Rosser Chiropractic

Most cyclists are looking for a little bit more speed, especially at the elite level. A new article takes a look at the historically controversial topic of the effects of strength training programs on cycling performance. As background on this topic, you should know that there are cyclists who don’t go near the gym any time of the year because they are afraid of building muscle that either doesn’t help them go faster or makes them heavier (and harder to push up hills!) I don’t know what the effects of the training program where on cyclist’s overall weight, but the authors of this study do report improvements in endurance performance in 5 minute tests (3% increased performanc) and 45 minute tests (8-10% improved performance.) From my perspective as a healthcare provider, I know the effects of having muscle imbalances from cycling and that strength training is one of the ways to balance them out. Most of us are not elite level athletes and we are also responsible for activities outside of cycling… like loading/unloading groceries, taking out the trash, moving a couch, etc. These are EXCELLENT reasons to strength train and be as strong as you can to prevent injuries.

Last night, I had the opportunity to be the guest speaker for the Capital Bicycle Club here in Olympia, WA. As I prepared for the presentation, I began thinking about how my specialty work with cyclists relates to everyone else that I treat here in the office. One of the common threads that emerged is that my clinical approach is always trying to seek the “weak link.” In other words, what important limitation exists that is disturbing the normal flow of function and creating the current presentation (Enter symptom here:______!)

As inspired by Gray Cook, PT, a weak link is a limitation such as a poor movement pattern, poor endurance, poor flexibility, poor training skill, etc that is a hindrance to normal function. Over time, a weak link can get perpetuated through our everyday lives and effect us at work, home, play, or sport.

One particularly telling example of how profound a weak link can be is in this story: A cyclist recently presented to me with pain in his right hip that began after a summer of riding a lot of miles up steep roads. Although it wasn’t much different from previous summers, the pain was new and was causing him great concern because it was affecting him off the bike, too… even walking was difficult.

Ultimately, this cyclist’s weak links were identified as inflexiblity of the deep hip muscles, poor recovery techniques, and overuse of these muscles. On the bike, climbing puts a lot of pressure on the hips and lower back, and this is the year they’d had enough and sent him the signal of pain. In the office, I provided some manual treatment to the area and then gave him a homework plan that included specific use of a foam roller, targeted stretches, and a few exercises. All of these were aimed at diffusing the power of his weak links. In a short time, he was painfree on the bike again, and climbing big hills. To that, my hat’s off to him!

I had a great time preparing for and teaching my first workshop in the office over the weekend.  Once I got my jitters out and we started doing the exercises I set out to teach, the time started flying by.  As always, every day is a learning opportunity, and that’s ESPECIALLY true on those days that we bill ourselves as the teacher.  Here’s what I learned from my day as teacher:  I have a lot to learn.  I’m always inspired by those who willingly throw themselves into learning something new.  I can only hope that I am as flexible and receptive.  I’m also constantly inspired by the persistence of my patients.  I’ve lived with lower back pain for most of my life, and it’s definitely guided the direction of my life.  As I see others and talk to them, I can see the same impact that chronic back pain and other ailments have had on their lives.  I look forward to doing the workshop again and being present to what I have to learn.

We are hosting a movie night for our good friends the MS’Kateers who are raising funds for their participation in the Bike MS Ride in September.  I participated in this ride several years ago, and had a great time doing it.  We will be showing The Ride, a documentary of Phil Keoghan’s ride across the United States in support of the MS Society.  We’d love to have you here to enjoy this uplifting movie and enjoy the company of those who are inspired to ride in support of MS.  Who knows, before you leave, you may want to join the MS’Kateers on their adventure.  If you want more information, please call Jessica or Dr. Andy at the office: 360-754-6499.  

When: Wednesday, August 24, 2011 @ 7pm
Where: Rosser Chiropractic, 705 4th Ave East, Olympia WA 90596
How Much? Donations of any amount will be accepted.

If you are so inclined… here’s a flyer.

Below is an article that I wrote earlier in the month for the Capital Bicycle Club Newsletter here in Olympia.  It was inspired by all of the injuries, especially concussions, that were part of this year’s Tour de France.  As you will see in this introduction, I think we all stand to learn a lot about what happens when we fall and hit our heads as cyclists:

The injury count in the Tour de France thus far has been high, as a result of the many crashes that have occurred.  One type of injury that has been in sharp focus this year is traumatic brain injuries, also known as concussions.  In fact, three major talents, Tom Boonen, Janez Brajkovic, and Chris Horner, all have had to abandon the race after hitting their heads hard enough to cause concussions.  Video footage of Chris Horner as he crossed the line after Stage 7 clearly shows him as being confused and without memory of a crash that he was involved in 30-40 kilometers from the end of the stage.  He was quickly taken away to the hospital where the extent of his injuries were to be properly evaluated.  Concussions are not limited to pro riders, though, they affect mere mortals, as well.  The Centers for Disease Control (CDC) names bicycle accidents as a leading cause of concussions in the United States.  The rest of this article will give you an overview of some of the basics you need to know about concussions.

