1
|
Bonfatti M, Bizzoni E, Gennari A, Salvioli S. The effect of cleat position on foot pain in cyclists. J Sports Med Phys Fitness 2024; 64:816-821. [PMID: 38512304 DOI: 10.23736/s0022-4707.24.15232-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Amateur or non-competitive cycling is one of the most popular and growing sports, and the repetitive nature of this sport, combined with a cleat position that is too far forward, often leads to peripheral ischemia or pressure, which can cause pain at the metatarsal level due to the nerve and vascular structures present at this level, according to several authors. This clinical series describes the work done to reduce pain in 21 cyclists who reported foot pain/discomfort exclusively during pedaling. To exclude different causes of pain, other than the position of the cleat, the cyclists received biomechanical assessments using an indoor bike smart trainer and a 2D motion capture system. The pain was found to be associated with the incorrect positioning of the shoe cleats, which were generally positioned at the level of the phalanges and, according to our hypothesis, in a significantly forward position. Our intervention was to move the cleat back under the metatarsal head in all the cyclists examined. After five cycling sessions, feedback showed significant improvements. The authors were aware of some limitations, such as the small number of subjects studied, the different types of cleats used by different cyclists, and the lack of information on cadence. However, the overall data collected during the study showed a significant improvement of 5 points on the Numeric Pain Rating Scale (NPRS) after treatment. This clinical series supports the hypothesis that cleat retraction improves foot pain in cyclists, but further studies are needed to better characterize and understand the mechanism underlying the development of pain. More methodologically sound studies are needed. The current clinical series is the first of its kind to describe an initial method of reducing metatarsal pain in cyclists.
Collapse
Affiliation(s)
- Mattia Bonfatti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, Savona, Italy -
| | | | - Alessandro Gennari
- Department of Bioinformatics for Computational Genomics, University of Milan, Milan, Italy
| | - Stefano Salvioli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, Savona, Italy
| |
Collapse
|
2
|
Bing F, Zhang G, Wang Y, Zhang M. Effects of workload and saddle height on muscle activation of the lower limb during cycling. Biomed Eng Online 2024; 23:6. [PMID: 38229090 DOI: 10.1186/s12938-024-01199-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/04/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Cycling workload is an essential factor in practical cycling training. Saddle height is the most studied topic in bike fitting, but the results are controversial. This study aims to investigate the effects of workload and saddle height on the activation level and coordination of the lower limb muscles during cycling. METHODS Eighteen healthy male participants with recreational cycling experience performed 15 × 2-min constant cadence cycling at five saddle heights of 95%, 97%, 100%, 103%, and 105% of greater trochanter height (GTH) and three cycling workloads of 25%, 50%, and 75% of functional threshold power (FTP). The EMG signals of the rectus femoris (RF), tibialis anterior (TA), biceps femoris (BF), and medial gastrocnemius (MG) of the right lower limb were collected throughout the experiment. RESULTS Greater muscle activation was observed for the RF and BF at a higher cycling workload, whereas no differences were observed for the TA and MG. The MG showed intensified muscle activation as the saddle height increased. The mean and maximum amplitudes of the EMG signals of the MG increased by 56.24% and 57.24% at the 25% FTP workload, 102.71% and 126.95% at the 50% FTP workload, and 84.27% and 53.81% at the 75% FTP workload, respectively, when the saddle height increased from 95 to 100% of the GTH. The muscle activation level of the RF was minimal at 100% GTH saddle height. The onset and offset timing revealed few significant differences across cycling conditions. CONCLUSIONS Muscle activation of the RF and BF was affected by cycling workload, while that of the MG was affected by saddle height. The 100% GTH is probably the appropriate saddle height for most cyclists. There was little statistical difference in muscle activation duration, which might be related to the small workload.
Collapse
Affiliation(s)
- Fangbo Bing
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, 999077, China
| | - Guoxin Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, 999077, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, 999077, China
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong SAR, 999077, China
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, 518057, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, 999077, China.
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong SAR, 999077, China.
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, 518057, China.
| |
Collapse
|
3
|
Klich S, Michalik K, Rajca J, Ficek K, Fernández-de-Las-Peñas C, Kawczynski A, Madeleine P. Fatigue-induced Alterations of the Patellar Tendon in Elite Sprint Track Cyclists. Int J Sports Med 2023; 44:995-1002. [PMID: 36690028 DOI: 10.1055/a-2018-2781] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This study aims to investigate morphological and mechanical properties and echogenicity of the patellar tendon (PT) after acute fatigue-induced alterations in sprint track cyclists. Fourteen elite track cyclists participated in this study. The exercise protocol consisted of three maximal start accelerations (over a distance of 62.5 m), one maximal start acceleration (at both 125 m and 250 m), and sprints from the standing start. Immediately after testing all measurements, PT stiffness and thickness were set at 5-10-15-20 mm distal from the apex of the patella and 5-10 mm proximal to the tibial tuberosity. CSA was set at proximal, middle, and distal, while echogenicity was at proximal and distal points. The results showed significant increases in PT stiffness at all reference points after start acceleration (p<0.001). PT thickness showed similar results for stiffness, except for location placed at TT-5 (p<0.001). CSA increased significantly in proximal, middle, and distal regions (p<0.001), while echogenicity of the tendon increased in proximal and distal regions (p<0.001) after start acceleration. Regional-dependent alterations of PT thickness and stiffness may be related to anatomical and physiological mechanisms due to acute isometric contraction in the initial phase of standing start. Tendon echogenicity might be also useful in monitoring tendon mechanical properties and defining acute fatigue-induced changes.
