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Five ways to reduce your risk of over-use injury on the bike

Experts in coaching and sports medicine offer five ways to improve your body's resiliency to injury on the bike

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As you plan your approach to the coming season, no doubt you’ve thrown the book at your quest to train better (and smarter) and race faster.

You’ve figured out how to more effectively periodize your training, you’ve vowed to train your sprint (and even determined when and how you’ll do it), maybe you’ve even picked up a Sufferfest DVD to get you through the winter.

But what about that twinge in your knee, or that ache you feel in your lower back as you scale nine-percent climbs, or that soreness in your Achilles tendon after Sunday’s “epic” ride? Left unchecked in January, any one of these seemingly small trouble signs can creep up on you in March to end the season you’ve worked so hard to make your own.

You can’t prevent some injuries, such as those suffered in a crash, but you can take steps to help your body handle all of those early training miles, making it less prone to on-the-bike injuries later in the year.

VeloNews spoke with experts in coaching and sports medicine about what you as a rider can do in the early season to reduce your risk of common overuse injuries later in the year.

1. Get a professional bike fit

In a sport based on such a highly repetitive action — pedaling — the first line of defense against injury is a proper bike fit.

“That is the biggest thing,” said Frank Overton, founder and head coach of FasCat Coaching in Boulder, Colorado. “A good bike fit ensures you’re in the proper position that’s biomechanically not going to cause you any overuse injuries.”

Overton pointed to knee, Achilles tendon, back and neck pains as just some of the common discomforts associated with improper bike fit. Many riders are most prone to overuse injuries during the transition from winter to spring, as the weather improves and six-hour training weeks spent indoors swell to 12 hours or more on the road. Taylor Phinney (BMC Racing) experienced this firsthand in 2011, seeing minor knee inflammation grow into a case of tendinitis that had him out of top racing form for much of his neo-pro season.

“It may feel ok for a week or two, but over time those little micro-tears in that Achilles, or if your saddle’s too low, it doesn’t hurt the first or second time that you ride it, but after a while your knee will start talking back to you,” said Overton.

“The biggest thing is to look for a fitter that has multiple years of experience, has seen the inside of an anatomy textbook, and then probably also has fitting experience with the discipline of cycling you’re training in or competing in,” Overton said, recommending a fitter who “has extensive experience with a good eye, and has access to the fitting technology available.”

2. Strengthen the Hips

Most knee pain on the bike has almost nothing to do with the knee itself.

Burning pain in the knee is often due to inflammation of the iliotibial (IT) band that runs along the outside of the thigh. This and other overuse-related hip and knee pains are due to weakness or tightness of the smaller, deeper muscles of the pelvis, according to Dr. Alex Meininger, an orthopaedic surgeon and sports medicine specialist from Steamboat Springs, Colorado, and  Moab, Utah.

The gluteus minimus and medius, or hip abductors, “play a really important role in aligning the (lower) extremities,” he said.

Strengthening the hip abductors early in the year can help keep the the knees in alignment while pedaling, reducing the risk of race-ending knee pain during the season; stretching the hip abductors can further reduce the risk of IT band inflammation.

“It’s the abductor strength that I think is the focus of pelvic balance,” Meininger said. “If we strengthen or balance [the abductors], you’ll find that those syndromes can be avoided, or you can recover [from them] faster.”

Meininger recommends training the abductors with light weight for three sets of 12-to-15 repetitions at least once weekly for injury prevention, and at least twice weekly for athletes recovering from an injury. Alternating sets of abductor strengthening with sets of core exercises is an efficient way to make use of the short rest period between sets.

3. Lengthen the hamstrings

Picture a bow and arrow.

“If you imagine that the knee is the bow, and the hamstrings are the string,” Meininger said, “You can imagine that the quadriceps and the kneecap have to fight against a tight hamstring… and if you have a really tight hamstring, [the knee] never wants to go quite straight.”

Chronically tight hamstrings, according to Meininger, increase strain on the knee and the long-term workload of the quadriceps, which can lead to thinning of the cartilage within the knee (patellofemoral syndrome) or inflammation of the patellar tendon (patellar tendonitis) below the quadriceps.

Additionally, “the hamstrings are intimately related with the IT band,” he said.

Therefore, the “common overuse syndromes in cyclists, like [frontal] knee pain, patellar tendonitis, patellofemoral syndrome, and IT band syndrome,” Meininger said, “you can conquer all of those with simple things like… abductor strengthening and hamstring stretching.”

4. Close the open chain

Besides muscle tightness, imbalances in strength between the muscles acting on a joint such as the knee can increase stress and wear on that joint, causing pain and increasing the likelihood of an overuse injury.

“The important thing is balance,” said Meininger. “You can’t neglect those hamstrings, so [do] leg curls (for the hamstrings) in addition to your leg extensions (for the quadriceps).”

Meininger recommends performing closed-chain exercises, which incorporate muscles on either side of a joint, rather than open-chain, or isolation exercises — such as leg extensions — which neglect opposing muscles.

“When you do a lunge or a squat, you’re working both the hamstrings and the quads; same thing with the leg press,” he said. “Whereas if you do a leg extension, you are only isolating the quadriceps and neglecting the hamstrings.

“So incorporating some hamstring strengthening and closed-chain exercises will help… avoid imbalance issues, particularly in the off-season for those cyclists doing their weight training program [in January].”

5. Ride, rest, recover

While many riders understand that recovery between workouts is key to building fitness, recovery is also a commonly overlooked injury prevention tool.

Allison Westfahl, strength coach to Garmin-Sharp’s Tom Danielson and co-author of “Tom Danielson’s Core Advantage,” (VeloNews’ parent company, Competitor Group, Inc., also owns publisher VeloPress), relates cycling to skiing to explain the correlation between fatigue and injury.

“A lot of people tear their ACL during skiing… during the last hour that the slopes are open,” she said. “Your muscles are fatigued, you’ve been skiing all day, and you start to take shortcuts… And you start to get sloppy. And the same thing happens on the bike.”

“Over the span of a season, you’re constantly getting broken down, you’re doing five-hour rides, you’re not recovering, you’ve got this little nagging thing, and it used to be every three rides, and now it’s every ride,” Westfahl said. “When one muscle is injured or under-performing, then another muscle next to it has to step in and try to pick up the slack.”

This, she said, is where fatigue can lead to or accelerate an on-the-bike injury.

“It ends up being this whole chain reaction of, if a muscle is not doing the job it’s supposed to, something’s going to get injured,” Westfahl said. “It might be a muscle, it might be a joint, it might be a tendon.”

Westfahl’s advice for using recovery to reduce the risk of injury is simple: “Give yourself a break. Rest.”

Lower extremity illustration and photos of Tom Danielson republished with permission of VeloPress from the new book “Tom Danielson’s Core Advantage: Core Strength for Cycling’s Winning Edge” by Tom Danielson and Allison Westfahl. Danielson photos by Brad Kaminski.