Watch Out for Knee and Shoulder Injuries
Many an avid cyclist
knows firsthand that two of the most common bicycle injuries are
those affecting the knees and shoulders. These maladies can turn
a fantastic outdoor sporting experience into a painful episode
that can result in frustrating periods of being unable to ride
while the body recuperates.
The largest and one
of the most complex joints in the body, the knee is composed of
four bones -- the femur, tibia, fibula and patella. They are held
together by muscles, ligaments (which provide stability to joints)
and tendons (which connect muscles to bones). Essentially, the
knee joint is a hinge joint.
For cyclists, knee
injuries can result from riding too hard for too long (overtraining),
maintaining low rotations per minute, steep climbing without proper
buildup time and poor cycling technique. Regarding the latter,
examples are using too high a gear, incorrect saddle height, shoe
cleats that don't allow the foot to be at its natural angle, lateral
(sideward) movement of the knee during the pedal stroke and cranks
that are too long.
Some disorders that
can affect cyclists' knees include:
patella. The cartilage under the patella (kneecap) degenerates.
Causes are overuse, trauma and too much force on the knee. Symptoms
are knee tenderness and pain that gets worse after sitting for
a long time, when climbing stairs or when rising from a chair.
Some patients sense a grating or grinding when the knee is held
straight out. To prevent this problem, avoid abnormal stress
on the knee and do exercises to keep leg muscles strong.
- Chronic knee pain
(patellofemoral syndrome). When cartilage breaks down it puts
extra pressure on the bones at the knee joint. This results
in significant bone pain and inflammation. Biomechanical problems
(often, side-to-side swinging of the knees while riding) as
well as overtraining are causes. To reduce pain and swelling,
rest, apply ice and use non-steroidal anti-inflammatory drugs
as the first course of action. Once the condition has been stabilized,
the cyclist is advised to undertake an exercise regimen designed
to improve joint mobility and muscle strength.
- Kneecap dislocation
(patellar subluxation). With this condition, the kneecap is
unstable and does not track properly in its groove on the femur
(upper leg bone). Patients complain of tenderness and swelling
around the knee, discomfort when active, pain at the edges of
the kneecap and giving-way of the knee. High-impact injury is
the most common cause. Treatment may include physical therapy,
bracing and taping, and, in some cases, surgery.
- Fractured kneecap.
Fractures can be partial or complete. Attached ligaments and
tendons may also be sprained or torn. Severe pain around the
kneecap, swelling, tenderness, pain when moving the knee in
both directions, problems extending the leg and a deformed appearance
of the knee are symptoms of a fracture. The cause is usually
a direct blow to the front of the kneecap from a fall. Surgery
is required to repair the kneecap.
joint -- the body's most versatile joint since it is able to move
in many directions -- is composed of four joints. The sternoclavicular
joint lies between the sternum and collarbone. The acromioclavicular
is located between the collarbone and the acromiom (shoulder blade).
The glenhumeral is situated between the socket of the scapula
and the humerus (ball). The scapulothoracic sits between the scapula
and the rib cage. Of these, the glemhumeral joint is the must
susceptible to injury because it is dependent solely on non-bony
For cyclists, shoulder
pain usually becomes apparent during longer rides. Placing too
much weight on the hands and riding with straight elbows are the
causes. To reduce the risk of shoulder pain problems, riders are
advised to keep their elbows slightly flexed to stop the shock
of the road from transferring to their arms and upper body.
- Broken collarbone
(clavicle). The collarbone connects the top part of the breastbone
to part of the shoulder blade. Causes are often sports-related
trauma. Symptoms of a break are immediate pain in the area of
the shoulder, a grinding or cracking sound when moving the shoulder
and a snapping sound at the time of the accident. If shortness
of breath, arm pain and progressive swelling occur, the patient
must receive immediate medical attention. Treatment typically
includes placing the arm in a sling, applying ice, use of pain
relievers and avoiding contact activity for about six weeks
after the injury.
- Dislocated shoulder.
The ends of the shoulder bones disconnect or separate and are
therefore forced into an abnormal position. Sudden and severe
pain occurs and the shoulder is immediately immobilized and
temporarily deformed. Numbness and tingling may occur in the
neck and arm and the shoulder may spasm. Trauma is the most
common cause of a dislocation. Treatment involves putting the
shoulder back in place (closed reduction), which almost always
results in immediate reduction of pain. Surgery (open reduction)
may be required if bones will not go back into place correctly.
A sling may be used to stabilize the area. With proper treatment,
the shoulder bones will return to their normal positions. However,
individuals who experience dislocated shoulders are prone to