Luxembourg's Andy Schleck was a favourite to win this year's Tour de France until a fractured pelvis, suffered during a crash at a race last month, forced him out of the three-week bicycle race. Of course, injuries are possible even if you're not a professional cyclist like Schleck. You don't have to ride fast to get them either. Most injuries tend to be chronic rather than acute, says Adrian Yahvah, a sports and manual therapist with The Body Group in Central. 'Cyclists don't get a lot of acute injuries because it's not a contact sport, but repetitive strain injuries do occur because you're sitting in a crouched position and doing a repetitive motion, usually for long periods of time,' says Yahvah. In 2005, the journal South African Family Practice published a report by Martin Schwellnus, a professor of sports medicine and exercise from the University of Cape Town. In it, he cited a survey of more than 500 male and female recreational cyclists in which 85 per cent of respondents reported one or more injuries caused by overuse. About one-third of these reported injuries were severe enough to warrant medical attention. The most common sites for overuse injuries: neck (48.8 per cent), knee (41.7 per cent), groin/buttock area (36.1 per cent), hands (31.1 per cent) and lower back (30.3 per cent). Acute injuries, says Schwellnus, are usually caused by accidents - from a collision with a vehicle, road surface or an obstacle, to mechanical problems with the bike. Up to 25 per cent can be severe: fractures, dislocations, head and internal injuries. Head and neck trauma can be fatal, so it's important to always wear a helmet when cycling. Compared with acute injuries, chronic problems are much more preventable as they are usually related to improper bike fit, equipment or riding style. Here's a look at some common repetitive injuries and what you can do to avoid them. If pain persists, seek advice from a doctor without delay. NECK Staying in one riding position for too long usually causes neck pain, especially for those who ride racing bikes that force you to lean forward, says Rufina Lau Wing-lum, clinical associate and registered physiotherapist in Polytechnic University's department of rehabilitation sciences. Handlebars that are too low or tight hamstrings and/or hip flexor muscles may also cause a rounded back, which puts strain on the neck, says Dr Brian Sennett, expert consultant with the American Orthopaedic Society for Sports Medicine. Weak back muscles or a saddle that's too high are other culprits. Prevent it: do shoulder shrugs and neck stretches during and after a ride. Change your grip on the handlebars to redistribute pressure to different nerves. Get fitted on the bike properly. WRIST/HAND Cyclists who ride for days in a row are more likely to feel pain, tingling and numbness in the hand - particularly in the ring and little fingers - due to the compression of a nerve caused by the constant pressure and vibration of holding the handlebars, says Yahvah. Prevent it: ride with your elbows slightly bent so that they act as shock absorbers, and change hand positions during the ride, says Sennett. Be sure that the wrists don't drop below the handlebars. Use padded gloves and stretch the hands and wrists before riding. LOWER BACK This is usually linked to neck pain and caused by improper bicycle set-up, although chronic lower back pain should be evaluated for other causes (such as intervertebral disc compression) through clinical examination. Prevent it: adjusting the saddle angle appears to be particularly effective, says Schwellnus. Adjustments to saddle height, and handlebar height, position and length, may also be required. Strengthening the lower abdominals and core muscles, as well as improving flexibility, will help. KNEE Two of the most common types of chronic knee pain in cyclists are patellofemoral syndrome (cyclist's knee) and iliotibial band (ITB) friction syndrome, both characterised by pain around the kneecap. Lau says knee pain can be caused by repeated movement, wear and tear, or riding position. Prevent it: ride using a lighter gear but pedal faster (as opposed to a heavier gear and lower cadence) to reduce pedal resistance. Yahvah advises increasing strength and flexibility in the hip stabiliser muscles. Shoe implants, wedges beneath the shoes and cleat positions may also help, says Sennett. GROIN/BUTTOCKS The pressure of the saddle during prolonged sitting can cause the compression of blood supply to the genital region, leading to numbness and pain in the genital or rectal area. Prevent it: select a saddle of appropriate size and shape for your body, adjust its tilt, and use a good pair of padded bike shorts. 'Some people with wide pelvis should sit on a wider saddle so it supports the whole body,' says Lau. FOOT Shoes that are too tight or narrow are the main cause of numbness and tingling in the foot. Prevent it: slight adjustments to the shoes, straps or cleats will help. Remove any irregular seams, straps or buckles that may be pressing against your foot.
