prolapse disc, microdiscectomy & cycling

cookiemonster

Hello

I appear to have a prolapsed disc (L5 S1 for the medically minded). I went down the conservative approach and all seemed to be slowly improving over the space of a couple of months; however a couple of weeks ago things became rapidly worse to the point that i've limited use of my left ankle and can neither sit nor stand.

ouch

So, its time to get the cutlery out and do a little chopping around the vertebrae. I'm hoping to be going in to get this sorted out in a couple of days, or beginning next week at the earliest.

Im interested in peoples experiences with regards to cycling after this? When did folk get back on their bikes, etc?

Also I currently have a focus cayo, it has an 80mm drop from saddle to bars, I need to raise the bars - but im not sure whether it will be ridable with a 25 degree / 130mm stem (to replace the 6 degree 110)? Should I be looking at swapping the cayo for a large headstocked sportive bike? Or am I going to be off the bike for long enough that I should sell the (hardly used) cayo and worry about a new bike next year?

Be interested in any experience or advice

cheers

Jon

flattythehurdler

I have a chronically sore back which I control with core strength exercises. i like all of my bikes set up so the bars are almost tthe same height as the seat. I have used long angled stems to achieve this. It works fine but looks pig ugly. Give it a go and see what you think before selling your bike. Don't know much about recovery time from surgery, but sounds like you need it soon. Good luck.

Klassiker

Hi,
I've had several bouts of back pain and numbness over the years, due to prolapsed discs in the lumbar region. Nothing as serious as your case though, as I've never needed an operation. The last time was in late 2003 which required treatment in the form of an injection to "dry out and shrink" the disc, thus relieving pressure on the nerves. Maybe this could still be an option for you? It was this experience which caused me to begin weight-training to stabilise my torso. I've been doing this for nearly four years now, and during the whole time I've been problem-free (except for a cracked vertebra - another story), whereas before I would regularly get a twinge, or the feeling that I'd "done something" to by back.

I've also been plagued by aches, burning sensations and numbness in my lower back and rump for years whilst riding the bike, and although I still get some of the symptoms, especially on long climbs or stretches of flat road, it's nowhere near as bad as it once was, and if anything is still improving as the years go by. I am convinced that the weight-training has been the key to the improvements, and would strongly recommend that you get your doctor to refer you for physio after the op. and then get a qualified person to work out a training plan for you.

I don't know about recovery times after an operation, your doctor will obviously know best, but I think if you take it slowly, recover properly and work on stabilising and mobilising your back you should be able to get back to somewhere near your original position on the bike. In the meantime you would definitely need to raise your bars, but it would be a shame to sell such a lovely bike if it's not necessary.

Only if the injury is so serious that they have to remove the disc and fuse the vertebrae would you definitely be looking at a significant and permanent restriction of mobility in the area, and need to significantly re-set your position on the bike.

Of course, these are all generalisations, based on one lay-person's experience (before some medically trained forum member jumps down my throat) but it is definitely too early to assume you will suffer long-term or permanent restrictions to your mobility, and core-strength training will definitely help your recovery and long-term health.

Good luck,
Steve

flattythehurdler

I think the diffrence in this case is that he is actually experiencing significant loss of function which , I think, may necessitate surgery. I am no expert however

Klassiker

Right, surgery may well be the only option, and I'm not in a position to say how long it takes to recover from that, but I don't think it necessarily results in restricted mobility in the long term.

The point I was making was that you can make a big difference to how well you recover from something like this with the right sort of strength training. I find stretching helps too.

Hopefully someone with direct experience of surgery and returning to cycling will post a reply soon.

