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Pain on/off bike?

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Haven’t checked on pedal room in a while. Wanted to see if anybody was having any musculoskeletal or neuromuscular pain while riding? I’d be more than happy to help identify and remedy the issue.

Regards,

Dr. A, PT
     
May 21, 2018 12:52 AM
Haven’t seen you on the forums in a while! Great to see you back.

Sometimes after long rides on my fixed gear bikes, I get a tearing sensation in my lower back. I’ve tried stretching it out but it doesn’t make much of a difference. I’ve narrowed my problems down to: handlebars being too low, carrying too much load in my bag, or not bracing my core enough when i ride. What do you recommend, doc?
     
May 21, 2018 07:53 PM
AznChiliSauce
From: Philadelphia, PA
103 posts
9 bikes
Hello! This is definately a passion of mine so I’m glad to help in any way I can. I love the spine but it can be quite complicated sometimes. A large portion of low back pain is non specific. What I see frequently are weakness/imbalances and soft tissue length issues. Without evaluating you it’s hard to say exactly what’s going on. Please be descriptive as possible with regards to onset, location, frequency, duration of symptoms. Usually what I see is hip flexor length (too short and hypertonic) and hamstring length deficits. Creating a pelvic rotation and changing the curvature of the low spine. Try to be more specific, it would help a great deal. Hopefully we can figure this out!

Cheers

Dr. A, PT
     
May 22, 2018 03:11 AM
Quick thought. If you feel your symptoms, brace (tighten) your core/pelvic floor musculature. Let me know if that increases or decreases your symptoms.

     
May 22, 2018 03:12 AM
Hello,

I've had pain in my metatarsal for two weeks now, feels like a fracture (I'm basing this off previous injuries) so I've been assuming its a stress fracture as there was no big impact for it to happen, likely caused by running but maybe also my toe straps on bike.
It hurts when I walk so iv minimised walking. Obviously I need to see a doctor but at the moment I really am too busy, so I'm wondering what I should do to help it heal and how long it will be before I can run again?

I should also note that in the past week it has varied in how much it hurts so I am wondering if it is being held back from healing due to daily activity and commuting. I also am assuming it will heal without a cast etc? I have no impairment to toe movement.

Any advice greatly appreciated,

Thank you
     
May 24, 2018 05:32 PM
ff6
2 posts
0 bikes
How much are you running? Your lack of mechanism of injury would make it more reasonable to have a stress fracture, but sometimes we don’t realize how we injure ourselves. Check your foot wear for appropriate support. Examining yourself, try to stress your metatarsals as you would a stick, with your foot relaxed. If there is pain I’d think more skeletal involvement (stress fracture). If you were to check motion between metatarsals, still relaxed, I’d suspect more ligamentous/muscle fiber involvement. If you actively move your feet even lightly and there’s pain I’d think more muscular. How long has it been bothering you? I’d still think something regarding your running mechanics is producing this issue. Metatarsal Head fractures are common place of stress fracture from what I’ve seen with runners. Tends to be the 5th (pinky) met. You could try taping your foot to release some stress points, works very well but we need to know what actions to correct. Give more details of symptoms please? Location, duration, action that makes it worse, better...

6-8 weeks is soft tissue healing guidelines, bone can be a bit longer. You are heading into chronic territory me thinks. Gotta lay off, and strengthen the intrinsic muscles that are in your feet below the ankle. Ice if swelling, heat, redness, elevate above heart and keep compressed comfortably

Hope some if this is helpful.
     
May 26, 2018 01:54 AM
Atom,
Thank you for the experienced response and temperate medical notes.
I read your response with interest.

I have cycled some 40 years, still ride a Look KG-176, all Campy, 1992.
Have a 1971 Scwhinn European import with Campy - Huret - Simplex - TA
which I spin 'easy' on a fluid-trainer daily.
Style is Tri, with aero bars, Cobb saddle.

Sympton:
I have bottom-of-foot pain, which hinders longer bike rides.
And, walking bare-foot has some pain.
Relaxing, applying analgesic cream, and mild stretching helps.

