I’d like to share this article published at The American Journal of Sports Medicine in September 2010, to help all level of cyclists understand more clearly my treatment approach.

Overuse Injuries in Professional Road Cyclists

Background: Little epidemiological information exists on overuse injuries in elite road cyclists. Anecdotal reports indicate anterior knee pain and lower back pain may be common problems.
Purpose: This study was conducted to register overuse injuries among professional road cyclists with special focus on anterior knee and lower back pain.
Study Design: Descriptive epidemiology study.
Methods: We attended training camps of 7 professional teams and interviewed 109 of 116 cyclists (94%) on overuse injuries they had experienced in the previous 12 months. Injuries that required attention from medical personnel or involved time loss from cycling were registered. Additional information on anterior knee pain and lower back pain was collected using specific questionnaires.
Results: A total of 94 injuries were registered; 45% were in the lower back and 23% in the knee. Twenty-three time-loss injuries were registered—57% in the knee, 22% in the lower back, and 13% in the lower leg. Fifty-eight percent of all cyclists had experienced lower back pain in the previous 12 months, and 41% of all cyclists had sought medical attention for it. Thirty-six percent had experienced anterior knee pain and 19% had sought medical attention for it. Few cyclists had missed competitions because of pain in the lower back (6%) or anterior knee (9%).
Conclusion: Lower back pain and anterior knee pain were the most prevalent overuse injuries, with knee injuries most likely to cause time loss and lower back pain causing the highest rates of functional impairment and medical attention.
Clinical Relevance: Future efforts to prevent overuse injuries in competitive cyclists should focus on lower back pain and anterior knee pain.

Ok, to the point, in my experience as a sports physiotherapist, elite mountain-biker and triathlete, the best results come from treatment of the cause of a problem, not the symptoms, which is what most athletes perceive as a priority. A treatment focusing in symptoms relief is going to feel good, but is not complete, the cause of the problem is still there. Based on results, the best is to take a holistic approach and not just work to release muscle tension with a massage, but instead, assess spinal and pelvic alignments, posture and muscle imbalances, overuse conditions, stress level, hydration, etc. to then decide and perform the most effective treatment for that particular rider’s condition.

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