Low back injury, Cruzbike vs DF

[Greg S]

As some might recall from my introduction and update threads (in the S40 forum), I bought an S40 at the end of last year and have been tweaking the fit and making other changes. I've ridden about 750 miles on it thus far and up until recently was mixing it in with riding DF bikes.

At this point, I'm not riding anything. I herniated a disc in my back at the S1 about 6 weeks ago and have both intense pain in my lower back and sciatica down my left leg. I'm trying to get surgery scheduled (another long, sad story) but it's looking like that will be at least another 4-6 weeks. I've had an initial consult, an MRI and a consult with the surgeon and he's recommending a microdiscectomy.

I asked both the initial Dr and the surgeon whether I should ride the recumbent (S40) or DF both pre-surgery (assuming it resolves itself enough that I'm able to ride) and post-surgery. Naturally, I got two different answers. One recommended the recumbent, one said definitely the DF.

Sigh.

I should note that both are cyclists themselves. Both gave reasonably good explanations for their recommendations.

So I'm looking for experienced advice from others. Disc herniations at the S1 are pretty common so I don't think mine is in any way unique. I'm therefore wondering whether others out there who have had low back injuries (bonus points for having had surgery ;-) ) what their experience has been. I suspect given this is a Cruzbike forum that most, if not all, replies will be recommending the recumbent (like walking into a bar and asking peoples thoughts about alcohol consumption the opinions are likely to be favorable ;-) )

I'm going nuts not being able to do anything. Right now I'd settle for being able to tie my shoes pain free but I'm hoping that some time soon I'll be able to ride again and the question is which is better/easier for both recovery and long term back health.

Thanks all.

 

[LarryOz]

As some might recall from my introduction and update threads (in the S40 forum), I bought an S40 at the end of last year and have been tweaking the fit and making other changes. I've ridden about 750 miles on it thus far and up until recently was mixing it in with riding DF bikes.

At this point, I'm not riding anything. I herniated a disc in my back at the S1 about 6 weeks ago and have both intense pain in my lower back and sciatica down my left leg. I'm trying to get surgery scheduled (another long, sad story) but it's looking like that will be at least another 4-6 weeks. I've had an initial consult, an MRI and a consult with the surgeon and he's recommending a microdiscectomy.

I asked both the initial Dr and the surgeon whether I should ride the recumbent (S40) or DF both pre-surgery (assuming it resolves itself enough that I'm able to ride) and post-surgery. Naturally, I got two different answers. One recommended the recumbent, one said definitely the DF.

Sigh.

I should note that both are cyclists themselves. Both gave reasonably good explanations for their recommendations.

So I'm looking for experienced advice from others. Disc herniations at the S1 are pretty common so I don't think mine is in any way unique. I'm therefore wondering whether others out there who have had low back injuries (bonus points for having had surgery ;-) ) what their experience has been. I suspect given this is a Cruzbike forum that most, if not all, replies will be recommending the recumbent (like walking into a bar and asking peoples thoughts about alcohol consumption the opinions are likely to be favorable ;-) )

I'm going nuts not being able to do anything. Right now I'd settle for being able to tie my shoes pain free but I'm hoping that some time soon I'll be able to ride again and the question is which is better/easier for both recovery and long term back health.

Thanks all.

I am not a surgeon, but I did stay at a Holiday Inn Express last night! Sorry - could not resist. - and maybe I get extra points since my wife is a nurse.
You are right in saying that most in this forum would recommend riding a recumbent over an upright - for just about any malady.
I however just find it a little laughable that any doctor would recommend an upright over a recumbent for someone dealing with a herniated disc that needs surgery. It would make sense to protect the back from any form of compression or twisting that could occur on an upright ride. When compared to resting comfortably on a recumbent seat at 40 degrees there would be so much less chance of stress. I would think even better on a V20 (but I know you were not asking about that.) since even more reclined. It is pretty much like laying in your lazy-boy while pedaling.
The only negative I would see about the reclined position would be getting into position and out of position that might need careful attention with a back injury.
Since Jim P is a "real" doctor - hopefully he will see this and chime in with his opinion
Larry

 

[Greg S]

I however just find it a little laughable that any doctor would recommend an upright over a recumbent for someone dealing with a herniated disc that needs surgery. It would make sense to protect the back from any form of compression or twisting that could occur on an upright ride. When compared to resting comfortably on a recumbent seat at 40 degrees there would be so much less chance of stress. I would think even better on a V20 (but I know you were not asking about that.) since even more reclined. It is pretty much like laying in your lazy-boy while pedaling.

