Injury is frustrating.
A recurrence of pain on the bike leads many to the conclusion that cycling is its cause. But Aurelie Almeida, director of TheTriTouch, a practice of 13 therapists based around the UK believes that in many cases cycling merely highlights a range off-the-bike issues from sleeping position to poor flexibility that, once addressed, allows riders to return to pain-free cycling. It’s this holistic approach that sees Almeida spend up to 70 per cent of her time on treatments to prevent injury.
Almeida and her team will be addressing your injury complaints in our new series, Ask Aurelie. The most common injuries witnessed by Almeida in her clinic above London’s Sigma Sport are those to knees, lower back, neck and shoulders. Many, she believes, are caused by posture at work and in other areas of life, whether that be driving or regular air travel. “People say cycling must be bad for me because I have never been in such discomfort. I believe the problem existed and cycling has highlighted it,” she says.
“Humans and bicycles can be a great combination. It can make you fitter, healthier, and save you money. Our job is to help people understand that the problem might not be cycling related. We ask them to make changes to their lifestyle. It could be something simple like a sleeping position. If people sleep on their front, their lumber curve will be extended. If you sleep like that for six hours, it may cause problems.”
Born in France to a family practicing kinésithérapie, Almeida trained in France and London. “In the UK there are sports therapists, sports massage, physiotherapists, osteopaths; so many different disciplines. If people have a problem, they don’t know who to turn to. ‘Should I rest, should I see a doctor?’ We encourage an understanding of the different therapies available,” she says.
A bike fit is one of many measures Almeida urges her patients to pursue to prevent injury. “Seventy per cent of what we do is prevention and maintenance but within that I include aches and niggles which could develop into an injury. They could be signs of a repetitive strain injury. For example, if someone is developing knee pain and we notice their quads are getting tight. It will start pressing on the knee cap. We would class that as prevention. The other 30 per cent is injury treatment. We would work with other partners: consultants, doctors and people who are following that process of recovery. All of our treatments are proven but we always work with the full spectrum of people they [the patients] have been working with. Even if they have been working with a physio who is not part of the team, we would definitely work with them.”
Almeida’s TheTriTouch team are frequently commissioned to work at multi-stage cycling events, such as the recent Aedas London 2 Cannes ride, where she treated people who had suffered from the same problem for years. Her day started with 5am massage treatments for the riders, before travelling ahead of the peloton to offer quick checks during their first 15minute break. By the time the riders stopped for a half-hour lunch break, Almeida and her team would have often set up in a hall and been ready to offer assisted stretching, icing, and other treatments. “At bigger events there is always a team of paramedics. People will ask them for painkillers and they will refer them to us. That’s great. It’s much more beneficial for the rider to find a stretch they can always use to make that pain go away rather than a quick fix with pain killers.”
Almeida says she is encouraged by a trend in British medicine and society towards prevention rather than cure, something in which she strongly believes. “Our therapists have a passion for health. We are not heart surgeons, but we can help people feel pain free. People are so grateful. They think it’s magical, but there’s no magic I’m sorry to say! It’s very sound principles with some creative thinking.”
An example of such thinking is the clinic’s free, cycling-specific stretching sessions, held to overcome a perception among her mainly male clients that yoga is a solely feminine pursuit. “We like to think outside the box. We know that yoga is very beneficial but lots of our cyclists are male. We looked at cycling specific stretching sessions. They are free and people come along. It’s usually our patients, but they are open to everybody. It’s mainly a male environment where it doesn’t feel odd to be stretching and becomes part of their routine. They are aiming for a better lifestyle and improving their sport.”
A typical first session will last an hour, with subsequent sessions taking 45 minutes. Consultations involve discussing a patient’s history, and in many cases, recommending a bike fit. “If it’s been a couple of years since their last one, we suggest another. Their riding style will have changed. They will have become more efficient, or some will have taken their bikes apart, put them back together with a different saddle height. These are common problems,” she says.
Later consultations might include ‘deep tissue treatment’ or ultrasound. Neither is recommended to clients who are competing the following day. A sweet ends the session for patients who have been ‘brave’, she jokes. More practically, it will raise the blood sugar level of patients who may been lying down for up to 45 minutes. Patients are asked questions, and if necessary, recommended to see a specialist through a process of GP referral.
Almeida is insistent that age and back problems are not linked. “People assume as they get older they will have back ache, and that’s not right!” she says. Factors other than age are almost always the cause, and can be eradicated by lifestyle changes or treatment. I know 70-year-olds who are in fantastic shape!” she says.
She is convinced that cycling’s star will remain in the ascendency after the Olympics and has witnessed the growth in its popularity from the perspective of one from a culture where the bicycle is king. “When I came here 12 years ago, there were no bikes on the road. I’m from France: it shocked me. Twelve years later, it’s become a massive sport. It’s grown exponentially. It’s fantastic to see. Every Saturday and Sunday morning, there are pelotons of cyclists in all the areas near our clinics. That will continue after the Olympics.”