Preventing cycling injuries

By Simon Gilchrist

Simon is an Australian Sports Physiotherapist. He has worked with various sporting teams and national and international athletes over the years. His special interests are spinal and knee injuries. He works at Marylebone Physiotherapy and Sports Medicine clinic, in London. He is a keen amateur cyclist and has spent many years competing in various sporting pursuits. He has put together a few ideas on preventing cycling injuries with all the training to be undertaken for L2P 2007. Simon rode in 2006 and will do so again in 2007.

Cycling is a sport that demands attention to detail to minimise and reduce the risk of injuries. There are many common injuries that can be avoided simply by taking a few important steps in ensuring your body is functioning efficiently. Common areas susceptible to injury are the cervical spine (neck), lumbar spine (lower back), knee and hands. According to the literature there is a 30-70% prevalence of neck or low back pain with cycling (Salai, Brosh, Blankstein, Oran, & Chechik, 1999). Riding a road bike places your low back and neck in a flexed posture. This loads up the ligaments, discs and joints within your neck and spine and causes the muscles to become inhibited (Burnett, Cornelius, Dankaerts, & O'Sullivan P, 2004). It is important to bear this in mind when training and early intervention can help to prevent these injuries becoming more serious. Some early studies have demonstrated by slightly inclining your seat forwards so the front tip is lower than the rear, will help to maintain a neutral angle between your spine and keep your back in a more advantageous position (Salai et al., 1999).

Keeping your spine and legs supple and strong can help to prevent unnecessary injuries and even help to improve performance. Knee injuries are extremely common with cycling with prevalence ranging from 30-70%. This can occur by overload with large increases in training volume, poor bike set up and biomechanical faults and deficiencies. An hour cycling can mean over 5000 revolutions of the knee which can introduce large stresses through the tissue. Common injuries at the knee are patella-femoral joint pain ( anterior knee), iliotibial band syndrome (pain and tightness at side of knee), bursitis ( fluid on knee) and tendonosis ( irritation of tendon). Most of these injuries are readily treatable and can be dealt with easily and quickly. It is critical that along with your cycling training you are doing other specific exercises to help increase the strength and power of your legs. This will help to maintain and increase your power on the bike and help to prevent unnecessary injuries. Studies have shown that cycling and specific leg strengthening will help to increase your power output and endurance on the bike (Hickson, Dvorak, Gorostiaga, Kurowski, & Foster, 1988; Marcinik et al., 1991).

Exercises to increase your strength and help to ensure that the quadriceps are functioning well are single leg squats, lunges, power lunges and single leg sit to stand. All of these exercises can be performed easily and will aid your leg strength and help to keep injuries at bay.

Single leg squat - Stand on the edge of a step and with your left foot in front of the step gently lower your foot towards the floor. You must keep your hips level and do not let them drop. Work towards the floor but it is not important if you do not touch the floor. Repeat and perform on the opposite leg.

Lunges – These are terrific functional exercises that can be performed to help increase the control of your VMO muscle which is an important stabiliser on the inside of your knee. Stand with feet together and then step forward and then lower your body vertically towards floor so that your back knee gently touches the floor and then push back up to the starting position ensuring your trunk remains stable. Repeat this focusing on the ones side and then repeat on the other.

Power lunges – This is an advanced version of the lunges to really work on your power through your quadriceps and gluteals. It is much harder so if having difficulty with the lunges leave this until the lunges are achievable. Begin in the full lunge position with the back knee touching the floor and trunk upright. Jump through the movement so that you swap your legs and come down in the same position with your other leg forward. This is a challenging exercise that will challenge your cardiovascular fitness and leg strength.

Another more challenging exercise is a single leg sit to stand. This is a movement we perform countless times a day but it is amazing how difficult it becomes only using one leg. Sit on a nice low hard chair and lift one foot so it is a few inches off the floor. Push down through that one leg and stand up without using your hands. Slowly lower yourself back down so that you don’t collapse. This will be a challenging strength exercise for your cycling legs.

It is vital to maintain flexibility whilst cycling. As you are cycling you never fully extend the knee so that your hamstrings (back of thigh) will become tight. Cyclists have notoriously tight hamstrings that can compromise the function of your knee and especially your back. Your quadriceps and hip flexors also become compromised through spending large amounts of time flexed and producing power through these muscles. It is vital to stretch after spending many miles in the saddle. This can help to prevent overuse injuries of the knee and spine and help to maintain the length tension relationship within our muscles so that optimal strength and power can always be achieved.

Quadriceps stretching can help to prevent excessive tightness and can decrease the irritation through the patella – femoral joint (kneecap). A simple way to do this is to pull your heel up towards your bum and keep your thigh parallel to the other side. Stretches need to be held for at least 30 seconds to allow muscle fibres to adapt to a new lengthened position.

Hamstring stretch – Standing place your foot on a chair or table of low height. Keeping your back straight bend from the hips and take your chest forwards to towards the knee to feel a good stretch at the back of knee. This is an important stretch after a long ride to reduce the tension within your low back.

Gluteal stretch – Figure 4 stretch. You can do this one lying down and place one heel over a knee. Pull that thigh up towards your chest so you are getting a stretch through your buttocks. Your gluteals produce a great deal of power through cycling and it is critical to ease the tension within this area.

Calf stretch- Push against a wall. Keep your body and pelvis straight. Have your back leg straight and bend your front knee to feel a stretch at the back of your lower leg.

Spinal stretching – A spinal rotation stretch will help to mobilise your spine again after being flexed for long periods. Lying on the floor take one knee over the other leg and pull this leg towards the floor. You should feel a stretch within the low back and outside hip region.

Massage of the legs will often help to revitalise the legs and flush excessive waste products from the tissues to allow improved recovery following cycling. The outside thigh often gets very tight in cyclists and can contribute to knee problems. An easy method of releasing these tissues is to try some self massage over the lateral ( outside) aspect of the thigh with some oil. It will be very tight and sore following a heavy ride but will aid your recovery so your legs are in better shape the next day.

 

Happy cycling

Simon

 

 

Burnett, A. F., Cornelius, M. W., Dankaerts, W., & O'Sullivan P, B. (2004). Spinal kinematics and trunk muscle activity in cyclists: a comparison between healthy controls and non-specific chronic low back pain subjects-a pilot investigation. Man Ther, 9(4), 211-219.
Hickson, R. C., Dvorak, B. A., Gorostiaga, E. M., Kurowski, T. T., & Foster, C. (1988). Potential for strength and endurance training to amplify endurance performance. J Appl Physiol, 65(5), 2285-2290.
Marcinik, E. J., Potts, J., Schlabach, G., Will, S., Dawson, P., & Hurley, B. F. (1991). Effects of strength training on lactate threshold and endurance performance. Med Sci Sports Exerc, 23(6), 739-743.
Salai, M., Brosh, T., Blankstein, A., Oran, A., & Chechik, A. (1999). Effect of changing the saddle angle on the incidence of low back pain in recreational bicyclists. Br J Sports Med, 33(6), 398-400.