Long Distance Competition/Ultracycling, Randonneuring and Endurance Cycling - Shermer's neck survey

Okay, this sounds a bit strange but I will just say this for right now...yesterday I had a rather strange experience and as a result I got to thinking, I had no other option and it brought up some rather interesting thoughts and I think something more devious(very easy to prevent/treat) might be going on for those that experience Shermer's neck. I could be wrong hence why I'm looking to do this survey...especially after talking to pyhsicans assistant today that I ride with quite often.

Who on here has experienced Shermer's neck? If you have please provide the information below:
1. What ride/race was you on when it happened(my guess not PBP or other standard rando/brevets but rather RAAM/RAW...I might be wrong)
2. How long after the start of the ride/race did you start to experience the problem(my guess, within the first 2 days)
3. How long did the problem last?(my guess the whole time)
4. Did the problem get any better as you got further into the ride/race?(my guess...yes, whether or not you made any modifications to the bike)
5. Did you have any other problems before you started experiencing the neck troubles?(my guess...yes)

If I come up with any other questions I will make another post inside this post.

Also question or two directly related to Shermer's neck that I think I know the answer to. Mike Shermer was the person who the complication is known for. When he first experienced the problem he wasn't using aero bars was he??? He didn't experience the problem on the very first RAAM(Great American Bike Race), rather he experienced on the second RAAM after it moved down to CA didn't he? Again I may be wrong but something tells me I'm probably not wrong. Maybe I'll get lucky and be wrong.

I had it on the Rocky Mtn. 1200k. It started around the last 200k or so. I lasted till the end of the ride. It doesn't get better without getting off the bike and letting it recover. It's basically just muscle fatigue, that doesn't get better without rest. No other problems prior to that ride or since. I wasn't using aerobars on that ride but I did have a light on my helmet. That's why I won't put a light on my helmet anymore. I don't care how light they are. I haven't had a problem since, even on RAAM and I use aerobars for most long events. I've seen it with other people a number of times on 1200k's and even on couple times on a couple 500 mile races. Some of it might be related to core strength and camelbak's as well as aerobars can make the problem worse. On 1200k's when my camelbak is empty I will take it off and stow it on the bike to give my neck muscles a break.

How much of it is directly related...in reality to dehydration. Study up on dehydration and you might learn the real cause of so many things that effect long distance riders, it may really surprise you...including Shermer's Neck.

Let me start what with I've seen this year, 17,300 miles so far this year.

Back in the spring, sometime in May I posted a question about muscle aches, neck and back side of the right arm. I thought the problem was the results of ramping up the mileage too much. Granted I rode 12,000 miles in 2011 and by the time spring ran around this year I already had 6000+ miles for 2012. Something their doesn't sound quite right does it. Not when your riding at least 1 100 mile day each week and by the time February rolled around it was more like 1 120-130 mile day per week. I haven't had a month since August 2011 where I haven't ridden at least 1500 miles, May-August this year...2000+ miles each month. Something is really sounding funny here.

All of a sudden sometime in mid May to early June I changed the way I doing things, nutritionally and hydrationally. Instead of drinking plain water while riding I started drinking salt water(I have no sense of taste or smell so I can eat/drink anything). I would add 1 tsp of salt to every liter of water I drank. I stopped having the backache problem(kidneys yelling at me) that I always use to have. I also started eating one or two bananas every 2-3 hours. I also changed my breakfast. I always use to eat oatmeal(7 days a weeks for years now). I stopped doing that before going out on long rides. Instead I switched to mac & cheese. High sodium content, check the labels. It and pancakes have some of the sodium content of any food out there. Everything else pretty much remained the same. All of a sudden, thinking back to it now it was at this same time the arm and neck aches stopped.

After the 2139 miles I rode in June I knew I only had 16-17 days in July to ride due to a trip I was going to be going on the second half of the month. I knew I wanted the 1500 miles, and after an email about the Tour de France contest on ridewithgps I decided why not try for the full 2172.9 miles in 17-18 days. I went for it and between June 30 and July 17 I rode 2197.84 miles, including 3 days in a row of 160 miles. No neck or arm problems whatsoever.

