Cycling and Disc Injury

Back pain isn’t limited to those in their twilight years. A disc herniation has forced some of the best athletes in the world to quit or take significant time away from their sport.

This injury can happen in either the cervical spine (the neck) or the lumbar spinal (the low back). It can be very serious and debilitating. Because disc failure can often be caused by repeated lumbar bending and only moderate compressive loads, cycling is a common cause. The severity of an injury can cause symptoms such as back pain, leg pain and weakness, as well as tingling and/or numbness. X-rays are generally negative.

Joanna Zieger, a professional triathlete, suffered a disc herniation several years ago that severely affected her season. After a collision at the 2010 Giro d’Italia, Carlos Sastre, a professional cyclist, suffered a disc herniation. After suffering severe pain for a month, inability to train or race, and intensive rehabilitation, he was finally able to compete in the Tour de France.

The spine is composed of many small bones that are stacked on top one another. These are called vertebrae. To serve various parts of the body, nerve roots extend from the vertebrae. These discs are made mostly of water and sit along the length of each spine between the vertebrae. The discs serve a variety of important functions. They allow for slight movement between vertebrae and hold them together. There are two layers to these disks: a tough outer layer and an inner layer that is gooey. As the disk ages, the outer layer may become brittle and lose some of its water content. When the outer layer of the disk ruptures, the jelly-like contents spill out. This is known as a ruptured or herniated disc. This can cause pain and numbness in your back, neck, arm, or leg. The pain can follow the course of the entire nerve.

Without a CT or MRI scan, it is difficult to confirm a disc herniation. If all other injuries have been ruled out and studies come back negative, the diagnosis of a disc herniation is usually a frustrating “Non Specific Chronic Lower Back Pain.” This happens because the tissues are stretched and the position of the rider is changing. This decreases the ability of these tissues to stabilize the spine segments. This causes a loss in control and unprotected movement of certain back segments, also known as “tissue crawl” or “tissue creep.” A disc herniation is when the spine becomes weaker and the muscles begin to compress the discs.

The hips should be strengthened and increased mobility. It is rare for cyclists to be restricted by their hips. It is counterproductive to focus on the range of motion of the spine as part of the problem. It is recommended to strengthen the muscles supporting the spine. These muscles can fail if they are in a prolonged position. Therefore, endurance is a must for strengthening. It is also important to position the bike properly so that the spine remains in a neutral position.

If the injury cannot be repaired, surgery may be an option. The safety of back surgery is now much better. The procedure of discectomy involves removing a portion or all of the disc between the vertebrae. The pressure is released and the pain is immediately reduced. This area is vulnerable to re-injury and rehabilitation is essential. A neurosurgeon or an orthopedic surgeon will determine if surgery should be performed.