Back goes pop

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ft_critical
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Back goes pop

Postby ft_critical » Fri Feb 19, 2016 6:47 pm

Hello all. I am looking to hear about members experience with recovery from a back issue. I am interested in whether there is a chronic weakness that results in re-injury and any tips to prevent recurrence.

What happened: big gear, steep hill, repeats. Sudden pop on my right side when pushing down hard on the left pedal. Walk home. Very painful.
What did I do: Hospital and physio.
Diagnosis: soft tissue injury, possible disc pop out and return. I have no tingling, bladder/bowel issues or referred pain. So this is the bodies 'normal' reaction to isolating too much stress in one spot on the back. The main site is above my right hip quite close to the spine. There is some swelling.
Treatment: strong lollies (oooohweee) and rest. Then some light 'Cobra' like exercise and back gradually to normal exercise after two weeks.

So other how have other members gone with this type of injury? Thank for sharing your experiences.

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Re: Back goes pop

Postby trailgumby » Fri Feb 19, 2016 9:23 pm

Mine was the sacro-illiac joint. Did it much the same way - put foot in pedal, stomp down to move off, POP! OWWW! Keep riding for 3 more laps of Manly Dam, oh, that's not good better stop now.

In my case, it was 3 days off work with a medical certificate for bed rest. Then, physiotherapy and resumption of the weights routine.

Best prevention of re-injury has been to strengthen muscles around damaged area to protect it while natural porcesses do their part, in tandem with exercises to fix the abnormal muscle recruitment issues that triggered the injury in the first place. I am still wearing my SIJ brace while riding, but no longer need it for normal activity. Eventually I wil be able to lose the brace wile riding as well.

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Re: Back goes pop

Postby ft_critical » Fri Feb 19, 2016 9:41 pm

What is a SIJ brace TG, why did you need it and how long have you needed to wear it for? I understand the acronym.

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Re: Back goes pop

Postby trailgumby » Fri Feb 19, 2016 10:07 pm

ft_critical wrote:What is a SIJ brace TG, why did you need it and how long have you needed to wear it for? I understand the acronym.
It's one of these: http://dianelee.ca/article-si-belt-compressor.php" onclick="window.open(this.href);return false;

Basically it reduces the movement of the sacrum against the illium. Mine is loose, as a result of injury sustained in my sedentary phase. Basically I missed my step in the street, landing with hard-heeled leather dress shoes (my job has always necessitated a suit and tie dress code) in a depression in the footpath with my knee locked out. The shock went straight up my leg and hip and displaced the SIJ.

NSAIDs were required to settle it down, but it has remained prone to injury over the last decade and a half if I get lazy with maintenance exercises, which happens when the pressure mounts at work. Latest episode was spring last year after 3 or so years being pain free.

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Re: Back goes pop

Postby ft_critical » Fri Feb 19, 2016 10:13 pm

Thanks TG. I did wear my wife's old maternity support belt yesterday. It looks similar to your SIJ belt but with two straps. I don't think it did much more than support me psychologically.

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Re: Back goes pop

Postby m@ » Fri Feb 19, 2016 11:09 pm

I had a similar episode recently; pretty much identical except that it happened off the bike, JWA... luckily I was at home as I spent the next hour prostrate on the floor. About three weeks of nasty pain and extremely limited mobility; I almost never take painkillers of any sort but this was severe enough for me to take whatever I was prescribed. Pretty much just came right, though very gradually - so I guess my only advice would be to not push it.
I've seen things you people wouldn't believe

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Re: Back goes pop

Postby ft_critical » Sat Feb 20, 2016 6:28 pm

Thanks m@, 3 weeks oh no - this is now day 3 for me.

So is the area now weak and subject to re-injury?

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Re: Back goes pop

Postby m@ » Sun Feb 21, 2016 3:57 pm

Well, I guess every injury is different... I did have some pins and needles in my leg initially, but not after the initial couple of hours... didn't seem to worry the Dr unduly, and I never had a solid diagnosis as he didn't want to send me for and MRI unless necessary. I didn't bother going back after the initial few days where I was off work as it gradually got better from then.

