A Good Question about Exercises and Chronic Back Pain

Last night I hosted a Core Exercise Clinic in my office for members of the cycling team that I race for here in Olympia. The question was asked of me whether I ever felt any discomfort on the bike because I do all of these exercises. I wasn't able to answer her very completely last night, so I thought I would do it here. In the first place, I got into chiropractic as a profession because of some injuries that I had as a child. As a result of a fall from a horse, I have had to deal with chronic lower back pain in some form or another throughout my entire life.

Throughout high school and college, lower back pain limited me in many of my most favorite activities such as biking, hiking, and canoeing. I didn't even consider sports like kayaking feasible because of the back demands. I spent most of my time stiff and sore. I couldn't even sit reading for very long without having it drive me crazy. When it came time to channel my energy into a profession, I chose Chiropractic, because it had given me much relief and mobility, personally, over the years.

Now, as a 36 year old, I would honestly say that the past 2-3 years have been my most comfortable. Many things have changed in those few years, too, and here are some of the notables: First, I have lost over 50 pounds that I had accumulated while going to school and starting a practice. I'll never forget the day that I looked at my scale and saw that I weighed 232 lbs. I was well on my way, at that point, and found it very depressing to be a health care provider who wasn't living a healthy lifestyle. So, I turned that around with some great advice from my naturopath and by rekindling my love of the sport of cycling. The second thing that happened is that I started taking my own advice and performing many of the exercises that I now give to my patients to take care of their backs. I try to be as consistent as I can with them.

I had all but given up riding my bike after college because of my lower back pain. Now, I've spent countless hours and at least 4 thousand miles on my bikes and feel the best that I ever have. I put the (good) blame on a dramatic loss of extra weight, and the exercises that I have put consistent effort into. I can see myself getting better, over time, as well. That's a good anti-aging type feeling.

Knee Problem Solved... Hopefully

Yesterday, I tried getting back on the trainer for a quick lunchtime ride. It quickly became obvious that I had some major residual pain in my knee from the previous day. Since I haven't had this problem ever before, it's been very distressing. I knew that I didn't want to continue the workout I was attempting. I also was quite sure that I have been feeling something clunking in the drivetrain somewhere. While spinning, I kept noticing that I felt a "bump" just about to the top of the pedal stroke on my left side (knee pain side.) I hopped off and checked the crank arm, and sure enough there was a few degrees of glide of the crankarm (FSA spindle axle.) I'm kicking myself for not looking there before, but what can I say, I'm a rookie.

Since I've been working a lot on my spinning and pedal stroke on the trainer this winter, I'm guessing that eveytime I kicked over the top, it was like I was kicking my toe into a wall. Let's see a pedal cadence of 90 would add up to 5,400 pedal strokes per hour... for 6 hours per week that would be 32,400 pedal strokes for the week... over roughly 4 weeks (a guess) would be 129,600 pedal strokes since I got the loose crankarm! That's a lot of repetition, and plenty of time to brind about this injury. I guess my focus was on other things, (like keeping my Clif Bars down on team rides.) Hopefully this was the problem and I caught it early enough to have it calm down quickly. By the way, the info on "Spring Knee" still holds, just luckily isn't the problem that I have.

Sunday Ride a Success

Yesterday I rode with the team on a 50+ mile loop through Rochester/Maytown and West Olympia. Overall, I feel like I had some good success on the ride even though the pace got pushed up to around 19 mph from 18 the previous weeks. My goodness, I never knew that 1 mph could make such a difference, but it does. I've been having a bit of trouble with a knee since last week. I think that it stems from putting in these early miles in the year, and jumping right into 50 mile rides. Dr. Andy Pruitt refers to this problem as "Spring Knee" in his book Medical Guide to Cycling.

Fitness development to increased exercise involves adaptations in the nerves, muscles and tendons. All of these components respond at different rates. The first changes come with the neurology. Within a very short time, the contol mechanism is more efficient, signals are stronger, and can sustain for longer. Secondarily, the muscles increase in size and ability to contract. More muscle fibers get recruited, etc. Third, the tendons play catch up. Timing for this suite of changes is something in the order of 2 weeks for the nerves, 4 weeks for the muscles, and 6-8 weeks for the tendons. It's no wonder why early in the year, many people drop out of a fitness program after 4 weeks. They have tendonitis and have to stop! Essentially, the nerves and muscles develop faster then the tendons, and mentally the athlete is feeling stronger... so they start adding on the weights feeling like they are ready to start pushing to a new level. Based on this physiology, it would be best to hold at a bit of a plateau to keep from stressing the tendons. So, here I am trying to manage this knee so that I don't develop full blown tendonitis in the knee.

In terms of skills I had some great input from more seasoned riders about positioning in the wind, around other riders, etc. This kind of knowledge is very important for me, as most of my riding has been by myself over the years. How it all works out in a group, is very different... As it stands, I'll be still trying to make the Mason Lake Race on Saturday for my first race.

2008 First Road Race

Next week will be my first road race of 2008, and, um... ever. This time, next week, I'll be checking my gear over for an early Saturday trip up to Mason Lake, which is north of Shelton, WA. This coming weekend will be a challenge for me, since the team that I train with is heating up the ride this week to a faster pace. On average the training rides have been about 50 miles with an average of 17-19mph. Last week was only the second ride that I held on to until the end with the group, which is quite a feat for my novice legs. Of course, everyone else was working hard while I tried to duck down behind, to stay out of the wind. Hopefully next weekend, I can achieve my only goal which is to finish the race under my own power (and maybe not last!) This, of course, may be a lot to ask... We'll just have to see what comes of this all. Tomorrow, my daughter and I are taking a pleasure trip to Seattle to attend the Cascade Bicycle Club's annual BikeSwap.