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Overuse Injuries| Bicycling

This post was written by etoims on June 1, 2012
Posted Under: Uncategorized

Overuse injuries are common in bicycling.  In a study of professional elite road cyclists (94%, 109 of 116 cyclists) had overuse injuries experienced in the previous 12 months. A total of 94 injuries were registered involving the back, knee and legs.

Lower back pain (58%) and anterior knee pain (57%) are the most prevalent overuse injuries, with knee injuries most likely to cause time loss and lower back pain causing the highest rates of functional impairment and medical attention causing even missing the chance to compete.

If one already has chronic pain, the problem is compounded from the inability of pelvic girdle muscles and thigh muscles to contract and relax in coordination.  The repetitive motion activities that actively engage in eccentric (lengthening) contractions cause most damage to muscles.  Since the hip and knee are consistently flexed, lengthening injuries primarily involve the gluteus maximus, adductor magnus, hamstrings, tensor fascia lata, quadriceps, ankle dorsiflexors and calf muscles.

Additionally entire trunk and neck muscles are kept flexed in a position of the eccentric contractions.  Eccentric contractions of the muscles of the shoulder girdle also occur causing pain not only of the trunk and neck but also the upper limbs.

Not uncommonly entrapment neuropathies also occur due to pressure on the wrist and hand with injuries to the deep ulnar nerve and/or median nerve producing tingling and numbness in the fingers.  If significant damage occurs, there can be even be atrophy of the hand muscles.  Similarly, injury to the peroneal nerves at the knee level or ankle level can occur.

The incidence and magnitude of back pain in cyclists can be reduced by appropriate adjustment of the angle of the saddle.

Often it is necessary to relieve the rider’s extended position by using handlebars with less drop, using a stem with a shorter extension, raising the stem, or moving the seat forward. Changing hand positions on the handlebars frequently, riding with the elbows “unlocked,” varying head position, using padded gloves and handlebars, and riding on wider tires all reduce the effects of road shock.

Often, delayed responses to pain development will occur depending on physical reserves.  Those with little to no physical reserves will have pain very soon after exercise involved with the cycling activities.  The degree of preexistent tightness of the muscles determine the onset of pain aggravation after cessation of the activity.

Treatments involve pain control relating to the primary neuropathic pain problem with additional supportive measures that facilitate healing of muscles and nerves.

Muscles that are in intense pain are so stiff and tight that stimulation of the trigger points with eToims cannot be performed since trigger points cannot be found.  Those muscles suffering from ischemic myofascial pain however will respond with large force twitches to eToims with good response to treatment.  The response to trigger point treatments with eToims will therefore depend on the electrical reactivity of the trigger points.

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