Back issue...

What was the injury?

I have issues with shoulder and back pain. I thought the shoulder pain was caused by a prior "intimate meeting" between myself and a house at 30mph many years ago and that the lower back pain, which was only on the same side as the sore shoulder was somehow caused by that. As usual, I was totally wrong - the low back pain was being caused mostly by a leg length discrepancy and overly tight hamstrings, as well as being about as inflexible as a lump of granite. After shimming the shoes and many stretches things seems to be a lot better. I only got the shoes shimmed a few weeks ago and now I don't get back pain until about the 5 hour mark...

The injury was the one in Feb when I strained the pirformis muscle. I re-starined three weeks ago through my own stupidity but the thing I have found the most strange is that I have never had back problems. But since this issue I have this one nagging bac problem even though my legs are now back to getting better again.

It would seem obvious that the pain is coming from my position on the bike. It is a straight path from my arms around my rib cage and into my spine. But I have no pain in my arms or shoulders just in that one area of my spine which can sometimes go to my rib cage and I am trying so hard to ride without putting any pressure on my upper body. Recumbrent cycles require no upper body strength at all and when on trainer I try not to put any pressure.

I just wonder can it be coming from the lower body up? And than the added pressure of the handlebar position is pushing it over the edge.

No doubt I am tight but given the amount of stretching, PT, no past back injury combined with them both happenning at the same time I havto think they are related.

What do you mean by shoes shimmed? Also did you change anything on the bike?

-js

swampy1970 said:

What was the injury?

I have issues with shoulder and back pain. I thought the shoulder pain was caused by a prior "intimate meeting" between myself and a house at 30mph many years ago and that the lower back pain, which was only on the same side as the sore shoulder was somehow caused by that. As usual, I was totally wrong - the low back pain was being caused mostly by a leg length discrepancy and overly tight hamstrings, as well as being about as inflexible as a lump of granite. After shimming the shoes and many stretches things seems to be a lot better. I only got the shoes shimmed a few weeks ago and now I don't get back pain until about the 5 hour mark...

jsirabella said:

The injury was the one in Feb when I strained the pirformis muscle. I re-starined three weeks ago through my own stupidity but the thing I have found the most strange is that I have never had back problems. But since this issue I have this one nagging bac problem even though my legs are now back to getting better again.

It would seem obvious that the pain is coming from my position on the bike. It is a straight path from my arms around my rib cage and into my spine. But I have no pain in my arms or shoulders just in that one area of my spine which can sometimes go to my rib cage and I am trying so hard to ride without putting any pressure on my upper body. Recumbrent cycles require no upper body strength at all and when on trainer I try not to put any pressure.

I just wonder can it be coming from the lower body up? And than the added pressure of the handlebar position is pushing it over the edge.

No doubt I am tight but given the amount of stretching, PT, no past back injury combined with them both happenning at the same time I havto think they are related.

I'd hate to guess about back problems - the causes and symptoms are so diverse that it's almost impossible to guess what it could be. One thing that I may offer up is since you may be pedalling a little more gently, more of your weight is being supported by your upper body than it used to be. It could be that the piriformis on that side is slightly shorter and could be 'pulling' on the sacrum and causing other back issues of which the one you're describing could be one. It could be something completely different...

... a good physio or doc may be in order.

jsirabella said:

What do you mean by shoes shimmed? Also did you change anything on the bike?

Small plastic shims placed between the shoe and the cleat. I think they were LeMond "LeWedges" or something similar. I did change the position of the saddle (1/2" backwards) and put on a shorter and slightly taller stem - but the latter was mainly for the 198 mile mountain ride I did the past weekend. It's working pretty well so I may leave it on for a while before trying something slightly longer and 'more normal' looking. It does feel a little short though.

No advice, but I feel your pain 😉

I struggled last week and cut my 75 mile ride short by avoiding a climb (as noted here) because I felt like I had strained my lower back. I visit a chiropractor once a week, but when he checked me he said everything was in line, could feel the muscular tension and also guessed it may be a strain.

