April 2, 2012
Common Cycling Injuries and Management
By: Justin Welch, MSPT
With the start of April upon us and our snow pack rapidly dwindling there is a lot of talk about summer activities around Summit County. There has even been some street cleaning in the county, freeing up even more possibilities for outdoor activities, especially cycling. It has been estimated that 33 million Americans ride a bicycle every year. Many cyclists will suffer from an overuse injury at some time, 40%-60% of riders will experience knee pain and 30%-70% will experience neck or back pain.
The most common types of injuries during cycling are overuse injuries, which come from repetitive loading of the bone, joint or soft tissues without enough recovery time between workouts. The most common injury site is the knee but the back and hip are also prone to injury for cyclists. There are many different ways to avoid these injuries including proper bike fitting, proper riding style, stretching to maintain muscle flexibility, strength training to maintain muscle balance.
The knee pain encountered by cyclists is usually on the front of the knee. This happens because of the hard work of the quadriceps muscle during the down-stroke of pedaling. This pain could be related to tendonitis, irritation of the contact between the kneecap and the end of the femur or even friction of tissues around the knee. Some of the things that cause knee pain in cycling are a cadence that is too low, a seat that is too low or too far forward. Physical therapy treatment can be beneficial to correct poor flexibility of the quadriceps or weakness of the hip muscles or hamstrings.
Other common injuries to cyclists are from the ITB (Illiotibial Band) rubbing over parts of the bones in the leg. The ITB is a fibrous structure that runs from the outside of the hip down and past the knee. This structure can rub on parts of the bone and cause pain, called bursitis, on the side of the knee or side of the hip. This issue is often corrected again by physical therapy treatments for stretching and bicycle modifications that may include altering seat height or even modifications to the shoe.
Cyclists can also be prone to experiencing pain and tightness across the low back because of the long periods of time spent in bend-over positions. These types of tightness problems can be related to muscles or joints. As with the other types of injuries presented physical therapy treatment involving manual stretching techniques and home exercises can be very beneficial. A study has been conducted examining factors likely to help reduce the occurrence of back pain. The study suggests that saddle angle can dramatically reduce back pain in 70% of those observed. They also propose different angles for town bikes, mountain bikes and racing bikes. Every cyclist is different and it may take an individual program to keep us all in the saddle.
March 22, 2012
Ibuprophen Can Help With Altitude Sickness
A recent study published in the Annals Of Emergency Medicine suggests that using ibuprophen before and during high altitude activities can help to decrease your risk of altitude sickness. In the study 86 subjects were randomized to either an ibuprophen group or a placebo group. The subjects then spent 2 days hiking in the White Mountains of California, reaching altitudes of up to 12,570'. About 43% of subjects taking ibuprophen had symptoms of altitude sickness (nausea, vomitting, fatigue) compared to 69% of those in the placebo group. This may be a reasonable addition to your routine the next time you travel to altitude such as Breckenrige, CO. As with any medication regimine you should check with your doctor to be sure ibuprophen is a safe and appropriate drug for you.
Justin Welch, MSPT
February 6, 2012
Achilles Tendons, A Weak Link For Over 2000 Years
By Justin Welch, MSPT
The term Achilles tendon comes from Greek mythology. Achilles was a hero of the Trojan War who was invincible as a result of his father dipping him in the river Styx. When his father dipped him, however, he held Achilles by his heel, giving him this one weakness that we still refer to.
To this day Achilles tendonitis has been affecting adults both young and old from athletic to sedentary. Studies have reported the incidence of Achilles tendonitis between adults aged 21-60 to be about 2.35 per 1,000. Thirty-five percent of these cases were related to sports activity and 52% of runners will experience this over their lifetime.
The Achilles tendon is the rope-like tissue just above the heel. It is the common attachment of the two muscles of the calf to heel. The jobs of this muscle complex are to propel us during walking, running, sprinting and jumping as well as slowing down our momentum as we go down stairs or lower into a squat. Most injuries to the Achilles tendon are suffered slowly over time because of gradual and repetitive over loading. It is possible to have a sudden strain to the Achilles, but this is less common.
Chronic Achilles tendonitis is difficult to heal because most of these injuries are overuse injuries. Most tissues follow a 3 step healing process that begins with rest and slow return to activity. When this tendon is injured from overuse it does not follow the normal healing pattern most tissues follow, and therefore it needs to be treated differently. This fact usually results in Achilles tendonitis lasting more than 3 months, which is considered chronic.
A review of the current literature in the Canadian Medical Association Journal has reported that the only strong evidence for treatment of chronic Achilles tendonitis is heavy eccentric loading exercises for the Achilles tendon and its associated muscles. In one of these studies there was a 60% success rate in the exercise group and only a 24% success rate in the “wait and see” control group. In another study 82% of the subjects had returned to their previous activity level within 12 weeks of starting the exercise program. Some studies have also shown orthotics and taping techniques to be helpful for short-term (4 week) return to some activity.
The types of exercise programs described should be progressed gradually and monitored for signs and symptoms of increased pain and tendon irritation. Eccentric loading puts a great deal of strain on the tendon and these programs should be monitored by a therapist to avoid further injury. Here at Breckenridge Physical Therapy we are trained in the complexities of tissue healing and the appropriate progressions of tendon loading from very little to full running and jumping activities. We also are able to provide orthotic support to correct poor alignment and other modalities that may help to decrease initial pain and get you back to activity as soon as possible.
© Copyright 2012 Summit Daily News and summitdaily.com