Returning from the couch - fractured vertebrae

Training
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Hello all, I just wanted to start a thread to share my progress and hopefully provide a support framework for myself and others as I return to working out and riding after I fractured my L1 vertebrae.

About 13 weeks ago I crashed hard, over the bars, when someone’s foot managed to get tangled din my wheel, sending me head over heels and on to my head and back.

The injury was a wedge compression fracture. Doing my research I soon realised that what people call a fractured vertebrae varies wildly depending on the specifics of the break, and as such, the treatment and recovery time also has a lot of variance.

For the last 12 weeks I’ve been wearing a back brace and my exercise has been regular walks and very light turbo sessions on the trainer at 150 watts while wearing my brace.

I now have sign off to start physiotherapy to rebuild my back muscles and very gently start ramping up exercise, including swimming, biking. Still no weights or load on my back and my Dr still wants me to avoid twisting and bending for another month.

My turbo trainer setup is modified with an adjustable stem to raise my bars and shorten the reach while I still have restrictions on my movement (and until my back muscles are stronger). Yesterday I did my first “endurance” session at about 170 watts for 45 minutes.

Before my crash my FTP was around 350 and I was doing a lot of z1/z2 training, and able to sit around 120 bpm at 200-220 watts. Now I’m obviously in quite a different place and rebuilding from quite a long period on the couch!

I also gained around 5kg in weight, and my weight is currently sitting around 8kg above last year when I was in peak summer shape.

I’ve read a lot on the topic and followed my favourite professionals who seemed to come back from this injury surprisingly quickly (Robert Gesink, Ian Stannard), but also the odd horror story about riders who didn’t take the injury seriously and put themselves in a hole long term (Ryan Trebon), so I’m in no rush to return to my former shape, but very motivated for the journey and to try my hardest to be the best version of myself and get there.

Today that looks like spending a whole day out of my back brace and aiming for 1 hour on the turbo, eating right and getting to bed early!

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Sorry to hear about your accident, I’m also returning to riding after fracturing my L1,L2 and L3 transverse processes, while not as bad as what you’ve been through the recovery will likely be roughly the same after the initial healing of the fractures.

I was able to be back on the bike after a week and a bit off, at that stage getting on the bike was a relief since sitting on the couch/standing was uncomfortable and the random stabbing pain I was getting would just about make me collapse if I had to move at all. This pain subsided after the 3rd week.

The rides started out at 30 mins and yesterday I was able to complete a 2 hour endurance ride, anything over sweet spot for me isn’t possible though. I also tried a workout with 2 20 sec sprints and that was a little sore afterwards.

My physio is surprised at how well I’ve bounced back and has given me a number of exercises to complete, one being a Jefferson Curl with a 4kg weight. This should help strengthen my back as I can definitely feel a loss in strength and flexibility, other exercises include hip flexor exercises and planks.

The main thing they said to me was not to stop moving but only do as much as the pain will allow you.

The main thing to remember is to take one day at a time, if in pain take medication for it. It’s helped me to have a goal for my recovery and to talk to a professional about everything, I hope you have access to that kind of support.

All the best for your recovery!

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@AdrenalineNZ you were right, a lot of Jefferson curls have been on the board for the last 30 days.

Getting back on the bike indoors has been going well and I’ve managed to get up to back to back turbo sessions 1-2 hours in length and looking to get out on the road once there is no risk of ice

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Good on you, this is probably the best attitude you could have. Wishing you all the best as you take those steps.

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So here’s a one month progress report:

It took me a few days to get used to riding on the turbo again but since early Jan I’ve been able to ramp up my hours indoors with a small smattering of rides outdoors.

I started by focusing on riding a basic tempo using heart rate and settled in targeting rides between 200 and 210
watts and I just randomly reset my FTP from 355 back down to 280.

Week 1: 11 hours
Week 2: 17 hours
Week 3: 16 hours
Week 4: 20 hours - with first rides outdoors
Week 5: 16 hours

For the first 4 weeks I did nearly all of my rides in and around that 210 watts, and I watched my heart rate for the same power come down from around 145 in week 1 to around 120 in week 5.

In weeks 4 and 5 I did one small threshold workout of 4x6 in week 4 and a 4x8 in week 5. The 4x6 felt comfortable at 280 watts so I reset my threshold to 300 for the 4x8s and this week used AI FTP detection which put me at 310 FTP, which I’ll try and verify if I can get the motivation to do a ramp test.

Squeezing in the hours during the work week is tough and generally it means doing 2 sessions of 90 minutes each, which I know at those low intensities isn’t the same as doing a 3 hour ride, but that’s life.

I’ve got back up to doing rides outside without discomfort and I’m doing physio therapy 4 times a week, which is all rehab gym work, a tonne of weighted stretching, rotation and starting to some more dynamic movements. Working with the physio is incredible, having someone who is monitoring progression and knows when to push, what the next progression is, and then when to back off again is invaluable, I don’t think I could do that myself.

So my FTP after 4 months off is down 40-50 watts, plus a few kgs round the middle, so I’m no bike rider yet, but to be able to train again and be outside is a reward in itself.