I have a new pair of street-shoes which feel flat ( with-out a built-in arch ) ,
and the pain started soon after I started wearing these new street-shoes.

Pain usually arises during cycling, about 35 miles out, and during the return trip ,
with several steep hills in the return route.

I have no mechanical injury, but have ridden with a club for 40 years.
I know that time and milage is wearing on my 74 year old body.

My remedial treatment :
(0) I do mild stretching, massaging, daily. My PT says 'very important'.
(1) I rub analgesic-rub under my feet, and take ibuprofen each day.
(2) I added 1 mm of foam to the arch area inside my street-shoes

(3a) I added 1 mm of foam to the arch area inside my bike-shoes
and make certain to have them tightened to fit my foot.
(3b) Right bike shoe has plus 2 mm of foam for slightly shorter leg.

(4a) Riding style is tri, with aero-bars, Cobb saddle, for 35 years.
(4b) on bike rides, I gear down for hills and do not stand on the pedals.
(4c) I train , easy, daily on a fitted bike, on a fluid trainerwheel.

(5) around the house, I now always wear my old sneakers
which have a slight arch support.
(6) may add another 1 mm of foam as an experiment.
(7) have tried raising / lowering saddle height 2 mm at a time
and watching for foot comfort.

Results: After six months of changed method.
(1) More comfort, much less stress in right foot.
(2) Distances becoming easier to 70 miles.

Note: I am aware of slight imbalance in my left-vs-right power
and slightly shorter right leg length,
and a right sciatica problem,
and I reckon it is good to keep track of things.

At age 74, I mostly seek
(1) management techniques,
(2) less stress while cycling,
(3) never "sure cures".

Again, thanks for the open and temperate advice on these matters.

     
May 28, 2018 07:32 PM
glene77is
1 post
0 bikes
Hi!

I was at work a few days ago and squatted down, at the bottom my knee made a popping sound and now it’s pretty crunchy. I tried riding two days later and after ~4 miles the pain was pretty noticeable. Anything else I can do besides rest and anti-inflammatories? How long til you would recommend training again?
     
June 6, 2018 11:31 PM
ayyyyy
From: LA, CA
57 posts
16 bikes
@glenne77 - foot problems, almost always relate to weakness (length tension relationships) and collapsing arches, furthering the deficit of length tension relationships. It is important to maintain an arch, in order to evenly distribute forces throughout the tissues. We cram our feet in shoes (for the better part of our activity) neglecting very important muscle groups in the foot, below the ankle, called intrinsics. I recommend arch support (always suggest 3x trial at Dr. Scholls foot mapping system at Walmart/target), soft tissue lengthening (stretching) of the gastroc/soleus complex (plantar flexors) and strengthening of the intrinsics (try picking up marbles with toes, scrunching up a towel with toes, actively/controlled splaying of toes). Soft tissue healing guidelines 6-8 weeks, unless the problem is chronic in nature. Once the mechanics are normalized (mechanical deficit removed) the tissue should be able to heal. Hope this is helpful.
     
June 28, 2018 02:17 PM
@ayyyyy - this is where I completely disagree with “ass to grass” squats, heavily weighted. Squats put a tremendous pressure of the tissues of the knee, ACL, PCL, meniscus. Without good technique, I.e. good neuro muscular control, they can easily create injury. You may have torn some cartilage or ligament. ‘‘Crunchiness” is worisome, mostly, if there is pain with it. Altered mechanics of the knee can produce “crunchiness” (aka crepitus) while no real soft tissue damage is present. Always stretch hamstring/hip flexor, then perform some hip mobility drills prior to squatting. Perform box squats, where the femur is essentially parallel to the floor at its lowest point, especially if heavily weighted. Per usual, soft tissue healing guidelines 6-8 weeks, let your body clean up the mess. If there is pain, modify activity. I’m no fan of “no pain, no gain" unless it’s for muscle hypertrophy (building muscle).
Attached Photos:
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June 28, 2018 02:31 PM

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