I did some stretching this morning and used an inversion table this evening followed by some more stretching. After the inversion table and stretching I feel relieved, but I have a 58 mile route tomorrow with some big rollers and that can be irritating having to sprint those hills with the group.

Not sure if this will help, but it might prevent future back issues..........

In Bicycling mag a few months ago they had a article on back pain and riding bikes, they went on to say how the riding position and the position of sitting in a chair is the same. The end result is you have everything being pinch in one position in the front of the spine and injuries resulting on the back or rear of the spine from the pressure put on it. They listed a few exercises to do to counteract the bent over riding position, stretching, yoga etc etc all designed to help strengthen the "other" part of the back. I have been doing them and I do feel the difference after a ride.

Man, I hope this isn't another deadlift-induced injury. 🙁

I'm wondering if the key difference between your CT and your commuter bike is the length of time that you spend on each one in one sitting. Does the back start to hurt immediately on the CT, or only after 60-90 mins of riding?

I agree with Swampy that it's tough to try to isolate a cause for back pain, as so many things can cause it. If you haven't made any changes to the bike since before the injury, then I'd guess it's mostly related to the injury itself rather than bike fit, etc.

Honestly I am not sure if it is related to the deadlift or not. The first time I screwed up my pirformis muscle was not due to the deadlift but due to a controlled fall which the doc said pulled a muscle which should have gone away anywhere from 6 weeks to 9 mos completely. The second injury was due to my ego as I had no business even touching a weight and was a deadlift, no doubt. I was doing what I believe was light weight and on my third set both IT bands just gave me an enormous amount of pain. After 2-3 days of icing and heating and an injection from the doc I was able to start PT and stretching again.

The doc gave me another shot on my last visit and I am coming on a month from my second injury. i can ride my bike but it is simply riding as I use my fix bianchi that has no gadets at all. I find it really does not give me much pain in my back while the CT can cause alot of pain in that area on any of my bikes. The doc believes that it could be that my body is compensating for the injuries so my back is in a weird position or doing too much of the work or he said it could have always been problem that came out after you stopped doing weights and honestly at this point there are way too many variables so I have decided to approach it like when I was a computer consultant which means one problem at a time...

1) Lets get the legs back to normal or as close to that. Meaning to me being able to ride for say 2-3 hours without the need for aleeve or my fractural patches. Sadly currently that is not the case but I am getting stronger and since my body seems to like that one bike than lets keep using that bike.

2) Once number 1 is solved than lets see what happens to my lower back and my upper back. If it continues to give me issues than I really want a cat scan or MRI. The one strange thing that has happened since my initial injury was my bones just keep cracking. I tell my PT and my doc but none seem to take it serious. They say it is simply air being released from pockets in your bones or something. But in all my life my bones never cracked. I mean could not get them to crack if I wanted to. There is something there as I believe maybe that fall put something out of whack in my spine.

So far none of the docs have given me cat scan/mri but I believe with this doc all I have to do is ask. He is great...I just said the other day to him my right side could not do the rides so either a shot or I must rest. He gave me a shot without a second look. The guy has worked out and understand where I am coming from.

2009 sux...but I have learned a lot and has changed my entire view especially of all the cyclist/gym rats who I thought were just wasting their time. As a boss I also did not have much sympathy for people in my office who were quick to take off or were constantly going to the doctor for something like knee pains. I would just think, loose some weight or come on you are like 10 years younger than me and you still can not make it into the office cause you have the sniffles. Take some comtrex and get your butt in here. I tend to have a little more patience to say the least now.

Also I try to remember it is during these tough times that we really learn what we are made of.

-js

frenchyge said:

Man, I hope this isn't another deadlift-induced injury. 🙁

I'm wondering if the key difference between your CT and your commuter bike is the length of time that you spend on each one in one sitting. Does the back start to hurt immediately on the CT, or only after 60-90 mins of riding?

