Posted on April 16, 2015 by Jenny Cromack
This article will discuss injury prevention and management for cyclists whilst providing understanding of how the muscular system works during cycling.
Phases of Cycling To learn how to modify things to reduce pain or prevent injury during cycling we need to understand which muscles are working and at which points during our pedal strokes they are working.
Power Phase: This phase is the pedal stroke from top to bottom, 12 o’clock to 6 o’clock if you like. From the top the gluteus maximus, hip extensor, initiate this power phase driving the foot and leg down and backwards. This part of the power phase runs through to 3 o’clock, and this is when the quadriceps, knee extensors, take over. They drive the foot and pedal further towards the bottom portion of the power phase. The last portion of the power phase (5-6 o’clock) is finished by the gastrocnemius and soleus, calf muscles or plantar flexors. This combination of the gluteus maximus, quadriceps, gastrocnemius and soleus create a powerful drive down and back, through hip and knee extension with plantar flexion.
Recovery Phase: This phase is the pedal stroke from bottom to top, often seen as a more passive phase. However, muscles are actively working to keep the stroke efficient and prepare the lower limbs for the next cycle of power phases. From 6 to 8 o’clock the tibialis anterior lifts the toes towards the shin, dorsiflexion. At the next point (8 o’clock), the hamstrings, knee flexors, take over and pull the heel, and thus the pedal, up towards the buttocks. The last portion of the recovery phase is finished off by the high-hip flexors, the psoas and the iliacus (ilipsoas). Again the efficient co-ordination of these muscles will determine the effectiveness of your cycling. The stronger and more efficient these muscles are, and the better their rate and timing of firing, the more you will get out of power and recovery phase in terms of performance and injury prevention.
Common Cycling Injury Complaints
Some of the more common injury complaints I have experienced with cyclists is pain or altered sensations in the hands, arms or shoulders. Pain in and around the knee and knee cap (patella), or patella-femoral, and lower back pain are also common complaints I have seen in a clinical setting. Most of these occurrences are usually a result of muscular imbalance or some postural alterations. From a therapy point of view if we can understand the process of cycling we can target muscles and combinations of muscles when rehabilitating or simply preventing injury or pain. As well as the rehabilitation, for cyclists, it is important to ensure your bike is matched and fitted for your body, if this aspect is slightly out your posture will have to pick up the slack and alter itself to suit the bike rather than the bike altering to suit your posture. This is where imbalances creep in and ultimately pain and injury.
Muscular Imbalances and Postural Changes
Commonly because of the excessive forward flexed position of the rider, their lower and upper back musculature becomes lengthened and weak. You may then notice a lot of cyclists have a very rounded spine. This can then lead to many things but it will certainly contribute to any lower back pain, and also any shoulder, arm, and hand complaints.
Lower Back Pain… This is because the weakened lower back muscles are not in an optimal state or strong enough to support the lumbar spine as effectively throughout a ride as they should, therefore more responsibility is placed upon the more passive structures such as the vertebrae and ligaments of the spine. Due to their weakness, the lumbar muscles (erector spinae), can then be susceptible to fatigue much more readily. This fatigue then presents as an ache of pain in the lower back.
Shoulder, Arm, or Hand… If the posterior musculature i.e., muscles of the back, and rear shoulder is lengthened and weak in comparison to the anterior musculature i.e. pectorals, front shoulder, and abdominals then this opens up changes in posture. The shoulders will start to roll forwards, causing the head of your upper arm to sit off centre in its socket. Like a chain reaction the arms will tend to rotate inwards placing all sorts of torsional forces on the shoulder, arm and wrist. These torsional or rotational forces alone can cause discomfort in these areas. However, through the postural changes in the shoulder there can be some irritation or compression of the nerves stemming from the neck that supply the arm and hand this can then cause the experience of numbness, tingling or pins and needles in the arm or hand.
Patello-Femoral Pain… A common weakness for most people are the gluteal muscles, this will obviously play a part in the initial power phase of cycling. If the gluteals are weak there will be more emphasis on the quadriceps to produce power in this phase. Similarly, if the hamstrings are weak and unable to effectively carry out the recovery phase the power phase then has to involve much more effort. This potential for over-activity of the quads could lead to excessive shortening of this muscle and cause some irritation around its insertion point, the patella (kneecap) However, the quadriceps themselves are also prone to having some imbalances within themselves. Most commonly the outer, lateral quadriceps muscles, the vastus lateralis becomes over-dominant. In combination with a weakness of the inner, medial quadriceps, the vastus medialis the way the patella tracks and moves is altered. With a stronger lateral pull the patella is pulled more to one side and causes irritation under the surface of the patella because it doesn’t track correctly in its groove. This is when an individual will present with ache and pain at or under the kneecap, and some feeling of grinding.
