Pain Management and Prevention for cyclists
Getting legs of iron that are sculpted and chiseled to perfection comes at a cost. Pain, and lots of it.
Climbing mountains is a skill and an art that takes years to perfect and even after years of practice and perfection, it’s never quite perfect.
Why do cyclists dread the mountains? Pain, injury
Why do we love them?
-The rewards of improvement, being fitter, stronger, faster and tackling pain thresholds that would make pin cushions cringe
-The scenery and sense of accomplishment when reaching the summit
Simply, climbing the peaks of Colorado on your bike, mountain bike or with just your left and right feet, is an unmatched experience and once you’ve done it, you will never forget it.
But, some of us do this everyday, or, on a regular basis. Those of us lucky enough to live in mountainous regions of the world know the beauty and challenges that mountain climbing provides.
This video will give you a glimpse of what it’s like to climb one of the tallest mountains in Colorado and, the highest paved road in the continental United States!
We will summit Mt Evans at 14,265 feet above sea level (4348m)
The scenery is amazing and the efforts are very hard. Some of us may have never experienced the efforts that you are going to experience today. Many of you have never experienced the pain that this collection will make you experience. You will discover new achy muscles that you never knew you had.
Hill climbing can lead to very painful conditions.
– sore muscles and tendons
– chaffing (saddle sores)
– painful back, neck, shoulders, hands
– foot pain
– not to mention cuts, bruises and road rash
* Hill climbing requires a steady difficult effort with continuous muscle exertion through the legs and feet for each pedal stroke. With few breaks, you will push and pull the cranks around at between 65-70 RPM
This leads to knee pain – foot pain – groin pain – hip pain
* The constant anaerobic efforts required to get up the hill will keep your posture more upright to open up your chest cavity
This leads to hand pain and lower back pain
* Hot dry air and slow speeds makes you sweat profusely with irregular evaporative cooling opportunities
This leads to cramping, heat exhaustion, chaffing
* Fast winding descents and hypoxia is a formula for crashes
This leads to road rash, cuts, sprains
So, how do we deal with all of this?
Pain via exertion
Pain via mechanics
Pain via crashes
Pain via Emotion
Pain via Exertion
– muscle fatigue
– joint fatigue
– overtraining syndrome
Feeling the burn
So, you’re working hard and lactic acid is making your muscles burn, right?
The reality is that when you become anaerobic (~80% max heart rate) your body begins producing Lactic Acid from the breakdown of carbohydrates which allows the cells to create ATP (andenosine triphosphate) (Lactate-related ATP production) ATP provides energy for most of the chemical reactions in the body. Lactic Acid is the fuel that your muscles run on when they cannot get enough O2 for the energy required. When this fuel is used, the Lactic acid is broken down into lactate ( a buffer) and a negatively charged hydrogen atom. The H- increases the acidity around your muscles which does most of the damage we dont like (loss of motor control and pain)
How do we manage this pain?
increase your pain threshold – training – Training with a lot of lactic acid in your system stimulates your body to produce enzymes that speed the use of lactic acid as a fuel.
High intensity interval training will cause cardiovascular adaptations that increase oxygen delivery to your muscles and tissues.
Over distance training causes muscular adaptations that speed the rate of lactate removal. Over distance training in running, swimming, or cycling increases muscle blood supply and the mitochondrial capacity. Mitochondria are structures within the cells that process fuels, consume oxygen, and produce large amounts of ATP. A larger muscle mitochondrial capacity increases the use of fatty acids as fuel, which decreases lactate formation and speeds its removal.
Nutrition is also important, strenuous training depletes glycogen reserves in the muscle and liver. A diet high in carbohydrates is essential for all endurance athletes. Carbohydrates supply an immediate source of glucose so the athlete has a feeling of well-being and a source of quick energy. Further, glucose is used to restore muscle glycogen from exercise. When the blood glucose and muscle glycogen reserves are renewed, glucose provides a source of lactate that helps replenish liver glycogen.
– warm up
– slow down (aerobic)
– stay hydrated
Delayed onset muscle soreness – legs, arms, neck soreness that begins 1-2 days after the ride
microscopic tearing of the muscle fibers
eccentric muscle contractions – spin bike (resisting downward motion)
VS concentric muscle contraction
ECC- holding head up, arms, standing on pedals (shock absorbers), resisting downward motion on spin bike or even regular bike
CON – pedaling (mashing)
Pain Management – while nothing is proven to be effective, these are a few things that have helped me and others.
