Cycling injuries: to hit the brakes or accelerate getting treatment?

Cycling injuries affecting both professional and amateur cyclists mostly occur in the same way: overuse of muscles, repetitive strain injury (RSI), or a result of falls or crashes. Leading consultant orthopaedic and sports medicine surgeon Mr Simon Moyes discusses the causes of common injuries all cyclists are vulnerable to sustaining. The London-based surgeon also explains how and when these injuries need to be treated.

How do cycling-related injuries occur?

Injuries to cyclists, whether professional or recreational, often happen for the same reasons: overusing muscles, RSI, and various musculoskeletal injuries as a result of falling or crashing, such as fractures, sprains, torn ligaments, or torn tendons. Posture and bike setup may also contribute. Ensuring the correct positioning of the saddle, cleats, and handlebars can reduce pain experienced in the calves, feet, neck, and back.

Thankfully, many cycling-related injuries are easily treated, if diagnosed promptly. Getting an injury checked by a doctor without delay can prevent the injury from progressing and potentially needing surgery if left untreated. Once diagnosed, the issue can be treated accordingly. Treatment varies from simply adjusting the bike to steroid injections or even surgery. 

What common injuries can result from cycling?

Knee injuries: The repeated pedalling motion puts stress on the knee cap. Swelling, inflammation, and pain can be caused by bones rubbing against each other and the pinching of the tissue between them. Knee tendon injuries can result in swelling, pain, and weakness. It is important to note that knee pain might be a result of another condition, such as arthritis.

Shoulder injuries: Commonly occurring as a result of falls, with an outstretched arm or falling directly onto the shoulder, causes a range of injuries. These include fractured collarbone, joint damage to for example the acromioclavicular joint, rotor cuff injuries, or torn cartilage. Each of these injuries requires specific treatment. For this reason, an accurate diagnosis of shoulder pain is important as most conditions have the same symptoms, such as pain, stiffness, weak muscles, and tingling or numb fingers.

Neck pain: Most cyclists (60%) suffer neck pain, due to the extra strain put on the neck and upper back muscles when cycling. Chronic or acute neck pain needs to be examined to see if the vertebrae or discs in the neck have been damaged.

Back pain: When cycling, the pressure on the soft discs between vertebrae increases which can irritate the nerves. The lower back can be affected by tight hamstrings or hip flexors, even before cycling, but the activity will exhaust the muscles and cause them to seize up.

Achilles tendonitis: This affects the tendon that connects the muscle of the calf to the ankle joint. Stress on the calf muscle can cause tiny tears in the tendon. The motion of pedalling can lead to Achilles tendonitis.

Foot numbness: Not just caused by cold weather, numb feet can be a sign of something more serious, like compressed nerves. Injuries causing foot numbness may be caused by poor bike fit or tight-fitting shoes. It is important to get the pain diagnosed before treating it.

How and when should these injuries be treated?

Treatments are injury-specific. That is why it is important to have them diagnosed by experienced sports medicine professionals who can identify and treat the problem correctly. Along with medical treatment, bike fit should be assessed to prevent reoccurring injuries.

Some pain is relieved with rest, icing, and anti-inflammatories. If the pain lasts longer than a few days or reoccurs, you should book a consultation with a medical professional.

MRI scans, for knee and neck injuries, or CT scans, for shoulder injuries, may be done to determine the cause or the severity. Physiotherapy is a common treatment that helps strengthen muscles and improve flexibility, preventing injury from reoccurring. Injuries caused by impact, for example, are often resolved with physiotherapy and in extreme cases, surgery is needed.

For more serious conditions, like osteoarthritis, vertebrae damage, or disc damage, treatment may require injections or surgery to prevent the injury from worsening. If certain injuries are left untreated, they can lead to arthritis, sciatica, or disc herniation.

It is vital that the injury is correctly diagnosed and is dealt with quickly to prevent more serious medical conditions in the future.

If you are suffering from a bike-related injury and would like to book a consultation with Mr Simon Moyes, don’t hesitate to do so directly from his Top Doctor’s profile.