L5/S1 bulge recovery

I’ve had a L5/S1 bulge which is compressing the exiting nerve root.

Started in July 2018. I managed to get away with racing and training taking pain killers.

I taken now 4 weeks off bike and pain improved. Been doing exercises and having osteopath treatment.

Just wondering do you full recovery from this kind of injury.
I’m sure it was cause my saddle on tt bike being to high.
Any advice welcome

I had a very similar injury to start the 2011 season. Similar as you, I ignored it and raced through it, though no pain pills. I actually had no idea what was wrong. Just had a pain run down my leg especially after sitting. I literally couldn’t move for 15-20 seconds.

I went along to far that I had to have a procedure done to correct it. However with proper rest, rehab, stretching and easing back into it I had one of my best years, even after a second set back of an early season broken collarbone.

So yes it is possible. Listen to your doctor. Take it easy to start. Let the fitness come to you. You can not build it in a day. It is imperative that you continue to stretch, do yoga and foundation work so it does not come back.

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As a Certified Chiropractic Sports Practitioner and FasCat Athlete who has also suffered disc bulges I can tell you YES, you can resolve this problem and get back to long hard bike rides!
Technically a “bulge” isn’t as serious a diagnosis as a “herniation” which is less serious than an “extrusion or protrusion”. Anyway, 95% of disc bulges slip posteriorly which results in an ‘extension bias’. That means back extension makes it feel better and flexion (as in bending at the waist to reach the handlebars) feels worse! So, yeah, it totally sucks to get this injury as a cyclist.

If you’ve seen a PT, they probably prescribed and coached you through “McKenzie Positioning” exercises. If you saw a good chiropractor, hopefully they did some decompression treatment. Once the radiating pain is resolved and you can bend forward without incident, you’re officially sub-acute or even resolved.

BUT - you are more susceptible to this problem in the future. If low back pain of this nature begins to rear its ugly head even a tiny bit, we have to be extra vigilant at maintaining GREAT core strength and integrity. Dr. Goodman’s Foundation Exercises are super awesome for those of us with this problem but another fantastic - secret trick is kick-board work. Get in the pool (especially in off season but also 1-2x/week in season) and do laps with a kick board. Keep your legs mostly straight and kick from the hip and low back. I do 3 laps increasingly harder and the 4th lap is an easy frog kick. Recover and repeat. I’ll to 600-800 yds of kicking. After just 2 or 3 pool sessions, my back feels awesome!

Good luck!

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Cheers for the advice
My osteopath has done a lot of work on my left Quadratus Lumborum muscle which feels super loose.
Last night when stretching I poked around on my right Quadratus Lumborum muscle which felt really hard.
I wonder if this could not be helping.

Here’s a decent, slightly dated systematic review, that has a number of interesting bullet points, including: “Clinical improvement is usual in most people, and only about 10% of people still have sufficient pain after 6 weeks to consider surgery. Sequential magnetic resonance images have shown that the herniated portion of the disc tends to regress over time, with partial to complete resolution after 6 months in two thirds of people.”

If you’re feeling better with 4 weeks off the bike, why not take some more time off, it’s the off-season right? :wink:

Also, nobody mentioned it yet, but you hinted at it initially. A professional bike fit with someone who truly understands and is educated in this type of injury may be the first step when you return to the bike.

The pain is getting better. Did 3x 10 mins last week on turbo flexion does bring the pain on. I’ve ordered a Teeter inversion table as been reading these can help.

After number of bike fits over years be interesting to know how others measure saddle height.
I’ve good for LeMond method but feels to low. My inseam is 850mm.

How does everyone else measure saddle height on there road bikes?

I’ve only had L5S1 herniations. Weak core and inactive stabilizer muscles were most likely the majority of the problem. Contributing factor was too narrow a saddle. Once I understood core was a year round necessity I’ve been pain free since my last ordeal in 2011.

Training with painkillers is a huge mistake ime/o.

Saddle height has always worked out very close to inseam(.883).

Thanks for your reply.
Interesting about saddle height. I had a bike fit years ago and fitter put saddle up to 799 years later I started to get pain on my right lower back.
Went back to the fitter in 2017 he put saddle down to 779 (18mm difference) then by early 2018 pain had gone from right to left lower back. From then I didn’t even no about disc bulges.

It wasn’t till August 2019 my GP agreed for me to have a MRI which showed up.

I’m going to drop saddle to 750 now to see if that helps. I belive MEDS just mask the issues

You bet. I should have added my diagnosis (weak/inactive core) was from MD’s and PT’s. The PT’s were the ones who really did the magic. Utmost respect for these peeps…

Re saddle height…IME while the height matters, it’s not necessarily “the” thing that matters the most in these cases. Unless of coarse it’s grossly wrong. What’s more important, as you are well aware I’m sure, is posture on the bike. Sort of like deadlifting, a neutral spine is important to avoid unnecessary lumbar pressure. Also, what I learned from too narrow of a saddle was my pelvis unsupported led to hips dropping a bit when I pushed the pedal down. It didn’t matter if the seat was low high or just right as the lower the saddle went I still extended fully by dropping my heal. All I know is slightly low is better than slightly high.

The .883 is BB center up seat tube to top of saddle. I’ve also used inseam(109%) to get a little better measurement from the pedal to top of saddle for bikes with different crank lengths. .883 and 109% are about 1mm difference.

Things improved drastically. I had 2 IDD Therapy sessions and started doing the 3 big exercises by Stuart McGill.

Most of nerve pain gone and back and core feel completely different from my last post.

It’s so nice not having pain. Hoping to start the SS 6 week plan next week.

Cheers for all advice.

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Cheers and stay with your exercises! :clap:

I’ve now started the SS 6 week plan, I’ve had to adjust the Saturday & Sunday sessions
I’ve been doing session on turbo but can’t hold bars so sitting upright. Today I managed to get hold of bars on last 10 mins pain free so happy.

My question is should I buy the 2nd part of the SS plan or the 40k TT plan. I’m really hoping by March I be recovered fully.

Even after 2 weeks I feel fit, really feel the benefits from doing sustained intervals this time of year. Today managed 4 x 10 mins @ 274w which very pleased with.

What is your CTL? That will answer the question of do you need more base training (sweet spot) or if you are ready to race (TT plan).

Base before, race, I always say :slight_smile:

It’s currently 40. I had been off bike for around 8weeks prior to starting 2 weeks ago.
Feel I’m getting so close to riding outside again.

Do the sweet spot and see where that takes your CTL up to - you want to keep doing sweet spot base till you get up into the 60’s before you consider moving onto TT intervals

Thanks for your time and good advice

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