Secrets To Treating Bicycling Injuries

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Secrets To Treating Bicycling Injuries
During one hour of cycling, a rider may average up to 5,000 pedal revolutions. The smallest amount of malalignment, whether it is anatomic or equipment-related, can lead to dysfunction, impaired performance and injury.
More than 49 million Americans ride bicycles at least monthly, with over 5 million people riding at least 20 days per month.
Recommended Bike Adjustments For Common Overuse Injuries
By Mark A. Caselli, DPM, Edward C. Rzonca, DPM and John J. Rainieri, DPM

   Treatment and management of these conditions consist of therapeutic exercise including stretching, ice massage and NSAIDs. Both conditions benefit from the use of foot orthoses and night splints. In the case of a leg length discrepancy, one should first correct any existing overpronation, proceed to fit the bike to the long leg and then address the short leg with orthoses or shim between the shoe and cleat. The thickness of the shim should be less than the measured discrepancy. The cyclist can aid recovery by decreasing riding time and intensity. Riding at a higher cadence with low resistance may also help.

   Since the foot is tightly bound into the shoe, one commonly sees problems related to compression in cyclists. Symptoms associated with neuromas, bunions, hammertoes, blisters and subungual hematomas arise with inappropriate shoe fit or too tight straps or toe clips.

   Treatment requires selecting shoes of the proper length and width, and ensuring an adequate toe box height. Complaints of metatarsalgia may be the result of tight shoes or a lack of shock absorption to the forefoot of the shoe. Certain types of pedals, especially those that are serrated (“rat trap”), may cause metatarsal pain.

   Shoes with cleats concentrate pressure on one focal area of the foot and can also be the cause of metatarsalgia. Employing shock attenuating insoles can reduce pressure to the bottom of the foot but exercise caution with this approach. If the shoe is too tight to begin with, one may compound the cyclist’s foot problems by placing bulky materials in the shoe.

Dr. Caselli is a Staff Podiatrist at the VA Hudson Valley Health Care System in Montrose, N.Y. He is also an Adjunct Professor at the New York College of Podiatric Medicine and is a Fellow of the American College of Sports Medicine.

Dr. Rzonca is a Staff Podiatrist at the VA Hudson Valley Health Care System in Montrose, N.Y. He is the Former Chairman of the Department of Orthopedic Sciences at the New York College of Podiatric Medicine.

Dr. Rainieri is the Program Manager of the Podiatry Service at the VA Hudson Valley Health Care System in Montrose, N.Y.


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