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Biking Injuries

Road cyclists are susceptible to many overuse injuries, so one must take precautions to avoid incorrect form and excessive wear on joints and bones. Cycling also engages a variety of muscle groups, including the quadriceps, calves, psoas and soleus, gluteus, piriformis, abdominals and obliques, so stretching thoroughly after riding when your muscles are warm will help prevent injuries common to cyclists. These injuries include Plantar Fasciitis, ACL and PCL injuries, Knee Bursitis, Iliotibial Band Syndrome (ITB), Patellar Tendonitis, Chondromalacia, Ulnar Neuropathy, Lower Back Pain and Muscle Strains.

Plantar Fasciitis is caused by inflammation of the plantar fascia, a thick band of tissue running from the heel to the toes on the bottom of each foot. This band supports the arch of the foot and is under strain when the foot is bearing weight. When the foot supinates, such as when pedaling a bike, this places additional stress on this fascia, which can result in excruciating pain along the arch of the foot. Also caused by improper arch support, plantar fasciitis can be prevented by using shoes that have good arch support and stretching the feet before cycling. It can take months before patients with plantar fasciitis recover so don’t let this condition ruin your training!

The ACL, or anterior cruciate ligament, works with the PCL, the posterior cruciate ligament, to provide stability during knee flexion and extension. Without the ACL and PCL ligaments, or if the ligaments are not functioning properly, the knee can move sideways, which is painful and inhibits movement. An ACL injury occurs when the ACL tears, either partially or completely, because it is overstretched. ACL injuries are common when an athlete changes direction suddenly, such as when you unclip your shoes to place your foot on the ground to stop your bike. Individuals with an ACL injury are often required to have surgery and use a cast for up to four months. Keeping the calves, quads, hamstrings, inner thighs and hip flexors nicely stretched when warm can help prevent this injury.

Knee Bursitis is a condition that occurs when the bursa, a fluid filled sac that cushions the tendons and ligaments, become irritated and inflamed. This leads to redness and swelling in the area. In some cases the bursa may rupture causing the fluid to leak out and impair the ability of the bursa to cushion. Repetitive flexion and extension of the knee can cause irritation to the bursa on the outside of the knee or on the top of the kneecap. The pain and inflammation will usually subside with rest. Flexibility training and regular stretching of the quads, hamstrings and calves can reduce your chance of this injury.

Iliotibial band syndrome (IT band syndrome) is caused when the iliotibial band, a thick band of tissue that runs down the outside of the leg from the hip to the shin, becomes irritated. The iliotibial band, commonly called the IT band, provides stability for the outside of the knee joint. Therefore, cyclists experiencing IT band syndrome experience pain in the knee joint. Pain often worsens with increased motion and diminishes when the knee is stationary. Treatment for this syndrome can be costly, so prevent your knees and wallet from pain by warming up and then stretching to prevent IT band syndrome. Stretching the IT band, glutes, hamstrings and tendons makes them flexible and more resistant to injury.

Patellar Tendonitis is often characterized by pain surrounding the kneecap, especially during times of intense physical activity. The exact reason patellar tendonitis occurs remains somewhat a mystery, but it is generally accepted that the pain is caused by trama to the tendon surrounding the patella, or kneecap. For cyclists, it is most commonly due to overuse or incorrect pedaling form. The tendon rubs over the bone and causes inflammation that aggravates the condition, leading to a cycle of inflammation and pain. Individuals with patellar tendonitis must reduce intense physical activity; so make sure you stretch so this painful condition won’t keep you off your bike!

Chondromalacia is often confused with patellar tendonitis sine the main symptom, pain surrounding the kneecap, is similar. However, it is damage to the articular cartilage located underneath the patella causes the pain associated with chondromalacia. Pain increases during physical activity and is extremely common for cyclists. Helpful treatments for individuals with chondromalacia include low-impact exercise that strengthens the muscles surrounding the articular cartilage such as swimming and cross-country skiing.  Arthroscopic surgery that cleans out damaged cartilage is a treatment for severe cases.

