Although superficial soft tissue injuries and musculoskeletal trauma are the most common injuries, head injuries are responsible for most fatalities and long-term disabilities. Overuse injuries may contribute to a variety of musculoskeletal complaints, compression neuropathies, perineal and genital complaints. Physicians treating such patients should consider medical factors, as well as suggest adjusting various components of the bicycle, such as the seat height and handlebars. Encouraging bicycle riders to wear helmets is key to preventing injuries; protective clothing and equipment, and general safety advice also may offer some protection.
Tyler Dumont, physiotherapist, discusses patellofemoral pain syndrome.
Tyler Dumont, physiotherapist, discusses Cycling Neck Pain and Bike Position.
Cycling and ITB Syndrome Injuries
ITBS, or iliotibial band syndrome, is a very common cause of lateral knee pain in athletes.
The iliotibial band is a fascia that extends from muscles that crosses two joints, across your hip and your knee, and it inserts at the lower aspect of your knee.
In cycling the repetitive extension and flexion of the knee contributes to the problem of iliotibial band syndrome, as the under surface of the iliotibial band becomes irritated, passing so many times across the knee joint.
In terms of symptoms, a cyclist may present with sort of insidious onset of dull pain on the lateral aspect of the knee, as well as possible swelling. Occasionally this might be experienced as a stinging sensation.
An athlete who presents with ITB syndrome may want to consult their primary care sports physician as well as their physiotherapist when managing this problem.
Management really revolves around stretching – a lot of stretching – as well as strengthening of hip abductors and other muscles in the region.
A sports medicine physician and a physiotherapist might be able to point the athlete in the right direction with respect to recovery tools that they could use at home that would be helpful in the treatment of this condition, as well as identifying any biomechanical features which may be contributing to the problem and could be modified.
Video filmed in conjunction with Larissa Roux, MD FRCP Dip Sport Med, MPH, PhD
Local Practitioners: Sports Medicine Physician
Larissa Roux, MD FRCP Dip Sport Med, MPH, PhD, discusses Cycling Palsy Symptoms & Treatments.
Patellofemoral Pain - Knee Pain in Cycling
There are a few cycling technique faults that contribute to patellofemoral pain syndrome.
One is pedaling in too big a gear. A lot of people and unicyclists tend to want to push a hard gear. That type of low cadence pedaling really adds the compression forces behind the knee cap, so it’s really important to get a good spin.
The other aspect is knee alignment while pedaling. When you look down at your knee when youre pedalling that knee should track in a linear path, shouldn’t be a lot of side-to-side motion. That’s been shown in the research to really contribute to patellofemoral pain syndrome.
The other aspect of cycling technique here is just the pedal stroke itself. Some people don’t apply force throughout the pedal stroke and have a very inefficient push-push pattern, rather than applying force throughout the pedal stroke.
There are neat tools out there, like the CompuTrainer, which allows you to spin and scan. It looks at where you apply your force of your pedal stroke. Or having a coach as well analyze how you pedal, but that’s another key factor at looking at technique errors for patellofemoral pain syndrome.
If cyclists that have patellofemoral pain syndrome have any questions I’d consider seeing a bike fitter or a physiotherapist that does bike fitting.
Local Practitioners: Physiotherapist
Tyler Dumont, physiotherapist, discusses bike setup and hand pain/numbness.
Cycling Neck Pain and Bike Position
Neck pain and discomfort can be a significant issue for cyclists, especially for tri-athletes that are in that low aero position.
There’s a lot of extra strain on those neck muscles and joints as they’re trying to sustain that position for hours on end. So the bike has to be set up right or else there is extra stress in that area.
If the bike’s not set up correctly what we might see this is the back of the head, here’s the neck and upper back. What we tend to see is a head forward or chin poke position, that can cause a lot of compression and shear through the mid part of the cervical spine.
The upper neck muscles here at the back of the head can get really tight and contribute to neck pain or headaches. And also, this part of the thoracic spine, the muscles are working really hard to hold the weight of that head and can get fatigued or sore. So the bike fit has to be adjusted so we can take stress off of those areas.
With regard to the lower back position, we want to aim for neutral. We don’t want to have an overextended lower back or an overflexed or rounded back. We’re trying to get relatively neutral so there’s less stress on those joints and those muscles so the rider can maintain a nice stable pelvis while riding.
If you have questions about your bike position and you’re experiencing neck pain or back pain, have someone do a bike fit on u you could see a cerified bike fitter or a physiotherapist that does bike fits.
Local Practitioners: Physiotherapist
Tyler Dumont, physiotherapist, discusses how a cyclist is treated for ITBS.