The Pain-Free Cyclist: Conquer Injury and Find your Cycling Nirvana

By Matt Rabin, Robert Hicks and Bradley Wiggins

The Pain-Free Cyclist takes you through the most common cycling injuries, lets you know what exactly they are, why you get them and what you can do to do get rid of them and get you back on the bike pain free.

It's not (just) about the bike. Ride your bike long enough and even with an optimal bike fit you're likely to get injured. It's not what cyclists want to hear, but it's the hard truth.

Cycling is a rapidly growing sport, and as numbers increase, so do the amount of injuries. What do you do if you get injured? Rest? Continue to ride? These questions need answering – to avoid confusion, further complications and more harmful injuries, resulting in substantial time off the bike. We want more riders out on the road, enjoying their cycling, pain free.

Foreword by Sir Bradley Wiggins and featuring interviews with pro-cyclists including Cadel Evans, Carlos Sastre, Dan Martin, Tyler Farrar and Andrew Talansky.

• Language: English
• Publisher: Bloomsbury Publishing
• Release date: Jul 16, 2015
• ISBN: 9781472921482

Matt Rabin

Dr Matthew Rabin (BSc(Hons), MSc(Chiro), DC, ICSSD, PGDip, FRCC) is a team chiropractor and nutritional strategist with World Tour professional cycling team Cannondale-Garmin. Matt has also worked with the Great Britain, American and Australian Cycling teams at the World Championships and the Australian cycling team in the run up to the 2012 London Olympic Games.

Book preview

Every cyclist can talk about the time when it all felt effortless. The time everything clicked and came together. It doesn’t necessarily have anything to do with winning per se but has everything to do with a feeling, an emotion, a state of mind, a connection with cycling that is rare to come by, despite how many thousands of miles you have clocked up on the bike. Cycling Nirvana is winning inside your body, inside your head and the real sweet spot of the sport.

You’ve picked up this book because you know how to ride a bike. As a keen cyclist you’re probably clued up on how important bike fit is and have, no doubt, done your homework on the right bike for you. Cycling injuries, however, are unlikely to have captured your attention in quite the same way. Yet, whether the result of a dramatic crash or just simply overworked muscles or overused joints, a cycling injury can dramatically hinder your performance, and cause significant pain and discomfort leading to unwanted time off the bike. Beating injuries before they take hold is the key to not only unlocking your potential as a cyclist but to enjoying every ride blissfully pain free.

When injuries or discomfort occur, a lot of cyclists simply don’t know what to do. Very few find it easy to understand what their body is telling them, what the cause of their problem is, and most importantly how to address and treat it. Rest? Continue to ride? Struggle on through? It’s these questions which go unanswered, leading to further complications and more harmful injuries, resulting in substantial time off the bike. Worse still, many cyclists see these feelings of discomfort as a natural by-product of bike riding. Not so. Cycling should and can be pain free.

There are more cyclists on Britain’s roads than ever before, with over two million people cycling at least once a week. As enthusiasm for the sport grows, we want to see as many people as possible enjoying their bike rides pain free and heading towards their Cycling Nirvana. That’s why we have written this book. We’ll guide you through, explain what the injuries are, how to spot them and, most importantly, how to treat them in order to get you back on your bike as swiftly as possible.

But this isn’t simply a book about injuries. It’s also your number one tool for maximising your performance as a cyclist. By exploring every aspect of your life as a cyclist, from preparation such as warm-ups and fuelling to recovery, common ailments and more, we’re giving you the ingredients to help you find your Cycling Nirvana – the sweet spot of the sport – and become a pain-free cyclist. But don’t just take our word for it; we’ve called upon some of the biggest names in world cycling to tell you about the injuries they’ve battled and what they did to overcome them. There really isn’t anyone better to help guide you through the world of cycling injuries than the pros themselves. Look out for their stories and what Cycling Nirvana means to them – it’s a fascinating insight.

The Pain-Free Cyclist is the first and last book any cycling enthusiast will need on all things cycling-health related.

PART 1

PREPARATION

As the old saying goes, fail to prepare then prepare to fail. Preparation is so crucial, especially if you want to make your rides as pain free and enjoyable as possible. Every bike ride, every training session, every sportive, time trial and road race begins with preparation. And if you get it wrong, it will have a knock-on effect and somewhere down the line you’ll pay for it.

