Whether you are a competitive cyclist or enjoy occasional recreational bicycling, you likely have experienced a few general aches and pains or maybe even some specific injuries that are common to cycling. I’d like to discuss some common cycling injuries that we, as physiotherapists, see in the clinic and offer a few tips to help prevent them.
To help understand the common musculoskeletal injuries in cyclists, let’s take a look at the postural alignment and biomechanics of the body during cycling and see what that means for the involved muscles and joints.
When you are on the bike, you are leaning forward with your hips flexed and your back rounded forward. This shortens the ‘hip flexor’ muscles at the front of the hip. The iliopsoas muscle is one of the main hip flexors and it is attached to the front part of your hip and it extends all the way up to the front part of your pelvis and even has attachments to your lumbar spine (lower back bones). Then you add the repetitive pedalling motion that cycling requires, and you contribute even more to the tightened hip flexors that are already shortened in this position to begin with. This is one of the most important muscles for cyclists to keep lengthened by active and passive stretching techniques.
The iliotibial band (ITB) runs down the outside part of your upper thigh and continually develops tension each time you straighten your knee as you press down into the pedal. The more resistance, or the steeper the hill, the more tension your ITB develops. The ITB has insertions to the outside part of your knee. Many cyclists that experience knee pain may find that the main culprit is a tight ITB. Therefore, regular ITB stretching and massaging are important.
Continual forward trunk flexion places unfavourable strain on the spine, causing low back pain in many cyclists. Maintaining ‘true’ core strength (as discussed in previous articles) is key in preventing low back pain, and also ensuring your hip musculature remains elongated (especially hip flexors and hamstrings) with regular stretching. Performing the opposite motion, such as back extensions (lying on your stomach and gently using your hands to press up as you extend your spine) can be beneficial after cycling.
Cyclists commonly complain of neck and shoulder pain. As you ride, you are reaching forward to grasp the handle bars, so your shoulders are not only flexed forward, but they are also rounded inwards. In order to see where you are going, your neck has to then extend back and your chin slightly pokes out forward. You can imagine the strain that this poor postural position places on your neck and shoulder joints and the muscles that surround them even just for short periods of time. So imagine the strain when you ride for extended periods. Anything even over 15 minutes can be considered ‘extended’! There are several ways to combat the effects of this poor upper body postural alignment: 1) Regularly stretch the muscles that are being shortened: pectorals (chest and front of shoulders), neck extensors (at back of neck). 2) Ensure that the muscles that are opposite to the shortened ones are strong and stable, which will contribute to better overall muscle balance (rotator cuff, muscles that stabilize the shoulder blade, certain muscles of the upper and mid back). 3) Cross train with activities that require different postures and different muscle groups (skating, inline skating, swimming backstroke, walking). Unfortunately, many of our activities require our arms to be consistently in front of us, working for us. This consistently contributes to the muscle imbalance already there. Activities like Yoga, Pilates, dance, or an individualized workout routine by a professional, can help place your body in positions and move in ways that you may not necessarily be exposed to on a regular basis, therefore helping maintain a healthy muscular balance thus preventing risk of injuries.
Lastly, ensure your bike is right for you. Proper seat and handle bar height are essential for a healthy ride!
This article was not intended to diagnose or treat. Please consult your health care professional.
Shelly Prosko is a Registered Physiotherapist and Yoga Therapist at Sun City Physiotherapy Winfield. She can be contacted at the Winfield clinic (250.766.2544) or by email at winfield@suncityphysiotherapy.com.