Collapse
Affiliation(s)
- Sebastian Klich
- Department of Paralympic Sport, Wroclaw University of Health and Sport Sciences, Wrocław, Poland
| | - Kamil Michalik
- Department of Human Motor Skills, Wroclaw University of Health and Sport Sciences, Wrocław, Poland
| | - Jolanta Rajca
- Department of Science, Innovation and Development, Galen-Orthopaedics, Bieruń, Poland
| | - Krzysztof Ficek
- Department of Physiotherapy, Jerzy Kukuczka Academy of Physical Education In Katowice, Katowice, Poland
- Department of Science, Innovation and Development, Galen-Orthopaedics, Bieruń, Poland
| | - Cesar Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
- Cátedra Institucional En Docencia, Clínica E Investigación En Fisioterapia: Terapia Manual, Punción Seca Y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Adam Kawczynski
- Department of Biomechanics and Sport Engineering, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Pascal Madeleine
- Health Science and Technology, Aalborg University, Aalborg, Denmark
| |
Collapse
|
4
|
du Toit F, Schwellnus M, Jordaan E, Swanevelder S, Wood P. Clinical characteristics of gradual onset injuries in recreational road cyclists - SAFER XXVII study over 5 years in 62758 race entrants. PHYSICIAN SPORTSMED 2023; 51:564-571. [PMID: 36281474 DOI: 10.1080/00913847.2022.2136984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/10/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Gradual onset injuries (GOIs) in recreational cyclists are common but not well described. The aim of this study is to describe the clinical characteristics of GOIs (main anatomical regions, specific anatomical sites, specific GOIs, tissue type, severity of GOIs, and treatment modalities) of GOIs among entrants participating in a community-based mass participation-cycling event over 5 years. METHODS During the 2016-2020 Cape Town Cycle Tour, 62,758 consenting race entrants completed an online pre-race medical screening questionnaire. 1879 reported GOIs in the previous 12 months. In this descriptive epidemiological study, we report frequency (% entrants) of GOIs by anatomical region/sites, specific GOI, tissue type, GOI severity, and treatment modalities used. RESULTS The main anatomical regions affected by GOIs were lower limb (47.4%), upper limb (20.1%), hip/groin/pelvis (10.0%), and lower back (7.8%). Specifically, GOI were common in the knee (32.1%), shoulder (10.6%), lower back (7.8%) and the hip/buttock muscles (5.2%). The most common specific GOI was anterior knee pain (17.2%). 57.0% of GOIs were in soft tissue. Almost half (43.9%) of cyclists with a GOI reported symptom duration >12 months, and 40.3% of GOIs were severe enough to reduce/prevent cycling. Main treatment modalities used for GOIs were rest (45.9%), physiotherapy (43.0%), stretches (33.2%), and strength exercises (33.1%). CONCLUSION In recreational cyclists, >50% of GOIs affect the knees, shoulders, hip/buttock muscles and lower back, and 40% are severe enough to reduce/prevent cycling. Almost 45% of cyclists with GOIs in the lower back; or hip/groin/pelvis; or lower limbs; or upper limb reported a symptom duration of >12 months. Risk factors associated with GOIs need to be determined and preventative programs for GOIs need to be designed, implemented, and evaluated.
Collapse
Affiliation(s)
- François du Toit
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- International Olympic Committee (IOC) Research Centre, Pretoria, South Africa
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
- Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
| | - Sonja Swanevelder
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Paola Wood
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
5
|
Liang L, Harris JA, Patel NA, Hajibandeh JT, Ji YD. Hospital Admissions Associated With Head and Neck Injuries From Olympic-style Sports and Activities Between 2010 and 2022. J Craniofac Surg 2023:00001665-990000000-01253. [PMID: 38018969 DOI: 10.1097/scs.0000000000009899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/20/2023] [Indexed: 11/30/2023] Open
Abstract
The objective of this study was to evaluate which Olympic-style sports and activities are most likely to result in hospitalizations relating to head and neck injuries. This was a cross-sectional study using the National Electronic Injury Surveillance System (NEISS) database. Subjects with head and neck injuries from selected Olympic-style sports and activities between 2010 and 2022 were included. Independent variables were demographics and injury characteristics (injury location and sport). The primary outcome variable was hospitalization (yes/no). Survey-weighted descriptive, bivariate, and logistic regression statistics were computed to measure the association between demographic/injury variables and hospitalization. There were 175,995 subjects (national estimate, 5,922,584) meeting inclusion criteria. After adjusting for demographic and injury characteristics, head injuries (odds ratio [OR] = 2.17; 95% CI, 1.83-2.56; P<0.001) demonstrated higher odds of hospitalization compared with facial injuries. Injuries from cycling (OR = 2.52; 95% CI, 2.16-2.95; P<0.001), mountain biking (OR = 2.56; 95% CI, 1.80-3.65; P<0.001), and horseback riding (OR = 4.01; 95% CI, 2.76-5.83; P<0.001) demonstrated higher odds of hospitalization relative to baseball injuries. In conclusion, head and neck injuries associated with high velocity Olympic-style sports and activities such as cycling, mountain biking, and horseback riding had the highest odds of hospitalization.
