Exploding head syndrome

After years of abusing his spine across the globe, this writer and cyclist found out how painful a back injury can be. His only cure was exercise - a program that can help your back, too.

Himachal Pradesh, India: I'm bicycling over slushy, winding footpaths in the Himalayas at 16,000 feet. Wending around villagers tending yaks, I feel a strange throb in my backside. But then the appearance of a wild-eyed Mongolian boy riding bareback ahead of me takes my mind off the ache. He seems to be stalking me, and then he begins to waif at the top of his lungs, a sound forever etched into my psyche as a reminder of my pain. Only back in New Delhi do I learn what the kid was yelling about: I had stumbled across Salman Rushdie's hideaway.

In 1995 and '96, I compiled some 80,000 air miles, crossing continents like Phileas Fogg trying to get around the world in 80 days. I wasn't trying to set any records; it was just a matter of completing assignments for two mountain-bike magazines that featured exotic locales. And I was determined not to let the physical strain get to me.

Knysna Forest, South Africa: Hoisting a bike over my shoulder while fording a cold streambed fringed by otherworldly 20-foot ferns, I feel a sharp knife-like jab just above my buttock. I ignore the feeling and go on to my next assignment.

Each place I traveled, I overlooked the pains that resulted from what could best be described as an abusive relationship with my back. I mixed long hours shoehorned into the back of an airbus with regular launchings over carbon-fiber handlebars. My weight-room practice was characterized by incorrect technique, too-heavy weights and too little stretching. And yet I managed to ignore the subtle, nagging aches ... for a while.

Salmon River, Idaho: on a sinewy outfitter trail crowned by a magnificent, wide-spreading canopy of old growth, I ride past a female moose and calf, a bull elk, an osprey on a low-level hunt, a wild turkey performing its mating dance. All in all, a beautiful trip - until I catapault headlong into a deep hole. This time, the pain cannot be ignored.

The upshot of that incident turned out to be seven months of my life spent in a long, black tunnel, with emergency surgeries and aftercare eclipsing $75,000 (of which my insurance provider paid about half). I had ruptured a lumbar disc and chipped a vertebra, which then thumbnailed itself into a nerve - all of which left me with something called complex regional pain syndrome. Initially, my right leg felt as though it was exploding. Then, for months, my right foot would seize violently, surging nearly nonstop with electric shocks.

Laid up and out for seven months on a panoply of barbiturates, steroid epidural blocks, muscle relaxants, antidepressants and anti-inflammatories, I basically turned into Gumby. Yet nothing helped; marijuana actually increased the pain. I could barely crawl into an MRI or onto a white-draped table for my every-other-day series of cocktails ferried into my spine by long needles.

But the accident's ultimate impact wouldn't become clear until post-surgery. That's when my surgeon's personal aide told me I would never be able to mountain-bike again.

A search for healing

Trying to find a way out of this bottomless morass, I began my own vision quest. From Third World to First, Asia to Russia, I dabbled through the spectrum: traditional Chinese herbs. Flower essences suggested by a white witch. Acupuncture. Pricey deep-tissue massage. Ancient Russo-Sino cupping. Modern electro-stimulus (not only to the back but to the brain). Not to mention a year of physical therapy. All, however, garnered nothing but short-lived results.

Eventually, I even came under the aegis of Rich Martinelli, a physiotherapist who, to make ends meet while building a career as a competitive bodybuilder, worked the graveyard shift - literally - as an embalmer for the city of New York. And when he led me to a former colleague, Ike "Kage" Njaka, I found myself going back to the drawing board: Remedial Gym 101. Amazingly, it was a workout that put me back on the path to recovery.

"Back problems are by far the most common ailment we deal with," says Njaka, the 33-year-old owner of Total Fitness Sports Therapy in West Los Angeles. "Chronic lower-back conditions can seem almost hopeless. Yet we've experienced a high rate of success in rehabbing back maladies."

The program Njaka designed (presented here) begins by shoring up the back's infrastructure. His experience showed that the body can withstand abnormalities in the lumbar spine as long as the muscles controlling the spine and hips are very well trained for strength and flexibility.

I took his advice to heart and devoted myself to the plan - after all, when a cut 200-pound Nigerian looks you in the eye and tells you to do something, you generally follow suit. After about four weeks on the program, my mobility began to increase. And with the help of a few pills - the anti-inflammatory nutrient pycnogenol, and the cartilage-promoting supplements glucosamine and chondroitin sulfate - these exercises even got me back on the bike again. Although I still need to work to manage my pain, I can and do ride whenever I get a chance.

That's my story. If you suffer from back pain - or want to help ensure that you never do - the following exercises can work wonders.

