Lower back issue

I know this is advice - but don't take advice from anybody who isn't an expert on backs.
The best people to trust are those who say "I won't touch you until I've seen an X-Ray or MRI scan".
Others who push and pull gently after watching you walk may also be trustworthy.

I admit to being a bore on this subject: having had an NHS physio prescribe exercises that the surgeon (2 days later) who operated on my spine agreeing with me that those exercises would have left me wearing a nappy for the rest of my life.

Give your GP a call, but I would also say £250-odd on a few sessions with a good osteopath would be a very worthwhile investment.

They'll be able to recommend stretches, strength activities and so on that suit you, much better than some dude on YouTube (or a forum).

Osteopaths are dangerous quacks. Not as bad as chiropractic but its still dangerous with zero evidence base

Not as bad as chiropractic

I had a few visits to a chiropractor 3 years ago and it was really beneficial.

Not all chiropractors are charlatans. There are 3 distinct groups. One is recognised by the BMA (the ones without Australian or Californian accents and don't say "holistic"). Mine is respected by the surgeon (who very successfully operated on me) because of the advice he gave me.

You could try a quack and waste aload of money, pain, pins and needles , deadness etc.
Docs and scan required, see what's pressing on what.
Prove if it's just muscular first.
Been here, got the teeshirt had the surgery due to disc pressing on spinal cord.

Plus I had a mate saw a chiropractor three times, scan showed he had broke his back, emergency surgery required.

I do the McGill big 3 and the Foundation back workout, if you're after random youtube suggestions. I think both of these have enough commentary around them to be fairly credible - the Foundation one is just good for getting movement into the back on a regular basis, but it's an intelligent application of glute / hamstring movement. I also like the Foundation tabata one but I find it easy, so think I may not be doing it quite right.

The McGill one is based on the premise that some people with very strong cores, have very bad backs. So trad core work (crunches / twists etc) may not necessarily be the right approach.

My back is often grumbly but has only properly spasmed once - given the dubious diagnostic value of back scans in middle-aged men I've not gone down this path. If I was persistently getting spasm or lock-ups I might rethink that - Lord have Mercy that is some pain and my back isn't even that bad.

https://www.youtube.com/watch?v=EGhQD9CVVGc

Osteopaths are dangerous quacks. Not as bad as chiropractic but its still dangerous with zero evidence base

Interesting - I was referred to an osteopath by my GP, and the osteopath practised out of the GP surgery/health centre. So I assumed this was all reasonably settled stuff.

He was shite as it happens, but I've since been seeing a different one privately who has been very good. Or so it seems to me

Osteopaths are dangerous quacks.

I have always been sceptical of osteopaths but saw one recently due to severe pain in my knee and a long wait for an appointment with the physiotherapist at my GP's.

I eventually saw both the osteopath and the GP physiotherapist twice and ended up considerably more impressed by the osteopath than the physio who didn't examine my knee at all and dismissed it as arthritis, she just gave me exercises to do. The osteopath was convinced that it wasn't arthritis and made do things which she said people with arthritis can't do. My knee is a 100% fine now.

I mentioned it yesterday to a biking friend of mine whose husband happens to be an orthopedic consultant, she told that her husband once had a session with a blind osteopath for his back. Not sure how successful that was though.

I think the reality is probably that a good osteopath with years of experience, like the one I was, is probably better than a young inexperienced physio, also like the one I saw.

But I am sure that there are also shit osteopaths and great physiotherapists.

It's relatively rare for my old lower back injury from '08 to flare up in the last ~5.5 years since I began cycling for fitness, rather than simply using a bike to get around. For ~9 years, I was heavily dependent on Homedics shiatsu back massagers, I could easily use them 10+ times a day. Since '17 I've used it less than 10 times in total.

I don't do core exercises anywhere near frequently enough, only tending to do them after a flare up...
The plank (work up to ~2mins)
The bridge (one and two leg variants)
Superman (just leg and opposite arm variants)
etc.

Based purely on personal experience I'd say that sounds like a spasm.

I had a good few low back spasms and they were debilitating, I think the last one even caused the herniated disc which eventually saw me under the knife ☹️

There can be a whole load of causes, but for me it boiled down to the muscles being tired and overworked, basically always tense.

