We recently sat down with sports medicine specialist Dr. James Ting and
asked him a few questions about preventive sports medicine and some tips
for cycling aficionados.
In what ways can sports medicine professionals take a proactive role in
Sports medicine professionals play a key and proactive role in preventing
injuries on several levels. One of our vital functions is in the coordination
and implementation of pre-participation screening, examination, and evaluation
of athletes. As part of that process we frequently discover deficiencies
or deficits in things such as strength, flexibility, and stability that
need to be corrected in order to prevent injuries, a process called primary
prevention. We also may detect current minor injuries that require further
treatment in order to prevent the development of major injuries, which
we call secondary prevention. At times we may also uncover significant
injuries that require additional treatment and rehabilitation in order
to prevent chronic, and/or debilitating injuries, which is known as tertiary
prevention. Sports medicine professionals additionally have training and
expertise in issues related to nutrition, strength, and conditioning,
which in combination with our knowledge of musculoskeletal medicine, allows
us to serve as effective counselors and educators in regards to injury
How important is patient education?
Patient education is extremely important. The more aware and informed patients
are in regards to potential risk factors for injury, the importance of
proper training and conditioning, as well as the demands of their individual
sport, the more effective sports medicine professionals and patients themselves
can be in preventing injuries.
How can cyclists be proactive, themselves?
Cyclists can be proactive with injury prevention by not only paying attention
to general issues affecting all athletes such as nutrition and conditioning
as mentioned above, but also by paying particular attention to the quality
and fit of their equipment. This includes but is not limited to, their
helmet, bike, seat, pedals, and shoes.
What are the most common cycling injuries?
There are many different injuries that can occur in cycling. They can be
broadly categorized as either traumatic, or secondary to overuse. While
not an exhaustive list, some of the most common injuries that occur in
cycling are fracture of the clavicle (collarbone), fracture of the scaphoid
(specific carpal bone that is located on the thumb side of the wrist),
Achilles tendonitis, patellar tendonitis, low back pain, neck pain, and
How can cyclists prevent these injuries?
Unfortunately, traumatic injuries such as a clavicle fracture or a scaphoid
fracture can’t be easily predicted or prevented. These fractures
typically occur during a crash when a rider reaches out with his/her outstretched
hand to break the fall. While it may not be instinctive or easy to remember,
holding onto the handlebars during a fall to allow your entire body to
absorb the force of the impact, rather than reaching out with your hand,
may help to prevent these specific injuries. Achilles tendonitis, patellar
tendonitis, low back pain, neck pain, and saddle sores are considered
overuse injuries. Taking care to ensure a proper bike fit can be helpful
in preventing all of these injuries. Items that can be adjusted in order
to prevent or reduce excessive strain and thus prevent injuries to these
specific areas of the body include, but are not limited to seat, pedal,
and handlebar position. Consider a professional bike fitting for help
with this. While improper bike fit can be a cause of both Achilles and
patellar tendonitis, be mindful as well of over-training, as this is also
a common culprit. In addition to a proper fitting, a core strengthening
program can be helpful to prevent low back pain, while strengthening of
the neck and shoulder muscles can help to prevent neck pain. The prevention
of saddle sores can be accomplished through both proper seat positioning
as well as the use of newer, well cushioned cycling shorts, and avoiding
ones that are old and potentially worn out. The use of chamois creams
to reduce friction can also be a helpful preventative measure as well.
When should cyclists seek care from a physician?
Cyclists should seek care from a physician whenever pain or an injury is
recurrent or persistent, and otherwise if there is any question or concern
regarding the severity of an injury, its proper rehabilitation, or when
it is safe to return to activity. In the event of traumatic injuries such
as a clavicle or a scaphoid fracture, care from a physician should be
sought immediately. Taking the example specifically of a scaphoid fracture,
delayed or improper treatment can have a significant impact on healing,
which in turn can potentially result in unfortunate long-term consequences
such as pain and arthritis. It is also advisable to see a physician prior
to starting a new exercise regimen or program to ensure that it is safe
to do so. Injury prevention after all, is key!
James Ting, MD, FAAFP, CAQSM who specializes in Non-Operative Orthopedic
Care, General Orthopedics & Sports Medicine