An Introduction to Common Cycling Injuries

The cycling season is well underway in the Alps and the mountain roads are full of lycra clad enthusiasts. When enjoying the power of the pedals, common cycling injuries are probably far from mind.  Cycling is a wonderful way to exercise, whatever your level or age with a whole host of health benefits. It’s also a great way for skiers to maintain their fitness throughout the summer season.

Cycling seems to be addictive and the number of people taking to road biking appears to be continually on the rise.  However, cycling is a highly repetitive sport and niggles can soon develop into overuse injuries if the cause is not identified and corrected.  Overuse injuries can occur to various areas of the body including but not limited to the knee, back, neck, hand / wrist, calf / achilles region and the foot.

Cyclists are also at risk of traumatic injuries as a result of falls and crashes. As well as bumps, bruises, lacerations, road rash and concussion, fractures commonly occur to the collar bone and scaphoid (small bone at the base of the thumb) as cyclists are at risk of landing on a shoulder or outstretched hand when they come off their bike.

Injury reviews in elite cyclists

A review of studies on injuries in professional cycling was undertaken by Marc Silberman and published in Current Sports Medicine Reports in 2013. Silberman observed the following:

• In a 4-year study of 51 top-level professionals, 43 cyclists experienced 103 injuries, with 50 (48.5%) traumatic injuries and 53 (51.5%) overuse injuries (De Bernardo, Barrios, Vera, Laíz, & Hadala, 2012).
  • Twenty-nine cyclists (67.4%) experienced more than one injury.
  • Twenty-eight fractures occurred.  The clavicle was the bone most commonly affected (11 cases).
  • Only eight cyclists (15.6%) were injury free
  • More than two-thirds of traumatic injuries occurred in the upper extremity
  • Two-thirds of overuse injuries were to the lower extremity
• Another study (Bagherian and Rahnama, 2010) collected data from 2009-2010 which looked at 93 cyclists.
  • This study reported a total of 117 injuries (1.2 injury per cyclist per year).
  • the most common types of injury were:
    • abrasions 63%,
    • contusions 23%
    • strains 8%
  • Most injuries were located in the upper (47%) or lower extremities (47%).  The most common sites for injury were:
    • the knee 18%
    • wrist and palms 16%
    • shoulder and clavicle 16%
    • elbow 14%
    • femur 14%

A more recent study in 2018 (Haeberle et.al) aimed to evaluate the injury epidemiology, operative incidence, and return-to-competition timeline among all elite cyclists participating in the 21-stage Tour de France race over a span of 8 years.  Their findings included that:

• the most common cycling injury leading to withdrawal from the Tour de France was acute fracture, comprising 49% of all injuries.
• the most commonly fractured bone was the clavicle.

I have not recited this data to put people off cycling. Cycling is a challenging sport and I feel that highlighting such data can only help to initiate appropriate injury reduction strategies. This data has been collated from professional cyclists and it clearly shows a high rate of injuries in this population.

Injuries in Amateur Cyclists

To my knowledge, there is very little up to date research on common cycling injuries in amateur cyclists, therefore a lot of my blog series will be based on my own professional experience treating cycling injuries. However, I did come across a study from 2014 (Van der Valt et al.) which collected injury data from 3300 amateur cyclists.  88% of the respondents reported non-traumatic injuries! The areas of pain were :

• back 41%
• hand/wrist 41%
• buttock/perineum 41%
• neck 34%
• knee 33%
• foot/ankle 24%.
• hip 7%,

Reduce your risk of injury

The research that I have mentioned clearly shows very high rates of both overuse and traumatic injuries in both elite and amateur cyclists.  I will be delving further into different areas of injury over the next few weeks.  I will also be discussing how to reduce the risk of injuring different parts of the body.  However, there are general points to consider when aiming to reduce your own risk of injury on a bike.

Bike Set up

One of the easiest ways to reduce your risk of injury is to ensure that you have a good bike set up.  Many riders overlook the importance of having their bikes set to their own individual parameters by a professional bike fitter.  A proper bike set up is not only more efficient for the rider, but it will help reduce the risk of overuse injuries due to excessive and often unnecessary strain on different parts of the body.

Overload

This leads me to my second point which is overload.  In a nutshell, overload is asking significantly more from the muscles (and body in general) than they are conditioned to tolerate. This can occur from one ride or training session or be of an accumulative nature over time.  So many common cycling injuries are as a result of riders not being fit enough or strong enough to withstand the repetitive nature of the sport.  Like any sporting activity, it takes time to condition yourself.

As road biking is an endurance sport, many amateur cyclists try and do too much without being properly conditioned.  If it is not possible to cycle year round, then don’t try and pack hundreds of miles into a weeks holiday if you haven’t been on a bike since the year before!  Consider off the bike conditioning as well.

Know your limits

Finally, it should go without saying (but rarely does) that you should ride within your limits.  Consider your limits from various perspectives including your fitness.  Once undue fatigue sets in you are more likely to loose control.  Ride with people that are a similar ability to you and challenge yourself without putting yourself at unnecessary risk.

Consider the gradients if you are cycling in the mountains, as well as the weather and conditions that you are riding in.  An inexperienced rider maybe asking for trouble if they are on wet, steep roads without the knowledge of how to handle themselves in more challenging conditions.

References