After getting back from that trip and helping out one of the local bikers I headed off for a bike trip to the midwest. 2828 miles with 35 pounds in a backpack on my back. No problems whatsoever. Yeah, had a sore butt on the first two legs of the trip as well as sore leg muscles on the first two legs but on the last leg, which included Athens, OH-Hancock, MD(RAAM) I had no effects of any kind whatsoever other than shock and awe at how peaceful everything was.

I got home from the trip and spent the next three weeks taking it a bit easy but still out riding pretty much every day. Finally I managed to get back to doing 100+ mile rides again and have now did 4 in the past two weeks and planning number 5 for tomorrow. It was on the most recent one this past Saturday that everything changed.

This past Saturday I knew I was only planning 100-105 miles(turned out to be 121 miles in reality) so I wasn't worried about anything. I ate oatmeal for breakfast and skipped the first gas station and almost the second. I didn't have to go to the bathroom so I decided to pass the first one up. I didn't bother drinking anything for the first 1.5 hours. When I made the first stop everything seemed normal. Temps were in the upper 60s and the humidity was dropping from .25 mile visibility earlier in the morning to probably being back down to around 75-80%. I made my way on down to the turn around(41.5 miles) and started my way back. Everything still seemed fine and acted like normal. I figured I would probably get home around 1:30PM, given it was 2 hours down and I knew it was uphill most of the way home. I stopped back by the same gas station on the way home. It was less then 10 miles from home when all of a sudden I noticed the arm ache hit me. I thought...dang this is the first time I've had this happen in 4-5 months. I was surprised.

I got home and ate a couple of bananas(I always eat two bananas for lunch everyday) and grabbed several cookies as well and drank some water. I headed off 5 minutes after walking in the house to head off and join the group ride I was going out on for the afternoon. I knew I was running a couple of minutes late and they were starting to pull out of the driveway as I pulled in.

We left and got 2-3 miles south out Nelson's house when all of a sudden I started to notice it in my neck. The same darn neck ache that I had bad all the time in the spring. Now I was really stumped. After the trip to St Louis with 35 pounds on my back, averaging 113 miles per day and not having any kind of problems whatsoever and now I'm having problems...what gives. About a mile further down the road it hit me. Dehydration. The only two things I was doing differently now compared the past 4-5 months was nutrition and hydration.

Sunday morning after I woke up it hit me...could Shermer's Neck be directly the result of dehydration? While out on the group ride Sunday afternoon I asked one the riders who happens to be a physicans assistant if dehydration could cause you to lose muscle control. He said "Yes".

Now in looking online this evening I noticed it can cause a whole wide range of effects that riders have all kinds of funny names for. I'm seriously thinking after what I have personally seen that Shermer's Neck is also one of the things that is nothing more than dehydration.

Dehydration can cause a whole range of symptom and the symptoms can be different in different people, and they can even be different under different weather conditions. Take a closer look at dehydration and you might be surprised at what you find.

Just my thoughts.

Very interesting hypothesis! I think a lot of people don't know how to gauge they're getting dehydrated until it's too late. We also know that too much water can also create a whole set of issues. So, it's like walking a fine line if one is into endurance sports.

Shermer's Neck is a caused when the neck muscles fail from fatigue and can no longer support the head. I can see how it's a possibility that dehydration could hasten it but I doubt that it's the main cause. If it was the cause then rehydrating should make it get better? I know when Paul Danhaus had it in 09 RAAM it took almost three weeks after the race for him to recover. I don't think I was anywhere near dehydrated when it happened to me. I'm pretty sure it was a result of the additional weight on my helmet as that is the only variable that changed for me on that ride and it hasn't happened to me since. I would be surprised if any of the RAAM participants were dehydrated either. Remember, RAAM racers have a crew that attends to them 24/7 and are usually very diligent about making sure their riders are fueled and hydrated properly.

