private and paying out of pocket available to you? If so small investment in your long term health even if it comes back clear so you know what you are dealing with.
Once you have imaging getting surgeon to review is the easy part. And no spinal surgeon is going to cut you up if you’re not a proper candidate for it. They are the ones that will tell you no typically.
I’d second a lot of @hdas advice in terms of prevention. I’ve been pretty bad at strength training the last while, the gyms are closed here, I only have a few kettle bells and heavier dumbbells to use at home.
But for rehab once the pain had resolved itself I was doing front squats (up to body weight) and deadlifts (up to 1.2x BW), one legged squats, bridges and deadlifts etc. All very good.
I got an MRI (it’s covered in my plan here in Ireland) but it was more to see if the cause was muscular or skeletal. Spotted the damage to L4/L5 but I was actually being affected more on the other side. I ended up with getting referred to a sports specialist Doc and a specialist physio who stuck me on the strength training plan. Definitely worked.
I’ve been round & round with the health insurance demons for a back injury (bulging L4, protruding L5) & a knee injury (torn meniscus & pretty bad arthritis) In the case of both injuries, I had to appeal the denial for an MRI. If you can, do it. There is absolutely no sense treating an improperly diagnosed injury. Your doctor will likely know how to advocate for you & maybe get it approved. I’m convinced the SOP for health insurance companies is to deny diag procedures like this simply because they can & they know that often a patient or provider will accept the denial.
Sorry not much to add about the mental aspect of a back injury but I know how difficult it can be to deal with. On more than one occasion when L5 has pushed into the nerves, my only mode of transport is crawling which is tough on the psyche!
I actually have experience appealing, a few years ago I was diagnosed with a minor meniscus tear and pushed for an MRI since it just wasn’t getting better. Turns out it was a torn ACL. But it does take a frustrating amount of time, so maybe out of pocket. I’m lucky to live by an outpatient MRI clinic that is pretty cheap too.
Sorry to hear about the L5. A few weeks ago I was there too with the crawling which was also a mental low point. Glad things sound like they improved some for you!
Cool, glad you are aware of your options. I think the crawling was the worst aspect of the whole thing. the good news is, if I can get better, you can, too! Just try to be patient with yourself & don’t push harder than your back will allow regardless of what your mind insists is a good idea!
Hi @danyodanyo. I had a similar experience, but with about double the duration. Successfully recovered using the Curable app and Howard Schubiner’s work. Lots more in the research space now, which is exciting!
which was also a mental low point. Glad things sound like they improved some for you!