Back Issues Are Dumb

[OakLeaf]

Itself, I know you mentioned a recumbent when I first got hurt, but I really can't understand how that wouldn't aggravate back issues. I can't climb in the saddle at all because of the torque at L3-4. Once you can extend your hip joint farther (as I can when I stand to climb), you can let the leg muscles do the work, not your back. Sitting, just sitting without torquing the low back, is really hard on the back. Most people I know with back issues need to sit more upright on their bikes (at least temporarily) - not more bent at the hip.

Zoom-zoom, I feel for you... as I mentioned in Catrin's thread, motor point acupuncture and Sutherland's osteopathic techniques seem like they're starting to do me some good, which months of physical therapy and chiropractic and massage really did nothing. Something to look into. I think core work is safe as long as you do mobility and not just strengthening - that's been the case for me - strengthening alone can be problematic, and of course some of the stretches can aggravate pinched nerves, so it's all a balancing act...

Good luck. Hope you find a solution.

[zoom-zoom]

Itself, I know you mentioned a recumbent when I first got hurt, but I really can't understand how that wouldn't aggravate back issues. I can't climb in the saddle at all because of the torque at L3-4. Once you can extend your hip joint farther (as I can when I stand to climb), you can let the leg muscles do the work, not your back. Sitting, just sitting without torquing the low back, is really hard on the back. Most people I know with back issues need to sit more upright on their bikes (at least temporarily) - not more bent at the hip.

Zoom-zoom, I feel for you... as I mentioned in Catrin's thread, motor point acupuncture and Sutherland's osteopathic techniques seem like they're starting to do me some good, which months of physical therapy and chiropractic and massage really did nothing. Something to look into. I think core work is safe as long as you do mobility and not just strengthening - that's been the case for me - strengthening alone can be problematic, and of course some of the stretches can aggravate pinched nerves, so it's all a balancing act...

Good luck. Hope you find a solution.

I am certain too much sitting has contributed to my own issues...perhaps is the primary issue. That and my goofy anterior-rotated pelvis. And lack of core work. Then the effort and stress of cyclocross. I'm not sure I could have happened upon a worse combination of back-killing factors than I have.

I'm going to call the doctor if taking it easy for a few days doesn't yield noticeable improvement. Replacing our mattress may be worth a try, too, since it's about the age when it's recommended they be replaced and it was never an ideal bed for us, in the first place (too firm when newer--it was a guest bed at my DH's grandparents' place) so we have a 2" memory foam topper on it. In nearly 16 years of marriage and >19 years of sleeping in the same bed we've never had a NEW mattress suited specifically for us. We could get away with that when we were younger and inactive, but we're both ~40 and determined to wear out our bodies in the years we have left on the planet.

[OakLeaf]

That and my goofy anterior-rotated pelvis.

Just make sure it is truly anteriorly rotated. I've had issues before with a lot of people believing mine is anteriorly rotated when it's actually posterior (working on it... getting closer, but still posterior). True neutral pelvis is when the ASIS and the top of the pubic symphysis are in the frontal plane. Some people judge by the ASIS/PSIS in the horizontal plane, because they can palpate both without getting too intimate ... but there's a great deal of anatomical variation, and that line actually doesn't tell anyone anything. Other people just look at the amount of lumbar lordosis, which there are both anatomical and mechanical factors at work there.

Easy way to judge is with a clipboard or cutting board. Mash it into the front of your pelvis so it's touching all three bony points and eyeball it from the side in a full-length mirror.


Or if you're doing yoga - the way I first found my neutral is by doing inversions. When I'm upside down I can't use any of the muscles I usually use to line things up the way I'm accustomed to, and if I don't get neutral I'll tip right over. I was amazed at how far forward I had to rotate my pelvis before I could get the weight of my legs directly over it.


And I need a new mattress too. Sigh.

[zoom-zoom]

Just make sure it is truly anteriorly rotated. I've had issues before with a lot of people believing mine is anteriorly rotated when it's actually posterior (working on it... getting closer, but still posterior). True neutral pelvis is when the ASIS and the top of the pubic symphysis are in the frontal plane. Some people judge by the ASIS/PSIS in the horizontal plane, because they can palpate both without getting too intimate ... but there's a great deal of anatomical variation, and that line actually doesn't tell anyone anything. Other people just look at the amount of lumbar lordosis, which there are both anatomical and mechanical factors at work there.

Easy way to judge is with a clipboard or cutting board. Mash it into the front of your pelvis so it's touching all three bony points and eyeball it from the side in a full-length mirror.

Oh, it's pretty obvious just looking at me what's going on. Some of the following terms have been used to describe my shape: swaybacked, bubble butt, ghetto bootay, "butt you could set a tray of cookies on like a shelf" (that came from my BFF). The graphic on the right looks like a cross-section of me:

[OakLeaf]

Yeah, like I said though, that can come from stiffness in the thoracic spine and can be partially anatomical, too. You can see where the hipbones line up in those drawings and the one on the right is indeed anteriorly tilted, but it's not as easy as if they'd drawn the pelvis as well as the spine. Take a look at this, particularly Fig. 5 - while that one is just pelves without sacra or spines, you can see how the corresponding sacra would have to be at different angles, too.

