Back Issues Are Dumb

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My lower back is stupid, and has been this way for about the past 2 months. For a long while it was just nagging tightness that irritated me, but I was able to mostly ignore it, since running and biking seemed to make it feel better. For about the past week it has hurt a LOT worse and is really f'ing with my sleep and ability to carry on my normal activities. I suspect I really aggravated it during last Sunday's CX race, which had some hills that I really mashed to get up (I have yet to convince DH that I could benefit from easier gearing on my CX bike, since I almost NEVER use my big ring during races and frequently wish I had a few extra teeth in the rear cassette or maybe a smaller small ring up front). Everything in the region of my lower back/upper butt/hips is tight and very sore.

This is probably the nicest day we will see in weeks...or even months. Could be my last chance to get in a ride on my road bike in relative comfort. My mileage this past week was crap. I'm gaining weight (already 25#s over where I'd like to be, so this does not help), I'm losing fitness, and I'm really freaking frustrated. I have a new mountain bike and I can't really ride it well until this is better.

So, I want to go out and ride an easy 20 miles on my road bike. Part of me thinks this is a good idea, since my back seems to feel better while I gently run and ride, but before and after it feels crappy. I don't know if my workouts are helping or hurting. I'm already wisely planning to skip tomorrow's Halloween CX race, since I am certain that that level of effort is not good and I don't really want to end up with everything seizing-up mid-race (I think I got close to that happening last Sunday).

Today the official plan is to do some yoga and an easy 3 mile run (2 with the rugrat). I should probably just run and forget the bike ride, even though I have all my clothes set out and the sun is shining and it's not very windy. I'm so tired from not sleeping well in months, anyhow--I wonder if it's a vicious cycle...I don't sleep well, so my back doesn't heal. Because my back hurts I don't sleep well. It's a wonder I haven't come down with something. I've never in my life dealt with lower back stuff like this, so aside from seeing the doctor in a few days if it's not better, I don't really know what to expect or how riding my bike might help or hurt matters. I do know that I need to be more diligent about doing core work in the future, but in the meantime I suspect that doing core work could make matters worse. Catch-22 with that, too.

Approaching 40 is really for the birds...since this back stuff started I feel really old and feeble. Our mattress is 10ish years old, so we wonder if it might need replacing, but DH has not been having issues and flipping it didn't help.

Thoughts? BTDTs?

[tealtreak]

what a bother! do you do core work? all the cyclists I know with low back issues (that have resolved the pain) found strengthening the core, strengthening opposing muscle groups,..helps much..... I am 51 and have found I need to strength train all year round to be able to go hard and be relatively pain free....This guy has several good books on that theme- He is 57 and still racing exterra!

http://www.bicycling.com/mountainbik...riding-forever

[itself]

Try a recumbent bike. My Bacchetta Ti Aero is fast and comfortable. No neck or back issues any more !

[zoom-zoom]

what a bother! do you do core work? all the cyclists I know with low back issues (that have resolved the pain) found strengthening the core, strengthening opposing muscle groups,..helps much..... I am 51 and have found I need to strength train all year round to be able to go hard and be relatively pain free....This guy has several good books on that theme- He is 57 and still racing exterra!

http://www.bicycling.com/mountainbik...riding-forever

I am really bad about my core work--especially in the Summer when it's hot in the house and I want to be outside. I KNOW everything works better when I don't neglect my core, but knowing something and DOING it are very different things (this is why I am still 25#s overweight...knowing to eat healthy and actually doing it...heh). This is my first ever bad bout with lower back stuff. I don't know how people who live with this all the time do it. I totally get how they could get hooked on pain meds.

[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.

[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.

[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).

[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.