One of the best things about cycling, when you compare it to other sports that is, is that your bike supports your body weight at all times and you are therefore less prone to injury than you would be if you were say, running or playing squash.
Of course that’s not to say cyclists all lead a completely injury free existence and it’s useful to have some idea of how to treat injuries if and when they do occur.
Cycling injuries can be neatly sorted into two distinct categories: intrinsic (overuse) and extrinsic (from crashing). Fortunately, for most of us at least, crashing is a pretty rare occurrence and the injuries that occur when you do crash are pretty easy to treat, mostly being limited to cuts and bruises. If you’re unlucky enough to break a bone in a crash, it’s more than likely to be your collarbone: thanks to its position it normally takes the brunt of any impact to the shoulder.
Preventing extrinsic injuries from occurring is largely down to luck but there are some precautions you can take; proper bike maintenance, bike-handling skills, obeying the rules of bunch riding, and of course common sense will all help minimise your potential for crashing.
Overuse injuries are a totally different kettle of fish, being both more difficult to diagnose, more difficult to treat, and very often you can’t be sure that the problem is “cured” for good.
Andy Knowles, a physiotherapist with a background in bike racing comments: “Overuse injuries are caused by tiny little tears, or microtrauma, occurring in a tissue like a ligament or a tendon every time an activity is performed. Eventually all these tears add up and the tissue can no longer do its job.”
The most common reason for developing an overuse injury is riding beyond your current ability. Obviously if you want to get fitter, you have to train harder: the key is not to train too much harder, too quickly. If you’re used to riding six or seven hours a week and you then start riding 15 hours per week, you’re putting yourself in a prime position to develop an overuse injury.
Other causes of overuse injuries include: position on the bike – be that poor alignment of cleats, too high/low saddle or saddle too far back/forward; other activities such as running or heavy weight work in the gym; body type – e.g. leg length discrepancies.
Overuse injuries come in a number of different forms. Knee injuries tend to start life as a niggling pain when you’re riding and this is normally caused by mild tendonitis, that is, inflammation of the tendons. In the hand, compression of the ulnar nerve can cause numbness where the hand is on the handlebar, and for chaps, pressure on the pudendal nerve from the saddle can be of detriment to your performance in the bedroom, as well as on the road.
Knowles says that “the first symptom of an overuse injury is inflammation of the damaged tissue (tendonitis in the case of a tendon) and if it is not treated then rupture could occur. Often cyclists use anti-inflammatory products like Ibuprofen as ‘it just gets me through training’. This isn’t too bad as reducing the swelling of a structure like a tendon often allows it to heal before the microtrauma occurs again. But if the pain becomes progressively worse then you should seek professional advice as the road back from a rupture is a long one.”
A number of different principles have to come into play when treating an overuse injury – not only do you want to get rid of the symptoms, but you don’t want them to return again. Andy Knowles says: “The basic treatment for an overuse injury is to first work out which structure is damaged and then provide it with the best environment for healing. More often than not this involves reducing the swelling with ice and anti-inflammatories and then stretching the damaged tissue in all the directions that it will be stretched during normal use, therefore providing the stimulus for it to grow back in the correct way. Following this it may be necessary to strengthen any surrounding muscles as they may have become weak if the injury has meant that they haven’t been used for a while.
“Finally the underlying cause needs to be looked at, for example position on the bike. If there’s nothing to blame other than too much training, then the only answer is to keep strengthening the structure until it can handle the stresses placed upon it by cycling, preferably under the supervision of a qualified physiotherapist with specific knowledge of sports.”
If you decide to look closely at the fit of your bike, especially if you don’t conform to a completely “standard” body shape, one of the shrewdest investments you can make is to visit a bike shop with a proper frame fitting device and an experienced technician who will be able to advise you on how to modify your bike to give you the perfect fit.
So, if you have a niggling pain, don’t ignore it or wish it away with painkillers, look into what’s causing the problem or you risk doing yourself longer-term damage.