What is a concussion? The Centers for Disease Control & Prevention (CDC) and The American Academy of Neurology (AAN) describe concussion as a traumatic brain injury caused by a bump, blow, or jolt to the head that changes mental function.  Loss of consciousness may or may not accompany the concussion.  In cycling, these injuries occur when the head hits the pavement or other object hard enough to injure the brain.  Helmets can help, but do not prevent these injuries, and should be worn whenever cycling.

How do I know if someone has a concussion? Commonly observed early symptoms of a concussion are vacant stares, amnesia, confusion, delayed verbal and/or motor response, disorientation, loss of consciousness, dizziness, nausea or vomiting.  Sometimes symptoms come on in the days and weeks following a blow to the head, however.  These late symptoms are persistent headaches, light-headedness, poor attention, irritability, and sleep disturbance, among others.  Concussions are commonly graded 1-3 according to increasing severity of symptoms.  The AAN’s grading scale is broken down as such:

Grade 1: Transient confusion, no loss of consciousness, symptoms resolve in less than 15 minutes.

Grade 2: Transient confusion, no loss of consciousness, symptoms last longer than 15 minutes.

Grade 3: Any loss of consciousness, either brief (seconds) or prolonged (minutes.)

What treatment should be sought for concussion? The best course of treatment is immediate evaluation by a qualified healthcare provider.  Often, the severity of a concussion can’t be made until symptoms begin to resolve and a clear picture of the extent of the damage is made.  Your medical provider will be able to observe progress or decline in your condition and determine an ongoing treatment plan.  In mild cases, rest, observation, and pain medication to control symptoms may be all that is needed.  In other cases, specialist care, and advanced imaging (CT scans or MRIs) may be used to evaluate for bleeding, swelling, or other more complex injuries.  Either way, concussions are not to be ignored, as many of the symptoms may not occur until days or weeks after the incident.

Even though I don’t provide emergency services in my office, I have frequently been the first to recognize that someone has had a concussion when they come in to my practice after an accident.  (Bicycle, motorcycle, automobile.)  In my experience, I would assert that many concussions go unrecognized and untreated, because they don’t recognize the extent of their injuries.  My hope is that by reading this article, you become more familiar with this injury and what to do in case you ever need the information. The Mayo Clinic offers a lot to readers who are interested in more reading about concussion.  Until we meet on the road… take care!

Many cyclists don’t feel that conditioning the upper body is an important part of their riding experience, but ask anyone who has dealt with shoulder, neck, or upper back pain, and you’ll hear a different story. A strong upper body is as vital to health on the bike as it is off the bike. As a cyclist, I like doing exercises that will help me ride stronger and more comfortably, and one of the exercises I love is the Plank Row. I’ve chosen this as my focus for the month because of the way it creates a challenge for the arms, legs, back, and core.

The movement patterns used in this exercise resemble some of the movements that are used while riding a bicycle. While pushing our way up a challenging climb or pedaling hard out of the saddle we often search for more power through the rhythmic pulling motion on the handlebars. The Plank Row helps create efficient transfer of that power into the pedals instead of being wasted.

The Plank Row is a step up from the static plank, a well-known core exercise. In this exercise, instead of holding a steady position for a duration of time, you will be lifting a weight off the floor with one arm at a time for a prescribed set of repetitions. The goal of the exercise, just like on the bike, is to limit side to side movement of the body’s trunk and any twisting movement along the spine. One of the major challenges of this exercise is trying to keep the hip from popping up on the same side as the lift. Ideally, there is very little movement of the body as you drive the elbow to the ceiling.

The accompanying pictures show how I use a kettlebell (15lbs) as the resistance. Another way to do the exercise is with two dumbbells held in your hands. Either way, I would aim to use a heavy enough weight to feel a strong challenge. I would recommend using a starting weight of at least 10-15lbs so you can feel how the core has to work hard to keep your hips down.

I hope you find this exercise useful and something that brings more power and comfort to your ride. As always, please get in touch with me if you have questions about this article. Happy rowing/riding! See you on the road…

Performing The Plank Row

(Another way to perform this exercise is by holding two dumbbells in your hands and lifting one off the ground while balancing your weight on the opposite dumbbell.)

It’s not uncommon for me to encounter cyclists who have knee, hip, and lower back pain after hard efforts of riding. When trying to explain possible causes, the discussion usually leads to talking about core fitness/endurance. The core provides the stable foundation for the generation of power and controlling forces that travel through the body. When our core fatigues but the legs don’t, there is potential for tremendous forces to get generated that can irritate and injure the soft tissue and bony structures of the spine, hips, and knees. In particular, we’ll see more rotation in the lower back as we try to get assistance from the arms. Also, the knees start to move from side to side slightly more which can stress the tendons and cartilage of the knees. Last week I found a video posted that described some of the basic findings of what actually happens to a cyclist’s body mechanics when their core muscles fatigue while riding.  The main idea of this study was to scientifically describe what is happening when we watch a rider who is obviously tired and still pushing to give it his/her best effort.  Often we’ll hear commentators say phrases like “He’s all over the bike!”  Here’s one of the author’s, Dr. Mat Brick, describing how they performed the study Relationship between cycling mechanics and core fatigue.

Alterations in cycling mechanics resulting from core fatigue from Ron Heptinstall on Vimeo.