Collapse
Affiliation(s)
- Lang Liang
- Harvard School of Dental Medicine, Boston, MA
| | - Jack A Harris
- Department of Surgery, Division of Oral and Maxillofacial Surgery, University of Miami and Jackson Memorial Hospital, Miami, FL
| | - Nisarg A Patel
- Department of Oral and Maxillofacial Surgery, University of California, San Francisco, CA
| | - Jeffrey T Hajibandeh
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA
| | - Yisi D Ji
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA
| |
Collapse
|
6
|
Hatefi M, Hadadnezhad M, Shojaedin S, Babakhani F, Tazji MK. The effects of the Posterior X Taping versus augmented feedback on lower-extremity kinematic and muscle activity pattern during unilateral weight-bearing activities in men with tibiofemoral varus malalignment. J Exp Orthop 2023; 10:70. [PMID: 37468708 DOI: 10.1186/s40634-023-00636-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/11/2023] [Indexed: 07/21/2023] Open
Abstract
PURPOSE Tibiofemoral Varus Malalignment (TFRV) contributes to overuse injuries by altering lower limb biomechanics. Both Posterior X Taping (PXT) and Real Time Feedback (RTF), have each been recommended for subjects with TFRV as they are thought to enhance control of excessive tibiofemoral rotations. This paper evaluates this claim. METHODS A total of recreational male 24 athletes with TFRV participated in the current study. Kinematic and electromyography variables of lower extremity were synchronously recorded on five consecutive repetitions of the single-legged-squat (SLS) and forward-step-down) FSD) tasks before and after applications of PXT and RTF. RESULTS The subjects at post-intervention in RTF group exhibited decreased hip adduction during FSD, and decreased hip adduction and internal rotation during eccentric and concentric phases of the SLS; Additionally, we observed increased gluteus medius activity during eccentric phase of the SLS and FSD tasks. In contrast, subjects at the post-intervention in PXT group exhibited decreased tibiofemoral external rotation and increased ankle external rotation during all the phases of both SLS and FSD tasks. CONCLUSION These results suggest that the PXT and RTF interventions are recommended to immediately improve the functional defects of the subjects with TFRV during SLS and FSD tasks.
Collapse
Affiliation(s)
- Mohamadreza Hatefi
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran.
| | - Malihe Hadadnezhad
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran
| | - Sadredin Shojaedin
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran
| | - Farideh Babakhani
- Department of Sport Injuries and Corrective Exercises, Faculty of Physical Education, Allameh Tabataba'i University, Tehran, Iran
| | - Mehdi Khaleghi Tazji
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran
| |
Collapse
|
7
|
Casado-Hernández I, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Soriano-Medrano A, López-López D, Navarro-Flores E, Pérez-Boal E, Martínez-Jiménez EM. The Effectiveness of Hard Insoles for Plantar Pressure in Cycling: A Crossover Study. Bioengineering (Basel) 2023; 10:816. [PMID: 37508843 PMCID: PMC10375994 DOI: 10.3390/bioengineering10070816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/31/2023] [Accepted: 06/23/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Hard insoles have been proposed to decrease plantar pressure and prevent foot pain and paresthesia due to repetitive loading. The aim of this research was to analyze the effect of three different hard insoles in cycling on healthy subjects. METHODS A crossover randomized trial was carried out. The mean age of the subjects was 35 ± 3.19 years, and all of them were men. While the subjects were cycling on a stationary bicycle, their plantar pressure was recorded with nine in-shoe sensors placed in nine specific foot areas to test a standard ethylene-vinyl-acetate 52° Shore A hardness insole, a polypropylene 58° Shore D insole, and a polypropylene 580 Shore D insole with selective aluminum 60 HB Brinell hardness in the metatarsal head and hallux. RESULTS The maximum plantar pressure decreased significantly with the polypropylene insole containing selective aluminum in the metatarsal head and hallux areas. The maximum plantar data of the polypropylene aluminum insole in the M2 area (5.56 kgF/cm2), fifth metatarsal styloid process (6.48 kgF/cm2), M3-M4 area (4.97 kgF/cm2), and hallux (8.91 kgF/cm2) were of particular interest compared to the other insoles. CONCLUSIONS The use of insoles made of polypropylene with aluminum in the metatarsal head and hallux areas decreases the maximum plantar pressure in cycling compared to standard EVA and polypropylene insoles.
