Injuries


I'm a 39-year-old former athlete, still in decent shape from speed- and power-oriented sports. I'm also new to cycling. My progress is being stalled by calf cramps, and I've been told that it's because I "ankle" too much when I pedal. Is that straining my calves? 

Last year I increased my mileage to 200-250 miles a week and developed serious upper-back pain between my shoulder blades. It still bothers me. My position on the bike is good. I didn't have this pain until I increased mileage and probably didn't recover well between rides. Any suggestions?

A saddle sore can ruin a ride. Even a tiny zit can begin to feel like you’re perched on a golf ball. Nearly as painful are crotch abrasions caused by shorts that bunch or have an irritating seam.  Even the pros, hardened by thousands of miles in the saddle, fall victim to what cycling author Arnie Baker, M.D., calls “crotchitis.” Fabled tough guys like Eddy Merckx and Sean Kelly had to abandon races when the pain became too great.  Most medical experts say that saddle sores are actually boils caused by skin bacteria that invade surface abrasions. Remedies have come a long way from the era when riders would put slabs of raw steak in their shorts to cushion the abraded area.  Of course, avoiding saddle sores is better than curing them (or ruining a good sirloin). Here’s how.

In cycling, it’s known as “hot foot” -- a burning pain in the ball of the foot, perhaps radiating toward the toes. Severe cases feel like some sadistic demon is applying a blowtorch.  Hot foot occurs most often on long rides. It may develop sooner or more intensely on hilly courses because climbs cause greater pedaling pressure. The pain results when nerves are squeezed between the heads of each foot’s five long metatarsal bones. These heads are in the wide part of the foot (the “ball”) just behind the toes.  We got some quick-tips.  For more detailed information on hot foot, orthotics and other foot-related issues, see "Andy Pruitt’s Medical Guide for Cyclists," available as an eBook in our online eBookstore.

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I sweat beyond belief. Sweat runs off my face and drips like a worn faucet. Then I cramp badly, even though I drink a lot. What do you suggest?

While riding, I sometimes feel my left leg drop off significantly in its contribution to powering the bike. Is there a training technique for dealing with this?

After hard climbs, my triceps get sore. I lift weights in the off-season, but my painful triceps muscles come back every summer when I begin riding big hills. What's the solution?

I bought a road bike about four years ago and did 2,500 miles the first year, 3,500 the second and 5,000 last year. I was excited about improving and last winter did many hard workouts on my trainer.

About six weeks ago I was really feeling tired. I went to my doctor, who told me I had Epstein-Barr virus. I took a break from riding, but when I started again I had discomfort in my stomach and chest. The doctor told me to "take it easy on the bike."

I want to do a 100-mile ride in two months. What can I do to regain my form quickly enough?

I'm a roadie who discovered mountain biking as great off-season training. I lost 20 pounds since last fall and was determined to hit the road strong this spring.

Then I tangled with a car. Fortunately, I must have learned something from those mountain bike crashes because I didn't break anything. I'm anticipating a clean bill of health on my next visit to the doctor. How should I start training to make sure I don't lose the conditioning and strength that I gained over the winter? 

Yesterday I went down hard on a sharp downhill curve. Ouch! Nine stitches in my left hand and I have a hip sprain. What's the best way to recover?

I'm 52 and ride 80-100 miles a week. Recently, I had a 7-hour surgery that will keep me off my bike and out of the gym for 4-6 weeks, possibly longer. I'm concerned that I will lose all of my fitness. Do you think it's okay to start training sooner?

I'm an avid 47-year-old cyclist who rides 90-120 miles per week and wants to improve. My performance has stagnated. My legs ache and feel weak. Is this just age, or is it overtraining or poor nutrition?

Next Tuesday I go in for surgery on a ruptured disk. How soon until I can get back on my road bike? My surgeon says to ride the trainer for 6-8 weeks first -- but it's springtime in Virginia! How can I possibly put off riding until late June?

I crashed a month ago, sustained a type-3 AC joint separation and had surgery. My physician says I have to wear a sling. I don't want to lose any more fitness. Can I ride the trainer one-handed? When I can ride outside again, how should I begin rebuilding my fitness?

At Thanksgiving I broke my left leg in a neighborhood football game. Why a guy in his 50s was playing football is a separate issue! A plate and seven screws were used to hold the bone together. I did not need a cast, but currently wear a brace that flexes at the knee.

I'm not allowed to put weight on the leg but have been doing physical therapy to get back my range of motion. I can now do easy spins on an exercise bike. In two weeks I'll be able to put weight on the leg and start building its strength. 

What advice do you have to help me get back in shape? There's a local century ride at the end of April I'd like to do. Am I being overly optimistic?

I just got clipless pedals and now I feel like I strained my groin. It's very sore when riding or walking. I have been trying to pull up with the new pedals to help round out my pedal stroke, so maybe that's the problem. Any suggestions? 

I get a bruise on my lower lip after almost every ride. I can't figure out what causes it. No one is punching me! Any ideas? 

This is a rather sensitive question. I'm a male who gets severely chafed nipples on rides. Sometimes they even bleed. I lube them with petroleum jelly but it rubs off in 20 miles. Anything else short of a padded bra that I can try?