It's not as laughable as you (or at least I) might think. When pushing against the pedals on a recumbent you're pushing against the seat, consequently your back, and compressing the disc at that point. I know that when I've made hard (maximal) efforts on the S40 in the past I feel the force/power all the way through my legs to my low back. I'm pushing hard against the seat. On a DF, you're pushing against gravity (your weight). This assumes of course that your position on the DF is more upright, i.e., not in the drops which I would take to be a big no-no since the angle in your low back is more acute.

With my back still inflamed, I've done short (3 minutes) rides on a DF and S40 on a trainer. I'd say they were a wash as far as pain is concerned but it was really too short a time to draw any conclusions.

 

[benphyr]

@Greg S
I think this forum is biases but much more circumspect and open to varied experience and opinions than any other online discussions I have seen bar none.

The information above sounds like valid concerns and suggestions. Here are a few other non-disc-problem-experienced thoughts that I had. Take them for what they are worth.

Riding outside there is a lot of bouncing around that we deal with but don’t think much about when we are uninjured. That of course varies considerably based on the condition of the road. The s40 and v20 both have rigid seat backs.
The Q45 has suspended rear which helps.
Larger tires with lower pressures are noted in some of the recent posts about 4000s will bring you to some of these discussions. That can have significant effect.
How much challenge is getting onto either s40 or DF giving the weak spot in the back?

Zwift might be a good option as a short term solution to bumps caused by road surface.

If pushing hard into the seat back causes pressure on the injury can you limit max force to a much lower power output until healing, and also spinning faster can help reduce force while maintaining overall power, or both.

Both will differently use all sorts of stabilizing muscles to stabilize pedal steer on recumbent and back as pushing on DF and both for steering and balance.

I would tend to think Zwift with lots of well guided stretching might be your best bet for a little while.

 

[Greg S]

@benphyr thanks for the reply. I'm on Zwift, right now just the DF with the S40 on a dumb trainer but I have an unused Computrainer and I'll likely set up the S40 on that. I recently put 650b's with 38mm tires on so I have plenty of shock absorption when I do return to riding on the roads. All I'm doing right now on either the DF or S40 is easy spinning so nowhere near approaching max effort and I expect that'll continue for quite some time.

I was hoping that I might hear from someone who'd "been there" both in terms of the injury itself (s1 herniations are pretty common) and in terms of what they did both pre and post-op. If they continued on a DF or whether they chose or were forced to ride a recumbent.

Thanks again.

 

[CuHead]

I relate to your story. Twenty years ago I had three vertebrae fused. That lasted about 18 years before the next joint was shot. The magnetic image was an eye opener because both vertebrae around the bad joint were growing what looked like inter-meshed fingers. The doctor cleaned that up, cleaned the two surfaces, inserted a cage between the vertebrae and growth hormone, checked his work the next day with x-ray, and operated again to insert support rods, clamps, and bone screws to stabilize the cage for a year of healing. Spinemd dot com.

I had bought a used CruzBike Silvio 1.0 about a year before my surgery because my upright bikes were causing lots of hand pain. The Cruzbike riding position took almost all of that pain out of the ride experience. The deterioration of the spine joint had me in bed, sometimes crawling, unable to walk or drive, often using crutches, and I stopped riding bikes. About three weeks after my surgery, I was riding the Cruzbike. I started out with daily five mile rides at a local park (Fort Hunt in N. Virginia) on a 1.2 mile loop. I quickly doubled the distance, soon tripled it, and kept it up daily, except for rain/snow days and got really tired of that loop. I kept improving, found a decent residential ride. and currently ride 27 mile out and back, doubling the ride once or twice a week, rarely missing a day.

