Hi all! New user, just had L5/S1 surgery. Looking for ideas / plans to help recover & build

HI all! Just joined after listening to the podcast for many months now.

I’m a 41, 107kg ex-semi-pro front-row forward UK-based bloke who has fallen in love with cycling over the last 3 of years since joining a bike brand for work.

I’m (obviously) not a racer, just a rider who is looking to TrainerRoad for help in coming back from surgery

I’ve just had my second go in 9 months of a L5/S1 discectomy keyhole surgery to help resolve pain and a numb right leg - the second surgery was 3 weeks ago. This is on top of a nerve block injection in January. Currently pain-free.

Following my first surgery I was back on Zwift about 3 days post-op, which was admittedly probably a bit rash. But it was what it was.

This time I have been more gradual getting back on, limiting myself to 30-40 min sessions with multiple changes of position & cadence to maintain movement, again on Zwift. My sports physio is comfortable with this approach as it now appears the pain/numbness was potentially caused by a spasming piriformis muscle which is affecting my sciatic nerve - the disc herniations were there and needed fixing, but probably weren’t the root of my pain.

Anyway, my aim is to get back [sic] so that I can complete my two main aims this year - the RideLondon 100 mile (not that hard, early August) and the Etape du Tour (considerably harder, especially at 107kg…late July obviously)

Does anyone here have any suggestions on my best plan of attack as a TR new user?

From March 2018 to January 2019 I went from being a mostly untrained man, 115kg with a starting body fat of over 30% :nauseated_face: I managed to get that down to 24%, with a matched FTP raise from 248W to 367W, with weight dropping from 115kg to 98kg. Now rebounded back o 107kg :scream:

Should I just follow sweet-spot base or would traditional base be a better option? Should I just ‘turn-down’ my FTP to protect my body/back, or should I avoid certain workouts altogether? I want to follow a plan, I just don’t know what plan to follow :japanese_goblin:

I’d be keen to see if anyone has had spine/back surgeries and what they did on their recovery journeys. I’ve gone through this return already once before in the last year so have an idea…would love to hear the thoughts of any coaches who’ve seen this before.

Obviously I understand that I need to follow the advice of my medical practitioner etc. and seek their advice. But as a private patient in the UK on healthcare insurance, the very act of asking that question costs £200 / $250-ish. His standard reply is ‘no cycling for 6 months’ which is patently ludicrous.

I’ve chosen to not follow this particular advice, and I’m just reaching out for some well-intentioned ideas on how best to try to get myself ready for the rides I will be undertaking in around than 3 months…

TL;DR
New user, 107kg now untrained/semi-trained before
Just had 2nd spine surgery
Seeking advice on what TR plans / routines to follow with this in mind
all views welcome, including telling me I am a doofus

My recommendation is to figure out how many hrs/week you plan to spend on the bike. Once that is nailed, start with EASY 30 to 40 min rides for a couple of weeks. Then go to Traditional Base. I followed this plan coming off a real bad case of knee tendinopathy. At least in my experience, there’s too much intensity in sweet spot base to start there if you’re coming off surgery or injury. I did Traditional Base 1 and 2, then went to sweet spot base. I’m currently in SSB 2. No significant knee problems, but I don’t always follow the sprint instructions.

Core and strength work!

At the very least the book “Core Advantage” is excellent.

Obviously in close cooperation with your orthopedic surgeon and physiotherapist.

His advice isn’t completely ludicrous. You’ve had a second microdiscectomy because the first failed?? Repeated and sustained spinal flexion often with rotation is a primary cause of the severely herniated disc you had resected. Continued sustained flexion, like riding a bike, limits the healing process and puts you at risk for further injury. Your body is not like a car. Parts don’t get fixed and go on your way. You need to heal. 2 surgeries is a major red flag that will require a prolonged healing process as there is now significant tissue damage from 2 surgeries. There’s nothing you’ve described that supports your desire or ability to get back so fast. 6 months may be long, but if you continue along the road you’re on, you are more than likely to reinjure. Don’t treat this yourself, find a good PT and follow a medical professionals advice. Stay off the bike for the time being.

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I had L4/L5 fusion for same issue. I started with a 3 hour/day rehab program consisting of water running (with flotation waist band), stat bike (recumbent type) and walking with a 4 wheel walker. Progress was slow but within 9 months was doing tri’s very slowly with walking the run leg. In 18 months won nationals/worlds…then got sideswiped out on road to end 40 year tri career.

Take a look here at a similar post: Training after an L5/S1 injury (sciatica)

Thanks for the info @T_Field - Traditional base appears to be a better option than Sweet Spot as you suggested. Advice taken. Thanks.

Read & Understood. All makes sense. It seems we’ve had far differing outcomes from the surgeries, but all L5/S1 cases are different. Makes sense @RONDAL

I’ve been fortunate that my cases have Ben significantly easier than this - 3 hours a day rehab sound awful. Glad you got through that. Nationals & Worlds is an amazing outcome, car sideswipe less so. That sucks @70plusmtb. Thanks for the read and the insight.

You are correct @AndrewL - I shouldn’t have used that term. But my surgeries have been so pain free it has been ridiculous. Literally both have seen me discharged the next day, with no pain relief on either case from the moment I came round to date - literally not even a paracetamol/acetaminophen. Only taken NSAID for toothache etc. and not for back each time. That’s what I meant when I was referencing the word ‘ludicrous’.

Don’t get me wrong - I get a cold and I’m all over those drugs, but these operations have been totally pain free which makes the standard / non personalised-time windows I’ve been given so frustrating. Hope that makes sense.