Preparation isn’t just about having miles in the legs, it’s about having a general understanding of: bike fit and anatomy; conditioning and training, ensuring that your body is physically capable of the pressures you are placing on it; knowing what to eat and when, in order to maximise your performance and recovery; warming up and preparing the body for the onset of exercise; making sure you’re ready to ride.

CHAPTER 1

SOMETIMES IT IS ABOUT THE BIKE

The right bike fit is not about being able to produce the most power; it’s one you can ride 10,000 km on without getting injured.

Nathan Haas AUSTRALIAN PRO CYCLIST AND TOUR OF BRITAIN WINNER

While this book is predominantly about the body, not about the bike, there’s no denying that bike fit plays a significant role in the prevention of injuries. While it’s naïve to believe that a proper bike fit instantly guarantees a pain-free ride, if you’re not set up correctly on the bike, you will risk developing injuries, or exacerbating pre-existing aches and pains. It’s not hard to see why – the riding position on the bike is completely unnatural.

A good fit will help you feel at one with the bike

It’s not just the ungainly position, riding a bike for several hours requires both holding your position for an extended period of time and constant repetition of your pedalling motion. To put it into context, let’s say you spin the pedals 90 times per minute – the average cadence of the majority of cyclists ranges between 80 and 90 rpm. If your Sunday morning ride lasts a couple of hours, that means you’ll spin the pedals nearly 11,000 times. For a 4-hour sportive, your legs will go round over 20,000 times. It doesn’t take a genius to work out that if you’re not sitting comfortably, issues can arise quickly on the bike.

So what can you do?

Well, the simple answer is to go and see a good bike-fitting specialist. True, the cost can seem a little steep (expect to pay around £150-£300, or 250-500 USD), but when you add up the money you’ve spent on a new bike, specialist clothes and the latest gadgets, a bike fit, which can significantly reduce your chances of injury, seems pretty reasonable. These trained professionals take into account not just your unique height, weight and reach ratios, but also your personal injury history, and tailor the bike just for you.

Do-it-yourself bike fit

If you’re not willing to fork out a couple of hundred pounds for a bike fit, then there are some bike fit principles you can easily apply at home to get you started.

Step one: firstly, you need a bike – well a frame more specifically, that isn’t too big or too small. When you’re buying a bike, that’s the priority. It sounds easy enough, but a lot of cyclists get distracted when choosing a frame size, worried more about brand names, gear ratios and the colour, and will end up buying the wrong-sized frame and then forever fight against their own position in a bid to make the bike fit.

Below is a table that gives some general guidelines for what size bike frame you should buy, based on your height.

THE IMPORTANCE OF A BIKE FIT

Alex Howes AMERICAN PRO CYCLIST

▪ ‘Bike fit is very important because injuries can come out of nowhere if you don’t know your fit or don’t have a decent bike fit, it’s as simple as that. You hear of pros sometimes that can’t pee for a while after a stage or it’s painful and stinging to pee, this is not good and bike fit can affect that. If injury doesn’t persuade you to get a good bike fit, the thought of stinging pee or potential erectile dysfunction certainly should.’

Understand bike basics

Saddle height: At the bottom of your pedal stroke, your knee should be between 80 and 90 per cent fully extended. It should never be fully extended. Find what works for you, as it’s largely dependent of the flexibility within your hamstrings.

Saddle position: When the cranks are horizontal with the ground – a three o’clock position – your knee should be vertically positioned over the pedal spindle. To start with, always set your saddle to horizontal – this is the standard. Avoid changing your saddle tilt, unless you know exactly what you are doing.

Handlebars (width, height and rotation): handlebar width should be roughly equal to shoulder width and height is largely dictated by your preference and comfort. When you purchase your bike, enquire the width that is recommended for you. Generally, the upper arm should be between 80 and 90 degrees to the upper body, which will stabilise the shoulders, minimising hunching, and enable your body to withstand the load that is placed upon it. Provided that saddle height and stem length are correct, your hands should fall naturally on to the hoods, in a neutral handshake position. Rotation of the levers is again down to preference, rotated slightly further forwards for improved aerodynamics, and more upright for improved comfort.

