Strong low back muscle pain, can barely walk, 9 days to Kona

Triathlon Forum
21

Hey guys, really appreciate your positive comments, have just read them all, can’t reply to all of you, but I’ve read ALL of them and saying a big thank you.

Just woke up (8 am Hawaiian time), feeling much better.
Now I can go to the toilet pretty fast, almost like normal (used to take me 5-7 min to get up, and then go step by step while bending end holding my knees, and then going back).

I can walk straight again, but turning the body left/right results in sharp pain in the center of low back.
Lying in bed is mostly fine, though some movements are painful.

So far I like the progress (it was 9/10 yesterday - not able to walk at all, only crawl on all fours, all movements are painful).
Right now is ~ 5/10.

No running is possible, might be able to take a walk (1 mile) to the expo afternoon and maybe take a dip in the ocean.

The doctor in Kona Community Hospital told me that it’s a muscle strain/spasm. There were no MRI necessary he told. Rest, medication, patches, then leg exercises (knee raises to the chest).

I’d suggest that maybe you should also smoke a joint, but there’s that pesky issue about it being a banned substance re:competition.
That’s funny - Uber driver getting me back from the hospital suggesting that too and was ready to give me some for free.
Yeah, don’t wanna risk with the doping.

Will keep your posted.
Thanks again.

22

When lying in bed, knees bent, legs parallel to floor plopped on pillow, suitcase, my issues were mostly tight ilia psoas, weak glutes, sore QLs. MRI would show minor disk bulge, but addressing muscle imbalances has helped. You are not in any condition to do couch stretch now, but that, glute strengthening, QL strength work and McGill 3 are my staples. But you need to get a pro to really confirm it is muscles vs spine issues if possible. Best of luck, be smart.

23

Most of the advice in this thread is not good and likely to prolong your acute issues. This isn’t stress, though stress can aggravate and it’s not a muscle strain. Tissue diagnosis will be inaccurate.

Can you describe your functional deficits more… difficulty sitting, bending?

Are you able to lie on your stomach? Most common reduction to symptoms like you describe and potential loss of extension range of motion is prone lying, prone lying on elbows and eventually progressing to pressups. Walking is great.

Most important to understand is this is a mechanical issue. Anything you do should not leave you worse. You can have pain with movement, but it should return to its pre activity level when you are done. Bed rest is contraindicated.

24

I’d bet dollars to donuts this is an SI Joint issue. Ended my Collegiate Track season because no one could figure out what it was.
Took my days to walk normally after each workout that I did. Has happened sporadically in the (many) years since.

This can happen for 2 reasons.

  1. SI joint dysfunction / Immobility
  2. Tight hip flexors / quads that cause an anteriorly rotated pelvis. This shocks the SI Joint with each running step and can lead to #1. This is especially apparent when running fast as the pelvis needs to rotate further forward to allow for the increased stride length. Doubly so when running fast downhill.

You can get significant relief in the next week.

  1. Consistently take anti-inflammatories. Not just to deal with the pain acutely, but to reduce the inflammatory response over the coming days. Consult your physician or another medical professional.
  2. Find a massage therapist STAT and have them focus on your quads, hip flexors, and lower back.
  3. Search how to mobilize your SI Joint.
  4. Stretch hip flexors with the kneeling pose
  5. Stretch quads
  6. Self-Massage deep hip flexors (Illiacus & Psoas) with a massage gun or research online.

While walking and running, you need to stabilize the SI Joint and reduce the anterior tilt of your pelvis.
Relax your buns, but keep your lower abs taut.

You likely also have a neural based strength deficit because of this. You’ll see this in your bike power balance if you use a power meter. Mobilizing the SI joint is imperative to regaining that strength.

25

Thanks, Andrew. I started to walk more rather than just resting in bed.
Feeling better, there’re so many movements I can perform right now.

I can lie on my stomach, do push-ups.
There’s pain when changing position from sitting → lying → sitting → standing.
When lying on the stomach, there’s a pain when trying to bend the knees.
Pain when bending and trying lift objects from the floor.
Some discomfort and pain when walking straight.

**xtrpickels, **could be it! I had problems with tight hips/quads in the past.
Also, that interval run on Tuesday was fast and I might run too quickly on the roads in San Francisco when going home after the track.
Thanks for all the tips, will do all as recommended. Will start stretching and self-massage. Appreciate your help.

26

10 days before my last ironman race out of nowhere in pilates I did something to my upper back. Never had an issue before, wasn’t doing anything extreme at all. Spent the week trying everything. Physio every other day, ibuprofen, chiropracter, massage, praying to every deity google could suggest and a few more. I was in total agony and whilst bizarrely could run, then I couldn’t stand, sit or hold a bike position. Ended up going down to the race mid week as had accom booked, a friend had travelled internationally to stay with us and race, and I just decided to see what happens.