My consultant is not the greatest at bedside manner / making eye contact (!) and I did feel that the 2nd op was probably unwarranted, but was easily billable to my medical insurers, so…

Essentially looking to get insight as to which training plan I should be focusing on to help with achieving a big day in the saddle 3 months from now. It’ll be always be just a ride, not a race for me, which possibly puts me as an outlier on here :woozy_face:

Excellent suggestion @brenph . Just ordered after some quick reading. Should be here later this coming week. Thanks!

This is the wrong thought process. Absence of pain does not equal healed. In your case, you were cut and your MD removed a herniation sitting on your nerve root. With the herniation gone, the radicular pain is gone too. However, the whole reason this gigantic symptomatic herniation occurred in the first place is ever present. You likely have a very weak poster annular wall that is increasingly subject to further injury now that you’ve had prolonged pain and two surgeries. My message to you is to respect the healing process and understand that pain is not a sufficient guide of how to proceed in your case. You are at such an increased risk for reinjury right now, you honestly need to rehab, get stronger and return your spine range of motion (especially extension) back to normal. The bike should not be your primary focus now.

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Hey dude. Sorry to hear this. I, too, suffer from a bulge at L4L5 and a minor protrusion at L5S1. Although, I haven’t had surgery, trust me, I feel your pain. Coming to a forum for advice for something this serious is probably not the best solution. What I’m telling you is listen to what your PT has to say, and what your sports med doc is telling you. You will hear opinions from everyone, but in the end, only your docs know your true training situation. Keep me posted if you will on your recovery. I’m pulling for you

Money issues aside, IMHO you should see a specialist who also has experience with athletes and you trust. But his or her answer might still be “no cycling for six months”. However, what you should do is get proper physio (with the approval of your physician, or course). It may cost you money, but it will definitely be worth it. They will know best what movements you should do or avoid. IMHO your focus should not be your FTP, but healing properly and doing everything to accelerate your recovery.

I reckon (I am not a doctor!) hunching over a road bike isn’t the best thing for your back at the moment, though. But perhaps there are alternatives out there such as the hated recumbent bikes in various gyms. (Again, don’t trust me, ask your doctor and your PT whether that is a smart idea.) I am sure there are forms of cardio that do not place undue stress on your spine.

Let me re-emphasize that. My dad had extensive neck surgery earlier this month. He didn’t go to the doctor despite the obvious symptoms, because (in his words) he didn’t feel any pain. Absence of pain doesn’t mean things are going well.

That’s my MRI report. It was over 4 years after I popped a disc that I finally went for an MRI instead of a PT.
I still get up every morning and move a stupid amount of gear around everyday.

If you’ve had surgery they’ve done all of the scans. Do not risk damaging the surgery you’ve just had. Follow the advice given.

In my personal experience, I have loads of problems with left hamstring and back tightness. I find the best solution is stretching and the exercises prescribed to me by my PT (6yrs with Cirque Du Soleil).
During the TR workouts I often have to stop and stand upright to arch my back for a moment on each side.

I ‘HTH’ without giving you false hope. Your back is Fckucked. Now you have to do lots of work to protect it.
My back has really liked the low impact bike riding.

Hello. Quite a thing to go through. I’ve had mid lateral thigh pain for a little over 2 years that has turned my life upside down. MRI showed L3 disc protursion and L4.

During the past two years I’ve only had two periods more than a few hours without substantial pain. The first was when I did a lot of low intensity riding about 20 hours a week for 4 weeks outdoors. I rode my gravel bike which has much less reach and drop and kept the intensity low. Unfortunately, I came off on a decent and broke my clavicle and scap. The pain came back when I was doing sweet spot TR sessions on the erg during recovery from the fractures.

More recently I had almost 9 days without pain after doing 3 x 2h rehab sessions, 2-3 swims, 3-4 1.5h to 2h Z2 only erg sessions per week. I started to add intensity and sweetspot back in and pain returned and I haven’t been able to shake it.

Very loosely there seems to be some connection with load when my spine is under flexion. I don’t feel I’ve ruled out every possible diagnosis other than radiculopathy, but the professionals I’ve sort help from have no further ideas.

I’m consulting a neurosurgeon in May, but concerned if I go down that path it may not fix it.

I have two friends who’ve had surgery and they have come back to cycling very slowly over 12 months with a lot of rehab under the guidance of physio.

My advice to you would be to scrap the two goal events you have planned and work towards being able to spend more time on the bike and slowly working up to intensity over 12 months. I know this is easier said than done, but you want to try to get the best outcome you can. Also the whole piriformis thing I was fed too and I don’t buy it. A physio stuck pins in my glute med and replicated the thigh pain, but the muscle isn’t in spasm it’s just a trigger point.

Find a good physio who knows bikes and spines and let them dictate your training load and then follow their advice. I’ve learned the hard way that it’s very suboptimal to be making the calls yourself.

I’ll repast this here from the post I linked because it seems to either have been missed, or disregarded;

Your body might be telling you no pain, but if your medical team which YOU trust in their experience and skill is telling you not to do something, listen to them. Recovery is a marathon, not a sprint, and rushing it can only increase the odds of a setback, or further injury/damage to nerves.

My opinion, not that its worth much; instead of focusing on a goal race, set a process goal of what you want to follow and simply see where you end up by the time your races come around. Maybe you race, maybe you don’t, but you do all your PT, all your stretching, all your rehab to 100% of your abilities, and you don’t compromise the health of your back in the process just to participate in some amateur bike race.