Torso angle: To maximise comfort and take load off the lower back, hamstrings and the neck, your torso should sit between 40 and 50 degrees while seated with hands on the hoods. This more relaxed comfortable position will compromise speed while a lower position (between 30 and 40 degrees) will improve aerodynamics and reduce comfort. The more aerodynamic, the more stress placed on the lower back and the more flexibility needed in your hamstrings.

Cleats: Place the cleat so that it sits under or slightly behind the ball of your foot. The ball of the foot should be positioned over the pedal spindle. The importance of the shoe/pedal interface and proper cleat alignment is so important, as a problem with the positioning of your cleats can have a knock-on effect causing problems further up the body – for example, on your knee or lower back.

▪ ‘You wouldn’t drive a car with the seat right forwards if you are 6 ft tall, just as your wife wouldn’t get in the car after you’ve driven it and leave the seat right back. Getting a good bike fit is key for comfort and avoiding problems.’

Sir Bradley Wiggins

Pedalling

The key parts of the body involved in the pedal stroke include all the muscles and joints of the legs and the lower back. It’s important these have the appropriate range of motion, muscle length and freedom of movement in order to get optimal transfer of energy from the body into the pedals throughout the pedal stroke. An issue or injury with any of these muscles or joints could create a secondary problem elsewhere. For example, there is good evidence to demonstrate that a lower back issue can create a potential knee problem.

Aim to pedal between 80 and 100 rpm; pedal briskly and the mechanics of propelling the bike will naturally encourage the pedalling action to fall into place. You’ll also start to optimise the use of the power phase from two o’clock to five o’clock (looking at the chain set from the right-hand side); remember, all you are doing from six o’clock to one o’clock is delivering the pedal deftly back to the power phase. Your ankle shouldn’t flex too much and will mostly be flat or with toes slightly pointing downwards at the bottom of each stroke, but this will come naturally and doesn’t need to be focused on as it will be determined by your body’s mechanics and flexibility.

Clip-in pedals

These are a must for an efficient pedalling style. While the pedals will hold the shoe in place, many can be adjusted to allow some lateral float (movement) while pedalling. When buying cycling shoes, the degree of lateral foot movement can vary between 0–12 degrees depending on which brand you go for. Although the amount of lateral float is a personal choice, if you are new to cycling, opt for a shoe with some movement, as it can be altered until a comfortable position is found, or adjusted should an issue arise.

Fixated on the upstroke

Don’t get fixated on the upstroke. Many cyclists work on pulling up, but there’s little research to suggest it’s beneficial to the pedalling stroke. There is some evidence suggesting that forcing the upstroke can actually lead to an increased chance of injury as you begin to use muscles in a slightly unnatural way. Remember, going with what feels natural to you is a good starting point.

SPECIFICS CAN MATTER

Andrew Talansky AMERICAN PRO CYCLIST

▪ ‘I notice if my saddle is off by 1–2mm; if it’s too high, then, when I get off my bike, I am destroyed after the race or, if it’s too low, I can’t put the power out and wonder why I am not going so well. Above all the saddle height is the most important for me.’

CHAPTER 2

CORE STRENGTH: A VITAL COMPONENT

Five minutes a day is all I need to keep certain muscles activated and engaged. It’s about knowing and finding out what works for you to keep your body strong on the bike.

Dan Martin IRISH PRO CYCLIST AND TOUR DE FRANCE STAGE WINNER

Core strength helps stability

Once you have a bike that fits and understand some fundamentals of the pedalling action, it’s now a case of building a body to ensure you are stable, strong and primed for action, which will undoubtedly see you on your way to Cycling Nirvana. Of course, aerobic training is a priority for any keen cyclist. But cycling involves the entire body; it’s not just the legs that get the bike moving. A strong core that can withstand the pressures and stresses being placed on it is absolutely critical, not just for boosting your performance but also for preventing injury.

▪ ‘The older you get or the more you ride, the more you have to work on your core,’ says German pro cyclist, Fabian Wegmann. ‘I focus on my posterior chain exercises to keep my glutes and lower back strong, which really helps me on the bike and has really reduced pain in my lower back after a hard stage. It makes no sense to have good strong legs when your upper body and core can’t hold it and control it; it’s a waste of power. Modern cycling means off-the-bike work like strengthening the core is critical for both comfort and stability.’

