Another PT related question

[Crankin]

Yesterday I went for my first outdoor ride on my road bike this season. Only 10.7 miles, as it was getting colder and darker out. This was a very hilly ride.
I am so discouraged. As soon as I start climbing or using a big gear, I get a weakness sort of pain feeling in my left groin area, which starts going up my back and makes me slow down. So, I end up using easy gears to spin and am really not able to get the power I need.
I've had this for years, but it has been on and off, usually getting worse after long and hard rides. I am doing all kinds of groin/IT band stretches and continuing PT for my neck/upper back. My PT is a cyclist/former racer and is working with me on everything I ask her to, as my scrip was very general on purpose.
My question is: Could this all be stemming from my leg length discrepancy from scoliosis? I have a shim in my cleat, which got rid of the pain in the girlie area from being "lopsided," but every problem I have is on the left side.
I have a ride to lead in 3 weeks and I am desperate! We have a 4 day ride across Massachusetts this summer and I want to do at least one century this year. My fibromyalgia symptoms are gone and I am feeling great otherwise.
Maybe I am just unfit? I didn't stop exercising while I was sick, but I did slow down. However, I've been doing a lot since the middle of January.

Thanks,

Robyn

[rocknrollgirl]

Oh Robyn,
I am sure the PT's will get back to you soon. I feel your frustration, and we are all with you. I hope you get an answer soon. HANG IN THERE!!!!

[KnottedYet]

What is your PT doing for your low back/lumbar spine?

Did your PT check your body on your bike? (up on a trainer stand)

(I'd be interested in knowing what your body position was like on the bike, and how it changes as you change your effort like when climbing or pushing a big gear.)

[Wahine]

I had a client (has finished RAAM 7 times) with the same type of symptoms. His were stemming from his back/rib cage, affecting his pelvis balance and leading to a functional change in leg length that was correctable.

Here's my advice, go get some serious soft tissue massage, focusing on the muscle around the hip. Talk to your PT about stretches for your hip and low back - I don't have time to explain these right now but here are some usual suspects:

Tensor fascia lata (TFL)
Quadtratus lumborum (QL)
Hip rotators
Iliocostalis lumborum
glutes and piriformis

Also, see if you can get you seat up a bit then adjust the for/aft position. Measure everything off of the shorter leg.

Then you have to start on the appropriate hip flexor strengthening. I'll try to post more about that later.

Gotta run (figuratively).

[Crankin]

So far, I have a couple of roller exercises for my back. They feel good, but no improvement so far. Most of what she has done has been for the upper back, neck, and shoulder, since this is what was hurting the most when I started.
I am going to ask her about bringing in my bike and setting it up on the trainer when I see her on Tuesday. It's not a sports practice per se, but that doesn't mean there isn't a trainer there. I'll bring my own if I have to.

[KnottedYet]

I am going to ask her about bringing in my bike and setting it up on the trainer when I see her on Tuesday. It's not a sports practice per se, but that doesn't mean there isn't a trainer there. I'll bring my own if I have to.

Excellent!

[Zen]

I get a weakness sort of pain feeling in my left groin area, which starts going up my back and makes me slow down.

Could this be sciatic nerve compression?

[Crankin]

That's what I thought it could be, but I had an MRI of my lower lumbar area last fall and it didn't show anything except some "normal" breaking down of the discs for someone my age, who's done years of exercise. A couple of the discs were a little bulgy, but they are not really at a point where it would require any intervention.
I did some core work today, which actually stretched out some of the stuff, but I feel like I need a major massage! It's going to be cold for most of next week, so I probably won't be riding outside; hopefully the PT can help me on Tuesday.

[Wahine]

OK - I tried hard to find an image or video of the hip flexor strengthening exercise that I wanted to share with you but alas, I could not find one.

So I will try to describe it. Stand at a counter top or table, lean forwards using your hands for support until your body is in about the same forwad angle that you would have in your most typical riding position on the bike. Reach the weak leg out behind you (as if you were pushing something away from behind) then bring you knee into your chest as far as you can. Hold it until you get the burn and repeat for 1 to 2 minutes. When you're good at that and It doesn't really feel like a challenge then you can go to moving in and out of position quickly for 3 sets of 40. When that's easy, you can add an ankle weight or elastic band/tubing for resistance. You don't get to go to the next phase until you can do the previous one well and without symptoms.

You can also do one legged drills on the bike. Those help. The important thing in either exercise is that the movement is coming from the hip and not from the low back or pelvis, these should be stable.

[Zen]

Wahine, I bet that's this one they call "cycling hip extension"
http://www.topbike.com.au/pdfs/colson-bicyc-austnov_dec2003.pdf but you explained it a lot better :D

[Wahine]

Wow Zen. Good on you for finding that. That is the position. In the description they give they emphasize the glutes but the exercise actual works the glutes and the hip flexors.

[Crankin]

Thanks, both Wahine and Zen! I am printing both as I type.
It is 29 and very windy now, but it may be in the 40s later. I really want to go for a ride! This is torture for me. I worked so hard to solve my other medical problems, which I suspect might have had more to do with some of this stuff than my doctors think. In my mind, I am so ready for the season to begin.
I just had my second person sign up for my ride on the 30th; I had to calm him down after he told me his riding history when I screened him. He's ridden the Pyrenees, RAAM, etc. Well, I told him it's a social ride and since it's the first of the season, we aim for an average of 14.
I am off to try the butt stretch!

[Crankin]

OK, I went to the PT tonight. She spent the whole session evaluating what I was describing. After probing me in various areas that hurt like he**, she said that it is definitely my hip flexor and she explained how it is all attached to the lower back, groin, etc. She did a very deep massage of the groin and then showed me 2 stretches, one of which I had already been doing. Then I had my electrical stim. treatment for my neck.
Next week I am bringing my bike and she will check me out on the trainer. My appointment isn't until Thursday, so it will be a bit of a wait.
At least I feel like I am making progress on stuff that has been around for a long time. I haven't ridden outside again, even though today was nice. I have a cold and decided not to breathe in the cold air. Yesterday I did nothing and Sunday we did a 4 mile brisk walk after trying to hike, but the trail was sheer ice. I did an interval workout on the trainer today, with very easy spinning, alternating with 3 sets of core/functional weight work on my cyclo-core dvd.

I feel like this is never going to end!