Yet Another Cycling Forum
General Category => Audax => Topic started by: Delph Cyclist on 07 July, 2018, 09:29:20 pm
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My Audaxing career has gone pear-shaped! I have these terrible pains in my left hip, left calf, left ankle and left buttock (the piriformis muscle, latin for "pear-shaped" by the way).
The pain is such that I'm living on ibuprofen, paracetamol and (only when I really need it) co-codamol, all as over-the counter medication. My GP has prescribed omeprazole to control the side effects of long term ibuprofen usage, as I've been on it now for 7 weeks. I have an NHS physio appointment for 3 weeks time, so I've had to take myself to my local physio for private treatment. It really is painful and I'm constantly watching the clock for when I can take the next dose.
My question is, is this common with cyclists, and with long distance cyclists? Does it sort itself in due course and have I just got to be patient? I have been given a routine of exercises so if it's all down to me, then so be it and I'll keep at them.
I'm off the bike, which is a blow as my last ride was the Not the Spurn Head 400 (which I completed without trouble) and my next should have been Rennes-Brest-Rennes 600 (DNS),which would have been my final qualifying ride as an Ultra-Randonneur.
Fortunately it's only down the left side. I can only hope that I'll be back for my 10th SR series next season. I can't see me doing a 600 before the end of September.
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The only time I got sciatica (or was it lumbago?) was when I was (semi-)seriously time-trialling.
I'd find a good sports-physio of the kind who wants to sort out your problems rather than adapt your lifestyle to cope with them (NHS in my experience tend towards the latter). Your local club might have a recommendation.
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IH's recommendation is the way to go.
While I've not seen hard numbers, I don't think sciatica is more prevalent in long distance cyclists than in the general population.
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Commiserations from a sciatica sufferer, sciatica is invisible to others but can be debilitating.
I was never much of a audaxer but was doing about 7K miles/year when it first struck just over 2 years ago. In my case, I am convinced that the cause of the first serious episode was working on a fence, maybe hammer drilling in concrete.
At its worst, I could barely walk and couldn't turn the right foot pedal at the top of the stroke. Sciatica is not just pain but any nerve interaction with the whole leg. I fell over when walking a few times.
It is worth insisting with your GP and the NHS to get to the bottom of the cause, in my case a herniated/slipped disc between the L2/L3 vertebrae. Surgery was initially on the cards but fortunately things started to recover first.
An MRI scan may identify the root cause. My initial NHS MRI didn't cover the whole lumbar system and the consultant follow-up was going to take months, so I used my work's health insurance to speed things up.
Physio may help (or not).
I'm now back to nearly full cycling. I have no long term pain on the bike.
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IME it can come suddenly, stay a while and depart slowly but that, of course, is dependent on there being no structural anomalies such as herniated discs. It may be, too, that something in your everyday life is prolonging the agony. I had a long dose of it in 2013 following a sacroiliac injury, and it only started to get better when I stopped driving distances over 50 km - which, incidentally, meant that I could no longer attend meetings of the regional FFCT committee, which in turn compelled me to resign and so lose my authority to organize Audaxes.
I'd go for the sports fizzy as LWaB suggests - and have a think about your driving position.
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Disclaimer: Your back will be different, IANAD
Try this: Clicky (https://www.verywellhealth.com/mckenzie-exercises-for-your-low-back-2696222). Probably best to read the book too: BigRiverLink (http://amzn.eu/7QgMT6d)
We assume it is the sporting activity that is affecting our spines, but only HAMR mileage riders are riding all day, every day. How you sit and stand in the rest of your existence makes (much) more difference.
The last two physios I went to (one private, one NHS) both said that a big issue for me was the massive difference in strength between my core and my quads. I'm supposed to do core strengthening exercises- but they hurt if my back is bad. The McKenzie exercises have given me relief within a week.
I use a kneeling chair at work, and try and avoid slumping.
My Mum was diagnosed with Piriformis Syndrome and has had relief through physio and pilates.
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How you sit and stand in the rest of your existence makes (much) more difference.
I think so too. As I mentioned to Mike the other day, I have had very similar symptoms for about 18 months now, though nothing like as severe by the sound of it. I haven't had a diagnosis yet and I just put it down to 'growing old'. At best I can walk about 5 miles and at worst (one occasion) I had to turn back after 100 yards. However in my case cycling seems unaffected and I have just returned from a successful and painless Alpine tour. I'm pretty sure it is connected with reduced activity in winter - I would simply call it stiffening up.
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I had sciatica about 12 years ago tho it was caused by a back injury
The worst pain I have ever felt
Physio worked after everything else failed
I remember phoning the physio one day to tell her the exercises hurt to which she replied" it's working then " and hung up
I found a tens machines helpful too
Keep at it
I cycled more often and further post sciatica
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As someone in a medical profession it's interesting to see the previous responses which are all about mechanical solutions.