Prevention and Rehabilitation
Weaker Muscle Activation… By “waking up” the muscles of the back and rear shoulder we can help pull everything back and into a much better posture. If these muscles are then regularly included in any training regime their resistance to fatigue will be improved and therefore the onset of pain or discomfort can be reduced. Including some specific exercises for the medial quadriceps will help correct any maltracking of the patella, reducing the risk of any patella related pain. On the same note, if we can strengthen the gluteals and hamstrings the reliance on the quadriceps to produce more power will be reduced. This workload can then be efficiently shared throughout the muscles involved in the cycling phases. Achieving well-conditioned muscles and a good posture can then be complimented by a fitting of the bike to your riding position. This well help reduce any current pain or complaints as well as reduce the risk of future injury.
Training Specific Muscle Patterns It is all well and good isolating weaker muscles, and is a necessity when addressing any muscle imbalances. However, to then ensure that your muscle can work in harmony and carry out their roles as a functional unit the exercises you include in your program or rehabilitation need to replicate the sport or movements of your activity. In the case of cycling training should include movements where legs are worked unilaterally independently, as the movement of cycling one leg is working differently to the other one. Exercises should also replicate the pattern of movements included in cycling. Therefore exercises should combine hip and knee extension, with plantar flexion, as well as hip flexion, knee flexion, and dorsiflexion of the ankle. These movements should be cyclically combined to ensure the muscles can work in this pattern efficiently.
Exercise Ideas
Lying “T”’s… This will help with recruiting the muscles of the back and the rotator cuff of the shoulder which will encourage the shoulders to be pull back and in a more stable potion. It will also help with conditioning the muscles to work for more prolonged periods of time. Lie face down on the floor with your legs straight. Then raise your legs and chest up off the floor as though your are folding yourself backwards, but keep your legs straight and your head in a neutral position (do not look up). The smaller muscles of the back and also the glutes should be working to hold this position. Once you have raised to this position, have your arms straight out to your side in a T position and raise those up off the floor. Ensure you pull you shoulder blades back together. Hold this position for 30secs and then relax back down. Perform 5-6 sets of these. You can then introduce raising your arms from the ‘T’ position up into a ‘Y’ position, hold it, then return and rest.
Glute Bridges with Knee Extension… This aims to get the glutes firing and the medial quad to fire also. This will help support the lower back and patella tracking respectively. Lie on your back on the floor and bend your knees so your feet become flat on the floor. Then keeping your shoulders flat on the floor raise your hips up off the floor as high as you can so your knees hips and shoulders are in a straight diagonal line. You should feel a squeeze from your glutes, once at the top hold this position and raise one foot off the floor and straighten the knee as much as you can, pause, then return the foot down and lower the hips back down. Alternate knee extensions with each hip lift. Perform 3 sets of 20 reps, but do them all in a slow controlled fashion focusing on a good glute and quad contraction and overall stability.
Step Ups… This will get the muscles of the leg working independently as in cycling but also combines knee and hip extension, then knee and hip flexion as in the cyclic movement. Find a step of box that brings the thigh to parallel with the floor when you step on it. Place one foot on the step and drive yourself up onto the step so this planted leg becomes fully straight. If you need to touch down with the other foot on the step for balance this is ok but minimise it. Return down off the step and repeat, work one leg at a time to bring on fatigue. Perform 3 sets of 12 Each Leg.
Walkover Lunges… As above this will help train the legs individually combining contractions of all the major muscle groups involved in cycling, and tries to mimic the repeated cyclic patterns of contraction. Stand with both feet together then perform a lunge forward dropping the back knee towards the floor, then return towards the starting position but instead of touching back down go straight through into a reverse lunge taking the moving leg back and dropping the knee to the floor. Repeat this movement cyclically working one leg only. Then swap legs once the reps have been completed. Perform 12 on each leg for 3 sets. The above exercises can be added into a warm up or current training program to ensure muscle recruitment is optimised and some of the weaker muscles start to get conditioned. These are just a brief sample of exercises to use and are by no means truly specific rehabilitation or preventative program or an exclusive list. If you do require more detailed assessments or rehabilitation advice please contact a health and fitness professional directly.