Hamstring

[Catrin]

Catrin - I really hope your hammie heals quickly and also that you can get your form to where you can put your seat up to proper height... one thing you are missing is the amount of extra power you will have when you are fitted with your knees at the correct angle. Riding with your seat so low may also have an impact on your knees down the road...

Take care and don't give up!

It has now been 8 days since I was last on my beloved steel steed, I can see that she is pining for the open road!

The leg is feeling much better, though still icing at the drop of a hat. Tomorrow afternoon I am going to give it a shot and see what it feels like to ride again, it has been a HARD 8 days! No warmth in my hamstring in two days and no pain.

So will take it easy tomorrow, make sure I warm up on the flats, and resist the urge to go find every hill I know to climb and no hammering... I would like to get 20 miles in, at least, but will listen to my body.

My saddle has been raised a few more millimeters, and that will happen every week or two until it is where it needs to be. No more long rides though (>40 miles) until that happens though - there are reasons why my fitter has chosen this approach and, for me, they are good ones.

[warneral]

best wishes! Hope you have a nice ride

[Deborajen]

Ask your PT to explain the symptomology of a lumbar anterior derangement to you (in particular how it effects WOMEN), and have her show you the flexion (bending forward) movements to correct it. Once it's corrected, the ham and piri will stop freaking out. The tingling with extension will also go away.

Also, ask her to teach you to stand properly in a neutral pelvic tilt, with knees unlocked and core engaged.

Thanks again, Knotted, for the recommendation.

I've had a couple more PT sessions and I asked about anterior lumbar derangement. She explained what it was and said it's a possibility as is spinal stenosis (walking the dog and leaning back/getting pulled is more painful than pushing a cart in the grocery store), and she put me on some stretches and strengthening exercises for the lower back. I'd been doing piriformis and hamstring exercises for several weeks and they weren't helping much.

Today, I mentioned that I noticed that crouching helps with the spasms and she said that sounds more like psoas muscle. Lying on the table on my back with my left leg hanging off the side was painful in the "spasm" area, lying on my back rotating both legs (knees bent) side to side was painful in the same area (left side) when rotating knees to the right - both of these she said point to the psoas muscle. She sounds very convinced that this is the problem, and since the exercises do pull the sore area I'm a lot more confident we're on the right track now, too. The only doubt I have is that the tingling didn't sound like a psoas symptom, but she did say that everyone is built differently.

Anyway, I hope I'm finally on track to getting this thing settled down. I'll keep doing the exercises and listening to my body. It sure would be a lot easier if body parts didn't blame each other so darned much!

[KnottedYet]

Today, I mentioned that I noticed that crouching helps with the spasms and she said that sounds more like psoas muscle. Lying on the table on my back with my left leg hanging off the side was painful in the "spasm" area, lying on my back rotating both legs (knees bent) side to side was painful in the same area (left side) when rotating knees to the right - both of these she said point to the psoas muscle. She sounds very convinced that this is the problem, and since the exercises do pull the sore area I'm a lot more confident we're on the right track now, too. The only doubt I have is that the tingling didn't sound like a psoas symptom, but she did say that everyone is built differently.

Anyway, I hope I'm finally on track to getting this thing settled down. I'll keep doing the exercises and listening to my body. It sure would be a lot easier if body parts didn't blame each other so darned much!

Psoas muscle is anchored on the 5 lumbar vertebrae. If it is so tight that it is pulling you into an anterior derangement, a tight psoas could indirectly cause tingling. (via what position it forces the vertebrae to take and the corresponding weakening of the disc between them)

The problem with a derangement is that the outer wall of the disc becomes overstretched and weak, and tends to take a blobby shape instead of a nice firm-edged shape. (perhaps overstretched from the tight psoas yanking on the adjoining vertebrae like I mentioned above) Now you have TWO problems: a messed up disc wall that needs to be addressed so it can heal, and a tight psoas. The messed up disc wall is what ultimately causes the tingling in lumbar extension.

But actually, you have THREE problems to address: blobby disc wall, tight psoas, and WHAT THE HECK CAUSED THE PSOAS TO GET TIGHT IN THE FIRST PLACE?

Again, please ask your PT to coach you through lumbar neutral in standing and walking, coach you how to protect and re-shape the disc so the weak blobby area can heal, and analyze the forces your lumbar spine experiences that may have caused the whole business to start in the first place.

(based on what you said about supine lumbar rotation, it could be a lateral relevant derangement rather than an anterior derangement, both can cause tingling in extension. Your PT should be able to figure it out in about 5 minutes and will teach you how to push it back into shape and what to to do keep it there for the 7 days it takes to heal the disc wall.)

ETA: as far as her initial mention of spinal stenosis is concerned: your asymmetrical response to supine lumbar rotation pretty much ruled that out, which is why she didn't pursue it further.

[Deborajen]

The exercises are starting to help a little. I did learn lumbar neutral stance and walking with Chi Running not too long ago so I'm working on that again. We did talk about cause at the last PT visit. I have a full-time office job so I spend a lot of time at a desk. Also, back in February I got a new dog and have been walking her every day. Her pace is a very fast walk/not quite a run pace for me, so this means stretching out my stride more than I was used to. I'd hoped a longer stride would help with my running, but my PT agreed that this along with a lot of sitting at work might be what caused the current problems. So the walks are now at a slow pace to the park and then the dog can run on a retractable leash. PT is also having me get up and stretch several times throughout the day, plus continue with the other exercises.

Back to the doctor tomorrow - see what he says.

[Catrin]

I saw the new physical therapist today, and I seem to have found someone very well qualified indeed. He is McKenzie certified, along with a lot of other certifications, years of experience, and is also a research fellow and professor. While he didn't actually say it, it seemed apparent that he thought my first PT didn't handle things properly. I don't know about that, I think he did his best, but results is what matters.

To make a long story short, he doesn't think the minor back arthritis has any role in my issues - he said that it is very, very minor. We just did the evaluation today and he took LOTS of notes (and a little hands on stuff), he thinks all of the weirdness with my hips/hip flexor/hammie/quad are explained by a dysfunction in my hips and soft tissue issues. More specific than that he won't say until our next session, but that is certainly more desirable over a fu**ed disc - he doesn't think it is that at all. Wheww

He is also contacting my personal trainer so that my training and PT won't be working against each other - and I see my trainer more often than I will be seeing the PT - the PT is QUITE the drive from me - even further than I thought.

Other good news is that last night, for the first time since early September, I was able to fully participate in spinning class without backing off Well, I didn't do the sprints, but THOSE can wait until I am on the bike - my trainer has advised me to hold off on them for now. Wonderful progress, even if some odd pains remain - but they have not bothered me on the spinning bike or regular bike

[indysteel]

I'm glad you got evaluated by a new PT--one that seems to know what he's doing. Hopefully, he'll get you headed in the right direction. I'm glad, too, that he's talking directly to your trainer.

[Catrin]

It makes perfect sense, my trainer is contacting him, he prefers that approach as well - in the end I am the one who benefits from the combined approach.

I AM feeling much better, outside of the odd pains and I am not surprised that he thinks my hip is playing a significant role...between his McKenzie training and other certifications, he has plenty of tools to work with. He did make an interesting comment that MRI scans are too quickly used because of false positives. Now he didn't say, yet, what he thinks the actual hip and soft tissue problems are...but at this point I don't care what it is called.