Cookiemonster, please let us know how you get on.

peanut

there is an extensive thread on bikeforums about this . Worth having a look as there were at least 8x cyclists having or had surgery on the lumbar area
http://www.bikeforums.net/showthread.php?t=359459

cookiemonster

hi,

I went on friday for surgery by which point the pain was pretty severe and flatty mentioned, I was at the stage where things werent working - although in my case it was just my left foot apparently incontinence and "erectile dysfunction" are possible, so there seemed to be a good case for surgery

The op was on friday afternoon, I was up and walking with no pain within 2 hours of waking up which was tremendous; slept 8 hours friday night, which was the first straight-through sleep I've had for three months. Home yesterday, no leg pain and my back pain is purely from the bruising and cutting work, rather than the nerve stuff. I then managed to sleep a mere 14 hours last night (with one pit stop), which qualifies as a record...

So far so good, and I think despite all the negativity around back ops, i've made the right choice.

This week is very light excerise - short walks and minor / basic pilates, next week will be more of the same. When the stitches come out I'm looking at swimming and stationary cycling - probably just the gym, but maybe get a turbo as the gym bikes always feel crap, and a bit more serious pilates. 6 - 8 weeks I should be looking at light strength training and perhaps simple road cycling, with the idea than 3 months gets me back to normal.

thats the plan anyway :-)

Klassiker - yes, I agree with the strength training, it's definately part of the program

peanut: cheers, I found the thread; its good to know that I'm not the first person to go through this

cheers

jon

Klassiker

Great news!

BigLights

Cookiemonster - I have just read this post. I had my discectomy 5 weeks ago now and it really felt life changing. I really, really miss my bike though. I was tempted to give it a go but I had to lift my 3 year old daughter up the other day (she faceplanted on islington high street and I was on my own). It's now complaining slightly.

Question is...in the end, how long did it take you before you got back on the bike, and how did it go?

cookiemonster

Hi - wow, seven years ago, bit of a blast from the past!

To be honest I'm struggling to remember how long things took given its so far back, but broadly it went to plan. When the stitches came out I started swimming every day, not long after I was doing light pilates/core stuff. I *think* I was back on the bike doing easy laps of regents park within 6 weeks or so, and I do remember fitting a god-awful 25 degree riser stem to be on the safe side! I definitely took it easy to begin, first time out was a single lap of the park and home kind of thing, so on the bike for maybe 15 minutes max, taking it up to 30 minutes over the week but still with no effort. Cant recall how fast I built up after that I'm afraid.

I swapped the cayo not long after for a 58cm cervelo rs with a long head tube, but after a few months had a -17 stem fitted and wanted to go lower, so that was sold on for a 56cm model.

I cycled the Manali-Leh highway in the Indian Himalayas that year, so maybe six months after the op, and did some other stuff like the "Les Routes du Ventoux" sportive/race (a sportive, but with mass start, rolling road closure and prizes for top 3 in various categories... welcome to France) in the September. By the summer I had a good level of cycling fitness.

So, basically I got back on the bike fairly quickly, took it very very easy to start and I've had no problems since. That said, I was and still am, totally paranoid about my back. I did a year of Alexander Technique which I think made the biggest difference - basically stopping me slouching or otherwise putting strain on my lower back, and I've done some form of core/pilates type work pretty constantly ever since.

I guess its the old "listen to your body", if you cycle 15 minutes and things dont feel right the day after then give it a week, maybe raise the bars and try again, etc. The only other thing is to try and understand why it happened in the first place and remedy that, whether posture, weakness, lifting things badly, whatever.

Good luck though!

jon

BigLights

Thanks Cookiemonster. I'm very much back on the bike - as you say, I started very easy indeed, basically coasting around Wandsworth Common to see how it felt, then gently in to work. I did a couple of laps of Richmond Park a couple of weeks ago, and I've got the all clear from the physios and the surgeon to go for it, which is great.

Because I went for years with such extreme pain, it turns out the right hand side of my body is quite substantially less muscled than the left, so a lot of work going on there. Now consciously pushing more with my right leg than left.