Young medics nowadays are taught listening skills (though I'm not sure how easy they are to use if they don't come naturally) so we really should begin with "Oh my goodness Mike, I'm really sorry to hear you're suffering so much, it must be really frustrating."
And I genuinely am, Mike: audaxing has been a major part of your life for a very long time and you've been an outstanding servant of Audax UK.
My (better medically qualified) other half echos the recommendations above and certainly doesn't have a quick or simple solution. Keep your spirits up, and for a while at least, be grateful you don't have to suffer the baking sunshine the rest of us are enduring.
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You could try exercises for Piriformis Syndrome. They worked for me.
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Another +1 to IH's point. I have had minor problems with sciatica, which is partly related to long distance cycling, but there are other factors - one of the biggest is commuting by train as the seats on South Western Rail are designed for people substantially shorter than me, so I sit with unsupported hamstrings and often not being able to move, because of interlocking knees and feet with the person opposite.
My issue is a combination of muscular and skeletal so it's not easy to pinpoint the root cause. I usually save up for 3 - 4 visits to the osteopath each year which helps - plus various exercises specifically designed for the muscles that are contributing to the problem. But everyone's problem is unique and so needs a unique solution - that's where the sports doctors and osteopaths are particularly helpful - IMHO better than a GP, who generally has a case load full of people who don't cycle long distances and so rarely see these sorts of problems.
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I remember phoning the physio one day to tell her the exercises hurt to which she replied" it's working then " and hung up
Been there. After one session with the fizzy I climbed down off the couch and the stab of pain was so intense that I collapsed.
Fizzy: Oh good, we're getting somewhere.
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Back related pain did for my cycling in 2006.
I was bereft until I saw a couple of recumbent riders zooming along Baker Street, stopped and had a chat then went to BikeFix where I bought a recumbent. Transformative!
My first one was a bit heavy but the key thing was no back pain - in fact my back felt massaged after riding. I then invested in a lightweight version and lo, audax opened up for me in place of sportive.
I rode further faster the next 3 years than I ever did on my high spec road machines. Best fun I had in cycling. All is not lost.
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I had sciatica on my right side about ten years ago (before I took up cycling). It took a lot of physio but eventually it was fixed, it probably took around six months before I could do any kind of exercise though. It will get better but it takes time, and definitely don't rush it.
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I pulled a muscle in my back while I was doing some filming of a Sky ride locally in May 2013. A combination of cold weather, and a tripod in a rucksack putting an an unusual strain on key muscles dismounting the bike. I exacerbated that by various motorcycle trips to prepare for filming LEL 2013.
I did find some relief through static cycling in the gym. I was on the static bikes at Brampton school during LEL. It just hurt, and didn't stop me working.
It went away, but I've had a recurrence since. It's largely linked to spending too much time huddled over a keyboard. Fortunately, the market for video is declining, so I can now make films for my own amusement again, which requires less polishing than an item for sale.
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I have an old back injury which gives me sciatica. This was very bad last year, it was triggered by sitting too long in a hotel stacking chair (the ones used for weddings / conferences). A physio diagnosed Piriformis Syndrome. He gave me exercises and it cleared after about 5 weeks but it was not as bad as yours.
Try rubbing lower back and other painful areas with Deep Relief (available from Boots) https://www.deep-relief.co.uk (https://www.deep-relief.co.uk)/ it contains Ibuprofen and Levomenthol. If you can use gel it is better than popping Ibuprofen tablets which are not good for the stomach.
Things that make it worse:-
Driving in slow moving traffic with lots of clutch.
Stacking chairs with the soft cushion.
Things that improve it:-
Firm chairs (remember me sitting on a table rather than the chairs at the Man CTC AGM)
Narrow saddle take weight off the your glutes and more support on the sit bones. The Brooks may have to be put into retirement. I use a Selle Italia SLR XP, narrow at the back, little padding
Good back support chair for work
Walking around for 5 mins per hour at work
Core strength exercises
Glute exercises, Hamstring stretches
Pilates
Foam roller
I found sking is very good to clear any sciatica I may have probably because I am working Glutes and hamstrings
A bike fit may help.
Also try a chiropractor
see https://www.spine-health.com/wellness/exercise/stretches-and-exercise-sciatic-pain-piriformis-syndrome (https://www.spine-health.com/wellness/exercise/stretches-and-exercise-sciatic-pain-piriformis-syndrome) for info about Piriformis stretch.
I have done most of the exercises on this site :- https://blog.nasm.org/sports-medicine/piriformis-syndrome-stretches/ (https://blog.nasm.org/sports-medicine/piriformis-syndrome-stretches/)
Interesting site http://www.velonews.com/2011/05/news/velonews-training-center-piriformis-syndrome-and-cycling_172757
(http://www.velonews.com/2011/05/news/velonews-training-center-piriformis-syndrome-and-cycling_172757)
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Key is to develop a strong back to counter the legs. Rock climbing does it for me, but I am sure swimming and other sports can achieve the same. Only time I have come close to back pain is when I have been lax in my other active hobbies.
