NICKY SNAZELL'S WELLNESS & PHYSIOTHERAPY

Cycling Injuries | Avoidance

Unless you fall off, cycling is a sport that causes very little, if any impact injury and is relatively body-friendly. On the road, there’s no impact to jar your joints as you would find in running.  In mountain bike riding, although there is still no direct impact there is an element of vibrational force depending upon the type of terrain you ride. Like any endurance sport however, cycling can produce a catalogue of niggling aches and pains, which unless diagnosed and properly treated can often lead to something more serious.

If you are a regular cyclist, maybe training for you first charity ride or even a sportive, it is important that you know how to spot the signs of an injury and that you get the correct treatment and advice to correct any problems.

Avoiding Injury

When you start to increase the amount of riding you do you will be adding stresses and strains on your body. You might be tempted to ignore slight niggles and stick to you training programme at all costs.  BEWARE.  Riding through the pain is very likely to turn what may be a minor problem into a major one.

If you get injured, take it seriously. Take some time off the bike or adapt your training regime but do not ignore it. If the problem does not ease after rest, it is wise to be assessed by a physio or sports therapist.  Whatever you do, don’t ignore a potential injury when it’s still in the niggle stage.

Common Injuries

Other than the obvious flesh wounds and trauma caused by falling off there are the less impressive but no less painful sprains and strains caused by overtraining/overuse injuries often resulting from biomechanical stress caused by muscle imbalances or incorrect bike setup.

Knee

One of the most common injuries reported by cyclists is pain in/around the kneecap.  This is often likely to be an overuse injury. Patellofemoral pain syndrome or Chondromalacia patellae are two possible causes and are usually found because of tightness or weakness in associated muscles that causes unwanted movement of the kneecap (patella) as you pedal. If the patella rubs on the bones behind it, this can irritate and inflame the cartilage at the back of the cap causing pain.

Similar symptoms can be caused by your illiotibial (IT) band becoming tight and pulling the kneecap out of line causing it to rub against underlying bones. If you consider the repetitive nature of the pedalling action – up to 5,000 pedal revolutions an hour – it’s no surprise that a problem like this can quickly escalate into a clinical injury.

The stabilising muscles of your hip/pelvis play a big part in preventing your knees rolling inwards, and can be weakened by an over tight IT band.  This is one factor that may lead to a number of painful problems, including medial knee pain, anterior knee pain and even lower back pain, in cyclists and also runners.

Hip

A number of issues can give rise to hip pain one of the most common is Piriformis syndrome.  This is often caused by overtraining (particularly if there is a muscle imbalance) and by overworking the gluteus maximus muscles in your buttocks.  If overstressed and tight, the piriformis can put pressure on the sciatic nerve, causing pain or numbness down the  back of the leg or in the hip and is a common cause of sciatica.

Neck

Pain caused by neck hyperextension can be exacerbated by positional issues on the bike combined with lack of flexibility and core strength.  The deep muscle of the neck ( flexors/extensors) help to hold your head up, when they become weak it is left to the trapezius and other muscle groups to support your head as you lean forward. When these muscles get fatigued, you can get the aches and pains in the back and sides of your neck.

Lower Back

After knees, the back is probably one of the biggest causes of pain reported by cyclists.  Again lack of flexibility and a poor posture/set up are often the cause.  The neutral position for the spine in a standing position allows for the curves of the spine to take your bodyweight and for the muscles to be relaxed.   Sitting and reaching forward causes tension in some of the muscles of the spine and can stress the joints causing aches and pains particularly in the lower back and across the shoulders. In extreme cases long periods of being in a bent forward position can damage the intervertebral discs causing them to herniate.

Any exercise causes a small amount of inflammation in muscles, due to microscopic amounts of damage.  After a long ride it is normal to ache for a day or so as the muscle repairs.  This is often referred to as Delayed Onset Muscle Soreness (DOMS)

Hands

Numbness, tingling, or pain in your arm, hand, wrist, or little finger is all common symptoms especially following a long ride.  Approximately one-third of all bicycling overuse injuries involve the hands.  The two most common are handlebar palsy and carpal tunnel syndrome. By making some adjustments to your bike and by wearing some protective equipment, you can help prevent these injuries from occurring.

Handlebar palsy

Ulnar neuropathy (sometimes known as handlebar palsy) is caused by compression of the ulnar nerve at the hand and wrist.  The ulnar nerve controls sensation in your ring and little finger and some of the muscular function of your hand. Compression of the ulnar nerve is a common problem for cyclists and is the result of direct pressure on the ulnar nerve from the grip on the handlebars and sometimes overstretching of the nerve when using the drop-down handlebar position for an extended period.

The pressure placed on the ulnar nerve results in numbness and tingling in the ring and little fingers, hand weakness, or a combination of both. Symptoms can take from several days to months to resolve. Rest, stretching exercises, and anti-inflammatory usually help relieve the symptoms. Applying less pressure or weight by adjusting your position will help prevent the condition

Carpal tunnel syndrome

Although it is less common than Ulnar neuropathy, carpal tunnel syndrome (compression of the median nerve) is another overuse injury that cyclists often experience.  This often occurs when a cyclist holds the handlebars on top and applies pressure directly on the median nerve. Symptoms include numbness and tingling in the thumb, index, middle, and ring fingers and weakness of the hand.  Although pressure from this riding position contributes to the symptoms of carpal tunnel, there can be other causes for hand pain and numbness, therefore, an evaluation for other possible causes should be performed by your health-care professional.

If you think you may have any of these conditions, it would be worth getting in touch with the clinic to make an appointment to have it checked out. Call on 01889 881488 now.

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