There are two main types of cycling injury, those caused by falling off (which we don’t discuss below) and the issues caused by overtraining, biomechanical stresses, often due to muscle imbalances, and incorrect bike set-up. It is particularly important for the sake of future injury prevention to identify the root cause and address this ASAP.
Unless you fall off, cycling is a sport blessed by its body friendliness! In fact, riding big miles is more likely to get you fit than fractured. But, like any endurance sport, cycling can produce a catalogue of niggling aches and pains, which if left untreated can become more serious. To give your pain a name and point you down the right road to recovery, over the course of a few blogs we will discuss the 8 most common cycling ailments, their most likely causes, and how to go about fixing them.
Let’s start with knee pain!
KNEE PAIN
One of the most common cyclist knee complaints is pain in the kneecap. This is most likely to be patellofemoral pain syndrome (PFPS). PFPS is often worse when walking up and down hills/stairs or sitting for long periods of time. It may include wasting of the quadriceps (thigh) muscles if the injury is an old one, and tight muscles around the knee joint.
PFPS occurs when the patella (kneecap) rubs on the femur (thigh) bone underneath. It is believed that incorrect tracking (gliding) of the patella over the femur is a significant factor and results in damage to the cartilage underneath the patella.
The cause may be from external factors like an increase in training, the seat being too low or riding too long in big gears. Internal factors such
as poor patella tracking may result from excessive pronation (fat foot), rotation of the lower leg and tight or weak muscles around the thigh and pelvis.
TIP ONE
Try variation in your pedal cadence – breaking up your training by pedalling in a high cadence (90 – 120 revs per minute) can help prevent injury. Raising the seat if it’s too low will reduce the amount of knee flexion and utilise more of the hamstring and gluteal (buttock) muscles thereby off-loading the quadriceps muscle and patellar tendon. If your foot rocks from side to side, use an insert to stabilise the rear of your foot, thereby reducing strain on the knee and increasing efficiency.
BACK PAIN
After knees, the back is probably one of the biggest causes of pain for cyclists, with lack of flexibility and bad posture generally the cause. Hunching forward on your bike, and probably also at work, places strain on your spine, loading structures for prolonged periods of time.
Cyclists’ back pain is often due to mechanical factors. Have your bike properly fitted to your body, then look at your body. Lack of flexibility, such as excessive hamstring and hip flexor tightness can contribute to low back pain.
Differences in leg length are common mechanical problems leading to imbalances in the spine. Core strength is very important to avoid low back pain. Core strength comes from a collection of deep muscles both big and small that work together to give you core lumbar and pelvic stability.
TIP TWO
Low back pain may arise in cyclists that push big gears, especially while climbing. The angle of your back in relation to the bike can increase or decrease the strain on your back. Consider alternating climbing positions by standing up, changing the angle of your back, especially during long rides or climbs, or talk to your therapist about a back rehabilitation programme to focus on strengthening your core muscles.
At Blackberry Clinic we specialise in treatment of all kinds of back pain and knee pain. Our physiotherapists are able to treat elite athletes and weekend cyclists with the same principles of rehabilitation and strengthening exercises.
If a condition is not responding to manual treatment our Musculoskeletal Medicine Doctors and Sport & Exercise Medicine Doctors can offer injections such as prolotherapy, facet joint injections, soft tissue injections and more. Don’t put your bike in the garage if you have knee pain or back pain. Come and see us at Blackberry Clinic and get back in the saddle!
More tips to follow, look out for the next blog with more common cycling injuries and how to avoid them.