In the short term I'd say stay away from the core work! You'll end up working muscles which are already overworked!

I'd say focus on mobility and gentle stretches, especially front of hips (maybe even get a foam massage ball and work your TFL (the wee muscle that sits in the same area as your trouser pockets).

Also learn to breath! My physio taught me a breathing technique (in through the nose, chest down, fill the belly) which she only later admitted was basic meditation. It is possibly THE most effective way to manage day to day grumbling back and hip issues as it helps me relax the muscles and relieve tension. Your back spasm is basically hyper tense muscles, so learning to loosen them yourself is a useful life skill 👍

Then when everything is settled get to work on your glutes, it's amazing how reluctant they can be to do their job so the body relies on other muscles (low back...) To do it instead. Next time you ride actually try and use your glutes, it will probably feel really weird to begin with

Really interesting advice, I’d think you’re right it’s definitely a spasm. I’ve always been v pleased as it’s never gone down my legs so isn’t sciatica. Have seen an Osteopath and Chiro before as it was an injury that happened when I was younger that caused it. Once I was much better the chiro was saying “best to come back once every 6 months just to check on it” at £36 a time I decided it’s ok I’ll make my own mind up.

Funny as I was doing a yoga with Adriene for lower back and one exercise was just a basic one, lift your pelvis….. nope absolutely not! Normally totally fine, the swapping of ibuprofen and paracetamol alternating did work wonders for the pain though!

lift your pelvis….. nope absolutely not!

Glute bridge? Feet and shoulders on floor, knees @ 90 degrees, lift bum up? I don't get on with that one either, seems very difficult to isolate glutes and not also use low back. Also difficult to keep low back in neutral, it always wants to hyper-extend (arch). Only way I can do them conformably is to really brace by abdominals* to stop low back hyper-extending, and also not too lift too much, even hips level with knees is too much in my experience.

I basically just avoid it now, ironically I get less low back aggro just doing squats, lunges and deadlifts.

*I think proper bracing is a tenet of the McGill stuff, e.g. McGill crunches barely have you curling at all but just bracing abs and lifting head. A useful technique.

I was wondering if there would be any benefits to glute activation before an event, like a TT say - I've never seen it, and it would look pretty weird doing glute bridges in an A-road layby.

Very common to do before squatting weight in the gym, but perhaps that's a silly comparison. 5 or so heavy resistance movements versus 1000s of pedal strokes.

Suffered with pretty major chronic low back pain, all pretty much resolved now.

Had MRI, I have herniated disc and hip impingment.

Saw chiros, oesteo etc etc (they are quacks). Read a bunch online, loads of books. Then stumbled upon John Sarno.

John Sarno: Healing back pain. Changed my life! It's quite dated now (he's since passed away). There's newer approaches to this from other authors I can recommend if anyone is interested.

This is more for reoccuring / chronic sufferers. But seriously, it is amazing.

was reaching down to the oven yesterday to get my croissant which was only 4” lower than stood up and got a massive shooting pain on my lower back!

Mate, that sounds like a slipped disc. If you weren't already aware of that, get yourself to the GP, then for scans to see what it looks like, before you plan anything else.

Longer term (based on my own experiences), lots of plank, bit of yoga, regular stretching of hamstrings (mine seem to tighten up and pull on the lower back muscles), day in day out.

I was wondering if there would be any benefits to glute activation before an event

Yeah, I'd seen the idea debunked, but I find it's quite helpful. Throughout a day of sitting I try to get up and do some easy body weight lunges/squats etc. and will do a couple of sets before any ride.

If you get the glutes working and firing through your pedal stroke it feels just 'right'. Your upper body feels like it's just floating there doing nothing whilst the whole pedal stroke is happening from the waist down. It's a surprisingly difficult feeling to 'find' in the first place, especially at lower efforts, and I put that down to the body preferring to use hip flexors/low back/quads as that's what it is used to.

regular stretching of hamstrings (mine seem to tighten up and pull on the lower back muscles), day in day out.

Unless they take corrective action don't all regular cyclists have tight hamstrings?

