Broken Back to Ramp Test-How to Prepare?

injury
ramp-test

#1

Imagine that someone just got the okay from their neurosurgeon to start riding on the trainer again (while wearing a brace) 8 weeks after fracturing their L1 and L5 vertebrae in a crash.

How should one in that situation get prepared to tackle the Ramp Test?

Should they spend a week or so soft-pedaling for 30 minutes to an hour getting used to pedaling again, or is there some sort of power output that they should be able to hit so they know their body is ready for a big effort again?

I’m asking for a friend (wink!).


#2

Hey there, simplejj. Sorry to hear about your injury! That sounds like no fun. I’m no expert, but I would think your best course of action is to bring your FTP way down and start with some aerobic endurance rides before trying to tackle the ramp test. It’s not that long of a ride, but boy does it sting there at the end. I would guess that would not be great for someone with so much other trauma.

This made me think of Nate’s journey back when he broke his collarbone. It may be worth checking out those podcast episodes if you haven’t listened to them before, or in a while. Hope this helps! Feel better!


#3

Not a broken back, but I broke my shoulder in early 2017. Once I was able to get the bike off the rack and set up the trainer (about 8 weeks post injury) I did a couple of weeks of Pettit for two reasons:

  1. I was still in a sling (horay for bungee cords!) and couldn’t actually get my hand on the bars
  2. I wanted to get used to things again
  3. It was pre-ramp test so I used them to guesstimate my FTP based on previous experience which I could then use in the 8 minute test.

Might be wise to go carefully with a ramp test, you could consider doing the 8 minute version instead to limit the stress a bit. I can imagine muscle tension on the ramp test trying to gut out the last minute could be unpleasant.

Chances are you’ll want to retest inside 4 weeks anyway as you recover your a lot of lost fitness, so ‘close enough’ might be good enough (I think I jumped up about 40W in first four weeks back so even a spot-on ramp test isn’t going to accurate for long).


#4

Hello,

Nearly 3 years ago I broke my T12 vertebra. It was an unstable fracture so I had titanium rods and screws from L1 to T11. Looking back at my Strava log, my first trainer(road) ride was about 6 weeks after the crash. I did about 10 minutes gentle pedalling, wearing my brace. A couple of days later I did half an hour, and I think after that I got unofficial permission from my physio to take the brace off whilst on the trainer (but to wear it whilst getting on and off). I stuck to half-hour sessions for another couple of weeks, with a self-selected FTP. I was just looking to get blood flowing around my body and mitigate the inevitable effects of my relative inactivity on muscle mass and aerobic conditioning. I kept the intensity fairly low - hurt too much to push very hard.

2 months after the crash I did a 2 hour trainer ride, just low intensity, but by that point I was OK doing sweet spot work with an FTP set a bit lower (can’t remember how much, maybe 15%?) than pre-crash. My first ride outdoors was 3.5 months after the crash (my surgeon was quite conservative and I didn’t want to screw things up - also had to buy a new hardtail mountain bike since the one I put on the trainer was stolen!).

I don’t know when I did my first FTP test though - I just figured that there was absolutely no point for me (and it would have really hurt). Those first few months were all about maximising my (long-term) recovery by keeping active. I wrote off that year’s plans the moment I came back from the CT scan…

With hindsight, I really wasn’t off the bike that long considering the severity of my injury. My back still hurts every day now, but it’s totally tolerable and doesn’t stop me doing anything important. I snapped my Achilles tendon last February - that’s proved way more difficult to come back from! (I’m not accident prone, honest!)

Best of luck!


#5

You can do it! Really. Just listen to your body.
So, 4 years ago April I had a car crash, hit a cow on highway at 65 mph at 3 am. going to work. Broken sternum and compression fracture of L1. (40% crushed). Followed PT instructions for 2 weeks, then went to gym for my own PT. SHOULD HAVE DONE MORE,took it too easy for 2 months.
The point of this is listen to Drs. and your body.
Two years ago in April 20, went down in a corner @ 40 mph, breaking the ball off the right femur at the neck. Surgery and a ORIF(OPEN REDUCTION INTERNAL FIXTURE). So while you all were riding I was learning to walk again. 30 days with a walker.:-1:Then it was thanks PTI’m in the gym doing my own. Lazy river at first then weight room and machines. Borrowed a Cyclops hydro and spun in front room racing the guys on tv. Any cycling race I could find. For me it wasn’t about power or even cadence, slowly regaining pedal stroke and dreaming of that first ride and the freedom in it. I did listen to the docs and my chiropractor. This time I really listened to my body. And I forgot, first week after surgery the leg was filled with blood clots.
After all that, we are all so much the same and so different, listen to your body, use the big head, and DREAM! YOU CAN!
I did return to my work 90 days to the day of the event. On my feet 8hrs day as produce manager.


#6

Thanks for sharing your experiences. I’m looking forward to getting back on the bike and seeing how I feel.

I figure if I can work up to an hour of riding on the trainer at a decent heart rate without any back pain, then I’ll try a ramp test and see where the power is at.

I’ll also look into doing some PT to see if that helps.

#cxnats2019


#7

In the longer term, my surgeon highly recommended regular swimming and pilates too, BTW!


#8

This one is near and dear to me. I’ve been in the Army my entire adult life and have spent 22 years jumping out of airplanes. Along the way, I’ve had a few injuries, but two stand out, I dislocated my hip with an associated cradle fracture, and I’ve broken my C4-C6 vertebrae with a really bad landing. These were thankfully separate injuries at separate times, but there were silmilarities in the healing and recovery process.

I’ll skip a lot of it, but the key takeaway for me, the thing that really enable me to get going again was to treat it not think in terms of what I could do before. The weeks before I broke my neck, I was riding 300 miles and running tss numbers of 650 or better on the reg. Obviously after 9weeks of recovery basically doing nothing, that wasn’t going to be the norm, but I didn’t realize how much everything had changed for a while. I had to be refit on my bike, my flexibility was reduced, my aerobic and anaerobic abilities were minuscule, and my over all endurance (toughness) was way, way down. It was a six month process to get back to something really solid, but pretty quickly in I was getting demoralized, thinking I’d never return, etc etc. obviously these are common emotions for people who use and train their bodies when faced with major setbacks and injuries, but I really let them bring me down. It took a good friend talking to me a few times (slapping me in the face with reality) to remind me that it didn’t matter what I got back to, I was only measuring myself against me, and that had to be the “new” me, the post injury me.

This guy was uniquely qualified to tell me these things as he had lost his right leg, and part of the same hand in Afghanistan, but was trying himself to get back in the triathlon game. He went through all this, the self pity, the unwillingness to accept the change etc, and in the end he was better and stronger. Bottom line, I realized that dwelling on what I used to do, and used to be capable of, was no good, and the way forward was just to focus on the here and now, one day at a time as they say.

Like so many of the previous posters said, you can totally do it just keep your head straight, let your body and your physical therapist be your guide, and keep moving forward.