Collapse
Affiliation(s)
- Israel Casado-Hernández
- Faculty of Nursing, Physiotherapy and Podiatry, University Complutense of Madrid, 28040 Madrid, Spain
| | | | | | - Alfredo Soriano-Medrano
- Faculty of Nursing, Physiotherapy and Podiatry, University Complutense of Madrid, 28040 Madrid, Spain
| | - Daniel López-López
- Research, Health, and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, 15403 Ferrol, Spain
| | - Emmanuel Navarro-Flores
- Frailty Research Organized Group (FROG), Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, 46010 Valencia, Spain
| | - Eduardo Pérez-Boal
- Faculty of Nursing and Physiotherapy, University of León, 24401 Ponferrada, Spain
| | | |
Collapse
|
8
|
Noriega-González D, Caballero-García A, Roche E, Álvarez-Mon M, Córdova A. Inflammatory Process on Knee Osteoarthritis in Cyclists. J Clin Med 2023; 12:jcm12113703. [PMID: 37297897 DOI: 10.3390/jcm12113703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/17/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
Osteoarthritis is a disorder affecting the joints and is characterized by cellular stress and degradation of the extracellular matrix cartilage. It begins with the presence of micro- and macro-lesions that fail to repair properly, which can be initiated by multiple factors: genetic, developmental, metabolic, and traumatic. In the case of the knee, osteoarthritis affects the tissues of the diarthrodial joint, manifested by morphological, biochemical, and biomechanical modifications of the cells and the extracellular matrix. All this leads to remodeling, fissuring, ulceration, and loss of articular cartilage, as well as sclerosis of the subchondral bone with the production of osteophytes and subchondral cysts. The symptomatology appears at different time points and is accompanied by pain, deformation, disability, and varying degrees of local inflammation. Repetitive concentric movements, such as while cycling, can produce the microtrauma that leads to osteoarthritis. Aggravation of the gradual lesion in the cartilage matrix can evolve to an irreversible injury. The objective of the present review is to explain the evolution of knee osteoarthritis in cyclists, to show the scarce research performed in this particular field and extract recommendations to propose future therapeutic strategies.
Collapse
Affiliation(s)
- David Noriega-González
- Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, Faculty of Medicine, HVUV, 47003 Valladolid, Spain
| | - Alberto Caballero-García
- Department of Anatomy and Radiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, University of Valladolid, Campus Los Pajaritos, 42004 Soria, Spain
| | - Enrique Roche
- Department of Applied Biology-Nutrition and Institute of Bioengineering, Miguel Hernández University (UMH), 03202 Elche, Spain
- Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Melchor Álvarez-Mon
- Department of Internal Medicine, University of Alcalá de Henares, 28801 Alcalá de Henares, Spain
| | - Alfredo Córdova
- Department of Biochemistry, Molecular Biology and Physiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, University of Valladolid, Campus Duques de Soria, 42004 Soria, Spain
| |
Collapse
|
9
|
Chartogne M, Millour G, García-López J, Duc S, Rodríguez-Marroyo JA, Pernía R, Bertucci W. Acute effects of small changes in antero-posterior shoe-cleat position on physiological and biomechanical variables in road cycling. Sports Biomech 2023; 22:510-521. [PMID: 35129429 DOI: 10.1080/14763141.2022.2034927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this study was to investigate the effect of changes in cycling shoe-cleat position on pedalling biomechanics, physiological variables, and performance in road cycling. Twelve competitive road cyclists performed three pedalling trials with the cleat positioned at the first metatarsal head, 15-mm anterior and 15-mm posterior. Each trial included three sets of 5 min performed at 35%, 50%, and 65% of maximal aerobic power (MAP) followed by a 10-s sprint. Results showed no significant changes in physiological variables, pedalling kinetics, muscular activity of six lower limb muscles, sprint performance and perceived exertion. However, significant differences were found regarding joint kinematics: hip, knee, and ankle angles during both extension and flexion were reduced in the anterior cleat position. Therefore, this study suggests that cleat position does not affect sprint performance, physiological variables, pedalling kinetics, muscle activity, and perceived exertion regardless of the cycling intensity. However, joint kinematics, and particularly knee extension angle which could be related to the risk of overuse injuries, was affected by the shoe-cleat position.