Swimming is also great, but with a second child arriving immently I can't really see me getting much time off in the evenings/weekends for a while.....

warreng

BigLights - my microdiscectomy and laminectomy was in July 2002 and my left calf had pretty much wasted away. It's still noticeably smaller than my right and there's a bizarre hollow where muscle should be -I'm guessing the nerve damage was so bad that it'll never grow back

It takes ages before you are physically confident. It took me even longer to recover mentally - I still have anxiety attacks when I get a twinge

drlodge

Jon, I feel for you, a prolapsed (or slipped) disc is horrid. I had the same at the end of 2007 (Lumbar 4-5) and it took quite a while for it to get better. I was offered a Cortisone injection (which I had but it did nothing) and a discectomy (which I declined) and was told by some others than it may just sort itself out, which I did after about 18-24 months. Clearly your back is much worse than mine was.

All I can add is that I took up cycling again in 2012 when my back was pretty much back to normal but still delicate, and I've had no problems since. Actually riding a bike seems to be quite gentle on the back.

I wish you a full and speedy recovery.

Rdb180283

Hi All

Glad to hear about the positive responses to surgery and being able to cycle again.

I am due to undergo a microdiscetomy for a prolaspe disc at L4/L5 in about 8 weeks time.

Have been suffering with this injury for 12 Months (un diagnosed for 4 months) and pre injury was cycling about 150 miles a week and racing weekly though out the summer months.

Will post updates on my recovery as a reference point for anyone else unfortunate enough to have suffered this injury.

All the best

Rob

grenw

Mine went around 6 years ago. Luckily I managed to get away without being cut open.

It's actually what got me into cycling. Well mountain biking anyway. I used to run a lot and the jarring was causing real pain for days after any run so I had to give it up. The mountain biking was for me a way to maintain some fitness with low/zero impact. I also thought (rightly) that it would improve my core strength. All that balancing and weight distribution.

I've only just started road riding this summer. I was actually worried that prolonged periods in the same bent over position would be a problem but have been pleasantly surprised. Most of my rides are over 100k so they are hardly short.

So for me, cycling has not only been okay, it has actually helped. Also as I've got fitter this year (and lost a couple of stone) I tend to have fewer 'episodes'. Before this year, every 8-10 months my back would spasm and I'd be in discomfort for anything up to a month. I've now been pain free for 18 months and feel stronger than ever.

Rdb180283

Hi All

Quick update.......

So had my microdiscectomy for l4 l5 prolapse disc 9 days ago.

So far have been doing my physiotherapy 3 times daily (very light) and just graduated from 1 to 2 x 20 minute walks a day. Think I over did it a bit from day 5 to day 7 and paid the price in terms of inflaming the nerve and ended up with pain down the back of the leg. I understand now the need to take it really easy (which is hard with a young family!)

Inflammation seems to be settling down but still on pain killers (diclofenac, paracetamol, coadine) not really any pain from the back but radiating down the leg.

Seeing the surgeon in three weeks time, I hope to be in better shape by then.

Will check back in then.

Rob

964cup

Interesting stuff. I'm in the early pipeline for this (L5/S1, intermittent numbness down left leg, pain with certain movements). Had the MRI, seeing the consultant next Thursday. Trying an inversion table to see if I can avoid surgery, but good to hear that most of you who've had surgery made a full recovery, and that leaving it is foolish rather than manly.

Rdb180283

Hi All

So yesterday I was given the green light to ride my bike again by my surgeon,this was 4 weeks & 5 days post op. I was told to literally just be spinning my legs at a low cadence in an easy gear. Physio said I should only be out for 10 minutes at a time for the first week then raise that by 5 minutes each week as long as I am not in any pain after ward.

Did not waste any time and went out same day,slightly misjudged the time / distance I could cover and ended up being out for 20 minutes in total (3.3 miles at 11mph Average on MTB on roads) I put this down to riding a lot slower than normal.Tried to keep it as flat as possible (hard when you live in the North Downs and live at the top of a hill!)

