To start off the 2015 new year, we are debuting a new feature of our blog!  Every 2 weeks, we will post a summary of a cycling related journal article.  The purpose is to bring awareness to new research, as well as spark discussion about cycling medicine.  We hope you enjoy this new addition to our blog.  Here is our first post:

The Club-Level Road Cyclist: Injury, Pain, and Performance

Dahlquist M, Leisz MC, Finkelstein M. The Club-Level Road Cyclist: Injury, Pain, and Performance. Clin J Sport Med. 2014 Jun 9. [Epub ahead of print]

Article Summary:

With the increase in popularity in cycling in the United States, there is more information about types of injuries in cyclists. The authors of this study looked to examine the differences in activity levels of injured and non-injured cyclists, identify factors that influence when a cyclist seeks medical treatment, and examine biomechanical measures and their relationship to injury in an observational and prospective study of 63 experienced road cyclists. Participants reported demographic information, training information, and 8-week injury incident questionnaire. Researchers collected anthropometrics, bike fit measurements, hamstring flexibility, isometric strength, dynamic strength, and plyometric strength. The researchers found that 68.7% of participants experienced pain while cycling due to injuries with 65.1% reporting the injury duration >1 year. Of those reporting pain at enrollment, the average visual analog score (VAS) was 4.8 at the worst. The most common injuries at enrollment involved neck, shoulder, lumbar spine, and knees, which were reported due to muscle, tendon, and stress/overuse. During the 8-week prospective injury-reporting period, 39.7% of participants reported 34 injury events. Those who reported pain at initial enrollment were 48.8% likely to have an injury during this period compared to 20% of those uninjured at time of enrollment. Those that had a professional bike fit performed were more likely to have prospectively reported an injury. Flexibility, strength, and bike fit had no relation to injury. The authors concluded that greater than 2/3 of participants experienced pain >4 on a VAS, cyclists train intensely even with pain, if pain intensity >5.6 a cyclist is more likely to seek medical treatment, and factors that contribute to seeking medical care included pain levels and age.

Questions for Discussion:

  • With one of the most common injuries at enrollment being related to the lumbar spine, are cyclists performing enough core training and stabilization activities to prevent this issue?
  • Cyclists train even with pain. Are we encouraging athletes to take adequate rest and recover to improve performance?
  • What are the common attitudes and/or mental aspects of cyclists that might lead to not seeking treatment?

Written By: Alexandra Flis, MD

Reviewed by Louis Yu, MD