1. Active recovery
3. Pre-ride warm up
4. Kineseo tape
5. Pain killers – anyi-inflamatories
6. RICE – rest, ice, compression, elevation
Patellofemoral Pain Syndrome – pain under and around the knee cap as a result am improper tracking of the kneecap
Mechanical – body mechanics – hip strength (alignment) glute strength or bike fit
spin bikes – so many people ride and readjust the seat without much thought.
When you go into class its tough to really dial in a club bike.
Cant take the time to plumb knee or decide on hight based on goiniometer angles. Gotta get on bike and go
Experienced cyclists. professionals and racers hate spin bikes for this reason. But, spin workouts are usually much shorter than bike rides.
muscular – weakness
orthopedics (adust cleat position)
Bike fit (patella over cleat)
hip strengthening exercise program (women)
quad strengthening programs
glute strengthening programs
Chondromalacia is a term used to describe damage or softening of the articular cartilage on the underside of the kneecap. The most common symptom of chondromalacia is a dull pain under or around the kneecap that increases while walking down stairs.
wear and tear
common in cyclists
The best treatment for chondromalacia is low-impact exercise that strengthen muscles (focused the inner part of the quadriceps) Swimming, stationary bicycle, and cross-country skiing are good ways to strengthen the joint without impact. helpful to avoid any activity that requires the knee to flex more than 90 degrees.
high cadence (less mashing, less climbing. lower resistance)
Very painful – debilitating involuntary contractions of muscle
What Causes Muscle Cramps
The exact cause of muscle cramps is still unknown, but the theories most commonly cited include:
Altered neuromuscular control – electrical signals confused at muscle junctions (acid H- ions?)
Electrolyte depletion – low buffer
Doing a new activity
bring fuel – what type of fuel?
– in the moment
Overtraining Syndrome – Listen to your body
Washed-out feeling, tired, drained, lack of energy
Mild leg soreness, general aches and pains
Pain in muscles and joints
Sudden drop in performance
Decreased immunity (increased number of colds, and sore throats)
Decrease in training capacity / intensity
Moodiness and irritability
Loss of enthusiasm for the sport
Increased incidence of injuries.
A compulsive need to exercise
Rest and Recover. Reduce or stop exercise and allow yourself a few days of rest.
Hydrate, Drink plenty of fluids and alter your diet if necessary.
Get a sports massage. This may help relax you mentally and physically.
Begin Cross Training. This often helps athletes who are overworking certain muscles or suffering from mental fatigue.
Core muscle fatigue – leads to a postural imbalance
out of saddle postural error
Leads to hip, back and knee pain
women – joints are more lax (less rigid) hormones to allow joints to flex – repetitive unstable strain = wear and tear = pain / arthritis
Management – exercise core
Pain via mechanics
– lower back
– bike fit
– body posture
– bike fit
– saddle fit
– clothes (chamoi – and creme) no underwear – benefits of bib shorts
– rubbing – 90RPM over 2 hrs = 10800
sander at 1700 RPM = 6.5 seconds
– the saddle
-bike fit and knee alignment
– shoe size
– bike fit
– cleat alignment
– bike fit (include bar and bar width)
– body posture – elbows bent
– hand position
– core strength
– gloves / glove type – padded gloves less comfortable?
Pain via crashes
Wound management and dressing
road rash – owch!
inflate and check tires
is your mind in it? – altitude and acclimation
are the roads suitable? – condition of road. Weather – wet / windy?
beware of slow traffic
Do you have the skills? Bike handling
Cold temps and freezing twitchy muscles – scared?
Shaved legs –> crashing
Slow yourself down and think. You may be more injured than you realize! Don’t jump back on the bike. Check for broken bones. Do you know where you are? Is anyone coming to help? Let them. Head injury.
Talk about sac trail ride.
So, you just have road rash – thank goodness!
Immediate response – dont wait and dont be tough
– if you dont have the proper supplies and have never treated road rash, go to the hospital
– clean wound – scrub would – clear debris –> the longer you wait, the more it will hurt and the longer it will take to recover
– warm water – mild soap
– treat with antibiotic spray – I dont like gels
– cover with hydrocolloid dressing – dont expose to air and dont allow it to scab.
– wait 2-3 days. Allow wound to blister. Change dressing upon drainage.
– check for discoloration
– debris wound and look for grafting of new skin
– clean / spray and re-cover
Pain via emotion