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Watch
Out for Knee and Shoulder Injuries
Many an avid
cyclist knows firsthand that two of the most commonbicycle
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:
- Chondromalacia
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.
The shoulder
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 connections.
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.
Shoulder injuries
include:
- 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 repeated dislocations.
Information
provided by
1-800-CEDARS-1
1-800-233-2771
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