A saddle sore can ruin a ride. Even a tiny zit can begin to feel like you’re perched on a golf ball. Nearly as painful are crotch abrasions caused by shorts that bunch or have an irritating seam.  Even the pros, hardened by thousands of miles in the saddle, fall victim to what cycling author Arnie Baker, M.D., calls “crotchitis.” Fabled tough guys like Eddy Merckx and Sean Kelly had to abandon races when the pain became too great.  Most medical experts say that saddle sores are actually boils caused by skin bacteria that invade surface abrasions. Remedies have come a long way from the era when riders would put slabs of raw steak in their shorts to cushion the abraded area.  Of course, avoiding saddle sores is better than curing them (or ruining a good sirloin). Here’s how.

I'm a new rider and have improved rapidly. I raced a criterium last weekend and it felt like my lung and rib were attached when I reached a high exertion level. This made it very hard to breathe. My friends told me it was a "stitch." Can you shed light on this?

I've had problems with elbow tendinitis for years. Supporting my upper body on my road bike causes major flare-ups. I've raised the stem and tried aero bars, but neither worked well. Could the cause be a too-wide handlebar?

In cycling, it’s known as “hot foot” -- a burning pain in the ball of the foot, perhaps radiating toward the toes. Severe cases feel like some sadistic demon is applying a blowtorch.  Hot foot occurs most often on long rides. It may develop sooner or more intensely on hilly courses because climbs cause greater pedaling pressure. The pain results when nerves are squeezed between the heads of each foot’s five long metatarsal bones. These heads are in the wide part of the foot (the “ball”) just behind the toes.  We got some quick-tips.  For more detailed information on hot foot, orthotics and other foot-related issues, see "Andy Pruitt’s Medical Guide for Cyclists," available as an eBook in our online eBookstore.

I got off my bike after a 70-mile ride and suddenly had a sharp pain along the outside of my right knee. It hurt so bad I could barely get my foot out of my pedal. I then struggled with this injury for a year before having it resolved. What do you think caused it, and how can I make sure it won't come back? I want to preserve my 20-year cycling career! 

 I'm 43, was in my best shape ever a month ago, then I tore a meniscus in my knee. I want the best medical help I can find. Any suggestions? 

 

I'm new to road riding after years of BMX racing and mountain biking. I get pain in my knee when I ride long and hard. It's the patella that hurts, not the tendon. What's the cause?

I'm a MTB racer who purchased a new road bike last summer and have trained hard on it, especially on short steep hills. This has made a huge performance difference in my MTB riding, but do you think pushing the bigger gears is why my knee hurts? 

I'm 52 and have bad knees. My bike has double chainrings. When I hit big hills, is it better for my knees if I sit and push at a cadence of 55-60 rpm or stand and get it over with?

I'm 17 and was just diagnosed with chondromalacia. I've been riding 15-18 hours a week and also lifting weights three days.  I had my bike position reviewed by an experienced coach here in Austin, so I don't think that's the problem. Any suggestions? 

Two months ago, I started getting pain and stiffness behind my knee where the calf and hamstring muscles connect. It began after doing 9 hard, 5-minute intervals in big gears on the trainer. Last week after 2 very hilly races I could barely walk. Two physicians can't figure it out, but I suspect tendinitis. I've been using ice and NSAIDs but it still hurts. Any ideas?

 

I just got clipless pedals and now I feel like I strained my groin. It's very sore when riding or walking. I have been trying to pull up with the new pedals to help round out my pedal stroke, so maybe that's the problem. Any suggestions? 

For winter training, I use weight machines a couple of times a week for my core and upper body, but I've had difficulty with squats and leg presses. Even body-weight squats hurt my knees. Are there other ways to build my quads?

I'm a 31-year-old female cyclist who had knee surgery last October. My doctor performed a lateral release on my left knee. I did the rehab and starting riding again as soon as I got the okay, but after a few races I experienced knee tenderness, pain and slight swelling. Is this normal after surgery?

Now that it's warmer I want to shed my tights. But all of the experienced riders around here tell me to keep my legs covered. Is there a rule of thumb (knee?) for when it's safe to reveal my gams to the elements? 

I recently developed a bad case of Achilles tendinitis. The real discomfort occurs hours after a ride while walking and climbing stairs. Bicycling is supposed to be low impact. What's going on?

I've had Achilles tendinitis for much of the season. My doctor said that I could ride TRAM (300 miles across Minnesota) but then I would have to stop cycling and deal with the problem. Is it possible to continue riding after TRAM? 

I've met several cyclists who've fallen and sustained injuries to the hip joint, pelvis or femur. We all wear helmets for obvious reasons, but is there any protection available for the hip?

Recently I suffered from a frostbitten penis on a long ride in subfreezing temperatures. I wore heavy tights over cycling shorts. The worst part was explaining what happened to the female emergency room doc. What can I do to prevent this misery from happening again?

I've developed tendinitis in my elbows, I think from riding my road bike about 5,000 miles per year. Can you suggest any changes in riding position or equipment that might help? 

I'm wearing a turtleneck under my jersey on chilly rides. It's irritating the heck out of the skin on my neck. What can I do to lessen the abrasion?