Tuesday, 6 March 2012

Common Cycling Injuries

Cycling and especially commuttig has to be one of the best ways to gain and maintain fitness levels as well as to have an enjoyable way of getting to and from work.  Even with my 36 miles a day and a lot of hard graft it is by far my prefered mode of transport, if not always the most practical.

If you do develop an ache, pain or injury while cycling, it is likely to be among the following:

Knee Pain
Knee pain is extremely common in cyclists. In order to treat the cause of the pain, it is important to have an evaluation and proper diagnosis. Common reasons for knee pain in athletes include the following.
Patellofemoral Pain Syndrome
This term usually refers to pain under and around the knee cap It is also called "Runner's Knee."
ChondromalaciaThis term refers to softening and deterioration of the underside of the kneecap. In young athletes this is typically an injury from trauma, overuse, poor alignment of the knee joint, or muscle imbalance. This leads to friction and rubbing under the kneecap the results damage to the surface of the cartilage. The sensation is a dull pain around or under the kneecap that worsens when walking down stairs or hills, climbing stair other weight bearing activity.
Osteoarthritis of the KneeOsteoarthritis is the most common type of arthritis in athletes. It is a degenerative disease that results in a gradual wearing away of joint cartilage. Typical symptoms of osteoarthritis are pain, swelling, and a decrease in the range of motion of the knee. Morning stiffness that decreases with motion is also common.
Abrasions and Road RashInjuries that result from a fall on a hard surface that causes outer layers of skin to rub off.
Hand Numbness / Ulnar Neuropathy
This is experienced as pain and numbness of the small and ring finger and is associated with pressure on the handlebars for long periods of time.
Muscle CrampsA cramp is a sudden, tight and intense pain caused by a muscle locked in spasm. You can also recognize a muscle cramp as an involuntary and forcibly contracted muscle that does not relax.
Sprains and StrainsThese are acute injuries that vary in severity but usually result in pain, swelling, bruising, and loss of the ability to move and use the joint.
Iliotibial Band Syndrome
IT band friction syndrome often results in knee pain that is generally felt on the outside (lateral) aspect of the knee or lower.
Delayed-Onset Muscle SorenessCommonly known as the DOMS, if you have done any type of hard training session after a long lay off this is what you feel as you try wake up as stiff as a board
Description: Muscle pain, stiffness or soreness that occurs 24-48 hours after unaccustomed, or particularly intense exercise.
External Iliac Arteriopathy - An Uncommon Cause of Leg Pain in CyclistsCould cycling at a high intensity really damage the leg arteries? It sounds unlikely, but some elite cyclists have experienced arteriopathy, or damage to the arteries of the pelvis, groin or lower leg.
Achilles Tendonitis
Achilles tendonitis is a chronic injury that occurs primarily from overuse. It tends to come on gradually over time until pain is constant and exercise or activity too painful to continue. Achilles tendonitis is a painful condition of the tendon in the back of the ankle. Left untreated, Achilles tendonitis can lead to an increased risk of Achilles tendon rupture.
Plantar FasciitisPlantar fasciitis is the most common cause of pain on the bottom of the heel and usually defined by pain during the first steps of the morning
Arch PainArch pain is a common foot complaint. Arch pain, also sometimes called a strain, often causes inflammation and a burning sensation under the arch of the foot. Treatment of arch pain often consists of adaptive footwear and inserts.
Piriformis Syndrome If the piriformis muscle becomes tight or cramps it can put pressure on the sciatic nerve and cause gluteal (or buttock) pain or sciatica.

Information supported by http://sportsmedicine.about.com

There are ways to ensure you don't suffer from any of the above

1. Stretch/Warm up correctly both before and after each session. When I arrive at work I spend 15-20 minutes on the Power plate to do core and stretch exercise?

2. Use a foam roller to work tough areas such as the IT band on the outside of the thigh

3. Do regular gym work to ensure correct development of the various muscle groups? This includes core exercise (for the back and stomach. Only working the stomach like many do, actually causes lower back pain). Also ensure you train the major leg muscles, especially the quads. This ensures you do not get any imbalance on the quadriceps muscles.

The quads are made up of 3 major muscles, cycling tends to work the Rectus Femorous and leaves the Vastus Medialis weaker. This causes the patella (knee cap to drag to one side thus causing pain)

4. Eat correctly. A balanced diet is all you need to ensure you are getting the correct number of calories each day. Remember that by starting to exercise you will be increasing your energy requirements. Do not see this as an excuse to binge on rubbish food, but it does mean you need to up the food intake. I would also suggest not dieting. This cuts out vital energy requirements and forces the body to store rather than burn fat. Eat healthy, aim for you 5 a day of fruit and veg. I always recommend taking a multi vitamin to ensure you get all you need and finally make sure your diet is a 25% fat, 35% protein. 45% carbohydrate mix where possible.