I agree with Swampy that it's tough to try to isolate a cause for back pain, as so many things can cause it. If you haven't made any changes to the bike since before the injury, then I'd guess it's mostly related to the injury itself rather than bike fit, etc.

Based on the advice from the doc and I wanted to just test it out myself I decided to just ride as long as I could and take several breaks and do some stretching for 10 minutes if I feel fatigue or strain.

The first hour not so bad. I took my pit stop in the park and did my stretching and after the stretching felt pretty good. The second hour was a different story as I decided to leave the park and try and find the entrance to the henry hudson green way which is as flat as a pancake. Unfortunately I could not find the right entrance and ended up going up a few hills I wish I did not. They were really not painful in themselves but on the way home I could tell my left IT band was not happy. I did a couple of body weight squats and felt the strain. I immediately took an epsom salt bath and resting on my couch now and will do some more stretching later.

It was actually a good experiment as I did much better than I thought and believe I am heading in the right direction. I will take two days off to have it recover as this is the first long ride in months but still wish it could have went better. Considering that I took 2 aleeve before I started the ride I should feel nothing so I have a lot more time to go to say the least.

Sorry to hear about the lower back. My lower back has not been much of a problem it was more my butt area and upper back. The shots have definitely done wonders on the pirformis muscles. The IT bands are a totally different story and really need a lot more time.

It seems you really believe a chiropractor is a good thing...do you recommend for people to use them? I want to first deal with the legs but if the back continues I am thinking about seeing one.

I have pretty much thrown away 2009, now it is just about the recovery and no more pain.

-js

Felt_Rider said:

No advice, but I feel your pain 😉

I struggled last week and cut my 75 mile ride short by avoiding a climb (as noted here) because I felt like I had strained my lower back. I visit a chiropractor once a week, but when he checked me he said everything was in line, could feel the muscular tension and also guessed it may be a strain.

I did some stretching this morning and used an inversion table this evening followed by some more stretching. After the inversion table and stretching I feel relieved, but I have a 58 mile route tomorrow with some big rollers and that can be irritating having to sprint those hills with the group.

jsirabella said:

It seems you really believe a chiropractor is a good thing...do you recommend for people to use them? I want to first deal with the legs but if the back continues I am thinking about seeing one.

I have pretty much thrown away 2009, now it is just about the recovery and no more pain.

-js

I can just say that using a chiropractor has greatly helped me personally, but I am around a lot of others who go and have not felt the same way. Fortunately for me most the chiro's that I have gone to train as hard as I do and they understand the pain or discomforts of training with an injury. The ones that have attended to me have been far greater in support than any medical doctor and also the one I go to lets me pay like a lump sum every six months or a year like a gym membership, but I can go as often as I need. Oddly enough most of my troubles with my back and neck are not from training, but sitting at a computer for 9 to 10 hours five days a week.

I am not sure, but I think my lower back problems as of late are from working longer hours and I notice that my posture starts getting bad as the work stress increases. Yet I can go with a neck problem and get a quick adjustment and my neck will be fine for the long bike rides.

I guess I can only say that chiropractic care has been good to me for the past 20 years, but there have been times when the doctor has moved on or sold his practice that I would spend a few months looking for the next best doctor that understands training and is not out to clean your wallet. There are plenty of those who seem to be more motivated to cleaning out your account than treating your problem.

Today's ride I did okay and felt no discomfort until I got home and laid on the bed. That is when it started hurting a little, but that is much better than hurting on the bike.

All that said my problem comes and goes, but I hope Js that you get past this issue and keep going forward. The biggest thing to remember is finding a way to keep training or doing some sort of physical therapy to strengthen the weakened area without further irritating it. I have been told by the best doctors, medical and chiropractic, that it is not good to go sedentary because then the area as well as everything else, becomes weaker. I know you know that already, but we all need reminding because physical therapy is often discomforting in itself and there is a natural tendency to stop.

Felt_Rider said:

Today's ride I did okay and felt no discomfort until I got home and laid on the bed. That is when it started hurting a little, but that is much better than hurting on the bike.