No immediate pain after the ride,in fact I felt like a had loosened thing up little (had been a bit tight with some itchy/ tingling that day). As I write this standing at my desk at work the leg is pretty much the same as yesterday before I went out, although I cam feel a tightness and intermittent tingling. I would put this down to general inflammation rather than anything more sinister.

I intend to ride every other day and increase my time on the bike every two to 3 rides. I will however be scaling back to 10 minutes for my next ride and working from there.

I will check back in in a couple of weeks.

dennisn

I've had L4-L5 fused with a plate last October. This was done because the micro discectomy I had last April failed, causing intense pain down my left leg. About 3 weeks after the fusion I was doing pool therapy and walking and all was well. Then I slipped and broke my leg in early December. So here I sit, unable to put any weight on the leg for another month or so. In any case try not to exceed anything the Doctor limits you to. Above all try to avoid any twisting of the waist and WEAR the big ugly belt he's most likely to give you. Let it heal.

top_bhoy

Rdb180283 wrote:

Hi All

So yesterday I was given the green light to ride my bike again by my surgeon,this was 4 weeks & 5 days post op. I was told to literally just be spinning my legs at a low cadence in an easy gear. Physio said I should only be out for 10 minutes at a time for the first week then raise that by 5 minutes each week as long as I am not in any pain after ward.

Did not waste any time and went out same day,slightly misjudged the time / distance I could cover and ended up being out for 20 minutes in total (3.3 miles at 11mph Average on MTB on roads) I put this down to riding a lot slower than normal.Tried to keep it as flat as possible (hard when you live in the North Downs and live at the top of a hill!)

No immediate pain after the ride,in fact I felt like a had loosened thing up little (had been a bit tight with some itchy/ tingling that day). As I write this standing at my desk at work the leg is pretty much the same as yesterday before I went out, although I cam feel a tightness and intermittent tingling. I would put this down to general inflammation rather than anything more sinister.

I intend to ride every other day and increase my time on the bike every two to 3 rides. I will however be scaling back to 10 minutes for my next ride and working from there.

I will check back in in a couple of weeks.

Perhaps at your next visit, consider asking if stretching is an appropriate or useful activity to undertake following your cycle. If so, which ones would be best without aggravating the injury. Obviously don't do anything without qualified medical advice.

Rdb180283

Hello Again

So today is exactly 7 weeks post op.

After my last post the inflammation seemed to increase over the next 24 hours leaving me with symptoms similar to those I had pre op. This settled down after a about 4 - 5 days only to re irritate after being a bit to enthusiastic on one of my twice daily walks.

All of which left me pretty dis heartened and fearing that the surgery had failed. Had physiotherapy two days ago and relaid all this to my physio. He did not seem concerned or surprised. He told me 20 minutes was way to long to be out on the bike 5 weeks post op and that I should try again but 5 minutes only at a time and allowing rest days in between. he also gave me some strengthening exercises to do every day (compact lunges, and simulated dead lifts). I note the previous comments, the physio did not mention stretching after riding. although that is something I would normally do anyway. I have not been given any back support to where as it was a micro not a fusion.

So I started on that routine this week, Phsyio in the morning which has left me aching in the legs (Muscle not nerve) which is already easing off as my body gets used to the new movements, it has also become very clear that my strength and balance is far weaker on my right leg (afflicted side), two daily walks totaling about 3 miles and I also intend to do some swimming.

My physio wants me to carry this on for 3 weeks before going back, the plan is to try and increase the cycling time every 2 or 3 rides providing there has been no irritation from the previous amount of time on the bike.

I still feel like the whole area is inflamed although the new routine does not seem to be making it any worse and the pain is starting to ease off.

I had to go back on to pain killers and Anti-inflammatories since the second flare up (diclofenac & paracetomol) which I hope to taper down over the next week.

So that's where i'm at right now.

I will see how I get on and post again in a couple of weeks time, hopefully with some positive news!

Happy cycling people!