I was waking up 2-3 times a night and needed to get up, stretch and roller my back in order to manage the pain to return to bed.

It did ease a touch the day before race day, and I got a swim in. So my theory was just see what happens.

Come race day the swim went ok, the bike I expected to be a shit show and I’d be pulling out after 5/10km. In the end then I stuck to my plan of taking alternating paracetamol and ibuprofen (at the normal advised intervals). In the end then finished the bike pretty much bang on my 5:10 target and power, although was fading in last 20km.

And that’s where it all went wrong. Got off the bike and instantly had no legs for the run. Was struggling at 5min pace, when all my training/plan including training camps on the course doing full distance bike and run off the bike, etc had me -20s on that. And after 3km the back went into full spasm. Post race I worked out the painkillers interfered with the nutrition / digestion and so by end of bike I’d just got a full stomach and nothing in my muscle/blood. So from there I did the most ridiculous lurch/march for the next 34 km. I’d try to run, but just was unable to do more than 100m. I was gutted. Totally destroyed, and lurching past all the support crew / coach didn’t really help.

Last 5km, after 4+ hours of lurching I’d managed to get some food in and then was actually able to run that last bit, which at the time pissed me off even more.

However, the postcript to that is that I f’cked myself up good and proper doing that lurch. Whilst I didn’t do any harm with the painkillers, I did to my pelvis from the lopsided gait. And so 2.5 years later I’m still going through rehab and struggling to get back (albeit last 6 months are showing positive direction - up to 11km running now).

So my main message is to just be aware of your body when you race. Assuming you aren’t a pro, then consider if how you feel on the day and in the moment is sensible for you to carry on remembering this is a hobby.

27

There are times when I love the collective nature of SlowTwitch, and times when I cringe at some of the advice given out.
As an MD who works in an acute and chronic pain based specialty, and who works alongside an interventional pain specialist, all the posts on here saying you have this and you have that and it sounds like exactly what I had this time etc and then offering advice on what to do, it is really inappropriate at times.
We do not actually have a clue what the OP has as the cause of his back pain. As an MD who works in this area and hearing his symptoms and KNOWING what the differential diagnosis is for these sorts of things, I cannot say what the source of his pain is, and that list of differentials is long. It may well be something simple, it may be an SIJ issue, it may be a “sprain”, it may actually be an acute disc prolapse, it could be an infection in his disc, the list is long and we may never know what the cause is if it all goes away of its own accord.
We all want the OP to get to the start line and hope it is nothing major, but lets avoid inappropriate posts saying that this is what he has, or I bet you have what I had etc. We cannot diagnose it from here, any respectable doctor would not diagnose it based on what the OP said in his original post. Any respectable doctor would also know that most emergency departments will take the view that if there is no gross motor defect then they will provide analgesia and discharge and use a tincture of time as a guide to whether it is anything more serious in nature and then may require more advanced investigations.
Sorry, a bit of a rant.

28

Lots of good advice from xtrpickels. The fact that you are experiencing some relief already is good news. Make sure all stretching and massage are gentle. See a good Chiro if possible.

And like Amnesia said, no one really knows what it is. But at this point, hope it’s minor and will clear up on its own.

My back has “gone out” several times a year since I was hit by a truck 12 years ago. Usually it’s a super acute center lower back pain for a few seconds, and then ~4 days of recovery… in which it’s pretty debilitating. One thing that really helps me is to get in downward dog pose and gently pull myself forward while relaxing my back as much as I can. If I can feel a slight pop, then I’ll soon be better. This may not help you at all, though.

29

There are times when I love the collective nature of SlowTwitch.
this won’t help the OP, but please know, i pay strict attention to whatever you have to say on these matters Amnesia, thank you for your contributions.

good luck NickMa, you’re pretty much obligated now to let us know the outcome, hope it’s a good one!

30

Duncan74, thanks for the story. Yeah, there’re more races to come, so no point in ruining the health.
Appreciate all the other posts!

Today’s morning wasn’t good, later went to a chiro and then got a massage from Gary Shields - a professional who’s done many ironmans, ultras, and bike races - he knows how to help a triathlete.
If you’re in Kona, text 808-319-3221, he might have some spots for the next week. Highly recommended.
Will visit both again next week.

Felt much better after that, though walking is not comfortable. Have 6 more days, and my condition is still much better than yesterday.

Odds that I’ll make the start line on Saturday are rising, my bib is #2559.

Will participate tomorrow at Ho’ala training swim, doubt it’s a good idea to swim the whole course, will see how it goes.
Run is a no-no probably until the race.