Ulnar neuropathy, also known as handlebar palsy, is an inflammation of the ulnar nerve that runs through your forearm to your hand. (When you hit your “funny bone” it is the ulnar nerve that causes the uncomfortable feeling all through your arm.) Ulnar neuropathy is characterized by numbness and pain throughout the arm, from the pinky finger up to the elbow. The condition is very common in bicyclists because of the repeated shocks to the hands and arms when bouncing and jostling on changing road surfaces. Treatments include wrist splints and anti-inflammatory medications. Stretching the upper arms, forearms, and wrists can help mitigate your risk for this injury.

Lower Back Pain can be caused by a cyclist maintaining a specific riding position for extended periods, having poor riding posture or being fatigued. The lower back muscles can then become tight and painful. This pain usually subsides with rest and stretching. Pressure on the intervertebral discs, however, may require medical help to relieve.

Muscle Strains are caused by overstretching, overworking a muscle or by overtraining a muscle and not allowing for rest and recovery. The muscle fibers tear causing inflammation and bruising. The resulting pain may lead to the surrounding areas guarding the muscle. Stiffness will also set in due to scarring.  Rest, ice, and anti-inflammatory medication are used to treat muscle strains. To avoid these strains, listen to your body’s limits and keep it flexible and lithe with a good stretching program.

Stretches for Cyclists

Top 6 Stretches (Calf, Quadriceps & Shin, Hamstring, Hip Flexor & Psoas, Gluteus, Low Back)
Top 12 Stretches (Add to the above: Planter Fascia, Shoulder & Triceps, Groin, Piriformis, Tris & Lats, Neck)
Top 18 Stretches (Add to the above: Arms & Shoulder, IT Band, Forward Stretch, Backward Stretch, Chest, Hip & Low Back)

Performing the Stretches Correctly

Arms & Shoulder – Cyclists spend a lot of time hunched over the handlebars. This basic stretch can help loosen a tight shoulder.

Bring your left arm across your body and hold it with your right arm, either above or below the elbow. Pull as close to chest as possible. Repeat on other side.

Backwards Stretch – Your abdomen and back muscles are the support system for your legs as they pedal. This stretch will help elongate the abdominal muscles.

While standing straight, place the palms of your hands against the small of your back. Tighten your buttocks and core and bend backwards, holding your neck straight.

Calf – Stand facing a wall or other support, approximately one leg’s length away.  Lunge forward with right leg, extending arms to allow the wall to balance you. Feet should be about hip width apart, toes forward and left leg extended back with the knee straight and the foot flat on the floor. Push the left heal to the floor and move hips slightly forward. Repeat on the other side.

Chest – Since much of riding spent with the shoulders rolled forward, it is important to counter this with an effective chest stretch.
With right arm extended, place hand on a fixed structure at about shoulder height. Turn your body away from the right arm until gentle stretch occurs in the chest. Note that the upper chest stretch increases with the elbow lower and the lower chest stretch increases with the elbow higher.  Repeat on the other side.

Forward Stretch – This intense stretch is wonderful for the hamstrings and spine, two areas that get taxed heavily when cycling.

Stand upright then bend forward from the waist, keeping your legs taut and your body weight equal on both feet. Try to touch the floor and, if possible, place your palms on the ground. Breathe evenly and try to increase the stretch on each out-breath.

Gluteus Maximus – Stand facing the back of a park bench. Take your left foot and cross it over your right knee, creating a figure-four-type posture. Holding on to the bench with both hands, begin to ease your rear end down until it is parallel to the floor. It should feel like you are sitting in an imaginary chair. If possible, release the left hand from the bench and press your left elbow down on your left knee for a deeper stretch. Release your elbow from your knee, put both hands on the bench, and slowly return to standing position. Release your crossed foot to the floor. Repeat on the other side.

