Knees and back health

Outside of being active and doing things to strengthen core (think we’ve got that covered w/ forum namesake activity) the best hack I’ve employed for years of chronic lower back issues (all thanks to college hockey) is splurging on a high quality mattress, also ensuring what I got was optimal for side sleepers (which I am).

Between mtb’ing and the mattress can’t remember last time I woke up w/ a stiff or sore back.

At one time lower back was so bad had to get an epidural due to one disk being torn and another herniated.
 
I have a ton of knowledge and opinions on back pain, I will say I have soured on McGill in recent months. I spent 2 months with a McGill Master Clinician to start after 2 months at a run of the mill local PT that was 15 minutes of exercises then 15 minutes of heat and stim. All that and I still ended up getting a L4/L5 microdiscectomy back in February. Orth and both surgeons I consulted all were positive.

His opinions on back surgery are off base. The stigma towards surgery as an option (when needed) is very harmful and people living with sciatica being pushed to "just do the big 3 bro!! or just walk!!" It's idiotic. I got my life back that day. I was laying on the couch 10+ hours a day any day I wasn't working. It was the only position that didn't agrivate my nerve. I returned to the bike trainer 4 weeks post op, the road 10 weeks post op and now mountain biking 5 months out. I feel fantastic day to day. If I didn't get surgery there's a chance I would've lost strength in my leg and the nerve could've been permanently damaged.

I will say protecting my spine day to day is a concern and will be for the rest of my life. I don't sit on bad couches, I alternate standing and sitting at work 1:1 ratio, I don't bend my back to pick things up (golfer lift, split squat or hip hinge), I do core work and stretch every day especially before rides. All that so I can go mountain bike and fingers crossed never have to have another MD.
 
With nearly 60 years of martial arts training and competition, meaning a lot of years kicking things and people, my knees pop and crack all the time. It was bad in the mid 90s when I needed knee braces just to walk. Quad stretches helped a lot. I still stretch every night. That's key.

I broke my back in 2020 just as COVID started. My lower back gets very weak during the winter when I do much less climbing on the bike. My back being stronger coincides with how much climbing I do. I suppose it's all about having a strong core. I also do spinal twists with my stretching regimen every night, which feels amazing.
 
Arthritis in my knees and back, as well a couple degenerative discs is why I ride so much. It has been the absolute best thing for my back after a bunch of medical imaging and PT I started in February 2023. Every month has been an improvement, haven’t even used any ice or Aleve in several months now. The shooting and/ or constant pains I was getting before getting my core strong, were pretty bad.

It’s important that I get out three times a week and ride, generally 2-5 hours per ride. Keeps me mostly pain free for other activities now. If I miss a ride, my back starts to bother me and the next ride clears it up! Amazes me every time. Still very careful lifting stuff, maintaining posture and getting out of the saddle on bumps.

Arthritis in my hands/ thumbs too but that’s been pretty much OK since I switched grips. Thought it was a coincidence until I rode the bike I hadn’t switched them on yet.
 
I have had on/off back issues for many years even before I was riding bikes, mostly because in my 30's and early 40's I was overweight and generally unhealthy.

It really came to a head in 2017 2 days before the GFNJ event. I was literally just making the bed and I ended up with probably the worst back spasms, lock up I had ever experienced, to the point I could not walk for a few hours. I hobbled myself to a Chiropractor that day and he gave me several treatments over the course of the next 24ish hours to try and loosen it up but it didnt really help. I don't know how I even went to the ride let alone finish it but I was stupid and determined to complete all 108 miles since i spent 6 months training for it.

The next year consisted of seeing many back and ortho specialists including the guy that does ortho for the NY Jets. The bad news was they never really found "the issue" and I had to just work through PT and home exercises to manage it. Since then I have always protected my back when doing ANYTHING and I am in much better condition fitness wise too.

If I feel anything strange or weird with my back at the very first sign (which there's always a warning feeling) I go back to the basic at home PT stretches which totally help. In fact doing the 31/31 challenge Ive had a few days where the back wasnt happy and doing these PT moves beforehand really loosens it up for me.


Like everyone else I could and should do more core work but I'd rather be out riding. ;-)
 
I unfortunately have much experience with this.

2004 Minimally invasive L4/5, L5/S1
2011 Open L3/4 anterior herniation, work comp, traumatic injury, emergency surgery, drain, overnight hospital stay
2016 L4/5, L5/S1 fusion

Chiros and PT think they can fix everything. Surgeons think Chiros are quacks and PT only prolongs the inevitable. Neuros think Orthos are hacks.

My mother and father and sister have all had some form of lumbar surgery, although not like my history, and there can be a genetic component to back issues. My vertebrae shape and disc height predisposed me to issues. High school football, many years as an EMT lifting patients, then 25 years in a patrol car sealed my fate.

Find the right doc and BE YOUR BEST ADVOCATE. No one really gives a shit except you, so speak up!
 
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Lunges, quad, stretches and pigeon pose keeps my lumbar spine from tensing up.

Dead hangs on a pullup bar stretches your entire spine plus has a benefit of relieving some scalene tension for your cervical spine. It can flare lower spine so be careful.

I had prolotherapy in my cervical spine for my back muscle knots and it has helped them a lot. i have a 4mm disc bulge in my c5 that has been giving me issues.