Collapse
Affiliation(s)
- M Chartogne
- Movement, Interactions, Performance Laboratory (EA4334), Le Mans University, Le Mans, France.,Performance, Health, Measurement, Society (EA7507), Reims University, Reims, France
| | - G Millour
- Performance, Health, Measurement, Society (EA7507), Reims University, Reims, France
| | - J García-López
- Faculty of Physical Activity and Sports Sciences, Department of Physical Education and Sports, Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - S Duc
- Performance, Health, Measurement, Society (EA7507), Reims University, Reims, France
| | - J A Rodríguez-Marroyo
- Faculty of Physical Activity and Sports Sciences, Department of Physical Education and Sports, Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - R Pernía
- Faculty of Physical Activity and Sports Sciences, Department of Physical Education and Sports, Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - William Bertucci
- Performance, Health, Measurement, Society (EA7507), Reims University, Reims, France
| |
Collapse
|
10
|
Bini RR, Hunter JR. Pain and body position on the bicycle in competitive and recreational road cyclists: A retrospective study. Sports Biomech 2023; 22:522-535. [PMID: 34142644 DOI: 10.1080/14763141.2021.1942967] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study compared the presence of pain in recreational and competitive road cyclists and body position on the bicycle between cyclists with and without pain. Seventy-one cyclists completed a survey reporting existing cycling-related sites of pain and comfort. Static sagittal and frontal plane images were taken to analyse body position on the bicycle. Participants were separated into recreational and competitive road cycling groups, and further into cyclists reporting pain in the upper body, low back, buttocks/hips and knees for comparison with cyclists without pain. A logistic regression model investigated possible predictors of pain whilst cycling. Pain was present in 67% of recreational and 70% of competitive cyclists whilst comfort was reported by 81% of recreational and 75% of competitive cyclists. Trivial to moderate non-significant differences were observed for body position on the bicycle between cyclists with and without pain, and between cyclists with and without pain in the upper body, low back, buttocks/hips and knees. The predictive logistic model was not significant (p = 0.07) with a model fit predicted by McFadden R2 of 0.07. Given most cyclists reported both pain and comfort, comfort is probably not a good predictor of overuse injury risk.
Collapse
Affiliation(s)
- Rodrigo R Bini
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Australia.,Sport Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Jayden R Hunter
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| |
Collapse
|
11
|
Association of Cycling Kinematics With Anterior Knee Pain in Mountain Bike Cyclists. J Sport Rehabil 2023; 32:40-45. [PMID: 35961646 DOI: 10.1123/jsr.2021-0233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/24/2021] [Accepted: 05/24/2022] [Indexed: 01/03/2023]
Abstract
CONTEXT Comfort and pain in cyclists are often discussed as a result of the posture on the bike, and bike fit, including motion analysis, is advocated as a strategy to minimize these conditions. The relationship between cycling kinematics, comfort, and pain is still debatable. OBJECTIVES To investigate the association of ankle, knee, and trunk kinematics with the occurrence of anterior knee pain (AKP) in mountain bike cyclists. DESIGN Cross-sectional study. METHODS Fifty cross-country mountain bike cyclists (26 with AKP and 24 without AKP) had their pedaling kinematics assessed. Linear and angular data from trunk, hip, knee, ankle, and foot from cyclists with and without AKP were recorded using Retül motion analysis system. RESULTS The binary logistic regression model showed that kinematic variables such as peak ankle plantar flexion, peak knee flexion, and forward trunk lean were significant predictors of AKP. Both larger peak plantar flexion and knee flexion decreased the probability of reporting AKP. On the other hand, larger forward trunk lean increased the probability of reporting AKP. CONCLUSIONS Ankle, knee, and trunk sagittal kinematics may predict AKP in cross-country mountain bike cyclists, whereas hip, knee, and ankle alignment in the frontal plane showed no association with occurrence of AKP. In other words, cyclists with larger ankle plantar flexion and knee flexion are less likely to have AKP, whereas those with increased trunk forward lean are more likely to have AKP.
Collapse
|
12
|
Hatefi M, Hadadnezhad M, Shojaedin S, Babakhani F, Tazji MK. Effects of the real-time feedback and knee taping on lower-extremity function during ergometer pedaling in subjects with tibiofemoral varus alignment. Gait Posture 2022; 96:322-329. [PMID: 35785656 DOI: 10.1016/j.gaitpost.2022.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 05/09/2022] [Accepted: 05/23/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The effect of the Posterior X Taping (PXT) used for subjects with Tibiofemoral Varus Malalignment (TFRV) aimed to control excessive tibiofemoral rotations is still unclear. Further, it is critical to use evidence-based therapeutic exercises to prevent non-contact injuries, especially in repetitive movements. OBJECTIVE To investigate whether the PXT and real-time feedback (RTF) interventions would improve lower extremity functions during the pedaling task in subjects with TFRV. METHODS Twenty-four male recreational athletes with TFRV participated in this study; Kinematic and muscle activity were synchronously recorded on ten consecutive pedal cycles during the last 30 s of 2-min pedaling. RESULTS The present study indicated that the subjects at the post-intervention of the RTF group exhibited significant decreased hip adduction and internal rotation, significant decreased tibiofemoral external rotation between 144° and 216° of crank angle, significant increased vastus medialis activity between 144° and 288° of crank angle, and significant increased gluteus medius activity between 180° and 144° of crank angle; In contrast, the subjects at the post-intervention of the PXT group exhibited significant decreased tibiofemoral external rotation and increased ankle external rotation at all the crank angles. No between-group differences were observed in pre-and post-intervention. SIGNIFICANCE These results suggest that the PXT and RTF interventions are recommended to immediately improve the functional defects of the subjects with TFRV during the pedaling task.