Groin – Stand with your feet as far apart as possible, toes pointing forward. Gradually shift all your weight to your left leg by bending your left knee. Your right leg stays straight. You can increase the starting distance between your feet for a greater stretch. Repeat on the other side.

Hamstring – Like the hip flexors, the hamstrings don’t extend fully while cycling and can be prone to stiffness. The pedaling motion develops short and powerful hamstrings. Unlike running, which lengthens hamstrings, cyclists are prone to tightness in these muscles.

Stand with your left foot on a park bench or low wall, no higher than hip height, with the middle of your shoe on the edge. Lock your left leg straight and bend your right leg slightly. Gently bend forward from the hip bringing your head towards the leg until you feel a gentle stretch in the left hamstring. Repeat on the other side.

Hip Flexor & Psoas – are groups of muscles that bring the legs up toward the trunk. Cyclists often have tight hip flexors because the cycling motion never allows to thigh to fully extend. Keeping the hip flexors limber is essential to avoiding muscle imbalance and post-ride stiffness.

Stand facing a bench or elevated platform, approximately one leg’s length away. Place right foot on bench or platform. Slowly lunge forward by bending right leg. With chest high, straighten hip of left leg by pushing hips forward. Keep torso upright, close to vertical and hips square to the wall. Repeat on the other side.

Hip & Low Back – This great cyclist’s stretch opens up the hips and stretches the muscles of the hips, groin and lower back.

Begin in a forward lunge position then drop your left knee to the ground. Place your right elbow on the inside of your right knee. Press your right elbow gently into your right knee and twist your torso to the left. Reach your left arm behind you until you feel a gentle stretch in your lower back and right groin. Repeat on the other side.

IT Band – The IT Band runs down the side of your leg and helps in balance and control. The section that affects cyclists is between the hip and knee.

Standing near a wall for support, cross your right leg in front of your left leg. Extend your left arm overhead and reach to your right side. Put your right hand on your hip and push slightly to move your hips to the left until you feel a gentle stretch along the left side of your torso, hip, upper thigh and knee. Repeat on the other side.

Lower Back – With your feet shoulder width apart and pointed outwards to about a 15 degree angle and your heels on the ground, bend your knees and squat. Then lean slightly forward and try to lower the backside as close to the heels as possible until you feel a gentle stretch in the lower back.

Neck – Checking for traffic and other riders behind you is where the neck muscles come into play.

Bend your head forward and slightly to the right. With your right hand, gently pull your head downward. You’ll feel a nice, easy stretch along the back left side of your neck. Repeat on other side.

Piriformis – Using a wall or bench for support, stand on your left leg, cross your right leg over and rest it just above your left knee creating a figure-four-type posture. Keeping your back very straight, do a one legged squat until you feel a gentile stretch of the piriformis muscle on the left side. Repeat on the other side.

Planter fascia – Squat down with your left foot in front of your right foot and your hands on the ground for balance. Keeping your toes on the ground and arching your right foot, slowly move your body weight forward until you feel a stretch to the arch of the right foot. Repeat on the other side.

Quadriceps & Shin – The quads are the biggest cycling muscle, and deserve a very slow stretch. Be careful not to pull too hard too fast.

Near a wall or bench, stand with your feet hip width apart. Bend your left knee and grasp the top of your left foot with your left hand. Bring your heel as close as possible to the left side of your buttocks, feeling a gentle stretch of the quad and shin. Keep your back straight, your left knee vertically in alignment with your left hip and horizontally in alignment with your right knee. Repeat on the other side.

Shoulder & Triceps – Extend your right arm straight up in the air. Bend arm at the elbow, pointing the elbow towards the sky and letting the forearm fall behind your back. Take your left hand and grab your right elbow.  Pull the elbow behind your head feeling a gentle stretch. Repeat on the other side.

Triceps & Latissimus Dorsi – Balance on the bike with weight resting on the arms. Let the head drop deeply between the shoulder blades to create a powerful stretch in the triceps and lats. Pulling down with the arms increases the stretch further.

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