Shermers Neck: Cyclings Most Bizarre Injury

Paul Danhaus was feeling strong, well into his inaugural Race Across America.

The brutal cycling event is a non-stop, 3,000-mile journey from Oceanside, California to Annapolis, Maryland. Most solo riders get about an hour of sleep per day, then spend the rest of the time pedaling across the nation. The winners typically finish in about eight days.

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Danhaus was about 1,000 miles into the 2009 race, rolling through the plains of Kansas, when he suddenly felt something weird.

"I just remember I was just having trouble keeping my head up," Danhaus said. "I was thinking 'Geez, I must be tired.' And then it dawned on me."

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He may have been tired, but that wasn't why his head wasn't staying up. Instead, Danhaus was suffering from Shermer's Neck, a fascinating ailment that affects cyclists who ride unusually long distances.

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To sum it up cleanly, Shermer's Neck is a condition where the neck muscles fail from fatigue and can no longer support the head. It is not a gradual ailment, either: after first feeling the symptoms, the neck will usually give out within two hours.

Danhaus had about an hour's notice before his neck stopped working. He still had about 2,000 miles left in the race.

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History

The Race Across America started in 1982, when it was called the Great American Bike Race. Four cyclists raced from Santa Monica, California to New York City in the inaugural event.

One of those competitors was Michael Shermer. He finished the race in 1982 (though he didn't win) and tried it again in 1983. About 2,000 miles into the '83 race, Shermer suddenly was unable to hold his head up, and he was forced to prop his chin up with the palm of his hand to keep going.

A new medical condition—called "Shermer's Neck"—was named, and all it took was a 3,000-mile nonstop bike ride across the vast United States to discover it.

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It is a rare ailment for endurance athletes simply because most will never be on a bike for the 500-plus mile minimum it takes for Shermer's Neck to pop up. Even then, Shermer's Neck doesn't happen to most ultra-distance competitors. But it does frequently pop up among participants in both the Race Across America and Paris-Brest-Paris, a famous 1,200K brevet (745 miles) in France.

Though what exactly causes it isn't fully known, theories like posture on the bike have been discussed.

But just knowing the possibility of Shermer's Neck exists forces most ultra-distance cyclists to have a solution in place to deal with it.

"I had planned in case it would happen," Danhaus said, "but I sure did not think I would be affected with it. I never had any of those kinds of problems at all."

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Symptoms

In Danhaus' case, he had no pain associated with his case of Shermer's Neck, though he does admit he was in a zone that didn't allow him to even acknowledge any pain he may have been feeling.

"I've read accounts of people that quit because of the pain," Danhaus said. "I tend to be pretty good at blocking pain out. At RAAM, I was so hyped up that nothing would stop me from finishing."

For Danhaus, it was simply a case of the neck refusing to hold the head up any longer. In most cases during ultra-distance bike races, Shermer's Neck does not go away for the remainder of the ride.

But most of the time, cyclists continue on despite the muscle failure. In that regard, Danhaus says that Shermer's Neck is more of a bizarre ailment rather than a crippling one. To him, compared to major saddle sores or hip problems or knee problems, Shermer's Neck is no big deal.

That is, if you're prepared for it.

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Solutions on the Bike

The popular solution for Shermer's Neck is a brace that's wrapped around the cyclist's torso, with a metal pole that goes up the cyclist's back and attaches to the bike helmet. Ideally, the head will be dangling off the pole and it allows the cyclist to continue looking straight ahead while riding.

A member of Danhaus' crew tried this, but the crosswinds of the Great Plains made it ineffective, because Danhaus' head kept rocking from side to side. So he dismounted and the crew huddled up.

"I said, 'Well, take my aero bars and rotate them up,'" Danhaus said.

The crew shifted his aero bars so they were straight above the handlebars, then wrapped the top of them with toilet paper and covered the toilet paper in duct tape to keep it in place. Danhaus then put his chin on top of the contraption and kept riding.

A simple Google image search of Shermer's Neck shows other creative ways to work around the ailment, including one that combines the Danhaus crew's two ideas and sends a metal pole up the back, then has an elastic band wrapping around each side of the cyclist's head that form a chin strap to rest the head on.

Another example was discussed in the New York Times involving female competitor Leah Goldstein. When her neck failed, her crew braided tape into her hair and tied it to her heart-rate montior or bra to prop her head up.

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Recovery

With his head resting on the makeshift aero bar chin rest, Danhaus kept pedaling toward Annapolis. He finished the 3,000-mile journey in 11 days, 11 hours and 51 minutes. He was 60 years old, the oldest of all the 2009 entrants.

By that point, his body was used to the sleep deprivation. He fell asleep after the race finished but only got two hours in before waking up. And his neck still wasn't working.

"On the drive home, I stopped at a drug store and got one of those neck collars for whiplash to help keep my head up," Danhaus said.

He returned to his full-time job as a veterinarian surgeon, but still had problems doing his work because his neck was not back to full strength. He frequently visited the chiropractor to try and speed up the recovery.

"It took three or four weeks before I could really keep my head up," Danhaus said. "But even then, if I went out for six- or seven-hour bike ride, it would still be weak. It gradually returned, but it took weeks.

"I never felt pain. It was just total muscle fatigue."

Danhaus has competed in 500-mile events since the 2009 RAAM, and has not had any problems with his neck in those rides. He's hoping to compete in the RAAM again in the future, knowing that Shermer's Neck might pop up once again.

For the extreme ultra-distance cyclists, it's always a possibility.

"I've done many races in the 500- to 600-mile range and never had a problem. But in RAAM, it struck me at around 1,000 miles," Danhaus said. "Until you get 1,000 miles under your belt, you don't know what your body is going to do."

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