Sunday, August 11, 2013

Back in business - the long version

After the tour, my fingertips were quite numb.  All my fingers and just the tips.  My instinct was to blame it on injuries from a head on car collision more than 20 years ago.  In the crash ( I was driving) I was kind of wrapped around the seat belt with my left side receiving most of the forward momentum.  My neck and shoulder were painful for a loooong time and triggered many a severe migraine.  I did everything I could to prevent/ameliorate that pain - mostly by trying to prevent any movement that made it feel like my neck was going to simply break in half and my head would fall off.  Stiff neck?  I had it.  I cultivated it.

Over the years I learned many ways to stretch and massage my neck and shoulder to make it somewhat more flexible and relieve the tension.  And when I started riding a bike, I was very very careful to find ways that would keep my neck and shoulder from tightening up and causing pain and/or immobility.  My whole bike setup was geared toward that and I thought I had been pretty successful.

But one day as the tour crossed into Arizona, not just my neck and superficial shoulder muscles were tightening up, but also the muscles that ran underneath my shoulder blades.  The whole left side of my chest was tight and getting tighter, making it difficult and painful to ride.  And that's when Carla the Wonderful entered my life.  Carla was a fellow rider and is a physical therapist from Brazil.  As I joined a group of riders under an underpass on the shoulder of I-10, I asked Carla if she could help me.  Her magical fingers worked their magic and I was able to ride another 30 miles or so that day.  A few days later, after another aborted ride, we were roommates and she showed me ways to stretch the tight muscles and then get them moving into better positions.  She saved my trip.

When I got home, I asked my doctor for a referral to a physical therapist who specialized in geriatric sports medicine.  He checked my medication list for side effects, sent some blood for B vitamin levels and referred me to a sports medicine doctor.  The sports medicine doc checked for carpal tunnel, elbow issues and thoracic outlet syndrome, and since I didn't appear to have any of those, HE sent me to physical therapy.

I have been going for about 8 weeks now and I have most of the sensation back in my fingertips.  We have worked on stretching out all those muscles I had put into "protect the neck at all costs mode', and strengthening the opposing muscles.  I have gained strength and fexibility in my shoulders and a wider range of motion - my posture is better and I think I might even be taller.

So, back to the handle bars.  The trekking (butterfly) handlebars were chosen specifically to give me a more upright posture and more hand positions on the bike.  They worked to a point, but my hands were usually flat on the bars with thumbs pointing at each other.  Getting a different hand position meant moving them out to a width wider than my shoulders.  Clearly, they weren't the final solution, but what was?

I'll spare you the details and frustrations, but finally I have gotten a setup that I think will improve my postion on the bike and preserve all the progress I have made with my international crew of physical therapists. 

This is how the handlebars look now.  Bullhorn bars upside down and flipped backward with bar end shifters modified to be thumb shifters.

And this is the new hand position.  Hands at shoulder width, elbows flexed, shoulders and neck relaxed.  I did have some hand numbness on my 20 mile ride this morning, and I will probably fiddle around with the positions of the components, but I think this is going to work.


Ken said...

Way to hang in there!! It's also good to know there are actually people that specialize in geriatric sports medicine, talk about a niche market :) As a disclaimer, I am not a PT nor an expert bike fitter, and of course your past injuries complicate the problem. However, numb fingers and hands are "usually" caused by imbalance of weight on the bike. In other words you are putting to much weight on them and not the other parts that come into contact with the bike. Bike fit is a matter of millimeters and just a little change makes a huge difference. If you make small changes do so before each ride and evaluate.

Judi said...

You are, of course, absolutely right. The going numb, tingling part was/is because of weight on my hands. The persistent numbness in the fingertips is most likely from a disc problem in my neck. And the muscles I was using to protect my neck/shoulder were what was causing me to put too much weight on my hands.

Now that we are well on the way to getting the neck/shoulder as good as it's going to get, I am starting to work on core strength so I don't need to use my hands to support my (considerable) weight.

The handlebar issues were part and parcel of all the rest. I am tweaking the measurements about 1/8" at a time after each ride - while I still remember what I thought it needed. Yoga starts Tuesday with emphasis on core strength.

I hope I get all this figured out before I'm too decrepit to ride.