Baby Puke

Even though I had a great season in 2019 with some pretty big PB's, I've had some significant back pain issues, at times enough to keep me from sleeping at night. Casting about for remedies, I'd been doing a bunch of yoga-type stretching stuff and old-school back rehab things like roman chair back extensions. Nothing gave much relief except for not doing anything, to the point where I started doubting what I knew. I just came upon this article:
https://spinehealth.org/breaking-dow...wn-your-spine/

It pretty much says no to anything that involves full range of motion, use of full flexion or full extension under load or duration, and no twisting of the low back. This basically blows 80% of the stuff I was doing out of the water, and supports the growing feeling I've had that doing nothing was better that doing what I've been up to. A central point is 'increased low back flexibility leads to increased incidence of low back injury'. I'd appreciate folks giving it a read and posting feedback if you have thoughts, thanks.

carleton

I haven't read the article linked yet, but I'll tell you: Cycling wrecked my back. And when I was on a 100% bike or spin bike only program, my back was the worst ever. Debilitating at times. Like, call in to work because I can't get out of bed.

This is the culprit:



There is something about being hunched over in a tuck and pushing max torque back and forth across the lower back as you pedal that does it.

The only thing that gave me relief was stopping all bike work then squatting and dead lifts with moderate wight to build up general core strength. I'd have relief for days, weeks, months, even over a year...until I got back on the bike. Then, bam...pain.

I bet if you took a break from cycling and lifted with moderate weights maybe 2x/week your back would heal up. Of course, pushing those weights into proper powerlifting numbers may then start to do a number on your back for powerlifting reasons.

Baby Puke

Yep. Making things worse (and faster at the same time) I went to a longer bike and a lower, narrower position this year, trying to do a Glatzer. It worked, but ouch. I'm hoping that fixing my off-bike stuff as much as possible will allow me to continue. I'll be visiting a sports medicine clinic soon (nationalized health care, yay!) and will get some professional advice. Hopefully it won't be, "stop riding".

ruudlaff

Interestingly, I have found that excess mass can also feed into this. I was carrying too much muscle for my core/back/hamstrings to be able to handle at about 17 causing issues with my lower back. These reoccurred in my 20s due to an increase in fat %. The only thing that ever guaranteed they went away was losing mass, be it fat or muscle. Now a few years on I'm able to carry a little bit more due to flexibility work and strengthening my core. Also, worth bearing in mind that the hamstrings all the way up to the middle back should be looked at as a one when trying to correct back pain, don't neglect those hamstrings!

carpediemracing 

Huh.

This is very pertinent since I had my back go out a couple weeks ago. I'm limited to sleeping in Junior's bed now, any other sleeping surface (except maybe the family room floor) is too soft - I wake up in excruciating pain. I thought it might be the back extensions I started doing (zero lbs to max 15 lbs).

I think I'll limit my exercises to stuff that works the core as a whole, like squats and lat stuff, not target my back specifically.

My hamstrings are really tight, and lifting, even as briefly as I've done so far, really demonstrated to me just how tight they are, although it's probably also related to my back spasming.

topflightpro

I first threw out my back when I was 19. I was working in a warehouse unloading trucks, and we were way too macho to wear back braces. I've been dealing with issues from that for more than 20 years now and every couple of years, I really mess it up. I did it again back in early November, to the point that I even had trouble walking. My wife commented that she had never seen me in so much pain. I am fortunate that given my extensive experience with these issues, I tend to bounce back fairly quickly, though I am still not fully recovered from my November incident.

Anyway, I find stretching and core work helps a lot. When I'm consistent with it, my back is good. And then I start to get a little lax with it, and things go south, quickly. I also have a pretty good chiropractor, though I try to limit my chiropractor use. They treat the symptoms, not the causes.

About two years ago, I had a bike fit - for road and track, and we shortened my reach on my road bikes. I honestly find that the shorter, more upright position is worse than the lower stretched position I had. My power may be better in shorter, more upright position, but long and low helps me elongate my back and hold my core better. And it works better with my spine curve.

For years, people told me my tight hamstrings were the issue. They weren't. It was my super tight hip flexors. Cycling (and sitting) encourages tight hip flexors. The result is I tend to have anterior pelvic tilt, which pulls on the hamstrings making them tight. It also causes a more significant curve in my spine. Rotating my hips throughout the day to try to reduce the anterior tilt helps reduce pain and discomfort, as well as works my core.

Regarding weight lifting, light squats are mostly fine. If I am slow and deliberate, I can get up to almost twice body weight, but it's a long process. Hex bar deadlifts are OK. Straight bar deadlifts are not - they are asking for me to injure my back. Reverse hack squats are actually pretty good too.

