Fit issues (any ideas)? UPDATE - I'm fixed.

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kbbpll
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by kbbpll

How old are you?

mdeth1313
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by mdeth1313

So I saw an orthopedic surgeon who specializes in the spine. He read the MRI and saw what the chiropractor saw. It's a bulge at L4/L5 on the right side, which explains the intermittent pain. I believe this all started years ago from stacking/hauling firewood. The pain on the bike started right after I had stacked 4 cords of wood and has gotten progressively worse this year being the worst, probably because of a few other things I did (off the bike).

I'm going on Friday for an epidural injection (cortisone shot) and I already started PT. I'm 45. I'm hoping this takes because the doctor I'm using for the cortisone shot is an ass. I really hate him. The one I wanted to use couldn't even see me until June 30th and I was not about to piss away 3 weeks. While I hate this guy, I have no doubt he can do the injection w/out issue.

Hopefully between that and PT I'll be back on the bike at some point in August.
Speedplay is the devil!

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CBJ
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by CBJ

How about an adjusted bike fit to accommodate the injury?

mdeth1313
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by mdeth1313

@CBJ:


That would be after I get back on the bike. I was fit in April (and July of 2014) and I think he had me dialed in really well, because I had zero pain and soreness after long rides (other than the L4/L5 issues) in my upper back and neck, no localized quad soreness and no cramping. Once I get back on the bike if how he had me set up isn't working I'd definitely go back.
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mdeth1313
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by mdeth1313

Valbrona wrote:https://en.wikipedia.org/wiki/Piriformis_syndrome


Funny people keep mentioning this, but I looked into it about 3 years ago (been stretching and strengthening since) and sure enough I have a herniated disc.
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Calnago
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by Calnago

I had a herniated disk (L5/S1) some years ago which really started causing a lot of issues near the end of a ride across America. I didn't know it was the disc at the time, the pain was in my leg. Once back at home I saw an orthopedic surgeon and had an MRI done. It was easy to spot the herniated disk jamming halfway through my sciatic nerve. The first step was some chiropractic treatment which I had 3x/week for several months and it did zero good. Then I started getting some numbness. I had a choice to try the cortisone(?) shots to hopefully reduce the inflammation enough to allow it to heal itself or surgery. It was February then and if the shots didn't work I would be looking at surgery in the summer. He thought the percentage chance of the shots working was about 30% so I just opted for the surgery straight away. At that point I couldn't sleep properly and could hardly bend over to tie my shoes. Had the surgery at 11am and woke up at 1:30pm and all the pain I had gone in for was gone, replaced by the pain of surgery of course, but that would heal. I've been good since. But I've heard other stories where they fix one thing only to cause another problem somewhere else in the spine. In my case it all went well. Hope you get yours sorted out.
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mdeth1313
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by mdeth1313

When I met w/ the orthopedic surgeon he suggested the cortisone shot. The surgery would work but there was no guarantee that it wouldn't come back (the bulge) and he seemed to think the shot would stick and coupled w/ PT I should be in a pretty good spot.

We'll see how this goes- I've been riding with this for at least 5 years now, any improvement would be nice.
Speedplay is the devil!

mdeth1313
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by mdeth1313

UPDATE:
I went for the epidural yesterday. Other than a splitting headache that kept me from sleeping well, I think it's taking quite well. I woke up this morning without any of the soreness I usually feel and I have zero pain or nerve sensations like I did up until yesterday. Granted, the PT has been paying off quite well as much of the pain I had was diminished, but now it's gone.

No rush back on to the bike. I need to give it a couple of days to really take hold and I'm figuring Monday I'll get out for a short ride and see how that goes.
Speedplay is the devil!

mdeth1313
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by mdeth1313

It's been interesting. The 1st epidural did wonders, but didn't work 100%. I went for a 2nd epidural on Aug 6th. I got back on the bike about 2 weeks after the 1st shot (epidural) and it went well- I was still getting some soreness and weakness in the right leg, but not the incredible pain I was having before the shot. The 1st shot also took away all the shooting nerve pain that was running down my leg and across my groin.

The physical therapy did wonders-- I started a week before the 1st shot and they identified several things:

1. my core (especially the front) was incredibly weak
2. my flexibility sucked, especially on the left side (which was the shorter leg)
3. my pelvis was totally out of alignment
4. my leg length discrepancy was functional (as they were able to get my legs level again)
5. my glutes were not firing properly (if at all).

They got me doing core exercises that wouldn't aggravate my L4/L5 issue, showed me how to stretch properly and have been working to get me back to full mobility, including getting me to consciously engage my core.