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I have no good advice to offer. Just my best wishes for a speedy recovery. :(
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Hi Mike
Sorry to read about your current difficulties.
I know an excellent private Physio and Osteopath.
I’ve been seeing both for years
One is based in Haslingden the other in Preston.
Be happy to pass you their contact details if your struggling to get your problem resolved.
My number’s 07815042606
Best wishes.
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Hi Mike
Sorry to read about your current difficulties.
:thumbsup:
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Hi Mike
Sorry to read about your current difficulties.
I know an excellent private Physio and Osteopath.
I’ve been seeing both for years
One is based in Haslingden the other in Preston.
Be happy to pass you their contact details if your struggling to get your problem resolved.
My number’s 07815042606
Best wishes.
That's very kind. I'm seeing a local physio who has given me a series of exercises and stretches to undertake so I'm diligently trying those. To be honest, the absolute most uncomfortable activity is driving, so any help has to be strictly local at the moment.
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Hi Mike
Sorry to read about your current difficulties.
I know an excellent private Physio and Osteopath.
I’ve been seeing both for years
One is based in Haslingden the other in Preston.
Be happy to pass you their contact details if your struggling to get your problem resolved.
My number’s 07815042606
Best wishes.
That's very kind. I'm seeing a local physio who has given me a series of exercises and stretches to undertake so I'm diligently trying those. To be honest, the absolute most uncomfortable activity is driving, so any help has to be strictly local at the moment.
That sounds like Piriformis. The length of the seat on chairs and the amount / shape of cushion will make it worse / better, as CrazyEnglishTriathlete says "one of the biggest is commuting by train as the seats on South Western Rail are designed for people substantially shorter".
If I sit in a chair and feel tingling within a few minutes I know that chair will cause problems. Sometimes it is the cushioning other times it is the seat length. I will always chose the hardest chair in a café to prevent a re-occurrence.
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That sounds like Piriformis
That's why it's all gone pear-shaped
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You just can't tell some people!
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I suffered sciatica on the right side for some time but much worse when driving than cycling and did all the suggested "this is what you need to do" exercises and therapy sessions all to no avail and eventually was prescribed Gabapentin and it has mostly cleared up.
Gabapentin apparently seals the ends of the nerves causing the problem, it takes a little while but gets there eventually.
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I had bad sciatica in 2013, it can be very painful and none of the medication seemed to help any. I used to have a wallet in my rear pocket, which twists you slightly when seated, I no longer put anything in rear pockets! I also now use an extra lumber support when driving.
What helped the most was the NHS physio, first consultation was all about what movements hurt the most. The most uncomfortable exercise was a press up with your hips still on the ground(sorry don't know the yoga pose name), this really hurt and I wasn't impressed when the physio lady said "that's the one".
I returned to the physio after about 6 weeks of doing said exercise, the pain was still there but had moved upwards from my thigh to buttock, this really pleased the physio, apparently the higher up the pain the less trapped the nerve is! After a few more visits the pain had gone, I still did the exercises for the next 2 years though, when youv'e had sciatica you don't want it to return.
Wishing you a speedy and full recovery Mike.
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FWIW, my wife's sciatica responded fairly well to physio, followed by pilates to build up core strength - MRI scans and hoping to avoid surgery c8 years ago, number and severity of twinges more or less directly related to how much (how little) pilates she's been doing for about the past 7.
Mike, it's horrible seeing someone in that sort of discomfort let alone being in it yourself - all the best for a solution.
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Mike, most of us like cycling - it's why we comment on this cycling forum - but it is not the end of the world not to cycle any more.
I hike as much if not more than cycling and there is another on this board who enjoys rowing, the point is whilst it sucks to lose an activity we enjoy though pain or disability or other causes, there is a whole world for us to explore by engaging it in different ways than can fulfill our love of being outdoors and challenging ourselves through physical exertion.
Besides, don't you live near Snowdon? I'd love to hike that diminutive mountain one of these days but I have roamed the national park around Betws-y-Coed and it is wonderful country, too nice to spoil riding a bike. ;D
Hope you get relief soon.
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Besides, don't you live near Snowdon? I'd love to hike that diminutive mountain one of these days but I have roamed the national park around Betws-y-Coed and it is wonderful country, too nice to spoil riding a bike. ;D
I'm in Saddleworth and (when the fires are out) there is loads of great walking near me. I'm relishing getting to see places I'd normally just wiz by on the bike - well perhaps not wiz but you know what I mean. You've given me an idea; I've never walked up Snowdon.
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You've given me an idea; I've never walked up Snowdon.
Every cloud, eh? Maybe getting sciatica will work out to be serendipitous for you.