Traumatic and overuse injuries in amateur cycling

Amateur cycling injuries are of two types: traumatic and overuse. We can define amateur cycling as a generic term for recreational, racing, commuting, and utility cycling. Its health benefits are well known. There is evidence that cycling improves cognitive ability and well-being in adults, while providing the benefits of aerobic exercise. Its popularity is booming, and at the same time, injuries from falls and overuse are also increasing.

Types of injuries in amateur cycling
According to multiple studies, the injury rate in amateur cycling ranges from 3.23 to 1.16 per 1,000 people, and the most common injuries are divided into traumatic injuries resulting from falls, and injuries due to overuse, overuse, or overload.

Within traumatic injuries, the most common injuries are superficial skin injuries (contusions, abrasions, lacerations, and hematomas), with fractures being the second most common injury. Among fractures, the most affected region is the shoulder (scapula, clavicle, and humerus), with clavicle fracture being the most common.

Clavicle fractures often pose a dilemma regarding their treatment. The long-awaited return to racing makes us wonder whether surgical intervention would allow us to return to activity again. In this regard, there is a study comparing surgical fixation versus conservative treatment for clavicle fractures, concluding that surgical fixation resulted in a return to activity within 77 days, compared to 44 days for conservative treatment. However, this statistic is attributed to the greater severity of the fractures treated, concluding that for the same injury, treated fractures return to competition more quickly. For this reason, most elite cyclists with a clavicle fracture undergo surgical fixation.

The clavicle is not the only site of fractures in cycling. Other sites affected by fractures include the hand, wrist, elbow, and forearm.

While fractures most commonly occur in the upper extremity, overuse injuries usually occur in the lower extremity, and of these, the knee is the region most frequently affected by overuse injuries. Among overuse knee injuries, patellofemoral syndrome (https://drjordijimenez.com/en/dr-jordi-jimenez/blog-take-care-of-your-health/chondropathy-of-the-patella) is the most common, closely followed by iliotibial band syndrome (https://drjordijimenez.com/en/dr-jordi-jimenez/blog-take-care-of-your-health/iliotibial-band-syndrome). Patellofemoral syndrome in cyclists is caused by increased pressure on the patellar cartilage during repeated knee flexion, sometimes exacerbated by factors such as a low saddle, an undersized frame, cranks that are too long, a downward-pointing seat post, or a saddle that is too far forward.

Overuse injuries can also be caused by anatomical changes in the cyclist (spine and lower limb deviations, patellar changes, or different lengths of the lower limbs), the bicycle (frame type or forward pedal strike), the terrain, or training/competition. Among the overuse injuries associated with training/competition, muscle, tendon, ligament, or cartilage injuries are common, presenting in various forms: cramps, muscle soreness, muscle tears or ruptures, or tendonitis.

Other studies have implicated the cervical region, hips, hands, dorsal, and lumbar regions as common sites of overuse injuries, and that this overuse often leads to the development of chronic pain.