Seems fine now, touch wood - in fact I'd forgotten about it until seeing your post! The initial injury was in early December and I rode the Goldfields Track a month later, though with some residual soreness. Now it's only laziness keeping me off the bike... :oops:
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Re: Back goes pop

Postby ft_critical » Sun Feb 21, 2016 8:10 pm

m@ wrote:Seems fine now, touch wood - in fact I'd forgotten about it until seeing your post! The initial injury was in early December and I rode the Goldfields Track a month later, though with some residual soreness. Now it's only laziness keeping me off the bike... :oops:
Gosh I hope I am in the same condition in a month because I am very debilitated right now. Every time I twist a certain way or relax my muscles too much I get a shooting pain. Only lasts 1 second, but it is enough to make me exclaim loudly!

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Re: Back goes pop

Postby trailgumby » Mon Feb 22, 2016 8:38 pm

ft_critical wrote:Every time I twist a certain way or relax my muscles too much I get a shooting pain. Only lasts 1 second, but it is enough to make me exclaim loudly!
Oh, that is not good. :(

Have you been given anti-inflammatories in addition to pain meds? I don't mean nurofen, I'd be getting an MRI if it doesn't start easing within a few days with anti-inflammatories.

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Re: Back goes pop

Postby ft_critical » Mon Feb 22, 2016 10:01 pm

trailgumby wrote: Have you been given anti-inflammatories in addition to pain meds? I don't mean nurofen, I'd be getting an MRI if it doesn't start easing within a few days with anti-inflammatories.
I have Endone which is pretty good. Hospital wouldn't do an MRI due to no referred pain, fever, loss of function etc.

As I have more experience with it I wonder if it is not the IC joint. What were the symptoms you had TG?

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Re: Back goes pop

Postby vosadrian » Tue Feb 23, 2016 11:02 am

I have SIJ issues. I get pain in the lower back and also in my hip on the iliac crest and down into the groin (pubis joint?). It turns out that mine got misaligned pretty badly at some point and I did nothing to get it realigned so my body got used to the misaligned position (probably for several years) and pain reduced but would never go away. I have recently been seeing an Osteopath who is able to realign it (Chiro should also... not sure a Physio would). The problem is that if it has been out for a long time, it can be hard to keep it in. Therefore it has to be regularly put back in. Mine was in for about a month until last weekend, and unfortunately it somehow was knocked out again. I think it may have happened when I was lifting some things in the garage, but was not acute when it happened. The pain got quite bad again. Osteo put it back in yesterday. Pain is still pretty bad, but will hopefully reduce now. So the best I have had so far is about a month in alignment. I am thinking of getting an SI belt to hold it in place better. At least I can wear that when doing any lifting or anything. When it is in alignment, the pain reduction is still quite gradual. Unfortunately I don't get the dramatic improvement I hear some people get from Chiros when they are manipulated. I think this is something I will probably be managing for the rest of my life.

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Re: Back goes pop

Postby ft_critical » Tue Feb 23, 2016 12:42 pm

Thanks vosadrian. Just back from the doctor and sports physio; it is not SIJ, it is L4/L5 herniation. I am very depressed. I was really on track with everything. The big gear repeats were just to prepare me for Thredbo and not to feature in regular training.
I would appreciate hearing how people have recovered from disc issues? They indicated the pain should ease such that I can resume a normal life. However,they don't probably mean 300km of cycling and racing.

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Re: Back goes pop

Postby vosadrian » Tue Feb 23, 2016 1:02 pm

It did surprise me that the SIJ would go when cycling. I tend to find that cycling causes me no SIJ issues. I have cycled pretty hard recently during the period I kept my SIJ in place.

I have had herniation before... for me it just took time to recover (I think it was 6-8 weeks). Cortisone injection may help (temporarily??)... or may do nothing (I find cortisone rarely helps me with anything). If you need to get going quickly, I would try the cortisone... some people get instant relief... even if it only lasts a month, that may be enough. Also consider some inversion therapy to decompress the spine (to take some load off the herniated disk). Inversion tables are pretty cheap... just a few minutes in morning and evening hanging may help.

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Re: Back goes pop

Postby ft_critical » Tue Feb 23, 2016 3:21 pm

vosadrian wrote: I have had herniation before... for me it just took time to recover (I think it was 6-8 weeks). Cortisone injection may help (temporarily??)... or may do nothing (I find cortisone rarely helps me with anything). If you need to get going quickly, I would try the cortisone... some people get instant relief... even if it only lasts a month, that may be enough. Also consider some inversion therapy to decompress the spine (to take some load off the herniated disk). Inversion tables are pretty cheap... just a few minutes in morning and evening hanging may help.
Thanks vosadrian. I have been told to do the 'cobra' position every hour to get the hernia back inside the disc - so great advice on inversion.