Dehydration and electrolyte losses don't cause muscle aches, cramps, loss of performance, or most of the things we blame on them.

It's an old wives' tale.

A study of 200+ Ironman completers found no correlation at all between hydration/electrolyte levels and cramping. Another study, of Kenyan long distance runners, detailed how they basically drank almost nothing while training or during an event, and easily rehydrated at night by drinking a milky tea. The runners with the best performance were mildly dehydrated at the end of the day.

Most Americans have more than enough salt in their diet to ward off hyponatremia, unless you're guzzling gallons during an endurance event (as we have been incorrectly told to do, for the past ~20 years), and you don't lose potassium or other electrolytes via sweat. Drink when you're thirsty (or, trust your support team to keep you drinking), eat a little bit during the event, recover with some chocolate milk, and you'll be fine.

Cyclists who spend all day in the saddle and get rest at night -- e.g. tourers and pro cyclists -- don't get Shermer's Neck. It only strikes a small percentage of the maniacs who ride without stopping. :D If Shermer's Neck was "just" caused by dehydration, people in a wide variety of events would get hit by it all the time. Doesn't happen. The necessary component is that you're putting a strain on your neck, with little or no rest, for extensive periods of time.

There are two possible causes (just to follow up on Baccia's post):

1. Continued tightening of the neck muscles which ultimately either cause cramp or loss of power from the muscle (a repetitive-strain type of injury).

2. A bike fit issue which leads to Item 1. Sometimes subtle bike fit issues become evident only after much riding, such as the OP is doing.

Dehydration and electrolyte losses don't cause muscle aches, cramps, loss of performance, or most of the things we blame on them.

It's an old wives' tale.

A study of 200+ Ironman completers found no correlation at all between hydration/electrolyte levels and cramping. Another study, of Kenyan long distance runners, detailed how they basically drank almost nothing while training or during an event, and easily rehydrated at night by drinking a milky tea. The runners with the best performance were mildly dehydrated at the end of the day.



Considering how little I tend to drink on the bike, I am quite encouraged by this info.

As well, I think I'd rather believe a study based on 200+ competitors (what's that, a 5-6% margin of error 19 times out of 20?) than on scattered bits of anecdotal evidence.

Any links to the studies? In my own anecdotal case, I probably drink too little (and only when I'm thirsty, heavily rehydrating after the ride is over), and I tend to cramp up at about the 100-mile point on hot, hilly rides in California! And I've tried using Endurolytes (maybe I didn't drop enough of them?). And I usually have a cold can of Coke at the rest stops, maybe that's a Bad Thing? Too many variables!

Luis

OK, here's a link:

http://biestmilch.com/pulp-research/archives/2011/06/13/exercise-associated-muscle-cramping-is-it-really-due-to-dehydration-and-a-salt-deficit.html

"The results of the Schwellnus study confirm that there is no correlation between exercise-associated muscle cramping and changes in electrolyte concentrations or changes in hydration status."

Other articles I've looked at suggest that cramping is just one of the risks associated with going faster. Typically, when they divide competitors into a cramping and a non-cramping group, the cramping group turns out to have higher expectations, and they tend to finish faster!

So basically, the studies tend to show that crampng is caused by:

- inadequate recovery from the previous competitin or training,

- a predeliction to cramping, or a previous history of cramping,

- starting off too fast, or going too fast for the amount of training you've done.

- one study even showed that taller and heavier competitors are more likely to cramp!

Consensus appears to be that hydration or electrolytes have little to do with it, all else being equal. But the studies warn that these are correlational observations, although the factors may help predict cramping.

