1 / 31

Cycling Injuries

Cycling Injuries. ATAF Spring Conference - 2013 Stephen A. Black, DSc, M.Ed., PT, ATC/L, NSCA-CPT RockyMountain Human Performance, Inc. Florida Gulf Coast University. Statistical Overview. Recent Statistics (2012) – total reported ~19,000+ Killed – 107

tyme
Download Presentation

Cycling Injuries

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Cycling Injuries ATAF Spring Conference - 2013 Stephen A. Black, DSc, M.Ed., PT, ATC/L, NSCA-CPT RockyMountain Human Performance, Inc. Florida Gulf Coast University

  2. Statistical Overview • Recent Statistics (2012) – total reported ~19,000+ • Killed – 107 • Seriously injured – 3,085 (hospital admission) • Slightly injured – 16,023 (non-hospital admission • 25% of total were children • 25% of those killed had significant head trauma NHTSA - 2012

  3. Statistics Cont. • Orthopaedic Overview • Back / Neck Px • Knee Px • Patellar / quad tendon tendonitis / tendonopathy • ITB • Hip • Medial Tibial Stress Syndrome • Foot pain / numbness • Pelvic Girdle Pain (PGP) Syndrome • others

  4. Cycling vs. Running What do you call an injured runner? A cyclist! • Non-impact • Fewer stress fractures • Eccentric muscle action not as important • Fewer muscle strains / tears • Hours spent in saddle • Less overuse problems than running? • Overtraining or staleness is more common Why

  5. http://www.youtube.com/watch?v=mYPDAry-A-s&feature=player_embeddedhttp://www.youtube.com/watch?v=mYPDAry-A-s&feature=player_embedded Cycling Injuries

  6. Macro-Trauma

  7. Micro-Trauma OVERUSE INJURIES

  8. Contact Overuse Saddle Sore Neuropathy Neuroma

  9. Neuroma • Impingement of nerves • Chronic inflammatory mass • Burning pain • See riders shaking foot out of pedals • Between 3rd and 4th metatarsal classically

  10. Neuroma On the Bike Treatment • Adjust cleat position, usually further back • Check inside shoe for cleat bolts • Change shoes to wider toe box • Shoe inserts may help

  11. NeuromaMedical Treatment • Biomechanics • STM / IASTM • Nerve Glide • Functional Ex • Guided Injection • NSAID • Surgery

  12. Saddle Sores • Moisture + Pressure + Friction • Chafing • Ulceration • Folliculitis • Abscess • Subcutaneous nodules

  13. Saddle Sores On the Bike Treatment • Change saddle • Check saddle height and tilt • Clean chamois, no seams, keep dry • Don’t sit around in your kit after riding • Emollients

  14. Saddle SoresMedical Treatment • Prevention • Keep dry, clean, chamois, avoid shaving high • Medical Treatment • Warm soaks • Topical cortisone, anti-fungal, anti-bacterial • Oral antibiotics • Surgical incision and drainage

  15. Hand Neuropathy • Cyclist’s Palsy (Ulnar Neuropathy) • Carpal Tunnel Syndrome • Worse after long rides • Worse on rough terrain • May become permanent

  16. Hand NeuropathyOn the Bike Treatment • Relieve pressure • Pad bars • New gloves (Specialized) • Reposition often • Bars • too far forward • Too low • Too much tilt

  17. Hand NeuropathyMedical Treatment • STM / IASTM • Kinesiotape • Nerve Glide • Guided Injection • NSAIDs • Night splint • Strengthen upper extremity • Surgery

  18. Bursitis Greater Troch Pre-patella and MCL bursa Ischial Tuberosity

  19. Ischial Tuberosity Bursitis • ‘Sits Bones’ sore • Cold weather, early season, time trialing • Modalities – relative rest • On the Bike: • Change saddle • Check saddle height and tilt • New chamois

  20. Greater Trochanteric Bursitis • Proximal ITB Syndrome • Pain with lying on side at night • Manual Modalities • Foam Roller / Stick • Kinesiotape • Guided Injection • On the bike: • Check saddle height • Check cycling form

  21. More Common Issues Patella Femoral ITB Patella Tendon

  22. Patella Femoral Pain Syndrome • Pain under the patella from excessive load • Hill climb • Wind • Big gear • Time trialing • Resistance training

  23. Patella Femoral Pain Syndrome • Tender patella facets • Tender patella compression • Unable to do one legged squat • No effusion

  24. Patella Femoral Pain SyndromeTreatment • Off the Bike • Soft Tissue Techniques • Modalities • SFMA / FMS • Surgery i.e. removal of medial plica • On the Bike • Bike Fit • Check if saddle is too low or forward • Check if cranks are too long • Cadence / Gear Ratio

  25. Knee Pain and Adjustment Location Cause Solution Anterior Saddle too low Raise saddle Saddle too far forward Move saddle back Cranks too long Shorten cranks Posterior Saddle too high Lower saddle Saddle too far back Move forward Medial Toes point out Point in Feet too far apart Move closer Tight pedal tension Lower tension Lateral Toes point in Point out Feet too close Move apart Arnie Baker 1998 Bicycle Medicine

  26. Training Mistakes

  27. Training Stimulus Performance Training Volume/Intensity

  28. Overtraining • Cyclists are notorious • Clinical history is most important • Many blood tests, not very helpful • Exclude organic disease • Profile of Mood States • Performance Testing Decrement • VO2, Lactate, HR, Watts, EPOC, RPE relationship

  29. Laws of Training • The race is won in the off season • Train frequently, all year round • Start gradually and gently • Build a big base • Go hard on the hard days, easy on the easy days • Do not overtrain • Avoid monotony • Train with others • Keep a logbook • Take a break at the end of a season, stay active Adapted from Tim Noakes in the Lore of Running

More Related