How have you been since your herniation?

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Re: Back goes pop

Postby vosadrian » Tue Feb 23, 2016 4:22 pm

In 2009 I had L4/5 herniation. This was prior to me doing any real cycling. I was working on my car and twisted to pick up a tool and I was in a lot of pain instantly. It stayed quite bad for around a month and then over a few weeks it reduced to normal. I still get some occasional numbness in my foot arch which I think may be related (as it started at that time). I never did cortisone at that time. A friend of mine did similar and had cortisone and a few days later he was back to normal. I think the cortisone did not fix the problem, but it masked the pain while the problem was being healed naturally. I think the real risk with cortisone is that you have to take it easy which is more obvious when in pain, but you may overdo it and prevent healing if not feeling any pain.

I have an inversion table now that I got when a recent bout of back pain started (before I worked out what was going on). It seems my current issue is SI joint, and the inversion table does not do much to help with that, but I think it would be good for a herniation. It should achieve similar to the Cobra, but maybe better and you can do it for longer in more comfort. Some people struggle with being inverted with the blood pressure to the head, but I am OK with it. My main issue is getting sore ankles from where you hang from. Thick socks helps. I just turn some music on and flip over and listen to a couple of songs... 5-10 minutes. Try to do it morning and evening, but mostly evening only. They say just prior to bed is good as it opens up the disk before you then lie down for sleep which does not put force back on it until you get up and gives it a good chance to heal over night. Note that in my case it has not helped mu pain much so I am not a success story, but I think it could help with yours. Plenty of people with herniation issues who have used inversion to good effect in product reviews/forum posts.

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Re: Back goes pop

Postby vosadrian » Tue Feb 23, 2016 4:26 pm

Oh, I should mention that I now have some facet arthritis at L4/5. I think it is probably related to the 2009 injury with the L4/5 disk. I wish I had done some inversion type therapy back then as perhaps I would not have damaged the facet joint! The arthritis will probably be an ongoing issue for me unfortunately so I doubt I will ever be pain free.

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Re: Back goes pop

Postby ft_critical » Sun Feb 28, 2016 12:37 pm

7days post injury CT. Managed 2hrs on the trainer today with occasional stabbing pain... :cry:

Image

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Re: Back goes pop

Postby NeillS » Fri Mar 18, 2016 4:30 pm

That disc looks pretty fine to me in that image (but CT scans suck at the best of times so it's a moot point really). Herniation will be more one-sided anyway so have to look at the other slices to see it.

FWIW discs heal up just fine (they don't regain their previous shape though) in a few months. The human body is well capable of getting past something as minor as this. Everyone has herniated discs by the time they're 50, and very rarely do they cause chronic pain. You'll be fine.

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Re: Back goes pop

Postby ft_critical » Fri Mar 18, 2016 9:09 pm

NeillS wrote:That disc looks pretty fine to me in that image (but CT scans suck at the best of times so it's a moot point really). Herniation will be more one-sided anyway so have to look at the other slices to see it.

FWIW discs heal up just fine (they don't regain their previous shape though) in a few months. The human body is well capable of getting past something as minor as this. Everyone has herniated discs by the time they're 50, and very rarely do they cause chronic pain. You'll be fine.
Hi Neil, you have a keen eye. Yes subsequent scans have shown it is much better. There was a fair amount of ligament damage as well.

I think we are now exactly a month post injury and I have been on the road once and am heading out tomorrow. With physio it has healed quickly, albeit there is still stiffness and some weakness. I haven't stopped working on the trainer which has probably slowed progress though.

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Re: Back goes pop

Postby jpgibson » Mon Mar 21, 2016 7:36 am

Glad you're getting better.As the owner of two disc prolapses ( the usual L4/5 and L5/S1) I feel your pain. CT is pretty useless and is a dose of radiation. MR is the best BUT if you're getting better and don't have any serious problems it is most likely a waste of money. Insurers may now see you differently too ( my income protection now excludes all low back type things).One of my mates did all his imaging etc 'privately' ....etc etc :D

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Re: Back goes pop

Postby ft_critical » Mon Mar 21, 2016 11:42 am

Thanks jpgibson. It is surprisingly painful.