Ignoring TJs hatred of osteopaths*, find a good physio, preferably with some sports expertise, and they'll do you a thorough check over to try and find the underlying cause, get you mobile and crucially give you the exercises to reduce the chances of it happening again.

Worth spending the money. But if you don't keep doing the exercises and following their advice, you'll be back to square one.

*the only osteopath I've used has always been excellent with musculo-skeletal stuff, but has a wider more physio type background. He wasn't so great with pinched nerves,to be fair.

Osteopaths are dangerous quacks. Not as bad as chiropractic but its still dangerous with zero evidence base

+1 regarding this sentiment

You need to make sure you do not have an impinging disc. A chiro was manipulating my wife's back and she had a ruptured disc. Just put her in a whole world of unnecessary pain, for which she eventually had to have a microdiscectomy.

Strength training, squats, bent over rows, deadlifts, ab roller ... should be a staple of any cyclists training. So many back issues are caused by not paying enough attention to glutes and lower back. A huge percentage of cyclists have strong quads, weak glutes and very little core strength.

Starting Strength by Mark Rippetoe was a game changer for my lower back pain. 2-3 hours cycling used to leave me with a sore lower back. Now I'll cycle 12 hour days on back to back bikepacking trips and have zero pain.

https://startingstrength.com/

If you do deadlifts with a barbell, you will soon find that when you bend over to reach into a cupboard or pick something up, you naturally adopt a deadlift stance, eg straight back, hips back and loading the hamstrings. That is a positive as you stop putting the spine into flexion when you pick things up and risk disc injury.

was reaching down to the oven yesterday to get my croissant which was only 4” lower than stood up and got a massive shooting pain on my lower back!

Mate, that sounds like a slipped disc.

 

My dad (lorry driver, used to mauling chains and tackle and railway sleepers around etc etc) once had exactly that, bending over to pick up a tea towel.

Osteopaths are dangerous quacks. Not as bad as chiropractic but its still dangerous with zero evidence base

You may be correct about the evidence base but both my dad and my sister having failed to get persistent back problems sorted by the NHS had vast improvement after osteopath treatment.

Not as a first stop but if I had back problems I wouldn't rule them out.

Just before going away in our camper for the whole of July I was floored with lower back pain (caused by awkward lifting in the course of my joinery work. Whilst I know I should have battled with the Gaurdian of the Threshold at my GP surgery, been perscribed pain killers and put on a waiting list to see an NHS physio who would have given me some exercises to do, I really needed someone to get their fat digits into either side of by spine asap. I went to a local chiropractor who despite being a quack and a charlatan, asked lots of questions about likely injuries, soon diagnosed the cause of my lower back issues as being a result of poor posture, then did some quick manipulation in the problem area and also at the neck and shoulders. The effect was pretty amazing really, I felt ten years younger, found it much easier to walk and stand upright and the improvemnts perist two months down the line. Paid for itself in about three hours as I was able to get back to work too.
It might not have a basis in science but then neither does dismissing something without having first tried it oneself.

I have had both chiropractic and osteopathy. Both are bunkum eith no evidence base and have horrendous rates of serious injury caused that would have any real medical treatment stopped if it caused such injuries

eg straight back, hips back and loading the hamstrings. That is a positive as you stop putting the spine into flexion when you pick things up and risk disc injury.

Not the modern moving and handling technique. That went out decades ago

My anectdotal evidence worked fine in my sample of one 🙂 Teej, what's your go to solution then if you say put your back out lifting a heavy bike up 104 steps and waiting six months to see a specialist is not an option?

https://www.mirror.co.uk/news/us-news/woman-28-ends-up-paralysed-27774867

Wow yes so if I was on the floor, normally I’d be fine to lift my pelvis and was able to do that. Have done an hours yoga before, even starting to do crow pose!

Thanks for all the advice, there’s a lot of it 🤣.
Going to keep doing the yoga for bad backs for a week and then will do planks etc….

Funny too as around 1 year ago did about 5 months of MTB Fitness the course, intensive planking, press-ups, sit ups, box jumps, squats you name it!

So bizarre….

I’m not going to read that link, it’s the Mirror and not alot truthful comes from that paper 🤣