All that said my problem comes and goes, but I hope Js that you get past this issue and keep going forward. The biggest thing to remember is finding a way to keep training or doing some sort of physical therapy to strengthen the weakened area without further irritating it. I have been told by the best doctors, medical and chiropractic, that it is not good to go sedentary because then the area as well as everything else, becomes weaker. I know you know that already, but we all need reminding because physical therapy is often discomforting in itself and there is a natural tendency to stop.

I am glad to hear you ride went completed with no issues.

I agree I can not go sedentary but it is hard to find that sweet spot where I am working the affected area without further irritating it. It is my first time dealing with these kind of issues so I am learning as we go. Today I believe I should have cut back atleast 30 minutes but if I just got into the park where I was suppose to there would have been no problems, atleast I think.

I have been riding and stretching pretty much everyday for about 3 weeks now so I want to see how I feel after these two days off. It is during the rest periods that my body should really respond...lets see. Also I have been doing PT 2 days a week for about 6 weeks on and off. I will continue as long as my insurance company does not keep messing up on me. That little girl can hurt...

I think I will look for a chiro if after the legs, the back is still having issues. I may ask for some advice of how to tell the good ones from the bad ones.

-js

jsirabella said:

Honestly I am not sure if it is related to the deadlift or not. The first time I screwed up my pirformis muscle was not due to the deadlift but due to a controlled fall which the doc said pulled a muscle which should have gone away anywhere from 6 weeks to 9 mos completely. The second injury was due to my ego as I had no business even touching a weight and was a deadlift, no doubt. I was doing what I believe was light weight and on my third set both IT bands just gave me an enormous amount of pain. After 2-3 days of icing and heating and an injection from the doc I was able to start PT and stretching again.

The doc gave me another shot on my last visit and I am coming on a month from my second injury. i can ride my bike but it is simply riding as I use my fix bianchi that has no gadets at all. I find it really does not give me much pain in my back while the CT can cause alot of pain in that area on any of my bikes. The doc believes that it could be that my body is compensating for the injuries so my back is in a weird position or doing too much of the work or he said it could have always been problem that came out after you stopped doing weights and honestly at this point there are way too many variables so I have decided to approach it like when I was a computer consultant which means one problem at a time...

1) Lets get the legs back to normal or as close to that. Meaning to me being able to ride for say 2-3 hours without the need for aleeve or my fractural patches. Sadly currently that is not the case but I am getting stronger and since my body seems to like that one bike than lets keep using that bike.

2) Once number 1 is solved than lets see what happens to my lower back and my upper back. If it continues to give me issues than I really want a cat scan or MRI. The one strange thing that has happened since my initial injury was my bones just keep cracking. I tell my PT and my doc but none seem to take it serious. They say it is simply air being released from pockets in your bones or something. But in all my life my bones never cracked. I mean could not get them to crack if I wanted to. There is something there as I believe maybe that fall put something out of whack in my spine.

So far none of the docs have given me cat scan/mri but I believe with this doc all I have to do is ask. He is great...I just said the other day to him my right side could not do the rides so either a shot or I must rest. He gave me a shot without a second look. The guy has worked out and understand where I am coming from.

2009 sux...but I have learned a lot and has changed my entire view especially of all the cyclist/gym rats who I thought were just wasting their time. As a boss I also did not have much sympathy for people in my office who were quick to take off or were constantly going to the doctor for something like knee pains. I would just think, loose some weight or come on you are like 10 years younger than me and you still can not make it into the office cause you have the sniffles. Take some comtrex and get your butt in here. I tend to have a little more patience to say the least now.

Also I try to remember it is during these tough times that we really learn what we are made of.

-js

Forgot to add a more direct answer, after 90 minutes but not really during the CT ride but after I get off. Today after the 2 hour ride my back is sore but the real issue is my left IT band and both pirformis are a bit tender.

jsirabella said:

I am glad to hear you ride went completed with no issues.