Twilkas, will keep posted for sure after the Saturday race, though don’t wanna get all the ST attention to my silly situation :slight_smile:

31

There are times when I love the collective nature of SlowTwitch.
this won’t help the OP, but please know, i pay strict attention to whatever you have to say on these matters Amnesia, thank you for your contributions.

good luck NickMa, you’re pretty much obligated now to let us know the outcome, hope it’s a good one!

Thank you, much appreciated. Sometimes on the internet you never know if people are reading or listening!

32

I’ve had back issues for years, and I’m pulling for you! It is not fun to deal with. I’ll be following this to see what works for you. Crossing my fingers for you that it keeps improving quickly!

33

No good news after 7 days.

Won’t make the start line on Saturday despite every possible attempt to recover (multiple chiro sessions, massages, meds, resting/walking etc).
The lower back is in pain even when walking slowly and bending. It gets worse in the middle of the night.
I suspect it can be a stress fracture, maybe a sacral? Will try to do an MRI in the next days to figure it out.
Don’t see this just as a muscle strain.

Swam the whole course of Ho’ala on Sunday and enjoyed it. Swimming is probably the only sport I’ll be able to do in the next month (maybe some biking later).

Waited for the start for 3 years (KQ in 2019), spent lots of energy and resources to come here, but the result is DNS :frowning:
A part of me wants to unpack the bike case again and give it a try on Saturday, but it’s a dumb thing to do - the best scenario I’ll start suffer from the beginning of the bike and then walk for 6+ hours.

Still, I’m really thankful to be here at Kona, meet new people and witness the top athletes racing. See the guys all over the world coming here for the race week and the volunteers doing all their best.

Enjoyed supporting my American and European friends today, and will do the same on Saturday.

Thanks everyone for the support and I’ll be back in 2023.

34

No good news after 7 days.

Won’t make the start line on Saturday despite every possible attempt to recover (multiple chiro sessions, massages, meds, resting/walking etc).
The lower back is in pain even when walking slowly and bending. It gets worse in the middle of the night.
I suspect it can be a stress fracture, maybe a sacral? Will try to do an MRI in the next days to figure it out.
Don’t see this just as a muscle strain.

Swam the whole course of Ho’ala on Sunday and enjoyed it. Swimming is probably the only sport I’ll be able to do in the next month (maybe some biking later).

Waited for the start for 3 years (KQ in 2019), spent lots of energy and resources to come here, but the result is DNS :frowning:
A part of me wants to unpack the bike case again and give it a try on Saturday, but it’s a dumb thing to do - the best scenario I’ll start suffer from the beginning of the bike and then walk for 6+ hours.

Still, I’m really thankful to be here at Kona, meet new people and witness the top athletes racing. See the guys all over the world coming here for the race week and the volunteers doing all their best.

Enjoyed supporting my American and European friends today, and will do the same on Saturday.

Thanks everyone for the support and I’ll be back in 2023.

Sorry to hear this. How about a DNF instead of a DNS? Since you have no trouble swimming, go enjoy the swim with the crowds at the start and then stop after the swim. Don’t unpack your bike, with a “Well, we’ll see how it goes.” Just go enjoy the swim. Then support your friends on the bike and run - you can’t really support them on the swim anyway.

35

This ^

Great idea.

36

I agree, was gonna be my suggestion too.

Go enjoy the most expensive swim you’ve ever paid for!

37

Yeah, I like the idea. Thanks, guys.

There will be no chip on me because I won’t put my bike into T2, so it’s still be formally a DNS, but at least I’ll have some swim experience!

Go enjoy the most expensive swim you’ve ever paid for!
Haha, so true.

38

Have a fantastic swim, knowing you can basically go eyeballs-out for the whole 2.4 miles. No need to preserve anything for the run !

39

So, we’re you pain free enough to swim? How was it?

40

Sorry, I haven’t seen your post.

After 1 month I can say that it was a good decision to DNF after swimming rather than didn’t start at all - the starting collar was fun, met some guys I know from other races and was able to feel the vibe, especially in the water waiting for the start.
So thank you for the advice you gave.

The swim was almost painless (the back was stiff) and enjoyable (though slow for me - 1:18, I usually do ~1:10), and I got the experience that will help me next year.

Before the swim, some volunteers noticed that there was no chip on my leg - I told them it was fine.
But after the swim, I had to give explanations to the race official in T1, and he wasn’t happy about me starting without the chip (safe reasons).
Then I left the transition watching all the guys starting the bike leg. It was sad, of course.

The pain in the back disappeared 10 days after the race. During those days it was impossible for me to run, getting out from car was painful, etc.

I still don’t know what was the issue, the X-Ray didn’t show anything. I bet it was a muscle issue.
Right now I do swim/bike/run without issues, no pain at all, though I haven’t done any interval running. Focusing on strength exercises right now.