The good news is my glutes are firing properly, my legs (and pelvis) are level (and staying that way), my flexibility is improving and most of all, I was able to get back on the bike. As I mentioned above, it wasn't perfect, but it was soooooo much better than before, I could actually enjoy the rides and not have to stop every 10 miles to make adjustments. The biggest improvement on the bike (other than no pain) was the payoff from the core exercises-- 3 weeks off the bike and I was faster when I got back on, smoother pedal stroke, able to hold higher cadences w/out bouncing, better balance and I really noticed when I got out of the saddle I wasn't swinging the bike side to side w/ my arms. Real big change.

After the 2nd epidural, things improved a bit more, it takes a few days for the anesthetic to wear off and I was still sore and not thinking things had improved all that much. Today was a week. I was building the miles up but most of my longest ride up until today was 56 miles. I did 101 today. The 1st 45 miles I had a little (very little) soreness and then it was gone. I had no pain at all. The only issue I had was my left leg cramped at mile 70 - inside of the leg above the knee-- I had to adjust my position when the shim came off and I needed to raise my seatpost 1-2 mm and slide my left cleat rearward 1-1.5 mm. Fortunately, that's an easy cramp to work out and I had zero issues the rest of the way home.

Other than being really tired, no localized soreness, hopefully this lasts! Either way, I'm back on the bike and enjoying it again.
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Mr.Gib
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by Mr.Gib

Glad to hear things are going well.

Core stabilization exercises are key. You need to become the king of the plank and all the variations. Also master the pigeon stretch. Just make sure for all your exercises, therapy, and activities that you avoid anything that causes compression in the spine. Having the glutes strong and working well also takes load off the lower back.

I had a cortisone injection into my spine about a week ago. They only did one side. I can feel the difference. I need to get the other side done. I have similar disc issues to you but also multi-level deterioration of the facet joints.

The thing I did that helped me most fit-wise on the bike was to lower the nose of my saddle. This allowed me to roll my pelvis forward without crushing my boy bits and take some of the flexion out of my lower spine. A flatter back means happier discs. I also run short cranks for someone my size (170 mm) - I am 6 feet or 183 cm tall.

Good luck.
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jadekim
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by jadekim

Sometimes, i got pain around my hip. After that, i take a rest enough until i don't feel pain.
i think, first you have to take a rest. and then you give a stimulus to your hip around.
Such as yoga, massage....
you can recover your healty. :-|

mdeth1313
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Location: Dutchess County, NY

by mdeth1313

I guess it's time for an update. Last time I posted was August. By late october the epidural had worn off and I was having pain again. Not as bad as it was before the cortisone shots, but I was still having issues. I decided to find a doctor at HSS in NYC (Hospital For Special Surgeries) as they're THE place to go in NY, or at least that's where everyone told me to go. After sending all my info & history to one of their surgeons his nurse contacted me and told me I should see a physiatrist. I did my research and then called to make an appointment. This was mid-November and the first appointment I could get was January 14, but I took it. This guy had worked with triathletes and cyclists w/ similar situations and I figured I'd just suck it up and wait.

In the meantime, I continued to stretch and do exercises daily and things improved, but I'd still have issues from time to time. The good news was I felt fine on the bike, just a bit of soreness in my back, but nothing like what I had before. Completely manageable. The worst I felt was driving, especially on longer trips. With the mild winter I made up for the 5 weeks I couldn't ride over the summer.

January 14th came and I met w/ the doctor. He went over my MRI and x-rays, looked me over and told me I didn't need him. He did point out in my x-ray how I have deep hip sockets and that was probably giving me mobility issues and he suggested 6-8 weeks of PT working on my hips.

When I went for PT the 1st time the therapist worked out a ton of muscular isssues I was having so I went with it. I'm just about finished w/ the PT now. The work on my hip mobility has done wonders. I haven't felt this good in year. The car still bothers me, but purchasing a lumbar support cushion has helped tremendously and I feel great on the bike. The PT found I had severely restricted outward rotation of my hips. Specific stretches and more exercises have helped with that and I can feel the difference on the bike. I also had to add in deep massage on my hamstrings and IT band and glutes, mostly w/ a lacrosse ball and a triggerpoint roller for my lower legs.

It's working and my therapist suggested coming back every 4 months or so to make sure everything is level. I can't wait for it to warm up a bit more so I can get out for longer rides. I was able to do some 100 km rides in February, but the weather had not cooperated the last week or so.

Definitely looking forward to more riding this season. Without pain!
Speedplay is the devil!

hasbeen
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by hasbeen

good news and thanks for documenting it.
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mdeth1313
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by mdeth1313

This kind of sums up how things have gone-- my first 100 mile ride of the year (103 to be exact), the one thing we compete for on the ride is this bridge- about .8 mi at 3-4%. Not much but after 77 miles, it hurts a bit, especially early on. The camera is under my seat.

https://www.youtube.com/watch?v=Tz23U_R ... load_owner
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Marin
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by Marin

Hehe is there a huge bunch of riders right in front of you? ;)

Nice, you dropped them for good!

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