A healthy diet is not rocket science but can be difficult to stick to. Be disciplined and allow yourself treats. A healthy diet ensures your body will be able to react effectively to exercise and allow the muscles to work efficiently. Supplements can be used but take professional advice before embarking on that route. There is a huge array of products and to be honest most bamboozle me.

5. Keep hydrated. You should be taking on board at least 2 litres of water a day to aid effective body and brain functions. When exercising you need to add a litre for every hour’s worth of exercise. I would suggest any longer than an hour you look at taking fluids with a salt and glucose element, such as Lucozade or other sports drink. Dehydration will not only impair performance it will all make you more susceptible to injury.

6. When injured make sure you rest before getting back in the saddle. Trying to train through an injury will only prolong the problem.

7. Acute injuries tend to be those caused by a situation or an action. Such as pulling a muscle or a strain. Chronic injuries tend to take place over time such as more muscle alignment, tight hamstrings and poor flexibility, painful backs etc.

8. Know your limits and don't over do it.  Your fitness level will improve but when you first start out maybe consider taking the train or using another mode of transport for part of the journey.  If you try too much too soon you will get sore or injured an end up giving up entirely.

Many of the chronic injuries are caused by poor riding position, poor posture, wrong size bike and poor bike/pedal set up. There are a number of basic tips you can use to try and get the bike set up correctly yourself.


1. Get a bike that’s the right size

Check your frame size – stand astride the bike, there should be approximately a 2 inch clearance between the top tube and your groin, increasing to a 3 inch clearance on a mountain bike.
Next check the crank length. There are lots of figures quoted for this, but as a rule of thumb the crank should be 21% of the length of your inside leg measurement.

2. Assess the saddle height

With the pedal in the 6 o’clock position i.e. where it is fully down, the heel of the foot should be able to just rest on the pedal with the knee straight and with the pelvis remaining level. This means that when pedalling the knee will be slightly flexed still at the extreme of the downstroke.

If the saddle is too high

To maintain power at the end of the downstroke the pelvis has to tilt laterally, also causing a side bend at the lumbar spine. This repeated lateral side bend and pelvic tilt can eventually cause sacro-iliac joint (the joint where the spine joins onto the pelvis) and lumbar spine problems.
Having the saddle too high also puts the hamstrings at a mechanical disadvantage at the extreme of the downstroke increasing the risk of hamstring strains.

If the saddle is too low

The knee doesn’t go through as large a range of movement increasing the pressures going through the knee cap and thus increasing the risk of anterior knee pain (pain at the front of the knee).
Additionally, at the top of each stroke the hip comes into a greater degree of flexion increasing the possibility of hip pain, and meaning that the lumbar spine will often give into flexion and thus set up back pain.

3. Look at the saddle tilt

Start off with the saddle horizontal. Put a spirit level on the saddle and adjust until it is level. A forward tilt on the saddle transfers your weight through onto your hands and shoulders. A backwards tilt on the saddle increases the flexion at the lumbar spine and the pressure on the groin.

4. Handlebars

Whilst low handlebars aid an aerodynamic position, handlebars that are too low in the recreational cyclist increase flexion at the back causing back pain. They also increase weight through the hands and shoulders leading to wrist or shoulder pain, and give a hinge in the neck. This is because you have to tilt your head up to see where you are going resulting in neck pain, sometimes with headache.
An ideal trunk position for the recreational cyclist is 40 – 60 degrees forward from upright which will enable a shoulder position of 80 – 90 degrees flexion.

5. Cleat position

At half way down the downstroke, the kneecap should be directly in line with the centre of the front of the pedal. Looking at it from both the front and the side, adjust this by moving the cleat forwards or backwards and rotating it and by adjusting the fore aft saddle position.
This is a rule of thumb only, people often have feet that naturally point in or out, and the cleat needs to be adjusted accordingly. An incorrect cleat position causes excessive rotation of the tibia on the knee and may cause knee and hamstring problems.

information by: http://physiobench.com

Most of all though make sue you buy a bike that is the rght size for you.  Your local bike sop should be able to help with this.   If not:

If you are looking to spend £1000 I would recommend you spend £150-£200 getting you riding stye analysed and your specific riding set up logged.  This way when purchasing a new bike you end up with the right frame, correct seat and handle set up as well as ensuring your shoes and cleats are set up.  There are a number of companies around the UK that will provide this service for you.  if you can't fidn them on the net ask your local bike shop.

1 comment:

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