I agree I can not go sedentary but it is hard to find that sweet spot where I am working the affected area without further irritating it. It is my first time dealing with these kind of issues so I am learning as we go. Today I believe I should have cut back atleast 30 minutes but if I just got into the park where I was suppose to there would have been no problems, atleast I think.

-js

That is the real trick. Mine has come with many years of experience through a number of injuries. Apart from doctors and friends with a lot of training experience only you can determine the path to take. I have received advice from doctor's in the past and just didn't follow it because the advice just didn't seem right. You have probably heard it many time to "listen to your body" and that is something that I have become very good at. Sometimes I am too stubborn and pay the price.🙂

I have some issues going on now (starting when I hit my 40's) and had to change my training. After continually tearing leg muscles I finally gave up the pursuit of heavy squats. I still train legs, but I have changed to adapt to an aging body. The hardest part is losing the ego because at one time I could use weights that the whole gym would stop what they are doing to watch me do a set of squats. Now I am just another guy in the gym using embarrassing light weights, but it is what it is and I just can't get under the heaviest weights anymore. I feel that I am still in better shape than most 45 year old men around me.

I struggled mentally for a few years before I accepted that I would have to adapt to a different style of lifting. Physically if I got leaner right now I could potentially still compete against younger guys in bodybuilding so I still look as if I can lift heavy, but the truth is I cannot. The next mental hurdle will be when I loose that aspect as well. I have been surprised that the lifting style that I have adapted I am still holding on the lean mass even with a lot of endurance training.

What is amazing and encouraging is that we have some 60 year old men that cycle in our group that can easily drop me and I dare say could probably hang with most CAT-4's with not much problem. These guys are almost 20 years older than me and are still riding many miles per week at a very fast pace. I think to myself if they can keep training surely there is a way for me to keep on training.

Keep the hope

jsirabella said:

i can ride my bike but it is simply riding as I use my fix bianchi that has no gadets at all. I find it really does not give me much pain in my back while the CT can cause alot of pain in that area on any of my bikes. -js

When you're out on the road, even at 16mph, the wind does offer quiet a bit of support to the upper body.

So, even if you rode the CT on your Bianchi with it's fixed gear you'd still get the back pain, correct?

Farmguy said:

Not sure if this will help, but it might prevent future back issues..........

In Bicycling mag a few months ago they had a article on back pain and riding bikes, they went on to say how the riding position and the position of sitting in a chair is the same. The end result is you have everything being pinch in one position in the front of the spine and injuries resulting on the back or rear of the spine from the pressure put on it. They listed a few exercises to do to counteract the bent over riding position, stretching, yoga etc etc all designed to help strengthen the "other" part of the back. I have been doing them and I do feel the difference after a ride.

+1 for stretching and simple core strength work. Should be part of every serious cyclist's training IMO.

swampy1970 said:

When you're out on the road, even at 16mph, the wind does offer quiet a bit of support to the upper body.

So, even if you rode the CT on your Bianchi with it's fixed gear you'd still get the back pain, correct?

Hmm...correct I am not comparing apples to apples. The issue was I have one of those cheap Bianchi Pista to get around and it use the wheelset with nuts and bolts (not sure correct term) instead of a quick release and you can not safely use that*rear wheel on a CT. But come to think of it I could take the rear wheel off and put one of my road wheels on the same size cog. I believe my Pista came with a 48x14(??) and just make it tight with the quick release.

I will try it! I like the idea....It would be a good test.

-js

As a side note my back feels great right now. I did not take any more aleeve and I did not exactly time the ride but it was somewhere between 2-3 hours door to door.

swampy1970 said:

So, even if you rode the CT on your Bianchi with it's fixed gear you'd still get the back pain, correct?

That's my read, and if so, is it possible that the CT unit is putting the bike at an unlevel position which is adding to the upper body or back stress? Also, riding in a higher gear (while seeming like just the wrong thing to do) would help improve the inertia of the unit at low wattages, and add more "road feel."

jsirabella said:

It seems you really believe a chiropractor is a good thing...do you recommend for people to use them? I want to first deal with the legs but if the back continues I am thinking about seeing one.

