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Discussion Starter · #1 ·
I've had lower back pain since late January, went to PT and it mostly went away, but I had to cut the ski season short. The pain has still lingered so I went back to the Dr. and he had me get an MRI. It came back that I have a small herniation at L4/L5 and a little arthritis. I'm doing all the stretching and core work. I'm just wondering if anyone has had this problem. If so how long did it take to fully recover or do you every fully recover? The pain is definitely a lot less then last winter, but I get soreness on rides that involve big climbs. The Dr. said just keep doing what I've been doing, I'm not to the point of surgery or injections but I'm also not fully recovered after 5 months.
Thanks
 

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smr- i'm in the process of getting my doctorate in pt and i've worked at pt clinics. back problems are very tricky, for some it goes away very fast, for some it lingers. what's best is to completely take time off until your back is heald. make sure you do plenty of quad and psoas stretchs as well as deload your back plenty of times during the day. sleeping with pillows under your leg is a DEFINATE plus. a large square ice pack for after races/biking and before sleep also helps.

anymore questions?

john
 

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Discussion Starter · #3 ·
Thanks for your help John.
Two questions, what do you mean by deloading?
and also about taking time off until it's completely healed, I was under the impression that I should continue to ride. Obviously I don't want to overdo it, but you're not saying to quit riding altogether until it goes away are you? If I ride for say an hour and 1/2 and don't do too much climbing things seem ok, it's only been on a couple rides where I did a lot of climing where the discomfort came back. I plan on avoiding those types of ride for the time being.
Thanks again.
 

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deloading is not something all therapist know about. it's sad really. where are you going for pt. i can check out their website to get an idea if the clinic is any good. what kind of degrees does your pt have?

deloading is to take stress off your back. if you're in the office push up with your arms onto the armrest of the chairs. this will elevate your rear off the chair and help unload the disk. at home you can hang a bath towel over the corner of a strong door. grab both ends of the towel with each hand, put the door between your legs and just hang down and hold your body weight up with your arms.

give me your e-mail, i can take pictures of myself doing it and send them to you.

get up and walk around once awhile at the office (assuming you work in an office). riding a little is ok, i would avoid all climbs, they strsess the iliopsoas mm a good deal and it's origin is the lower lumbar spine.

john
 

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Hold on to your horses kiddies

ahhchon said:
deloading is not something all therapist know about. it's sad really. where are you going for pt. i can check out their website to get an idea if the clinic is any good. what kind of degrees does your pt have?

deloading is to take stress off your back. if you're in the office push up with your arms onto the armrest of the chairs. this will elevate your rear off the chair and help unload the disk. at home you can hang a bath towel over the corner of a strong door. grab both ends of the towel with each hand, put the door between your legs and just hang down and hold your body weight up with your arms.

give me your e-mail, i can take pictures of myself doing it and send them to you.

get up and walk around once awhile at the office (assuming you work in an office). riding a little is ok, i would avoid all climbs, they strsess the iliopsoas mm a good deal and it's origin is the lower lumbar spine.

john
Not trying to belittle your SPT status or your soon to be DPT, but you need to slow down and look at the bigger picture here!
If you can tell what kind of care that you will be getting by looking at some web site then you are a much better person than I!
Our web site does not list all of our clinical certifications, and even if it did, there is little way to know the care you are going to receive when you get there. I would much rather be worked on by a BS with 20 years under his belt than somebody straight out of school with his DPT.

I, along with many other manual therpists do not put a lot of stock in "unloading". Once upon a time traction was the silver bullet, any good therapist will tell you that it is a good tool from time to time, however, it has really fallen out of favor in many areas. I would much rather put the effort into his posturing and his segmental stability than "unloading".
When we climb, we tend to forward flex and kick in our muscles much more than in other situations. Yes, the Psoas is likely tugging on the segments and he is not able to stabilize
these secondary to likely having deficient strength and control at those segments.

I don't think that there is any reason that he should stop riding all together, in fact this may be counter productive. If the positioning of riding alone were evoking his radic sx's, then I would have him stop. If he is able to ride and only bring on sx's when he is getting after it while climbing, then I would avoid the aggrevating activity.

SMR did not mention if the pain he was getting was even radicular in nature. It could be that he has some OA type sx's and he is just getting the arthritic type stiffness. It would be nice to hear a bit more about his sx's so that we could give him a better direction.
 

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i'm not saying that his clinic sucks, i'm just curious because there are too many clinis out there that do hot pack/ US / cold pack and send their patients home and i wanted to make sure that wasn't the environment he was in.

smr, you have a good therapist, or it seems so. why are you here for information? your therapist is the first person to go to.

john
 

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I had lumbar disk herniation surgery in late february. I upgraded to expert (mid- pack in 1 race in june) from beginner/sport last year despite being off the bike for several months. So the best advice I have is to try and stay positive, be patient, listen to your back, and do daily core exercises (working transversus abdominus and multifidi muscles specifically-ask your PT). Unfortunately, back pain can be unpredictable and not all disc herniations are the main source for back pain. I still have bad days and weeks with back pain and leg numbness that keep me off the bike on occasion. I've personally decided to limit my racing and do more road cycling but I'm just happy to be biking given how I felt several months ago. Despite successful surgery, which is an absolute last resort, I will never be the same but that doesn't mean I can't continue to improve as a cyclist. Good luck!
 

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I also had a herniated disk about 2 years ago - took about 18 months to work down from being agony to now a niggle. Been back on the bike for a year, (got to get rid of the few pounds put on during not doing any riding!), it doesn't really stop me getting on with things. Just need to take care not to do silly things - I still for example can't run much, as it will aggravate things. As hogut says, being patient and positive is the best way to getting back to norm, even though as I experienced, the sciatica pain was awful, and its hard to be patient and positive during the bad bits.
I avoided surgery, but did have an epidural steroid. I'm very skeptical whether this did anything, but hey - its significantly better than it was 18 months ago!
There's nothing on the bike I can't do now than I did before - but I can get pain after say 90 mins or so on the bike without getting off, but a quick rest standing up with a walk clears this up. Physio didn't help at the time, but I now find it does help to keep the core and back muscle exercises going. I also found deloading a relief, and of course the painkillers, but don't need these now.
 

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ptdavies said:
I also had a herniated disk about 2 years ago - took about 18 months to work down from being agony to now a niggle. Been back on the bike for a year, (got to get rid of the few pounds put on during not doing any riding!), it doesn't really stop me getting on with things. Just need to take care not to do silly things - I still for example can't run much, as it will aggravate things. As hogut says, being patient and positive is the best way to getting back to norm, even though as I experienced, the sciatica pain was awful, and its hard to be patient and positive during the bad bits.
I avoided surgery, but did have an epidural steroid. I'm very skeptical whether this did anything, but hey - its significantly better than it was 18 months ago!
There's nothing on the bike I can't do now than I did before - but I can get pain after say 90 mins or so on the bike without getting off, but a quick rest standing up with a walk clears this up. Physio didn't help at the time, but I now find it does help to keep the core and back muscle exercises going. I also found deloading a relief, and of course the painkillers, but don't need these now.
Thanks ptdavies! Now I have something to actually look forward to......little or no pain!!!:thumbsup:

:cool:
 
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