Collapse
Affiliation(s)
- Mohamadreza Hatefi
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran
| | - Malihe Hadadnezhad
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran
| | - Sadredin Shojaedin
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran.
| | - Farideh Babakhani
- Department of Sports Injury and Corrective Exercise, Faculty of Physical education, Allameh Tabataba'i University, Tehran, Iran
| | - Mehdi Khaleghi Tazji
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran
| |
Collapse
|
13
|
Branco GR, Resende RA, Bittencourt NF, Mendonça LD. Interaction of hip and foot factors associated with anterior knee pain in mountain bikers. Phys Ther Sport 2022; 55:139-145. [DOI: 10.1016/j.ptsp.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 10/18/2022]
|
14
|
Abstract
Both lower extremities and lower back are common sources of injury for cyclists. For providers to optimize care within this area of sports medicine, they need to understand the most common sources of injury in this population. Cycling presents a unique challenge: treating both the athlete and the complex relationship between rider and bicycle. Physicians should not replace the role of a professional bike fitter and should view these individuals as integral members of the team to alleviate current and prevent future injury. This article explores common lower extremity and lumbar back overuse injuries in cyclists and their medical management.
Collapse
|
15
|
Abstract
The focus of this article centers on bicycle injury prevention and related infrastructure. The article discusses the current epidemiology of cycling injuries, and known prevention strategies, specifically individual recommended practices related to helmet use in both adult and pediatric populations. The article also discusses different ways in which the environment plays a role in protecting cyclists from injuries, and what environmental changes have been adopted to reduce the likelihood for cycling injuries.
Collapse
|
16
|
Ultrasound-guided release for iliotibial band syndrome: A novel ultraminimally invasive surgical procedure. Knee 2021; 30:9-17. [PMID: 33784536 DOI: 10.1016/j.knee.2021.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/01/2021] [Accepted: 02/15/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Iliotibial band (ITB) syndrome is the most common cause of lateral knee pain in runners (affecting 7-14%) and in persons taking part in other sports. The aim of this study was to show how to perform a distal release of the ITB guided by ultrasound and present our initial results with this new technique. METHODS The surgical technique - either Z-plasty or transverse section of the ITB - was first validated on 14 cadaver specimens and then applied in clinical practice. We operated on 32 patients (27 males and five females, 34 cases) from 2013 to 2018. Mean age was 40 years (25-60). The patients comprised 21 recreational middle- or long-distance runners (23 cases), five cyclists, two basketball players, two military personnel, one fireman, and one boxer. RESULTS All patients were satisfied after 3 months and returned to their sporting activities without restrictions. The visual analog scale score for the practice of sports activities improved from 7 (6-9) before surgery to 0 (0-1) after. The average Lysholm score was 68 points before surgery and 97 (91-100) after, with five good results and 29 excellent results. No patients complained of instability or muscle weakness after 3 months. CONCLUSION Ultrasound-guided release of the ITB is a novel minimally aggressive surgical approach that potentially enables faster recovery. It is relatively easy, quick, and painless, with a small incision, and can be performed under local anaesthesia in an outpatient setting. It does not require limb exsanguination or stitches, and complications are minimal.
Collapse
|
17
|
The Effect of Crank Length Changes from Cycling Rehabilitation on Muscle Behaviors. Appl Bionics Biomech 2021; 2021:8873426. [PMID: 33995578 PMCID: PMC8096580 DOI: 10.1155/2021/8873426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 04/06/2021] [Accepted: 04/17/2021] [Indexed: 11/29/2022] Open
Abstract
Background Many sports and physical activities can result in lower limb injures. Pedaling is an effective exercise for lower extremity rehabilitation, but incorrect technique may cause further damage. To some extent, previous experiments have been susceptible to bias in the sample recruited for the study. Alternatively, methods used to simulation activities can enable parametric studies without the influence of noise. In addition, models can facilitate the study of all muscles in the absence of the effects of fatigue. This study investigated the effects of crank length on muscle behavior during pedaling. Methods Six muscles (soleus, tibialis anterior, vastus medialis, vastus lateralis, gastrocnemius, and rectus femoris), divided into three groups (ankle muscle group, knee muscle group, and biarticular muscle group), were examined under three cycling crank lengths (100 mm, 125 mm, and 150 mm) in the present study. In addition, the relationship between crank length and muscle biological force was analyzed with the AnyBody Modeling System™, a human simulation modeling software based on the Hill-type model. Findings. Based on inverse kinematic analysis, the results indicate that muscle activity and muscle force decrease in varying degrees with increases in crank length. The maximum and minimum muscular forces were attained in the tibialis anterior and vastus lateralis, respectively. Interpretation. Studying the relationship between muscle and joint behavior with crank length can help rehabilitation and treating joint disorders. This study provides the pedal length distribution areas for patients in the early stages of rehabilitation.