Fabian Wegmann

Core strength improves cycling stability

Weak core = weak performance

When you’re cycling, it’s so important to keep still and steady, like a swan paddling on the water: the top half should be still and majestic while the legs are pedalling furiously underneath your stable body. A weak core will have a negative effect on your stability, and your lumbar/pelvic position (seated riding position) will significantly suffer. This can lead to excessive side-to-side movement, otherwise known as rocking. Although it might seem like a trivial issue, it’s anything but, because you will lose power in your legs as you start to use your primary movers that power the bike and move you forwards – such as your gluteals (buttocks) and quadriceps (thigh) muscles – to compensate and keep you still. Put simply, the power you should be generating to propel the bike is now being wasted through your body. Rocking may even contribute to saddle sores due to excessive friction being generated, an additional concern you don’t need.

In order to now sustain speed – without the use of the muscles you should predominantly use for pedalling – you may have to call upon other muscles such as your hamstrings to help. And if they aren’t conditioned or prepared, this could result in pain elsewhere. For example, one cause of lower back pain could be insufficiently conditioned hamstring muscles.

The PFC core strengthening routine (see here) helps to both directly and indirectly strengthen these core muscles.

The moment your body starts adjusting and compensating and as you move away from your ideal position, your set-up on the bike is being compromised. This can have a domino effect and lead to the development of pain and injuries elsewhere and notably hamper your performance. All the muscles are interconnected, they seldom work in isolation, and if there’s any sort of muscular imbalance, other muscles will try and compensate to help and your body may naturally adjust itself. Once you can no longer compensate or adapt, pain and injury can creep in.

It requires just a little dedication and some aptitude and within a couple of weeks, you will improve your power to transfer through the pedals, your stability on the bike and reduce your chances of developing injuries.

See the rehab toolkit for a comprehensive core exercise programme.

BELIEVE IN CORE WORK

Tyler Farrar AMERICAN PRO CYCLIST

▪ ‘I’m a big believer in core work. It improves my energy transfer on the bike and helps prevent injuries. Cycling naturally strengthens some muscles but weakens others; that’s why most pros slouch when they walk. I have specific gym days that involve core activities, where I’ll spend an hour going through exercises, for example squats and dead lifting where you use the whole core to stabilise. I try to keep it cycling-specific, and finish every gym session with a difficult core workout where I’ll do core exercises to fatigue.’

CYCLING NIRVANA

Daryl Impey SOUTH AFRICA | FIRST AFRICAN TO WEAR THE YELLOW JERSEY AT THE TOUR DE FRANCE

▪ ‘My Cycling Nirvana without question was the first day in the yellow jersey at the Tour de France in 2013. Just wearing the jersey took away any pain and made the whole day feel effortless. They say the yellow jersey gives you wings, I can attest to that. Maybe I was focusing on how awesome the moment was and how big it was that any pain I was experiencing, because of how hard the stage was, was worth it. What a special day.’

CHAPTER 3

WARMING UP TO THE IDEA OF WARM-UPS

The exercises I do give my body proper activation and my mind a few minutes to drift off before a hard workout or competition. An efficient warm-up is a true way to connect the mind and body.

Lucas Euser AMERICAN PRO CYCLIST AND UNIVEST GRAND PRIX WINNER

Warm-ups and stretching – it seems an unlikely topic to cause friction, but sport scientists can’t quite agree on how beneficial they are. While various studies have shown that a decent warm-up can improve performance and reduce injury, others have shown it has little effect and some have even found them to be detrimental if the intensity of the workout isn’t correctly tailored to the sport. So let’s try and clear it up: some form of warm-up is necessary for cycling, and we’ll explain why. The key is making sure it’s the right type of warm-up for the intensity and length of ride you’re doing that day.

An unconventional way to stretch, best left to the pros

Warm-Ups

The purpose of a warm-up

The purpose of a warm-up is to, quite literally, ‘warm up’ the body by increasing core body temperature. An increase of 1–2˚C will create a number of physiological changes that will have a significant positive effect on performance, such as:

•Reduce sports-related musculoskeletal injuries by increasing the elasticity of muscles. Strains and tears are often a result of an abrupt, forceful muscle action where muscle fibres suddenly lengthen and a cold muscle will significantly increase the chances of muscle injury. A warm muscle is a looser, suppler, and more flexible muscle, which will be far more tolerant of forces and movement.

