Download Cycling Injury Prevention Workshop

Cycling Injury Prevention
Workshop
Focus on Thoracic-Shoulder & Associated Conditions
Ian Wee – Occupational Therapist / Cycle Coach
Chris Thompson – Physiotherapist / Cycle Coach/
Exercise Physiologist
Workshop Program
• Overview on cycling
based injuries
• Types of ThoracicShoulder Conditions
treated
• Types of associated
conditions
• Bike Ergonomics
• Stretches
• Application
• Sponsors
• Questions & Answers
Common cycling injuries
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Acute vs Chronic
Acute normally caused by accidents
Acute – 50% & more: with motor vehicle
Acute – 12-24% due to mechanical problems
with the bicycle, road damage & obstacles
• Minor acute include lacerations, abrasions &
contusions
• Major acute include fractures, dislocations, head
injuries and internal injuries
• This scope is not covered during this workshop
Chronic conditions
• Otherwise called Overuse Injuries
• In survey conducted in South Africa, 520
cyclists: 85% report one or more overuse injury
with 36% of these requiring direct clinical
intervention
• Yet research also points out that cyclists are
generally poor at seeking clinical intervention
until conditions become very chronic and affects
their functional performance on the bike directly
Common sites of chronic injuries
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Neck (48.8%)*
Knee (41.7%)
Groin / Buttock (36.1%)
Hands (31.1%)
Lower Back (30.3%)
This workshop is focusing
on the upper quadrant of
the body which includes
the neck & hands due to
its association with the
shoulder region &
nervous system
Scapulothoracic Rhythm
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Overstrain caused by incorrect
bike ergonomics
Extensive shoulder-wrist
placement @ static positions
over long duration of time
Existing poor biomechanics of
the shoulder / existing
underlying injury
Importance of all rotator cuff
muscles working in unison and
not merely so called site of
pain or pathology
Active and Passive Range of
Motion can assist practitioner
determine the scapular rhythm
or lack thereof.
Paraspinal Imbalance or Strain
• Lack of core strengthen
development
• Overuse syndrome & lack
of cross training
• Poor bike positioning
• Neuromuscular issues
• Biomechanical issues
• Ligament & Deep Tissue
conditions
• Associated neck-mid
back-lower back pain
Kyphotic Conditions
• Consider Lance
Armstrong’s mid thoracic
spine
• Amendments can be
made in bike ergonomics
in the presence of
musculoskeletal
conditions
• Development of strength
in associated muscles
and ligaments as well as
synergistic muscles are
crucial to stabilisation
More of Lance…positioning,
conditioning…so called limitations..
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Even one of the greatest cyclists
can conqueror odds with
biomechanics differences
Consider the biomechanical
requirements of each rider and the
importance of bike ergonomics vs
a bike fit
Consider the clinical knowledge of
your health professional when
consulting for your cycling based
conditions which should also
include at post treatment phase –
fitness & exercise physiology
training
After all Lance spends 40-45% of
his time with other fitness
workouts and not merely on the
saddle
Ligamentous Conditions
• Two major ligaments
assist with shoulder joint
stability namely the GH
and AC ligaments.
• Stretches needs to be
effected by cyclists to
achieve pre-ride and post
ride movement to ensure
ligaments which have
less blood supply get the
mobilisation they require
• Important also to stretch
while riding
Rotator Cuff Conditions
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Muscles around the shoulder
joint
Three dimensional – namely
anterior-posterior and lateral
Balance required by all rotator
cuffs
Normally associated with
Ligamentous based injuries
Superficial injuries sustained
normally with side falls during
rides
Once again imbalance created
by poor conditioning and bike
ergonomics
Cyclists Palsy & Carpal Tunnel
Syndrome
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Pain & numbness in fingers
Cyclists Palsy associated with ulnar
nerve compression- ring & little finger
Carpal tunnel associated with median
nerve – thumb & forefinger
Tingling sensation in hands and
fingers which may include numbness
Causes – hands compressed against
handlebar or brake lever hoods –
riding with wrists cocked & angled
towards the thumb-fixed positions on
flat bars – saddle tilted downwards too
much thus too much weight on hands
Need to consider usage of proper
gloves – properly anatomically padded
gloves
Need to change hand, arm and
shoulder positions
Bike Ergonomics
Appropriate Stretches
PIHC Methods Used
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Key Module Treatment – for acute / post operative
care including muscles, ligaments and tendons
Hands On Soft Tissue techniques – involving muscle
mobilisation and adjustments to assist with muscle
fibre realignment and feedback to nervous system
Huber Dynamic Treatment Systems
Vibration Science with WBV 3000
Exercise Physiology
Feet Biomechanics through Podiatry
Therapeutic Massage
Key Module Techniques
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Reverse Pressure
Roller & Suction
Pressure to prevent
ischemic compression
of soft tissue
Pressure hence
intensity is variable
Recovery rate up to
70% faster than
conventional hands on
approach
Huber Dynamic Systems
WBV 3000 – Use of science of
vibration
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Varying the intensity of the
vibration (harmonic
frequency) can assist with
thoracic / shoulder
strengthening
Use of various positions by
a qualified clinician can
assist with the rehabilitation
of areas such as the
shoulder, mid back and
para spinals
Our sponsors
How we can help….
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Speak to one of the PIHC practitioners present in the room this
evening
Use the PIHC-Cycling WA screening card for your complimentary
shoulder-thoracic assessment (valid to end of June 2009)
Grab a brochure about the various techniques & technologies
available
Email [email protected] for a copy of our stretch brochure
If you are keen on our cycling training program – take the lime
green brochure that says “Cycling”
Email Ian Wee at: [email protected] His card is enclosed in
the pack provided.
Check our website: www.pihc.com.au
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WE ARE WELCOME YOUR FEEDBACK VIA EMAIL SO WE
CAN HELP BY IMPROVING ON OUR WORKSHOP &
PROGRAMS