Luis

Shermer's Neck is a caused when the neck muscles fail from fatigue and can no longer support the head. I can see how it's a possibility that dehydration could hasten it but I doubt that it's the main cause. If it was the cause then rehydrating should make it get better? I know when Paul Danhaus had it in 09 RAAM it took almost three weeks after the race for him to recover. I don't think I was anywhere near dehydrated when it happened to me. I'm pretty sure it was a result of the additional weight on my helmet as that is the only variable that changed for me on that ride and it hasn't happened to me since. I would be surprised if any of the RAAM participants were dehydrated either. Remember, RAAM racers have a crew that attends to them 24/7 and are usually very diligent about making sure their riders are fueled and hydrated properly.

Not necessarily. You have to remember one thing, it all comes down to weight. You shouldn't lose all that much body weight during a long ride unless it is coming from losing water weight. Unless you replace all the water weight you have lost then you are still dehydrated to a certain extent, the extent of the weight you haven't regained. When you are riding through CA/AZ/CO/KS dealing with each of there own idosyncranisy's(sp?) you are still going to be sweating and losing water out your system. You not only have to replace that water but also the water that you previously lost.

The whole concept came up in part to reading the blog for one oft he RAAM riders from 2011 or 2012 that came down with Shermer's Neck. Yeah, he said it never improved until after the race but he also said he did lose 5 pounds during the race. I'm not sure if he indicated in his blog if that was by the finish or at one of the time stations. If the rider was keeping up on nutrition than the only other source of weight loss would have to be coming from water.

Why is it suggested to anyone planning to do RAAM that they should give themselves some time riding both in CA and CO? Why so they can kinda acclimate themselves to the environment they are going to see during the beginning of the race. The key word is acclimate. I've seen from winter biking last winter how you can acclimate to anything...including getting use to your body running on less fluids than normal. It all comes down to repetitive training under a certain set of conditions. Now will you perform as well as if you were fully hydrated, more than likely not unless you are in tiptop condition.

One other thing you have to think about is where you are riding, the desert or someplace a bit more tame for both temperatures and humidity. I know I normally don't ever see sweat on my skin when I ride. I always use to when I lived in NW Ohio, but now living in much cooler/less humid New Hampshire I don't. The amount of fluid of intake all comes down to what you need to maintain your body weight. If you are riding in a cool environment without overbearing humidity than more than likely you can get away without drinking as much as you would need to if you were riding in the desert or on a nice 90 85 degree summer day in central Florida.

Shermer's neck is not cramping, it's muscle fatigue. I think those would be two seperate issues.

Not necessarily. You have to remember one thing, it all comes down to weight. You shouldn't lose all that much body weight during a long ride unless it is coming from losing water weight. Unless you replace all the water weight you have lost then you are still dehydrated to a certain extent, the extent of the weight you haven't regained. When you are riding through CA/AZ/CO/KS dealing with each of there own idosyncranisy's(sp?) you are still going to be sweating and losing water out your system. You not only have to replace that water but also the water that you previously lost...

Just so you know, I've raced in RAAM four times and officiated twice. First off, staying hydrated is the easy part, the reason that racers loose weight is not water loss but the fact that the racers are continuously running a calorie deficit. Your body can only absorb around 250-350 calories/hr (less than 9,000/day) and you are easily burning way over 15,000calories a day. I remember seeing 18,000 calories/day from one rider (that rider lost 11lbs). Even staying on top of your nutrition you are still loosing weight from body mass that has nothing to do with hydration. If a rider becomes dehydrated on RAAM their crew sucks and should be fired (even in the heat of the desert).

The reason they suggest you train in CA is that it is the hottest part of RAAM is usually the CA/AZ desert but we usually cover most of it in the first night. Slower riders will often get caught out in the heat though. Most riders who get Shermers neck during RAAM get it well after they've ridden 1000 miles and usually closer to 2000, well past the desert heat. They suggest riding in Co to acclimate to the altitude.

FYI, here's the study on Kenyan runners: http://www.ku.ac.ke/images/stories/docs/publications/enviromental_human/Elite-Kenyan-Endurance-Runners.pdf

given that Shermer's neck is much more prevalent in older riders, I'm going to go with simple muscle fatigue and not anything that has to do with nutrition. My understanding is that it's not particularly painful.