-js

We discussed this last week, but during my appointment today's adjustment was sweet relief.

I have not been as much pain as you js and I would rate my lower back pain as of late as an annoying discomfort than pain.

There was a substitute in for my doctor today and when she adjusted my lower back/hip with a nice crisp pop sound and almost instant relief. The muscles in the hip are still a little tender, but that will subside in time. Now if I don't tweak it again for a while that will be even sweeter.

Felt_Rider said:

We discussed this last week, but during my appointment today's adjustment was sweet relief.

I have not been as much pain as you js and I would rate my lower back pain as of late as an annoying discomfort than pain.

Glad to hear the doc is doing the trick.

Honestly for me bad just keeps going to worse, remember the ride I did this weekend where I said my left IT band was bothering me. Well I woke up the next morning, my wife looks at my legs and says did you fall? I said what do you mean. You have black and blue marks. I look at my left IT band and I have two black and blue marks and below my knee. I poke them all and only the knee is sensitive but I can tell me IT band and my lower back on both sides are really irritated.

I can not win this year bro...I went to PT and she did some magic on my left side but honestly at this point she keeps working on different issues each time, back, than pirformis an now IT...there are not enough hours in the day. I have a vacation/business trip I leave for tomorrow so now I have to worry that I do not over do it carrying luggage.

I have my scheduled appointment with my doc after my return but I feel bad for him and me. I know he has been pulling for me. I think at this point I really need those cat scans. I have now decided no more aleeve as I have not used it since the ride and I want to feel the pain except for heating and icing. My logic is now the pain is there and all these pills and shots are masking them and than I over do it. The pain will let me know how far to go and makes me take it mroe seriously.

I am not touching a bike until the black and blues are all gone which is now coming on 4 days as I use arnica cream on them. Only stretching every morning and the walking I do at work.

-js

To think I had broken my ankle and never had these issues to recovery. I never had back, leg or any nerve/muscle issues in my life. I could lift and ride for hours. Now I have to worry I do not hurt myself with luggage on this trip...if this is my future put me out of my misery now.

jsirabella said:

Honestly for me bad just keeps going to worse, remember the ride I did this weekend where I said my left IT band was bothering me. Well I woke up the next morning, my wife looks at my legs and says did you fall? I said what do you mean. You have black and blue marks. I look at my left IT band and I have two black and blue marks and below my knee. I poke them all and only the knee is sensitive but I can tell me IT band and my lower back on both sides are really irritated.

I hate to hear the news.
Internal bleeding? Seems like something is torn.

jsirabella said:

I have now decided no more aleeve as I have not used it since the ride and I want to feel the pain except for heating and icing. My logic is now the pain is there and all these pills and shots are masking them and than I over do it. The pain will let me know how far to go and makes me take it mroe seriously.

I am not touching a bike until the black and blues are all gone which is now coming on 4 days as I use arnica cream on them. Only stretching every morning and the walking I do at work.

IMO - that is the best stradegy. I do anti-inflammatories, but for the most part I really want to be senstive to pain signals so that I can listen to my body when it screams, "stop doing that!" I have a high threshold for pain so I can tolerate a good amount before taking something. Usually I like to stay with topical things like ice, heat, compression, heat rubs, massage and so on. Once my chiropractor used some sort of ultra sound that was supposed to help heal a tear. I am not sure if it helped or not.

If you have something torn, only speculating from the bruising, you may not want to stretch right now. Stretching may keep the internal wound from binding together or in other words stretching pulls the wound apart before it heals. My general rule of thumb for my past tears was to wait at least 3 weeks after the point of the bruising clears. Let's just hope that whatever is causing the internal bruising will heal on its own without surgery, but I hope you can get the test done so you know for sure which path to take for healing and physical therapy. If you are nervous about walking around on the injured leg use a neoprene or elastic compression. The compression seemed to help me mentally and perhaps a little physically.