Phil is just an ordinary bloke. An ordinary bloke who likes to ride a bike. Phil and I know each other from Wednesday rides out with Bigfoot CC, but he first came to me in my professional capacity in May for a bike fit with former colleague Mal at Le Beau Velo. I was very aware when we fitted Phil that a bike fit might not be enough to resolve the back pain which was then starting to interfere with his riding. This has often been the case with bike fits, and its one of the reasons I now focus on the biomechanics of the body in a bike fit more than anything else. However, a look at the body on the bike first can certainly help to keep a keen cyclist riding as much as possible, and allows me to ensure that the riding position itself is not contributing to the problem.
Needless to say Mal and I were able to improve Phil’s position quite a bit which helped offload his lower back and make riding more comfortable. As well as changing Phils position at that time I provided a tailored stretching program, to make a start on some of the issues that came up with my assessment as possibly contributing to Phils pain.
People sometimes mistake me for a physiotherapist because I work with clients with injuries/pain issues using exercise. However, I’m not a therapist but a ‘corrective exercise specialist’, which means that instead I use ‘corrective’ exercise to change what I see with my physical assessment through personally tailored progressive exercises. Often clients who work with me in this way have got as far as they can with physiotherapy and treatment, and are trying to move forwards for the longer term, away from the acute problem towards or a more permanent long term resolution.
Many of my assessments overlap with those that physios use, including range of movement, core function, and in Phils case, an assessment of the neurological components to his back pain and sciatica. The overview above is a summary of my findings from May, and by the time I caught up with Phil in the Autumn he had reached a plateaux with physiotherapy and an MRI had been sought to help identify the specifics of Phils ongoing back problem and ‘referred’ pain and weakness down his left leg.
In the interim period since our first session, Phil had been having on going treatment and had only intermittently been following the exercise plan that I had given him. Like most people he was hopeful that someone would find THE ANSWER and be able to FIX THE PROBLEM for him. By the Autumn it was becoming apparent that treatment options were narrowing, which motivated Phil to have another go at my corrective approach in a more committed way.
For me as an exercise specialist, in difficult cases like this one, an MRI can be a really helpful diagnostic tool in confirming exactly what is going on in and around the spine. The images that came back from Phils MRI and the report that came with them identified a ‘left lateral prolapse at L5/S1 compressing the descending S1 nerve roots in the lateral recess'. I’m trained and qualified to assist in rehabilitating this kind of disc derangement, and at the heart of the holistic approach is to not only use exercises, but closely observe and adjust the way the client moves in their day to day life, educating them to avoid aggravating the problem, whilst getting to work on provided greater support with exercise.
This approach is by no means a quick fix, but with the next likely suggestion being back surgery I’ve caught Phil in a motivated mood and am keen to see what we can do before it comes to the knife. This is where you pick up the story with Phil. If you have the early signs of back pain and are not looking after your body, maybe Phils story will encourage you to get a bit more proactive sooner. Keep an eye on my twitter and Instagram feeds if you’re keen to follow Phils story with the hash tag #followphil. It will be like #followfabian but with an ordinary bloke.