Post physio and back on the bike, I am in part stronger. Like most things, it is clear that my injury was as a result of a weakness, exacerbated by misunderstanding. In getting lower on the bike I was bending more through the lumbar. I had previously had pain in the area of the iliac crest. What I didn't realise was that this was a result of the arching of my back forward (not maintaining the neutral spine) and shortening of the ligaments in the front of my body (legs and stomach).

The exercises give to me by the physio have immediately given me that neutral spine when climbing and facilitated stronger hamstring and glute engagement when climbing. This engagement is something I have been searching for for years.

The back is still weak descending over bumps and oddly very weak when changing gears standing (I think this is referred to the as the 'footfall' issue).

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Re: Back goes pop

Postby vosadrian » Mon Mar 21, 2016 1:42 pm

Hey ft,

Your mention of pain on the iliac crest caught my attention. I have recently been getting pain on my right illiac crest. It started about 9 months ago 1-2 months into a period of no riding (trying to rest my ankle) and I was swimming for fitness. It was about a month after I twinged my back very painfully and I am not sure if the two were related. ANyway I continue to suffer pain on illiac crest and have been seeing an Osteo and acupuncture for it. Lots of deep (agonising) massage of the area. Some stretches, but I have been riding the last 6 months or so and it does not hurt while riding. I am interested in any information on your iliac crest pain. Mine is worst after sitting at my desk all day. It can make it very uncomfortable at work so would like to fix it. I have also been suffering pelvic alignment issue (SI joint), so not sure if it is related to that.

Cheers,

Adrian

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Re: Back goes pop

Postby ft_critical » Mon Mar 21, 2016 1:57 pm

vosadrian wrote:Hey ft,

Your mention of pain on the iliac crest caught my attention. I have recently been getting pain on my right illiac crest. It started about 9 months ago 1-2 months into a period of no riding (trying to rest my ankle) and I was swimming for fitness. It was about a month after I twinged my back very painfully and I am not sure if the two were related. ANyway I continue to suffer pain on illiac crest and have been seeing an Osteo and acupuncture for it. Lots of deep (agonising) massage of the area. Some stretches, but I have been riding the last 6 months or so and it does not hurt while riding. I am interested in any information on your iliac crest pain. Mine is worst after sitting at my desk all day. It can make it very uncomfortable at work so would like to fix it. I have also been suffering pelvic alignment issue (SI joint), so not sure if it is related to that.

Cheers,

Adrian
Hi Adrian,

So as always, disclaimer, this is about me and my experience but it would be awesome if it helps you. So my pain in the iliac crest was also right side and never extended into the leg. So it was localised. I would characterise it as a deep burning sensation. I would get it on rides but more when not riding (as in next day or a few hours after riding - as you say, sitting at your desk). What initially worked was doing a quad stretch and at the same time stretching my right arm up above my head on the wall. In effect trying to stretch through the front of my right hip. This made the area manageable.

What I have been doing with the injury is pretty simple three fold and means I don't have any pain off the bike:

Pelvic floor exercises, just simply engaging them,
Glute stretch on my back, glute massage on the roller, and
Get a neutral spine, engage the pelvic floor (down on all fours) and rear leg lift to straight behind me.

When on the bike, I would eventually get the pain when climbing. Now by rolling my lumbar forward and also in effect breathing in deeply to draw my ribs up and back I can climb without pain. I engage my hamstrings, glutes and my cadence is higher.

To be honest - it is amazing.

Happy to discuss in more detail if you like. If I get any inkling of the issue at work, I simply bring my lumbar forward under me and sit tall. It goes almost immediately.

FT.

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Re: Back goes pop

Postby vosadrian » Tue Mar 22, 2016 9:44 am

Thanks FT,

I will look into some of those stretches/exercises. Was there any diagnosis for you? Like a syndrome in a particular muscle or something? Are there more aggressive treatment options (cortison injection??). I have spent the last 2 years doing exercise and stretchs to fix varying ailments without success (and I believe I am very compliant in doing what a physio tells me). I am losing faith in that approach. I will definitely give it a go, but if there is something to accelerate the process, I would look into that.

Cheers,

Adrian

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