PT helped my neuro said i am lucky to feel as good as i do. I have been using an amazon traction device and being gentle with it and i don't have severe arm pain anymore. I told him that helped me the most and he said he would advise not but i still use it as it has been what helped me the most.

An artificial disc is almost inevitable but i can do everything except DH and really cranking on my road bike using my arms.
 
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Lunges, quad, stretches and pigeon pose keeps my lumbar spine from tensing up.

Dead hangs on a pullup bar stretches your entire spine plus has a benefit of relieving some scalene tension for your cervical spine.

I had prolotherapy in my cervical spine for my back muscle knots and it has helped them a lot. i have a 4mm disc bulge in my c5 that has been giving me issues.

PT helped my neuro said i am lucky to feel as good as i do. I have been using an amazon traction device and being gentile with it and i don't have severe arm pain anymore. I told him that helped me the most and he said he would advise not but i still use it as it has been what helped me the most.

An artificial disc is almost inevitable but i can do everything except DH and really cranking on my road bike using my arms.
Ive been trying to get up to three minutes with a dead hang. My hands hate me for trying.

Then I see this guy:

 
L5/S1 fusion
what kind of impact did this have on your movement and QOL? Any regrets? I had the discectomy but am a bit concerned about fusion if I have to go back for it.

On another note, here’s a great place to visit and browse for back relief products. I’ve given the one in Cherry hill a lot of my money: https://relaxtheback.com/
 
what kind of impact did this have on your movement and QOL? Any regrets? I had the discectomy but am a bit concerned about fusion if I have to go back for it.

On another note, here’s a great place to visit and browse for back relief products. I’ve given the one in Cherry hill a lot of my money: https://relaxtheback.com/

My recovery was a bit slower than I had expected, even with lots of PT and a bone stimulator. But 5 months later I was fully healed, back to work, and riding. It's likely the strongest part of my back now.

The surgeon told be the idea is to get you from a 7/8 pain and numbness down to a 2/3. Mission accomplished. I have some lingering numbness in my right shin but that is from the L3 emergency surgery. And it's nothing that prevents me from doing anything within reason.

Longterm, I do occasionally have some thoracic aches in the T9-11 area and I for expect that L3 may need some work down the road as that's where my flexibility comes from now.

QOL is better and I'm happy with my fusion. My biggest issue was instability, not pain. I was at risk for another traumatic event at work that could have paralyzed me. My surgeon had another patient who ended up incontinent and needing to learn to walk again. I certainly didn't want that to happen. The fusion locked everything down.

ROM is not great. But I manage just fine. I can ride and clean my cars and tie my shoes!

Surgeon told me no shoveling heavy snow, no golf or softball. Otherwise, no restrictions.
 
My recovery was a bit slower than I had expected, even with lots of PT and a bone stimulator. But 5 months later I was fully healed, back to work, and riding. It's likely the strongest part of my back now.

The surgeon told be the idea is to get you from a 7/8 pain and numbness down to a 2/3. Mission accomplished. I have some lingering numbness in my right shin but that is from the L3 emergency surgery. And it's nothing that prevents me from doing anything within reason.

Longterm, I do occasionally have some thoracic aches in the T9-11 area and I for expect that L3 may need some work down the road as that's where my flexibility comes from now.

QOL is better and I'm happy with my fusion. My biggest issue was instability, not pain. I was at risk for another traumatic event at work that could have paralyzed me. My surgeon had another patient who ended up incontinent and needing to learn to walk again. I certainly didn't want that to happen. The fusion locked everything down.

ROM is not great. But I manage just fine. I can ride and clean my cars and tie my shoes!

Surgeon told me no shoveling heavy snow, no golf or softball. Otherwise, no restrictions.
Ugh…socks and shoes are the worst 🤬. I think you’re right that a (little) reduction in ROM is a small price to pay for less severe pain, less concern of paralysis and the ability to think of anything other than how to get rid of the pain in your back.
 
I just had an epidural injection at c5. im planning just one before thinking about surgery. Slightly dizzy for the first 15 minutes. So far i feel the same tonight like it didn't happen.
 
I just had an epidural injection at c5. im planning just one before thinking about surgery. Slightly dizzy for the first 15 minutes. So far i feel the same tonight like it didn't happen.

I had a few at the recommendation of my surgeon to reduce inflammation before surgery. And to get to warmer weather so I didn't slip on ice after surgery. But pain wise they lasted a few weeks.
 
Outside of being active and doing things to strengthen core (think we’ve got that covered w/ forum namesake activity) the best hack I’ve employed for years of chronic lower back issues (all thanks to college hockey) is splurging on a high quality mattress, also ensuring what I got was optimal for side sleepers (which I am).
What mattress did you get? Inquiring fellow mountain bikers with sore backs who sleep on their sides would love to know
 
What mattress did you get? Inquiring fellow mountain bikers with sore backs who sleep on their sides would love to know
Never would have guessed that I’d end up with a tempurpedic but did. Can’t for the life of me remember the model. It was many years ago so probably irrelevant anyway. But researched mattresses best for side sleepers and went w/ that model after comparing against other recommended mattresses. Of course it had to be like one model down from top of the line, but ended up and still is a great investment.
 
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