Baby Puke

What kind of stretches do you do? The article proposes that most of the traditional stretches intended for low back are actually damaging, and that in fact having a more flexible low back increases your chance of injury.

topflightpro

Stretches I do most commonly:

• Standing quad
• Standing hip flexor
• Downward dog
• Cat stretches
• Cobra
• Pigeon
• Child pose
• Knees to chest
• Figure 4s
• Straight hamstrings

For strength work, I do:

• Planks
• One leg planks
• One leg-one arm planks
• scissor kicks
• Bosu ball curls
• On hands and knees - one arm-one leg extended
• Side planks
• Side planks with one leg up.

I've never heard anyone say stretching was bad. I've been to orthopedists, chiropractors and physical therapists about my back. All encouraged stretching and strength work.

There's also a substantial body of literature arguing that athletes who injure their back should continue exercising, as it will help. I once tweaked my back right before a hockey game, and I struggled to get to the ice, but after the game, it was like it never happened. Of course, a lot of this research is tied to people who exercise in upright positions. I have not had the same experience with cycling, and lifting will make it worse.

Baby Puke

It isn't that it says stretching is bad, but that stretches that twist the low back or put in in full flexion are bad, according to the article. Child's pose, for example, was my foundational low back stretch, but that is full flexion, so off the table. These are new ideas for me as well.

I'd appreciate it if people would read the article and then comment. It's pretty convincing, but I'd love to hear form people who have experience with this thing and are willing to read the article. (It's a little long, but very well written, I promise).

topflightpro

I just read the article in full. Other than the child's pose and cobra, all of the stretches I listed fit with the suggestions of the author as the spine is not flexed. Same with the strengthening exercises. And with the cobra, I tend to focus on stretching my hip flexors and abs more than arcing my back.

I do find the perspective that bending is bad interesting, and my experience doesn't disagree with it. As I mentioned, I find that having a longer top tube and stem is better because I can elongate my back more, as opposed to curving it (which the author says is not good.) I am also very adept at rotating my hips forward when on the bike.

Baby Puke

Yeah, most of the stuff you're doing is in line with this article, and I've dropped the things from my routine that conflicted with it.

I'd encourage anyone here with back issues to read this article. It's definitely a new perspective to me. I've always accepted that strength training requires full range of movement stretching as a safety and efficiency consideration. This article suggests the low back is a special case where this is not true, and it makes some points that are pretty compelling from a mechanical perspective (but of course I'm not a doctor). I'm taking these suggestions to heart and will report if they help me.

I'd particularly like to hear from people who are invested in/have extensive experience with traditional yoga poses, as this clashes with a lot of that, as far as I can tell.

brawlo

FOR ME my issues all broke down to my gluteus medius. The symptoms described were me 100%.

I have come across a sensational masseuse who is a fixer. She doesn't mess about. If you have an issue, she will either fix you, or with her wealth of knowledge, she will know where to point you to get the help you need. I had a constantly recurring back issue. I would keep working up my squat to about BW and forever be hurting my back, but I'd be over it in a week or so so persisted with it. So after one such occasion, I went to her thinking back pain again....can you fix it. She didn't fix it unfortunately on the first try, but she freed up enough of the spasming back muscles that I could literally put my finger on the problem.... my glute med. I had a recurring tear. She told me she could fix it, it would hurt and I would be bruised, but she would fix it. And she did, but I had to do something about strengthening it up otherwise it would forever be a problem.

The glute med is the muscle that does the work when we do something like a side step in football, or any other sport for that matter. As we get older and we no longer run around as much and become one dimensional (forward-back) movers or we take up a one dimensional sport like cycling, the glute med gets very weak. It is a supporter muscle for a lot of heavy lifting work and just persisting with squat or DL won't do the work to strengthen it up enough to work with the other big muscles around it. I now have lunges as part of my gym routine where I hold a KB on one side, throwing off the balance and forcing the med to work hard for stabilisation. I haven't had a problem since. BUT I also don't lift heavy any more, but I do lift a lot and I do a lot of heavy work outside of the gym.

Now I'm not saying that it's the same problem for everyone, but a weak glute med leading to back issues as people get older is a well known issue, and cycling's one dimensional movements will not help it.

Things like yoga and pilates will help you, but if you're a heavy lifter, then you will need to give the glute med some focused attention as yoga and pilates likely won't give it the level of strength needed to support heavy lifting

topflightpro

Went through my full stretching routine this morning. Mondays are my rest days, so I get the full routine in.

One thing that occurred to me when doing it is that when I do Child's Pose, I don't really bend my back. It stays pretty straight, as I'm really working to stretch my glutes.

pah

My wife and I were both track cyclists. 4 years ago her lower back totally crapped out in the SI joint. She was dangerously close to being in a wheelchair. After a very long path of different physiotherapists, massage, acupuncture and doctors and not really getting any better she was directed to a "Feldenkrais" practitioner who has worked miracles. She is able to work again and have a decent life.