Collapse
|
18
|
Encarnación-Martínez A, Ferrer-Roca V, García-López J. Influence of Sex on Current Methods of Adjusting Saddle Height in Indoor Cycling. J Strength Cond Res 2021; 35:519-526. [PMID: 29912071 DOI: 10.1519/jsc.0000000000002689] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
ABSTRACT Encarnación-Martínez, A, Ferrer-Roca, V, and García-López, J. Influence of sex on current methods of adjusting saddle height in indoor cycling. J Strength Cond Res 35(2): 519-526, 2021-The popularity of indoor cycling has increased in fitness centers, and therefore, proper bike fitting is important to avoid biomechanical-related injuries. However, no previous studies have compared the biomechanical kinematics of various existing protocols of saddle-height adjustment in indoor cycling. Furthermore, it was not clear if these protocols were appropriate for both men and women, as these equations were primarily obtained in male cyclists. Therefore, lower-limb joint kinematics were compared among 4 different protocols of saddle-height adjustment (1-Preferred, 2-Ferrer-Roca et al., 3-Lemond & Guimard, and 4-Static Goniometry) in 30 experienced indoor-cycling subjects (15 men and 15 women). Only 20-33% of the women had a knee extension while pedaling within the recommended range for each of the different protocols except for the preferred adjustment (73% were within). By contrast, all the protocols were moderately suitable for men (47-60% were within the recommended range). A multiple linear equation to estimate the recommended saddle height in both men and women (R2 = 0.917, p = 0.001) was obtained from the following variables: inseam length, stature, foot length, and knee angle. The differences in the findings between men and women may be partially explained by differences in anatomical structures, as well as the male-based equations, which argues the need for future investigations in female cyclists.
Collapse
Affiliation(s)
- Alberto Encarnación-Martínez
- Faculty of Sport, Catholic University of Murcia, Guadalupe, Murcia, Spain
- UCAM Research Center for High Performance Laboratory, Guadalupe, Murcia, Spain
| | - Ventura Ferrer-Roca
- Performance and Health Research Group for High-Level Sports (GIRSANE), High Performance Center (CAR), Sant Cugat del Vallès, Barcelona, Spain ; and
| | - Juan García-López
- Department of Physical Education and Sports, University of León, León, Spain
| |
Collapse
|
19
|
Evaluation of Accelerometer-Derived Data in the Context of Cycling Cadence and Saddle Height Changes in Triathlon. SENSORS 2021; 21:s21030871. [PMID: 33525481 PMCID: PMC7865533 DOI: 10.3390/s21030871] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/24/2021] [Accepted: 01/24/2021] [Indexed: 01/03/2023]
Abstract
In the multisport of triathlon cycling is the longest of the three sequential disciplines. Triathlon bicycles differ from road bicycles with steeper seat tube angles with a change to saddle height altering the seat tube angle. This study evaluated the effectiveness of a tri axial accelerometer to determine acceleration magnitudes of the trunk in outdoor cycling in two saddle positions. Interpretation of data was evaluated based on cadence changes whilst triathletes cycled in an aerodynamic position in two saddle positions. The evaluation of accelerometer derived data within a characteristic overground setting suggests a significant reduction in mediolateral acceleration of the trunk, yielding a 25.1% decrease when saddle height was altered alongside reduced rate of perceived exertion (3.9%). Minimal differences were observed in anteroposterior and longitudinal acceleration. Evaluation of sensor data revealed a polynomial expression of the subtle changes between both saddle positions. This study shows that a triaxial accelerometer has capability to continuously measure acceleration magnitude of trunk movements during an in-the-field, varied cadence cycle protocol. Accessible and practical sensor technology could be relevant for postural considerations when exploring saddle position in dynamic settings.
Collapse
|
20
|
Klich S, Ficek K, Krymski I, Klimek A, Kawczyński A, Madeleine P, Fernández-de-Las-Peñas C. Quadriceps and Patellar Tendon Thickness and Stiffness in Elite Track Cyclists: An Ultrasonographic and Myotonometric Evaluation. Front Physiol 2020; 11:607208. [PMID: 33381054 PMCID: PMC7767861 DOI: 10.3389/fphys.2020.607208] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/25/2020] [Indexed: 12/12/2022] Open
Abstract
Track cyclists are required to perform short- and long-term efforts during sprint and endurance race events, respectively. The 200 m flying sprint races require maximal power output and anaerobic capacity, while the 4,000 m pursuit cyclists demand a high level of aerobic capacity. Our goal was to investigate spatial changes in morphological and mechanical properties displayed using 3D topographical maps of the quadriceps muscle and tendons after 200 m flying start and 4,000 m individual pursuit race in elite track cyclists. We hypothesized a non-uniform distribution of the changes in the quadriceps muscle stiffness (QMstiff), and acute alterations in quadriceps tendon (QTthick) and patellar tendon (PTthick) thickness. Fifteen men elite sprint and 15 elite men endurance track cyclists participated. Sprint track cyclists participated in a 200 m flying start, while endurance track cyclists in 4,000 m individual pursuit. Outcomes including QTthick (5–10–15 mm proximal to the upper edge of the patella), PTthick (5–10–15–20 mm inferior to the apex of the patella)—using ultrasonography evaluation, QMstiff, and quadriceps tendon stiffness (QTstiff) were measured according to anatomically defined locations (point 1–8) and patellar tendon stiffness (PTstiff)—using myotonometry, measured in a midway point between the patella distal and the tuberosity of tibial. All parameters were assessed before and after (up to 5 min) the 200 m or 4,000 m events. Sprint track cyclists had significantly larger QTthick and PTthick than endurance track cyclists. Post-hoc analysis showed significant spatial differences in QMstiff between rectus femoris, vastus lateralis, and vastus medialis in sprint track cyclists. At before race, sprint track cyclists presented significantly higher mean QTthick and PTthick, and higher QMstiff and the QTstiff, as compared with the endurance track cyclists. The observed changes in PTThick and QTThick were mostly related to adaptation-based vascularity and hypertrophy processes. The current study suggests that assessments using both ultrasonography and myotonometry provides crucial information about tendons and muscles properties and their acute adaptation to exercise. Higher stiffness in sprint compared with endurance track cyclists at baseline seems to highlight alterations in mechanical properties of the tendon and muscle that could lead to overuse injuries.
