Movement as Medicine: Rotem's Story Of Correcting A Biking Injury With Exercise

If you’re a part of the incredibly active and athletic community of Durango, Colorado, chances are you’ve dealt with an injury or two. Whether from an accident (endo, anyone?) or overuse, it’s easy to get hurt when you spend most of your time in motion. Especially if you have a tendency to push the envelope when you’re out on the trails and slopes. 

And while some degree of soreness is expected from leading an active lifestyle, it doesn’t mean you have to live with a lingering musculoskeletal injury or chronic back pain. Especially because we happen to have one of the best spine health centers right here in our own zip code. 

For over 20 years, Spine Colorado has served as a leading healthcare provider in the Four Corners community by helping locals get back on their feet with top-rated spine care. Just last year, they helped one particular member of our community make a remarkable recovery. 

From a common cycling-induced back injury that involved weeks of pain and reduced mobility to a full recovery after just one office visit—this is Rotem’s story of how he got better and back on his bike after being treated by the spine care team at Spine Colorado. 

Overworked, overplayed

Injuries from overuse are a dime a dozen, especially if the vast majority of your hobbies involve physical activity. That’s a common enough narrative here in Durango and also happens to be exactly what happened to Durango local Rotem Ishay, a coach and instructor at Fort Lewis College.

“I came to Spine Colorado because I had three consecutive days of overloading my back,” he says. “I was doing too many activities—classic Durango. On the first day, I loaded 200 hay bales by myself, then I went mountain biking the day after, and then the following day I played basketball. That was when I did this weird movement and my back tweaked on me— I was in a whole lot of pain.”

Hoping the injury would resolve itself in time, Rotem spent the next several weeks trying to take it easy and recover. 

“I waited seven to eight weeks to seek treatment, because I was feeling more mobile, and I’d heard somewhere that the rule is that if your back doesn’t feel better after six weeks, you should see someone. So that’s what I did: I went to see my primary doctor, who referred me to Spine Colorado.”

Seeking spine care treatment

In addition to dealing with the pain and discomfort of the injury itself, Rotem says he remembers being concerned about the scope of the injury and what it might mean for his mobility in the future. 

“My biggest concern was the uncertainty of what the injury was,” he says. “I wasn’t sure if it was just an injury that would heal over time or if I really messed something up—like a disc or one of the vertebrae.”

But beyond that, Rotem was also worried about what treatment might look like. Knowing that many spine care centers recommend invasive treatments (like surgery) to fix back injuries left him wondering what his recovery would be like, and how long it would take. 

“How is this treatment going to affect my lifestyle? I couldn’t even bend forward to tie my shoes for a few days, so I was pretty worried.”

Fortunately, many of his concerns were addressed as soon as he walked in the front door of Spine Colorado’s Durango office. 

Better after ‘just one visit’

For most people seeking specialty treatment like spine care, there’s a familiar thread of long wait times, complicated and costly treatments, and lengthy recoveries. But for Rotem, the complete opposite was true. He got the answers he needed to start recovering after just one visit with Spine Colorado’s physician assistant, Dan Prince. 

“The first thing I noticed was that it was a very professional setting, everything was timely, unlike many clinics where you sign up and then sit and wait for an hour—that didn’t happen there.”

After some quick imaging procedures, as well as some movement testing and a musculoskeletal evaluation, Rotem met with Dan to discuss his mobility goals and treatment options. 

“He asked me about my lifestyle and work, and I told him how important movement was in my daily life. He said the one thing we wanted to avoid was a surgery involving a fusion of the vertebrae, since that would severely limit my mobility in the lower part of the spine.”

Unlike some spine health centers, Spine Colorado prides itself on avoiding invasive treatments whenever possible. Because of the increased recovery times and chances of complications down the line, they strive to provide noninvasive treatment first, and whenever possible thereafter. That’s exactly what was recommended in Rotem’s case. 

