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Cycling – Injury Prevention

With the FedUni Road Nationals on in Ballarat this week it is the perfect time to talk cycling with many of us inspired to jump on the bike ourselves. For those of us however that perform cycling as a competitive sport, injuries can always be a worry that is at the back of your mind. As cycling is a very repetitive sport by nature, overuse injuries are unfortunately all too common. These types of injuries are generally far less debilitating than the acute injuries that can occur, however they can still affect training and ultimately race day performance. Broadly speaking, overuse injuries in cyclists have two common causes; bike positioning alongside lack of strength in certain areas. Let’s have a look at what some of the most common overuse injuries are in cycling and what we can do to prevent them. 

Neck Injuries

Neck injuries account for the biggest proportion of overuse injuries in cycling as often a cyclist’s neck can be placed into excessive hyperflexion for extended period. It is therefore important that we take note of a few things including handlebar and seat positioning. We can then also look at strengthening through the upper back, not only the strength but the conditioning of these muscles to hold this position for long periods of time too. There are a few upper back exercises we can do to help reduce the risk of this including: 

  • Ring row
  • Banded pull apart 
  • Dumbbell bent over row
  • Cat Camel stretch

Knee Injuries

The next most commonly injured area is that of the knee with an array of different overuse injuries that can occur, however the main ones being patellofemoral pain (PFP) and iliotibial band syndrome (ITB syndrome). Due to the high demand that is placed on the quadriceps during the downstroke of cycling (where the knee is extending), this leads to a large amount of force being translated to the patellofemoral joint. This reaction is said to be the cause of PFP, while ITB syndrome can be better accounted for through the repetitive nature of the sport. As with the non-specific neck injuries that cyclists can have, the set up of the bike is a large contributing factor to the occurrence of these injuries. Other factors include a rapid increase in training volume and an increase in hill work performed. It is therefore important that we be mindful of this as a cycling community and prepare our bodies appropriately to be able to withstand the increase in load. It is important that our increase in load is no more than 10% per week and we are not increasing both volume and hill work at the same time. It is also then important that we strengthen our bodies to withstand this added volume. For this it is important that we improve the strength in our glutes and stabilizing muscles through the hip. A few key exercises that we can use to aid in this include:

  • Banded glute bridge 
  • Side lay leg lift 
  • Split squat

Lower Back Injuries

The last injury we will talk about is that of chronic lower back pain. This type of non-specific pain is generally caused by the prolonged flexed position that the athletes are placed in, resulting in a flexion/relaxation inhibition or fatigue of the erector spinae (lower back) muscles. Again, preventing this type of injury can be attributed to making sure that the athlete has the correct set up of their bike. It is also important however that we look to improve our lower abdominal and general core strength, to offset any weakness through the erector spinae muscles. There are a few key exercises that we can use to help target these areas. 

  • Dead bug 
  • Swiss ball crunch 
  • Bretzel

Summing it up…

In summary, if you are a keen cyclist there are a few very important things that you will need to take note of in preventing any chronic overuse injuries from occurring. Firstly, making sure that the bike is fitted correctly to you, correct seat type and position and correct handlebar position. It is then important that we don’t increase the amount of training that we are doing too quickly (10% at a time) and only in one form at a time whether that be increasing volume or hill work. Lastly it is important that we perform some strength work to off set any injuries that could occur. 

Happy cycling 😊

References

  1. Schwellnus, M,P. & Derman, E,W. Common injuries in cycling: Prevention, diagnosis and management. South African Family Practice. 47(7): 14-19. 2005.
  2. Visentini, P. & Clarsen, B. Overuse injuries in cycling: The wheel is turning towards evidence-based practice. Aspetar Sports Medicine Journal. 8: 486-492. 2019.