Baby Puke

Sorry to hear about your wife's misfortunes but glad to hear she's ok now. If it's not too personal, would you mind sharing some details of her story? For example, what kind of racing was she doing? What kind and how much supplemental training (weight training, plyo, etc.) was she doing? What was her athletic history like? Did she have any pre-existing back issues? Was this a chronic/cumulative type injury or a sudden catastrophic injury? Any details you share could be helpful for others on here (and me). Thanks for sharing.

Gloope

BP: your linked article makes some important (i think) references to Dr. Stuart McGill. I highly recommend that if you're not familiar with him that you check out his site at backfitpro dotcom (and his reputation across the webz). From track racing I plugged into competitive powerlifting many years ago--wherein i found Dr. McGill to be held in high regard in learned circles. His "Big 3" are foundational movements and his book "Back Mechanics" is a preferred reference for many of us with back issues. Following his protocols I'm currently pain free while closing in on 60...

queerpunk

Damn, when I get sore I have to stretch my hips outward and I think it's my glute med - a lot of stuff you've written in here really resonates with me. I'm not lifting heavy anymore but I think I can definitely do some bw work to help stabilize things. thanks!

Baby Puke

Thanks @Gloope I'll check this out!

I've been doing some work on myself and have found I have a massive hip flexibility problem, maybe along the lines of what Queerpunk mentioned. I've been working it, things are improving, levels of pain are definitely down on what I was experiencing over the summer and I'm back to reasonable starting weight numbers (~100kg) for squat and DL. Also trying a narrow sumo style DL seems to be a lot easier on my back than conventional (hands outside of knees) style.

Baby Puke

This page outlines a method of back injury self-assessment and looks pretty helpful:
https://squatuniversity.com/2018/04/...low-back-pain/

Baby Puke

...and here is a plan for stability rehab and maintenance:
https://squatuniversity.com/2018/06/...ore-stability/

carleton

Baby Puke , any thoughts on what happens when you stay in the gym but stay off the bike. My back was best when I did that.

I really think the forces that sprinters send across the hips and lower back are a lot of for the body to take. Especially when hunched over in a tuck.

Baby Puke

Well, we'll see what happens, I guess. At the moment, I'm just doing gym work and pretty much no-load roller stuff as there's snow on the track here now. Feeling very good at the moment. I've adjusted my stretch routine as above, am doing the rehab mobility and core stability stuff as above, and have moved to sumo from conventional deadlift which is huge. I'm also squatting to a box to check depth. I am not going as deep as I used to, but I'm going gradually deeper as my hip flexibility improves.

it will be interesting to see how this changes with the bike work that will start in a month or so. My bike work is pretty minimal though- I do not do any road miles really, and all my track workouts are very focussed and low repetition. Maybe it will be ok.

brawlo

My 2c worth is that this points to a problem with regimented lifting, and kind of relates to what I said earlier. We become very planar and regimented in our movements as we get older and less mobile. Hitting the gym and sticking with standard lifts and strict form doesn't get all those supplementary muscles working as well as they should in order to keep up with the strength gains of the larger muscles groups. So like you mention, you can have a wicked squat and DL, but as soon as you throw the alignment out as you twist your body up eeking out all your power, those smaller muscles can't cope and *BANG*

I took up timbersports last year and the wood chopping disciplines are definitely one where you are thrown out of the planar movements. I make an effort these days to try and strengthen myself in ways that are out of the ordinary. When I do slam ball work, I purposely keep a rounded back. To start with it was taxing, but I have strength gains right through the muscular structure of the back. Every month I squat once with kettlebells hanging from the bar on rubber bands to change things up and really upset the stabilising muscles. I don't like the work to failure with big lift side of crossfit, but the functional fitness side of it I see as being hugely beneficial as we get older.

carleton

Crossfit got a few things right and quite a lot of things wrong.

I agree with you about the regimented lifting not being ideal.

Baby Puke

Totally agree with this. We get overspecialized and lose the ability to perform "normal" sports. I remember feeling like this after being a committed road racer for 3-4 years as a kid. I felt pretty strong and athletic on the bike but felt fragile doing anything else. When I started sprinting 10+ years ago, I remember it feeling more like a normal sport specifically because of the supplemental work necessary to do it (weight training)-- In addition to being fast, you are also generally strong. I liked that.

But now it's as you say: When I play soccer with my kid, I'm wrecked! I do not have a generalized fitness for athletics. I've been thinking of ways to address this, and it's a challenge as a time-limited regular adult with a life. I'm going to do more stair running/bounding type stuff, more jumping and lunging type stuff (side lunges seem like a pretty valuable movement), and also just more playing soccer and whatnot with my kid!