Kwesi Browne’s crash in the velodrome at the Paris Olympics shone a spotlight on the dangers of high-speed cycling. Thankfully, the 30-year-old track sprinter from Trinidad and Tobago, who appeared to lose consciousness following a collision with another rider, sustained no major injuries according to his team manager, Rowena Williams. In the men’s Madison race on the same day, Team GB’s Ollie Wood was struck from behind by another rider and had to be checked over by the medical team before being allowed to finish the event.
Such incidents are, of course, not common among amateur cyclists. Browne was competing in an Olympic keirin, which is where a group of six riders are towed by a motorbike pacer (known as a derny) for three laps before the derny leaves the track and the racing begins. The final speed achieved by the victor in a keirin can exceed 43mph. At such speeds the chances of sustaining serious injuries during an accident are high.
By contrast, the average amateur cyclist reaches speeds of around 17-18mph on flat ground. Even at these speeds, of course, there is a risk of injury if you have an accident.
Our article on cycling-related pelvic and acetabular fractures covers some of the injuries that can result from high-impact collisions.
What are overuse injuries?
Carrothers Orthopaedics specialises in treating cycling injuries and by far the most common problems we see are not due to traumatic accidents but strains and overuse. We call these overuse injuries and they occur when the joints and soft tissues are repeatedly overloaded. The result is micro-trauma rather than a single acute injury. You may overload your joints, bones and soft tissues (muscles and tendons) by pushing yourself too hard or fast or by failing to rest sufficiently between workouts which means the tissues don’t have time to repair themselves. Poor technique also increases the likelihood of overuse injuries.
Common overuse injuries in cyclists
One of the most common overuse injuries in cyclists is knee pain. If you have pain at the front of the knee around the kneecap (referred to as anterior knee pain) you may be suffering from Cyclist’s Knee (or Patellofemoral Pain Syndrome). This is often caused by a sudden increase in the duration or intensity of training. It may also be due to riding a bike that is not properly set up for you, poor technique or muscle weakness. If your saddle is too low or too far forward, it can cause abnormal movement in the kneecap and your foot is likely to roll inwards. Adjusting your bike will ensure you move symmetrically when pedalling.
Lateral knee pain, which is pain around the outside of your knee, is often the result of Iliotibial Band Syndrome. This occurs when the connective tissue that runs down the outside of the thigh from the hip to the lower knee becomes inflamed. Repeatedly flexing and extending the knee joint can cause rubbing against the lateral condyle which is on the outside of the knee. If the saddle is too high or too far back, the leg and foot will be misaligned and could result in foot pronation and this injury.
Other common cycling injuries include:
- Hip impingement syndrome which is where the femoral head (the ball part of the ball and socket joint) pinches against the acetabulum (the cup part of the joint). This can cause damage to the fibrous labrum surrounding the hip joint or damage to the related cartilage within the hip joint and may cause stiffness and pain, plus an increased risk of arthritis.
- Snapping hip syndrome which is where the iliopsoas tendon slides over the front of the femur. If you have internal snapping hip syndrome you may experience a deep pain in the groin and a snapping sensation when you move your hip in a frog-kick type motion. External snapping hip syndrome causes pain on the outside of the hip.
- Stress fractures.
- Cyclists also commonly experience injuries to the hands (Cyclist’s Palsy), feet and lower back.
Preventing overuse injuries
While it’s not always possible to avoid injuries, there are certain steps you can take to reduce your risk of overuse injuries. By far the most obvious way is to avoid pushing yourself too hard or fast, thereby allowing time to build up your fitness levels. You should warm up and cool down before going out on a ride to allow your muscles time to adjust.
Wearing the right shoes reduces the strain on your feet, ankles and knees, and ensuring your bike is in optimum condition and set up correctly for you will minimise the chances of injury. If your body is in an incorrect position while you are cycling, the joints are forced to work harder to compensate for this misalignment so it’s essential to avoid this. Among the areas to check are saddle design, height and tilt, the pedal systems and any issues where the foot and the pedal come into contact, and the positioning of the handlebars.
Read our article on avoiding cycling injuries for more useful tips.
If you injure yourself while cycling, we can provide a diagnosis and recommend a treatment plan. Contact us for more information.
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