I'm sure I set myself up for some of the trouble I'm having now by trying to force my pelvis farther and farther into posterior tilt so that my ASIS/PSIS and my lumbar spine would line up to people's satisfaction (including some running instructors and health care professionals') - instead of "lifting my sitbones," as my wonderful yoga teacher puts it.

At this point I look pretty swaybacked when I urge my pelvis towards neutral too, but that's as much from thoracic stiffness as it is simply anatomical. It sure does feel more comfortable to run that way though - I can finally get my legs into full extension - and it's the only way I can balance in headstand or handstand (or could, when my neck and shoulders would allow it ).


I'm not saying yours isn't anteriorly tilted, obviously - just it's important to be sure and not try to go the exact wrong direction the way I did for so long. The fact that you feel that sitting has contributed to it is a clue ... sitting obviously urges the pelvis into a posterior tilt ...

[zoom-zoom]

Interesting--those are very different shapes.

Another thing that has me suspicious that my pelvis is "abnormal" is my seriously tilted uterus, endometriosis, and inability to successfully use menstrual cups (I tried 2 reusable ones and the Instead disposables. All were uncomfortable and leaked...actually, the insteads were comfortable, just useless). Stuff just doesn't fit right. My mom and sister have the same issues. We're all bubble-butted, too (as is my brother).

[ny biker]

I do very few exercises that directly work core muscles, though most of the weight training I do engages the core muscles to some extent.

I have had problems with my sacroiliac on the right side for years. Regular stretching has been the most important thing to manage it -- hamstrings, hip flexors, IT band, quads. Foam rolling my legs also helps.

BTW, even if your mattress is not worn out, it might not be the right mattress for you anymore.

[itself]

[QUOTE=OakLeaf;661351]Itself, I know you mentioned a recumbent when I first got hurt, but I really can't understand how that wouldn't aggravate back issues. I can't climb in the saddle at all because of the torque at L3-4. Once you can extend your hip joint farther (as I can when I stand to climb), you can let the leg muscles do the work, not your back. Sitting, just sitting without torquing the low back, is really hard on the back. Most people I know with back issues need to sit more upright on their bikes (at least temporarily) - not more bent at the hip.

Oakleaf,

Most folks who go to a recumbent who have had back problems like I have, consistently find that a more reclined position, around 30 degrees, is the most comfortable. It is incredible important on a bent, just as it is on a DF bike, to set the seat distance to the crank properly, so that there is no hip overextension.

[Hi Ho Silver]

I had lower back problems for many years and finally ended up having a spinal fusion. That was 42 years ago! And to this day if I don't walk at least a couple miles every other day, I start having some minor twinges in the back. I have always guessed that walking benefitted my back by strengthening the stomach muscles, but I am no whiz when it comes to muscles and anatomy. Also, I have to have a fairly stiff mattress or the sag in my spine when I lay on my side causes some minor back twinges that can occasionally blossom into sciatica.

Good luck - I hope you can fix your problem!

[zoom-zoom]

I had lower back problems for many years and finally ended up having a spinal fusion. That was 42 years ago! And to this day if I don't walk at least a couple miles every other day, I start having some minor twinges in the back. I have always guessed that walking benefitted my back by strengthening the stomach muscles, but I am no whiz when it comes to muscles and anatomy. Also, I have to have a fairly stiff mattress or the sag in my spine when I lay on my side causes some minor back twinges that can occasionally blossom into sciatica.

Good luck - I hope you can fix your problem!

You know, one thing I mentioned to DH earlier is that I wonder if my relative lack of running is a contributing factor. I was a runner before I was a cyclist and averaged 30-40 miles/week for several years. This Spring I trained for and ran a half marathon on that sort of mileage, but after the early May race I cut way back on my miles and most weeks all summer long I wasn't running more than 10-12 miles. I wonder if this contributed to some imbalance. I have never been great about doing core work, but I've never had back issues like this while doing a more even mix of running and biking. With the coming of Winter I'll be back to more running and less biking and that may very well be a good thing.

[jessmarimba]

I'm no expert, but running certainly helps me (in moderation, anyway). And wearing flatter shoes...the minimal running shoe movement came along at just the right time, as the standard 12 mm drop seems to increase lordosis of my lower spine just enough to throw everything out of whack. I think without returning to running and without the help of my pilates teachers, I'd definitely be on the couch popping pain pills.

[zoom-zoom]

Yup, I am already a big fan of minimal shoes. I alternate between Nike Free Runs and Brooks Pure Flows. I do use Superfeet in my cycling shoes, though, and I've wondered if it might be worth throwing them in my running shoes, at least temporarily. I used to run with Superfeet. I'd still get the benefit of the low drop and flexible forefoot, but with some medial pronation control.