Two time L5/S1 discetomy surgery patient checking in here.
First surgery 2011, second 2016.
I’ll break this down into a few components; bike fit, rehab, off-bike work, on-bike
Bike Fit:
I can’t get aero as a result of back issues. I can ride in the hoods for short periods but I need to be more upright. I went and got a professional fit down with a physio and we got me more upright with spacers under stem and a shorter stem. I ride more now on the hoods as well just to keep hip and back angles where they need to be to avoid discomfort on a longer ride. I also initially moved to a synapse to help with comfort and cutting down some of the road vibration, but a lot of the newer bikes manage this really well anyway.
Rehab;
Rule 1: Listen to your body
Rule 2: Listen to your doctors/medical professionals helping you.
Find professionals that you trust and are looking out for you, not simply trying to sell you something. I’ll assume in all of this that you have gotten to root cause (mine was ruptured, and then bulged disc). But if you dont know, get it figured out with imaging so that you dont make things worse.
Getting up and moving is the first step. Literally walking. Your back isn’t going to heal and recover lying down, so get mobile. Avoid bending, lifting and twisting combo movements. Use ice to manage inflammation and pain to best degree possible, NSAID as needed and anything stronger only if absolutely necessary. Opiods get prescribed way too easily and I can tell you from experience it does not take much for a chemical dependency to begin, plus they destroy your stomach. Make sure your sleeping situation is taken care of properly; if you can sleep on back do it, make sure mattress is supportive, and use pillow between knees to alleviate pressure if you are side sleeper. After a week or two of movement and proper sleep your symptoms like sciatica should start to feel better.
Off-bike work;
Mobility mobility mobility. Can’t stress this enough.
As cyclists we are quad dominant and have weak hip flexors. This doesn’t help for back issues. Get your glutes activating properly and it will make your life so much better. Start doing some proper form glute bridges on your back on the floor. work up to 3x60s holds. Make sure you’re stretching quads, hamstrings, calves and hip flexors. Build a daily routine where you do this when you get up for 5-10min and before you go to bed. This will take time, but over time you will start to see results. I could barely touch my shins a few years ago, now I can go palms on the floor.
When the timing is right and your medical team says it is OK, start lifting some weights. Back Squats and Deadlifts. Proper form only. No hero weights. Work with a trainer who knows how to cue and coach form. Perfect the form with a dowel before you start adding weight. Building weight gradually will help strengthen your posterior chain and help protect your back.
Work your core, ab roller and planks/side plank. This too will help protect and strengthen your core.
Clean up your diet - I was carrying around some extra weight as a result of pain and immobility. Weight is hard on the back, bad diet does nothing to help you recover. Feed your body properly.
On-Bike;
I left this until the end, but if you’re doing the above there should be no workouts that you can’t do. Longer rides initially will be harder and may lead to back or leg fatigure. Bike fit will help.
If it hurts don’t do it. I did taku on 50% 10 days after surgery just to get the legs turning over. I used TR exclusively for my recovery and to get back into racing shape. I really liked the traditional base plan on low volume. The efforts aren’t too hard and there is not a lot of sprint work, really helped get things back to an acceptable level while I worked on the other items above.
If you have questions feel free to ask more, I know all too well the issues of this and spent more time and money than I care to think about trying to address the issue, and tons of time doing medical research once I finally knew what was wrong with me. Hope things start to improve.