I'm a 66 yo male. I've been riding since I was four. I've had many bikes. None of them are cushy rides. I've got a full suspension ProFlex 856 mountain bike, that I upgraded to coil springs. I've got a Trek 660 df road bike and in the past I used it on many century rides. The Silvio is the most comfortable for my back and for my hands, but it is still an almost rigid ride. I've been on it about two years and I'm still getting better at riding close to the edge of the street. I like the low seating position on the CruzBike. It's more aero than a standard race bike, good for a time trial. I would not feel as safe riding in a pack, and from what I've seen other riders usually give more space to bents in a pack, which messes with you riding in a draft. There is no standing up on the Silvio for bumps or jumping over a rough patch, no stand up and sprint, or stand up going up through a 180 curve in the mountains. But the bent is nice on flats and flies down hills. I assume my bent is faster on a downhill than my Trek 660, but I used to get into a really tight tuck going down hills on Skyline Drive out in Shenandoah National Park. Those downhills lasted for miles. The better the tuck, the faster you go on a df.

I used to ride rollers in the winter, on my Trek. I tried a magnetic trainer, but it seemed lame compared to spinning on rollers. High cadence is something I cannot do on my CruzBike setup. I used to commute on a df nine miles to work spinning at 100 cadence for miles and using electronic monitor. I think I've 'spun' at over 70 cadence on my Silvio, but I lose smoothness the faster I spin. No way could I spin it at 100; I have a 53 big ring and 170mm crank arms. On rollers, on my df, I used to spin at 100 for nine minutes, kick it up to 120+ for a minute, and repeat it for a 30 minute workout, using a 52 ring and 170 cranks. I suppose mag trainers have pluses, too, but I enjoyed the rollers.

Finally, post surgery, my back felt safe on the CruzBike with respect to healing. I was worried about falling, but the fall is lower than a downframe bike. And I stayed on a 1.2 mile loop for a few months almost devoid of traffic. Good luck.

 

[Greg S]

Thanks for the detailed reply @CuHead! I was beginning to think that I was the only person that started riding a Cruzbike due to back trouble ;-)

We have a lot in common: I'm also 66, I'm a long time DF rider, I've also recently (last year) started having trouble with my hands when riding the DF. I did Paris-Brest-Paris last August and was in real pain in both hands until the end of the year.

I've been struggling with back problems related to cycling intermittently since 2016. It's been very strange. I did three 1200K's in less than 45 days in 2018 including London-Edinburg-London and had no trouble at all with my back. I've had three episodes since November and my longest ride has been 200K. This latest go-round is, by far, the most painful and the most debilitating. I'm actually looking forward to the surgery in the hope that it provides some relief. The one problem is that if my back "resolves" itself between now and when the surgery is scheduled (early Sept) they won't operate. I guess I could always dead lift a VW, that'll give 'em something to work on!

I still am hopeful that I can continue to do long distance rides on the DF but if it turns out I'm on the Cruzbike riding shorter distances, I can live with that. What I can't live with is the debilitating pain.

It's encouraging to know that you're able to ride the Silvio pain free and I thank you for your reply.

 

[bladderhead]

I think @LarryOz is right. Getting on and off a S or V might be a pain, literally. You may find that you do not want to put your feet down. This leads to risk taking at roundabouts and traffic lights. This happened to me. Not a serious back injury, but I pulled something. Riding the Silvio was okay, but stopping was uncomfortable. Maybe a Quest or T50 would be easier. Since then I have modified the Silvio and cured it of this problem.

There is no standing up on the Silvio for bumps or jumping over a rough patch, no stand up and sprint, or stand up going up through a 180 curve

Pulling on the bars is sort-of like standing up. If I hit a bump on my Silvio I lean forward. This is also the way to get through tight turns. I do a lot of commuting and riding in pedestrian places on my Silvio and I think it is more agile than my Grasshopper.

All this might be difficult if your back is bad. Maybe a different species of Cruzbike would be easier. Difficult decision. You can't just go into the LBS and say "Find me one that is comfortable.". Not unless you live in Lumberton

 

[3bs]

my skeletal back problems are mostly upper. cervical fracture, thoracic chronic bad disk. smattering of disc degeneration, arthritis and mild impingement depending on my bad decisions. all of my low back pain is typically strains due to lifting and the like. i have never totally blow that disk, but i have irritated the roots. When my low back is a mess, the best bike to ride for me is any trike with web seat in low easy gears on flat surfaces. it is quite therapeutic.

but, if you have a smoked disk at l5/s1, that has become really symptomatic, particularly if you are experiencing private parts numbness or voiding issues, it may be that the best bike to ride is no bike. it is important to stay active, but i think i would just do walks and low back exercises for a while.