Rob

warreng

Jesus - take it easy. I was still being overtaken by old ladies in zimmerframes after 3 weeks

I know how you feel about feeling down - I didn't notice major improvement immediately - it took a good 8-10 weeks before I realised I was getting better.

Don't push yourself - just listen to your physio.

964cup

Holy thread resurrection, Batman!

I'm going in for a fusion of S1/L5/L4 in three weeks time (ALIF + pedicle screws, but no laminectomy). Opinions seem to vary wildly on recovery time. Anyone care to share their experiences of convalescence, with particular focus on when you managed to get back on the bike (turbo or actual) and how that went?

fat daddy

prolapsed disc .... sounds like Cannondale CX bike !

964cup

Sadly, I've got a spondylolisthesis rather than just a prolapsed disc. More like an Assos jacket, then, than a 'dale.

diy

I'm curious to see your MRIs if you have any?
this was my screw up caused lifting a 25kg water carrier after driving a motorhome for 6 hours.

My recovery has been so far:
Weeks 1-2 unable to walk more than 50 ft, with lots of spasm.
week 3-6 gradual stretching no heavy exercise, unable to sit for more than 20 mins
week 6-8 light spinning, no heavy weights
8-10 weeks more spinning, some heavy weights no heavy squats or deadlifts.

I'm currently about 15% off my strength pre-injury. So I reckon if you are having an Op, then you are looking at 12 weeks+

964cup

@diy - what was your treatment - just physio?

My MRI:



The op is to remove the failed discs from S1/L5 and L5/L4, reposition L5 (which has slipped forward as you can see), replace the discs with titanium prosthetics, screw these in place, add posterior rods and bone grafts, then insert additional posterior pedicle screws.

diy

Ouch - I can see you've buggered the one below as well . My treatment - get back to exercising as much as you can - its broken now and wont get better, but I'll probably make a good recovery without any further intervention. Focus on building your back and core muscles as best you can, lots of stretching etc.

No Physio, because I already exercise loads and do a lot stretching, so he couldn't see the point. My osteo is good though and she does a bit of physio as well. It was her who told me to go to my doc, as I was convinced it was just muscle strain.

When I'm warmed up and stretched I can jump around like a 5 year old, but if I've sat for a while I hobble like a 95 year old.

I also struggle with free weights, because you are in compression a lot, so I've started to adapt how I train.

964cup

The trouble with mine is that the L5 has slipped forwards and is compressing the nerve root. I fractured the pars joints (the joints that connect the vertebrae together) at L4 and L5, so the L5 isn't connected to anything. The result is that, off the bike, I struggle to walk more than 1km without extensive pain and/or numbness in my leg, and I can't really sleep. Weirdly, on the bike I'm as strong as I've ever been because my position means I'm opening that joint up a bit. Although my L/R balance isn't great, so I should eventually be stronger once I've recovered.

andy9964

I had a fusion on C5/C6 after a whiplash type accident at work. Pain was typically, a searing pain shooting down my back from my neck and numbness/tingling in the outer 2 fingers of my left hand.
Back on my MTB after around 7 weeks, and commuting after 9. With hindsight, this was probably too early, it took a few months for the aching to go away (more like me finding my limitations)
This was back in 1995, I have had no problems since, other than a little numbness above the scar- about halfway down my neck and up to the jaw line

dennisn

I'm one year post L4-L5 being bolted together. Doing OK and able to ride 40 or 50 miles a couple times a week with a shorter ride thrown in. I still get the old familiar achy legs symptoms on occasion but it comes and goes. Even though I do stretch I still have trouble bending over to put my socks, pants, underwear on. Flexibility may never be my strong point in life again. All I can offer is "Take it easy and don't do ANY exercises that twist the waist". Oh yeah, almost forgot. I sleep with my legs curled up toward my chest with a small pillow between the knees. Doctor told me this. Does seem to ease things up overnight and I've kept doing it.