June is a great month for cycling. The summer is here, the Tour de France is just around the corner, and Bike Week – an annual campaign that has been running since 1923, would you believe – hits the high road between 9 and 17 June: you can view some of the events on offer here, in case you fancy getting involved.
Personally, I love cycling. I like the sense of fresh air and freedom you get from jumping on a bike, and I have many happy memories of tackling the South Downs Way on spare weekends. Many of our patients here at Chris Bailey Orthopaedics are keen amateur and pro cyclists, too. And with good reason. Cycling is great for cardiovascular health, with the added benefit of being low-impact on knee joints.
As with any sporting pastime, however, it does carry the potential for injury. With that in mind, I’ve compiled a quick list of the most common cycling injuries – and how we can be better prepared to avoid them.
‘Avoid accidents’ sounds like a no-brainer, but working in orthopaedics very quickly gives you a sense of how crashes can come about. Road-related incidents happen more often than any of us would like: over 18,000 cyclists were involved in reported road accidents in the UK in 2016. From our experience in clinic, one of the most common bicycle-related injuries is a clavicle fracture, or broken collar bone. These are typically caused by high-impact falls, when sudden pressure travels down the outstretched arm with such force that it cracks, or breaks, the uppermost bone in the shoulder. Treatments (click on Shoulder Trauma Surgery) range from nonsurgical (arm supports and pain relief, for example, as the damage heals naturally) to surgical (plates or pins can be used to correct misalignment). Unfortunately there’s no catch-all solution to avoiding every possibility of an accident in the saddle! So the important take-home point is to be self-conscious about your safety before you hit the road. Slow and steady is better than quick and careless.
Don’t rush in
Talking of slow and steady… this is good practise when it comes to exercise generally. Many knee and shoulder injuries – indeed injuries of all kinds – happen through a sudden increase in explosive activity. In a cycling context, that might be a sprint up a hill when you usually ride on the flat. Or perhaps something less obviously explosive but equally wearing: a long-distance charity event after little or no preparation, say. Muscles and tissues that are unaccustomed to being used in daily life are more prone to damage when you put them under unexpected pressure. So the key thing is to build up little by little, giving your body time to accommodate itself to new forms of exercise. Sportspeople sometimes advocate the ‘10-percent Rule’, which suggests that we never increase our weekly mileage by more than 10 percent over the previous week. The principle behind this is sound.
Get it fixed
Sadly, I can’t claim to be an expert in the finer points of bicycle calibration. (Though I sometimes wish I was when my bicycle chain snaps!) But I do know from experience with patients that cycling posture makes a big difference to injury prevention. Poor saddle positioning is a key culprit when it comes to knee and shoulder issues. If your saddle is set too high, for example, your body will be hunched towards the handlebars, throwing your bodyweight further forward across the bike. This could predispose you to a shoulder problem, such as an impingement. Similarly, incorrect cleat positioning on the pedals may also cause knee problems. Pain on the medial (inner) side of the knee could indicate damage to the cartilage or meniscus, for example, and badly positioned cleats might cause or exacerbate that issue. For this reason we often suggest our patients visit a good bike shop for expert, individually-tailored advice on bike set-up. It’s time and money well spent.
Make it mixed
A final piece of advice for injury-avoidance is to diversify your exercise routines. If you’re only ever doing one form of sporting activity, you are repetitively loading your joints and muscles in the same way each time. That can predispose you to overuse injuries. So it’s a good idea to build in some variety. Runners often recommend outdoor routes rather than treadmill-only exercise, for instance; on a treadmill, your muscles are being loaded in a similar way each time, whereas a road or trail route encourages your body to adapt to uneven surfaces. To a degree, that advice could be applied to cycling too. In an ideal world, we should all be prioritising different kinds of exercise. Gym work. Cardiovascular work. Gentle runs and cycle rides. Variety, as someone might have said, is the spice of sporting life…