 

[Greg S]

@3bs to this point, I've found that I'm able to ride the S40 on a trainer and as @bladderhead mentioned, since it doesn't involve stoplights or other things that I need to stop or get up to do (I just sit and spin easy gears) I'm at least able to do that. The trainer has an additional advantage that if it does start to hurt I can stop instantly without having to worry about how I'll get home were I out on the road.

And pulling on the bars is a definite no-no.

 

[CuHead]

Pulling on the bars in order to sit upright helps me on rough surfaces. Sitting up lets the bent bounce over with a lot less bounce for the low part of the seat. Much less impact is absorbed by the bike, and less is transferred to me.

Did you modify the suspension or the saddle or other? Is your Silvio a leaf spring model like my 1.0?

 

[CuHead]

The first back doctor I went to took x-rays and told me 'you're getting old'. I never went back to that guy. The spinemd doctor gave me a clear explanation, showed me the pictures, and told me what he could do to fix the problem. It was not cheap, but my insurance covered most of it.

 

[dule0911]

@Greg S
My diagnosis circa 2012-2013: herniated disc L5-S1, on one side the vertebraes were almost fused together, the MRI scan didn't show much space between them. L3-L4 were close behind, just not that bad. I was 24 years old at that point. Pain similar to what you are experiencing, went on for months, I had pain in every possible position, even when lying flat on the ground. Didn't operate it in the end, but was stubborn to try physical therapy and after ~5-6 months or so of daily exercises (one weekly hour long therapist session) and it was much much better, after 8 months it was like before.

And now for the bike. 2006-2011 I rode a MTB of right frame size but not too often (like, 2000km a year at most). In 2012 I rode 4000-5000km on a MTB that was to big for me, and that accelerated my condition rapidly. I was in denial at the time that the bike was causing that issue, but after a couple of years I finally admitted it. In 2013 after my initial recovery I started to ride again (also MTB but correct size this time round), with the regular excercise, and it was fine. But, and this is a big but, it was ok if I didn't sit during the day, except to eat/on the bike. So working, studying was done lying in the bed. In 2014 once I got back to work full-time in the office, I used the bike daily to commute (about 45km round trip), and some weekend rides. So, 8h of sitting and the bike before/after that, the rest of the day I tried to avoid sitting. Exercise daily, of course. 4 months later - bam! The issue has returned. Of course, not so severely as a couple of years before, but it was a good reminder that the DF position just doesn't suit me for my riding style (longer rides). The compression, especially on bad surfaces, and work - my spine just coudn't handle it. I fixed it quite fast, like in a month, tried the bike again for one month, the problem resurfaced again, and I made a decision to stop riding. After that, I didn't have an issue again - and I strongly attribute that to the DF riding position. I tried a road bike - it was much worse than a MTB, so maybe a city bike would have been a better option, but that is just not my cup of tea.

Fast forward to 2019, precisely a year ago. After my sons first birthday my sister gave me her bike child seat, since her kids have grown out of it. It only took 2-3 small local rides for me to get into "the zone" again. I started to pedal again, thinking my condition was ok now. But, a month after that, my back greeted me again with lower back pain, working from the bed for two months etc. That is when I decided not to give up and bought myself a Q45. The bike arrived september last year.

Once the Q45 got to me, I still had lower back issues, and started to learn how to ride it with the pain. The getting on/off the bike I did slowly to reduce any chance of hurting myself more. Maybe it was a placebo effect, but after each ride I felt like my lower back agrees with that riding position, it terms that I felt it was getting better by a very small amount. Maybe it was just getting better as time passed, but the crucial thing is the bike didn't make it worse, in contrast to the DF.