The workout

Knee to chest

Starting position: on your back, knees bent, feet flat on the floor. Arms should be relaxed and flanking your sides.

1. Lift your right knee toward your chest as far as possible. For a little something extra, try to pull your knee a little closer to your chest with your hands. Do this slowly. As your knee approaches your chest, you should feel the curve in your lower back flatten out. Hold for a minimum five to 10 count; over time, increase the duration to a 20-second threshold. Don't worry if you hear a "pop"; usually that's a joint unlocking itself.

2. Lower that same knee to the starting position, then extend your leg straight out. Shake it a bit to relax the muscles.

3. Return your right leg to the starting position (bent with your foot flat on the floor).

4. Repeat with the left leg. Do two or three reps with each leg.

Double knee to chest

Starting position: on your back, knees bent, feet flat on the floor.

1. Reach out and clasp your hands around your knees. Pull them in slowly toward your chest.

2. When you feel resistance, pause, then try again to pull them in a skosh further.

3. Hold this position for a few seconds. Gradually work toward holding for a 20 to 25 count.

4. Return to the starting position and repeat. Once you feel confident, try holding your knees roughly shoulder-width apart as you raise and lower them to expand the stretch. Perform this movement two or three times.

Knee drop

Starting position: on your back, knees bent, feet flat on the floor.

1. Keeping your knees together, lower them both to the right as far as possible. Your left hip and buttock will rise up as your knees descend to the right. But keep your shoulders flat, maintaining contact with the floor or mat throughout. (Don't fret if your knees don't go down very far at first. Elasticity will increase with repetition.) Hold for 10 to 15 seconds.

2. Return to the starting position.

3. Lower both knees to the left. Repeat on each side twice.

Knee-to-chest rock

Starting position: on your back, knees bent, feet flat on the floor, arms at your sides.

1. Pull both knees to your chest, either simultaneously or one at a time.

2. Hold your knee or knees in this position up to 10 seconds. For the best range of motion, clasp your arms just under your knees. If this doesn't work, try holding the backs of your thighs.

3. Curl your head and shoulders forward, then gently rock back and forth 10 times, then side to side five to 10 times. An added fillip is the back massage you're self-administering. If you're left with a slight pain in your neck, don't worry, but stop if it's bad. Eventually, your neck should become stronger.

Bent knee sit-up

Starting position: on your back, knees bent. Your feet should be flat on the floor, arms relaxed and at your sides. (These protect your back while strengthening your abs.)

1. Fold your arms across your chest and begin to pull in your abdominals while raising your upper body toward your knees. Exhale once you reach that point. Concentrate on seeing your navel, or on lifting your shoulder blades off the floor.

2. Hold the position for a few seconds, being conscious of breathing in and out.

3. Relax your muscles slowly - and inhale - as you lower your head and shoulders. Do 10 sit-ups, working up to 25 or 30.

Standing side bend

Starting position: Stand straight, holding a dumbbell at your side in one hand. (Begin with a comfortably light weight, and work up to one that's slightly heavier.) Leave your other arm at your side or placed behind your head. Your body weight must be balanced equally on both feet, with your pelvic girdle firmly anchored.

1. Lower your shoulders and upper trunk to the dumbbell-holding side. Go as low as possible without shifting your pelvis.

2. Upon reaching the end of the motion, inhale and hold your breath as you raise your trunk sideways and back to the erect beginning position. Now bend toward the free-hand side as far as possible. Exhale as you reach the vertical. Repeat 12 to 15 times, working up to 20.

Back raise

One of the few exercises in which you can safely work your lower back through a full range of motion. Remember that back raises, or hyperextensions, are safe only when done with minimal arching. Keeping your legs straight throughout the movement will decrease the chance of over-arching your spine. This movement is most effective on a glute-ham developer ("Roman chair") if you have one in your gym.

Starting position: Place yourself in a prone position, face down, your pelvic girdle resting atop the chair. Secure your feet between the rear pads. Relaxing your spinal muscles, hang your upper trunk down over the seat. Keep your legs fully extended and straight.

1. Inhale slightly more than usual and hold your breath while extending - and straightening - your spine. Raise your head and the upper section of your spine. Your trunk should follow suit in one fluid motion. Your upper trunk should rise slightly higher than your legs.

2. Upon reaching the uppermost level, exhale and return to the starting position, keeping your movements controlled.

3. Once you've reached the lowermost position, relax the muscles and repeat. Do as many repetitions as is comfortable, but not more than 15.

Los Angeles-based writer Michael DiGregorio is a contributing editor to Bike and Mountain Bike magazines.

COPYRIGHT 1998 Weider Publications
COPYRIGHT 2000 Gale Group