“Our conversation gave me an idea of the game plan—like the road to recovery, where I need to make this joint as stable as possible and avoid having this injury happen again.”

The injury in question? Flexion intolerance, a common enough musculoskeletal injury incurred by cyclists that’s caused by the repeated bending posture adopted during cycling. In Rotem’s case, the solution was simple: Stabilize the core and avoid overuse. But the actual exercises prescribed came as a big surprise. 

Medicine in movement

While movement was the prescribed medicine, it wasn’t the kind of movement Rotem, an experienced coach and graduate of the University of British Columbia’s School of Kinesiology, assumed he should be doing. On the contrary, he learned that some core exercises, specifically those involving a curved spine (like classic crunches), could actually make an injury like his much worse. 

“It’s not something that’s really talked about in cycling,” says Rotem. “Even if you look up core exercises for cyclists, it's all the wrong things they shouldn't be doing. Because cycling posture is not natural to the body, the way say running posture is, when you're upright. So you need to correct that, not do more of it.”

To make the correction, Dan Prince of Spine Colorado recommended core stabilizing exercises that would not only strengthen but more importantly stabilize and synchronize all of the muscles supporting the torso, and not just the ones you see in a ‘six pack’. 

“It was all about finding the types of movements I was able to do without irritating the injury, in other words, how I could remain active with it, and also a lot of core stability exercises. Some traditional exercises like crunches felt horrible, whereas planks with the correct pelvic and spine posture were okay. So it was also about finding the exercises that worked and would make things better and not worse.”

The short road to recovery

After coming up with a game plan, Rotem was pleasantly surprised at how relatively short the recovery window really was. While stories abound of career-ruining injuries for cyclists, that wasn’t at all what happened to Rotem. In fact, he was back on his bike in just a few short weeks. 

“After the initial injury, I wasn’t able to get on my mountain bike—it caused too much irritation in that joint. But just three or four weeks after starting the exercises that Dan Prince gave me, I was able to—and that was a big thing for me because it’s my number one sport. After that, I just kept getting better and better.”

Another pleasant surprise for Rotem was that he got all of the info he needed in just one visit, and didn’t require invasive treatments of any kind. 

“Prince told me that there was no need for injections as long as I was managing the pain, which I was.”

Passing it on

Beyond getting back to his normal mobility and daily activities, probably the best part of Rotem’s experience with Spine Colorado was the professional growth it gave him and the knowledge he’s now able to pass along to his student-athletes. 

“With coaching cycling athletes, it's important for me to understand how spine stability works, and I actually tweaked the program for my athletes because of this experience.”

After his conversation with Prince, Rotem felt he had gained a better understanding of the nature of his injury and other common spine injuries incurred by cyclists. Because of this, he was able to change his training program accordingly.  

“Basically, leaning over like we do in cycling can cause a lot of shearing forces on the lumbar spine, and if we’re also spending time in a rounded position, say working on a computer and doing traditional exercises like crunching, then all of those activities come together for a greater negative effect.”

Rotem now brings a new awareness of best spine health practices when recommending exercises for his cycling athletes.

“The adaptation I made is that if I’m giving them any exercises involving the core, I make sure it's with a neutral curvature of the spine—and not curving the spine the way a lot of traditional ab workouts do.”

‘Different from other providers’

But it wasn’t just the successful recovery and newly gleaned professional insights that made Rotem’s trip to Spine Colorado a success. It was also the way they prioritized non-invasive treatment that made their clinic really stand out. 

“A lot of athletes I work with have injuries similar to mine that don't necessarily require any type of invasive treatment. I would advise them to come here because they actually personalize the care and ask what their desired outcomes are, instead of just pushing them into invasive treatments.”

Another stand-out quality of the team at Spine Colorado? The level of personalized care.

“The care felt very personal, and that set them apart. They took the time to understand my lifestyle, not only asking what I did for work but also what my activities and physical goals were. They took the time to understand my lifestyle, and because of that, really earned my trust.”