Nothing compares to the simple pleasure of riding a bike.
John F. Kennedy (1917–1963)
This chapter outlines the relationship between biomechanics and injury for a number of sports—cycling, cricket fast bowling, golf, rowing, swimming and tennis.
The demands and injury risks differ greatly across the various disciplines of cycling. Traditional road cycling involves long-duration submaximal effort, and places stresses on the body due to monotonous loading and maintenance of static postures for extended periods. In contrast, BMX and track sprint cycling require maximal effort over a short duration. Riders from these disciplines are more likely to suffer injuries related to strength and power training, such as weightlifting and plyometrics. The various subdisciplines of mountain biking encompass a wide range of demands, and both acute and overuse injuries are common. This section focuses on the main overuse injury problems affecting cyclists across all disciplines—knee and low back pain.
Relationship between risk factors and loading
Overuse injuries in cycling are commonly blamed on extrinsic factors such as bike position or shoe and pedal setup, as well as intrinsic factors such as anatomical anomalies, poor cycling technique, or reduced neuromuscular control. These factors may certainly be important due to the repetitive, uniplanar nature of the sport. However, it is important to recognise that even among top professionals, a wide variation of anatomy, techniques, and bike setups is normally well-tolerated without injury occurring. In almost all cases of cycling-related overuse injury, symptom onset can be linked to a mismanagement of training and racing loads. Cyclists are most likely to develop injury following a rapid increase in load, such as when pre-season training is resumed after a winter break, as well as during intense periods of the season. When injuries are apparently ‘caused’ by a change in equipment, it is normally because the change was made at an inappropriate time of the season when the cyclist was already close to their limit of load tolerance.
The key to successful management of cycling injuries, therefore, is load management. The clinician, cyclist and coach should establish the volume, intensity and frequency of cycling that the rider can tolerate and create a systematic plan to increase these parameters over time. Wherever possible, loading should be quantified using a power meter and training software should be used to monitor the acute and chronic training load during rehabilitation (Chapter 12).
Once an appropriate training plan is established, intrinsic and extrinsic risk factors should be assessed. The following section covers biomechanical factors thought to be associated with the most common cycling injuries. It is important to note that there is little high-level evidence in the field of cycling injuries, with current practice largely based on indirect evidence and expert opinion. It is therefore necessary to take a trial-and-error ...