Scenario: We've all experienced the backache that starts after you've been grinding uphill for two
long without a break. And we've all had sore back muscles. What we're talking about here
is back pain following an injury -- for example, from wrenching your back during a fall.
Description: Back strain is a stretching injury to the muscles and ligaments of the back. It's treated
with the same principles as other orthopedic injuries: rest and ice, then early activity
and strengthening exercises. Think of it as a "sprained ankle" in your back.
Concerns: If you hit hard enough, you could break your back. Or if you've crunched a disc in your
back, it could put pressure on a nerve. Symptoms of nerve compression include pain
radiating in a stripe down your leg into the ankle or foot, weakness of the ankle, and
numbness in the foot or lower leg.
See the doctor if: - pain is severe and prevents motion - there's radiation of pain beyond the thigh, numbness, or tingling
down the back of the leg or weakness in the leg - there are problems control your bowels or bladder
Immediate care: Rest on a firm surface. Avoid lying on your stomach. It's usually most comfortable to lie
on your back with a couple of pillows under your knees, or on your side with the hips bent
forward and a pillow between the knees. Ice pack the painful area. Take an
anti-inflammatory medicine such as ibuprofen 600 mg four times a day.
Ongoing care: After a few days, gentle heat may be used intermittently to relax the area. Don't overdo
the heat -- it can make you more sore. Limit it to about 20 minutes four times a day. Get
back to your activities as quickly as you can. After a day of activity, an ice pack in the
evening can reduce the next-day stiffness.
Back rehab: As quickly as the pain allows, you should begin exercises to restore mobility and
strengthen the back. PELVIC TILT: Lie flat on your back with knees bent. Tighten your stomach and buttock
muscles so it flattens your lower back against the floor. Hold 10 seconds. Repeat 10
times, twice daily. KNEE RAISE: Lying on the back with knees bent, raise one knee to your chest, then the
other. Hold both knees against the chest 10 seconds, then lower one knee at a time. Repeat
10 times, twice daily. PARTIAL TRUNK RAISE: Lie face down, arms at your sides. Keeping your waist on the floor,
use your arms raise your chest up. Support yourself on your elbows for 30 seconds. Repeat
twice daily, increasing the time to two minutes as you recover. PARTIAL SIT-UPS: Lying on your back with your hands behind your head and knees bent up,
crunch your abdominal muscles so it raises your shoulders off the floor. Hold for ten
seconds, then lower down. Repeat 20 times, twice daily.
Scenario: You're sprinting for the finish line in the big race, and suddenly there's a sense of
ripping in your calf muscle. Next comes a horrible calf cramp. You coast to the finish
line and limp over to sit down.
Description: A muscle strain is a rip or a damaging stretch in the muscle. Typically, there's sudden
pain during violent physical exertion. The muscle becomes hard or knotted, and painful to
move. Over the next few days, swelling and bruising may appear over the muscle.
Concerns: At its worst, a big rip in the muscle creates permanent weakness (it's impossible to
repair a torn muscle to its pre-injury condition). Even for more minor tears, the scar
that forms in the area is prone to rip again.
See the doctor if: - you can't move the injured area fully - pain is severe - there's severe swelling or bruising
Immediate care: Apply an ice pack to the painful area. Compress it with an elastic bandage. Rest. Take an
anti-inflammatory pain reliever, such as ibuprofen 600 mg four times a day.
Ongoing care: Ice-pack for 1/2 hour, every two hours during the day, for two days. Keep compression on
the injured area with an elastic bandage for about four days. As the injury starts to
improve, begin range-of-motion stretching exercises to prevent formation of stiffening
scar tissue within the muscle. Expect around a month to heal. There may be occasional
problems with the muscle for many months.
Muscle rehab: Stretching exercises: Warm up the muscle so stretching will be more comfortable. First get
your circulation going by exercising other (uninjured) areas of your body. Now warm up
area with a warm soak or a heating pad for about 15 minutes. Look at the course of the muscle. You'll be bending the joint above the muscle and the
joint below the muscle. You'll bend these joints in the direction that stretches the
muscle. For example, for the front thigh muscle (quadriceps), you'll bend the hip
backwards and bend the knee back. For the back thigh muscles (hamstring), you'll
straighten the knee and bend forward at the hip. Stretch the muscle until it starts to become uncomfortable. Hold it there for 30 seconds,
then relax for a minute. Repeat this 10 times. If the muscle is aching after the
stretches, cold pack it for 1/2 hour. Repeat the stretches twice a day. Active exercise: Begin active strengthening after three or four days of rest. Tighten the
muscle against resistance. Start in the fully stretched position, and slowly contract
until the muscle is fully shortened. Start with a light amount of weight or resistance. Do
10 repetitions. Increase the weight, then do 10 more. When the weight makes you feel
discomfort from the injury, back off. Do the active exercises about every other day.
Scenario: You're dropping of the thousandth ledge of Porcupine Rim when your front tire hangs up. As
the front shocks compress, your head flips forward before the bike bounces free. Ouch.
Your neck hurts.
Description: Neck strain (cervical strain, sometimes called "whiplash") is a stretching
injury to the muscles and ligaments of the neck. It can occur when the head is
forcefully
bent forward, back, or sideways. Or the neck can be strained when the head simply bobbles
back and forth from a sudden stop. It's treated with the same principles as other
orthopedic injuries: rest and ice, then early activity and strengthening exercises. Think
of it as a "sprained ankle" in your neck.
Concerns: If you strike your head hard enough, you could break your neck. Or if you've crunched a
disc in your neck, it could put pressure on a nerve. Symptoms of nerve compression include
pain radiating in a stripe down your arm, weakness of the elbow, wrist or hand, and
numbness in the arm or hand.
See the doctor if: - pain is severe and prevents motion - there's radiation of pain beyond the shoulder, numbness, or tingling
in the forearm or hand - there's numbness or weakness of the legs - there are problems control your bowels or bladder
Immediate care: Rest. Lie back with an ice pack wrapped around the painful area for 30 minutes. Take an
anti-inflammatory medicine such as ibuprofen 600 mg four times a day. Repeat cold packs 30
minutes, four times a day for two days.
Ongoing care: After a few days, gentle heat may be used intermittently to relax the area. Don't overdo
the heat -- it can make you more sore. Limit it to about 20 minutes four times a day. Get
back to your activities as quickly as you can. After a day of activity, an ice pack in the
evening can reduce the next-day stiffness.
Neck rehab: Stretching: After two days' rest, begin to restore the neck's mobility. Begin by warming
the neck for 10 minutes. Some light aerobic activity may help loosen the muscles. While
sitting, tilt your neck forward until you begin to feel the stretch. Hold there for 30
seconds, relax a minute, then repeat 5 times. Do the stretch in the backwards direction,
then tilting to each side (ear towards shoulder), then rotating (chin towards shoulder).
Hold each stretch for 30 seconds, repeating 5 times. If the discomfort has increased after
the stretches, cold-pack the neck for 30 minutes. Repeat the exercises twice a day. Active exercise: Use the palm of your hand as a "graded resistance machine." Put
your palm against your forehead, and push your neck against it. Slowly push the hand
forward with your head until the neck is fully bent, then let the head return to the
neutral position while continuing resistance. Repeat 10 times. Do the exercise for
backward motion (with both hands behind your head), then with side-tilt (with a palm
against your scalp just above the ear). Do the exercises twice a day.
