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Common Overuse Injuries - Pt 1

14 June 2010

When it comes to overuse injuries the best intervention is EARLY INTERVENTION or if you can: prevention! Please consult one of our physiotherapists should you be experiencing any of the above complaints. You can find us at www.centreforsportsmedicine.co.za

The following article is the first in a two part series which highlights the most common chronic or overuse injuries associated with mountain biking. It provides a brief overview of the prevention and management of these injuries.

Recent research lists the most common anatomical sites for overuse injuries associated with cycling as; neck (48.8%), knee (41.7 %), buttock (36.1%), hands (31.1%) and lower back (30.3%).

When managing chronic injuries it is always vital to precisely identify the anatomical structure at fault and also to identify any risk factors that predispose one to the injury. Risk factors will be intrinsic (cyclist- any postural problems, muscle imbalances etc.) and extrinsic (bicycle set up/ bicycle frame and environment factors). Treatment is therefore always two fold; reducing the symptoms (physiotherapy, medication etc.) and addressing the underlying causes for the injury (bike set up, correcting the cyclists muscle imbalances, correct training errors etc).

NECK PAIN

Neck pain is usually caused by muscle spasm as a result of the sustained hyperextended position of the neck during cycling. The constant jarring associated with off road cycling also can cause microtrauma to the joints and ligaments of the cervical spine, resulting in increased muscle spasm and pain.

Predisposing factors:

Weak upper back and shoulder muscles
"Dropped" handlebars
Raised saddle
"Heavy" helmet
Sustained poor posture

Management:

Treatment of muscle spasm through localised physiotherapy treatment (soft tissue and cervical joint mobilisation)
Addressing the bicycle set up
Strengthening the upper back and shoulder muscles
Correcting the cyclist's posture and strengthening the stabilisers at the neck

Should one experience radiating pain down the upper limb or severe headaches, please consult your physiotherapist.

LOWER BACK PAIN

Lower back pain is a common complaint due to the sustained flexed (bent) position of the spine whilst cycling. The added jarring of off road cycling is another causative factor. Back pain can be related to disc compression or traction on the spinal joints which can cause ligament or muscle strain. It is vital that one's lower back pain is evaluated by a medical professional to identify the anatomical cause of pain, as treatments may vary. Clinical investigations such as an X-ray may also be required. Should you be experiencing pins and needles or weakness in the lower limbs please consult your physiotherapist as soon as possible.

Prevention:

Bicycle set up (adjusting saddle height, saddle position and angle as well as handlebar positioning)
Strengthen your back and abdominal stabilisers (core muscles)
Improve flexibility at the spine and limbs

www.centreforsportsmedicine.co.za

Tarryn Graham BSc Physiotherapy (Stell)
Physiotherapist
Centre for Sports Medicine, Umhlanga

031 5605557 or info@centreforsportsmedicine.co.za

6 comment(s)

Charly

22 August 2010 @ 09:11 AM

Thanks useful article, could you advise on the best exercises to strengthen the upper back and shoulders.

Melanie Roux

20 September 2010 @ 09:14 PM

i get very bad abdominal pain after a 70km ride. i am fine on the 40km mtb rides, not sure what to do.

Charmaine

21 September 2010 @ 11:47 AM

I have only recently started getting lower back pain on my right hip, whilst cycling I get a burning sensation on that on particular spot. Can you make any suggestion for me.

Wayne Holroyd - Centre for Sports Medicine Physio

24 September 2010 @ 11:34 PM

Hi Charly
There are no "best exercises" as such. You should be performing a combination of exercises that strengthen the muscles at the front and back of the shoulders, including the muscles around the shoulder blades. What is more important, is that you execute the exercises with good form. Performing shoulder exercises poorly can lead to injury. Get your gym instructor to show you, or make an appointment with a biokineticist.

If you are suffering from an injury, it is best to seek professional advice from a sports doctor, physio or biokineticist rather than trying to randomly strengthen muscles on your own. Shoulder problems can be quite technical and will definately heal quicker if diagnosed correctly and the appropriate rehabilitation prescribed.

Wayne Holroyd - Centre for Sports Medicine Physio

24 September 2010 @ 11:41 PM

Hi Charmaine
The symptoms you describe could be spinal, muscular or neural in origin. With the information that you have given, it is impossible for me to give any specific advice. Please feel free to contact me on the Centre for Sports Medicine details shown above so I can help you.

In the interim, you can try stretching your lower back, buttock and outer hip muscles as this may well give some relief.

Wayne Holroyd - Centre for Sports Medicine Physio

24 September 2010 @ 11:48 PM

Hi Melanie
Your abdominal pain may be from muscle cramping which could be as a result of fatigue, or gasro-intestinal as a result of your fluid or food intake prior to or during the race. Try using different rehydration solutions and reducing the amount of solid food you eat prior to or during the ride. Should your pain persist or get worse, please consult your doctor or a sports physician.