•An increased cardiac output means elevated blood flow so more blood is pumped around the body faster, carrying oxygen, nutrients and minerals to the working muscles.

•Muscles contract more forcefully and relax far quicker, enhancing both speed and strength.

•Increased speed of nerve impulses and heightened sensitivity of nerve receptors. During the initial onset of exercise, faster signalling within the body occurs.

Loosening up may be part of a warm up

What constitutes a warm-up?

Is a slow five-minute spin of the legs an adequate warm-up or should the body be pushed close to the point of fatigue in order to prepare the body for peak performance? If you’re competing in a 10-mile time trial, should the warm-up replicate the event and is that same warm-up necessary for a 50- or 100-mile sportive? And what about stretches, should they be incorporated into a warm-up and if so, what type?

These are all valid questions, and the truth is, there isn’t any one specific way to warm up. Warm-ups can be systemic on the bike, or they can be exercises off the bike to get the muscles activated and ready for action. When you’re watching TV coverage in the run-up to cycling events you’ll see a whole range of warm-ups taking place, yet they all serve a similar purpose. For example, during Grand Tours before time trials, you’ll see the pros spinning away on a home trainer, following structured plans, working to certain intensities, while concentrating on cadence and effort. It’s a workout in itself, but they’re preparing their body, so that they’re ready to go from the starting gate. On other race days that start off more ‘easily’, you’ll regularly find riders using the neutral zone – the 5–10 km as they roll out of town to the official start of the day’s race – to loosen and warm up.

▪ ‘If I’m doing a time trial when I know I need to go flat out 100 per cent from the line, then I’ll do a specific, deliberate warm-up to get the body going and ready to race,’ says Canadian pro cyclist and 2012 Giro d’Italia winner, Ryder Hesjedal. ‘The majority of pro races have a 5 km or so neutral zone so you’ll roll out easy and use this as the warm-up, but if you’re trying to get in the day’s breakaway or the stage starts up a mountain then I’ll warm up as I don’t want to get caught cold. If you see a whole team on the rollers before the start of a stage, buckle up as they’re going to make the race hard, right from the start.’

Ryder Hesjedal

As Ryder points out, for short, specific sessions that require the body to be performing at its peak, it’s imperative that your body is prepared and ready. Suddenly forcing cold muscles into all-out effort increases the chances of muscle tears and injury.

But what about rides that don’t require such intense efforts straight away – is an intense warm-up necessary? The answer is no, and a slower, easier warm-up will suffice. For example, if you’re heading out on a Sunday morning ride, then riding moderately, gradually increasing the intensity for the first 10–20 minutes, will be enough to raise body temperature by 1–2˚ – which is the important factor – and prepare the body. And yes, you guessed it, if it’s cold outside to begin with, your warm-up may need to be longer by 10–15 minutes or so to have the same effect.

Remember, when performing warm-ups, it’s not necessarily the duration of the warm-up that counts, but rather what it consists of, how it activates parts of the body and that it raises body temperature.

Stretching before the start of a race may help

So how do you know when the body is sufficiently warmed up? It’s important to realise that there’s a fine line between a warm-up that will signal the physiological changes you are looking for, and a warm-up that starts to eat away at precious energy levels. A reliable, quick barometer that will tell if you are suitably warm for exercise is when you can almost feel a bead of sweat about to drop down your forehead. Why? Well, in order to offload the extra heat that is being produced, the body’s first mechanism is to sweat – simple. Otherwise, feel inside your jersey, if it’s clammy, you’ve started sweating and you’re warmed up.

To optimise performance and minimise injury, you must be sufficiently warmed up before riding hard. But there’s another piece to the puzzle…

Stretching

▪ ‘When I’m heading out on a long ride, I’ll take 20 to 30 minutes to begin with, to spin my legs easily,’ says American pro cyclist, Caleb Fairly. ‘But before I get on my bike, I’ll also do some glute and hamstring dynamic stretches and specific movement preparation to get the muscles firing and activated.’

Caleb Fairly

Before Caleb even gets on the bike he will stretch specific parts of the body. A lot of other pros do, too.

And they’re right to do so. Stretching, specifically dynamic stretching,