Now, 6000km later, I didn't have any issue with my spine/back during/after rides, and I am enjoying it much more then riding the DF. The push on the back of the seat is nothing compared to the pain the DF gave me - it doesn't even hurt, only if you try to do it on purpose. Do I miss the DF? Just on the steepest of uphills and offroad. Other then that, I accept all the flaws that come with the cruzbike because the positives outweight it by a hefty margin. The only reason I didn't buy a recumbent earlier (in 2014) is the price. In hindsight I should have taken a credit. No one is going to give me back the 5 years of riding I missed

And I would also add one more thing. Spine injuries are common and symptoms are common, but the recovery isn't the same for everybody. I come in contact with lots of riders who had similar issues as mine, but in their case even a DF helped their condition, the more they rode the better they felt. So I would say that everybody should try and determine what helps their case. On that front, fot the DF, I can recommend SQLab Active line of seats, it really made a difference in my case for the DF. Unfortunatelly it was not enough, but it was still better than any other seat I tried.

 

[benphyr]

Sq-lab.com

 

[Greg S]

@dule0911 thanks for your reply and the detailed history! Although her symptoms were different, my wife went through the same experience with a DF that you did with the MTB and also had problems caused by an office job. She tried for a long time to make the DF work (we had one custom made for her) but went through a fairly typical ride->injury->PT->heal->ride->injury... cycle for several years before she finally gave it up and went all in on a recumbent - at my suggestion.

I've not detailed my history but suffice to say it's been a bit puzzling as far as what the cycling related causes have been. I've done a number of long/hard rides successfully followed by periods of repeated injury - all done on the same bike(s). Being the analytical sort that I am, I've pored over the data (ride logs, power data, etc) looking for patterns but in truth haven't been able to find any. I've started hard rides with my back already hurting and finished successfully with no after effects. I've started easier rides with everything in good shape and have DNF with back pain. My training program has been relatively constant over the years. As I say, it's been puzzling.

All I know right now is I'm almost two months into this and it's the worst it's ever been. As I mentioned previously, I have surgery scheduled in early September if it doesn't resolve itself and I'm of mixed mind as to whether I hope it'll get better on its own or to hope it stays bad enough that surgery makes sense.

I have both the Cruzbike and a DF on trainers and right now the S40 seems to irritate my back less so I've been riding it exclusively for the past few weeks. Relatively short rides (longest is 24 miles) at moderate effort.

I was beginning to think I'd just skip the surgery as my back has been feeling better for the past few weeks although I still have had flareups in my calf, hamstrings, etc., and my toes have been consistently numb. Nevertheless, it is somewhat improved so I was optimistic the trend would continue and I could keep back issues at bay with a combination of core strengthening and perhaps riding the recumbent vs the DF.

That all came to an end today. I bent over slightly (maybe 10 degrees) to pick something up and wham! Not the worst pain I've ever had but certainly not something I'd want to live with long term.

What this all means post surgery is still an open question. I'm committed to core strengthening/PT for life and whether or not I can do long rides, DF vs. recumbent, etc., is very much undecided.

 

[McWheels]

Hello Greg. Quite the condition you have to fight through, you have my sympathies.

Some of this may be discountable quickly, but it's a series of thoughts and ideas and one or two might fit.

• A friend had what appeared to be a ruptured disc (doc described it like squeezing the jam out of a doughnut) while rowing. Several years of having to be careful with back, pain like you're describing, have to be v.careful bending slightly at the waist. FFWD several years and 2 pregnancies, and she gets a diagnosis for Ankylosing Spondilitis (AS). Now on the regulation anti-inflammatories and things are almost normal. There is a school of thought that there was no ruptured disc. Note that there is a history of auto-immune diseases in her side of the family.
  
• Rarely does the back get better without moving. Therefore have you considerd a Thor seat, or something that's more of a bucket than a perch? The aim being you can cycle more with greater support and comfort.
  
• Linked to the above, and sacrilige here, would a RWD stick-recumbent be better? Or maybe a trike where you can allow the motion of your hips to be a more dominant lumbar input than the all-over effect of a Cruzbike?
• Being committed to regular PT/exercise is no bad thing. Would that everyone had to take it so seriously.

 

[BranchRider]

I developed sciatic issues after getting my Q45 2 years ago and then training for a long tour (Erie Canal Trail). Ever since, I've had sciatic nerve pain even after L5-S1 decompression surgery. Riding the Q45 seems to aggravate the condition even more than riding the stationary recumbent at the gym. I suspect the shape and hardness of the Q45 seat pan are the culprit, putting a lot of pressure on the sacrum and tailbone. Thinking I need to find a better seat or fashion some high-density foam to redistribute the pressure. Anyone else in the same boat?