Collapse
Affiliation(s)
- Sebastian Klich
- Department of Paralympic Sport, University School of Physical Education in Wrocław, Wrocław, Poland
| | - Krzysztof Ficek
- Department of Physiotherapy, Academy of Physical Education in Katowice, Katowice, Poland.,Galen Orthopedic Center, Bieruń, Poland
| | | | - Andrzej Klimek
- Biomedical Science Institute, University School of Physical Education in Kraków, Kraków, Poland
| | - Adam Kawczyński
- Department of Paralympic Sport, University School of Physical Education in Wrocław, Wrocław, Poland
| | - Pascal Madeleine
- Department of Health Science and Technology, Sport Sciences-Performance and Technology, Aalborg University, Aalborg, Denmark
| | - Cesar Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain.,Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Spain
| |
Collapse
|
21
|
Millour G, Duc S, Puel F, Bertucci W. Physiological, biomechanical, and subjective effects of medio-lateral distance between the feet during pedalling for cyclists of different morphologies. J Sports Sci 2020; 39:768-776. [PMID: 33167791 DOI: 10.1080/02640414.2020.1845440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Improper medio-lateral distance between the feet in cycling can increase the risk of injuries and decrease performance due to hip/knee/ankle misalignment in the frontal plane. The objective of this study was to measure the impact of pedal spacing changes during pedalling on the biomechanical, physiological, and subjective variables of people with different morphologies. Twenty-two cyclists were divided into two groups according to their pelvis width (narrow and wide). They performed four submaximal pedalling tests with different pedal spindle lengths (+20 mm, +40 mm, and +60 mm compared to the pedal spindle lengths of standard road bikes). EMG activity, 3D joint kinematics of the lower limbs, comfort, and perceived exertion were measured during each test. Moreover, gas exchange data were collected to measure gross mechanical efficiency and cycling economy. No significant differences in muscular activity or joint kinematics were observed among the four experimental conditions. However, gross mechanical efficiency, cycling economy, and perceived comfort significantly improved while perceived exertion significantly reduced with the narrowest pedal spacing for the whole population, as well as for the narrow and wide pelvis groups. Therefore, the lowest medio-lateral distance between the feet seems more suitable for comfort and performance improvement, irrespective of the individual's morphology.
Collapse
Affiliation(s)
- Geoffrey Millour
- Laboratoire Performance, Santé, Métrologie, Société (EA 7507), UFR STAPS, Université de Reims Champagne-Ardenne, Reims, France
| | - Sébastien Duc
- Laboratoire Performance, Santé, Métrologie, Société (EA 7507), UFR STAPS, Université de Reims Champagne-Ardenne, Reims, France
| | - Frédéric Puel
- Laboratoire Performance, Santé, Métrologie, Société (EA 7507), UFR STAPS, Université de Reims Champagne-Ardenne, Reims, France
| | - William Bertucci
- Laboratoire Performance, Santé, Métrologie, Société (EA 7507), UFR STAPS, Université de Reims Champagne-Ardenne, Reims, France
| |
Collapse
|
22
|
Epidemiology, clinical characteristics and severity of gradual onset injuries in recreational road cyclists: A cross-sectional study in 21,824 cyclists - SAFER XIII. Phys Ther Sport 2020; 46:113-119. [DOI: 10.1016/j.ptsp.2020.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 11/17/2022]
|
23
|
Liang KH, Wu HW, Hsieh LC, Chang YW. A Clipless Pedal-Sensor System for Three Dimensional Kinetic Analysis During Cycling. J Med Biol Eng 2020. [DOI: 10.1007/s40846-020-00572-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
24
|
Bini R. Influence of saddle height in 3D knee loads commuter cyclists: A statistical parametric mapping analysis. J Sports Sci 2020; 39:275-288. [PMID: 32910745 DOI: 10.1080/02640414.2020.1816289] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study used a statistical parametric mapping method to compare temporal patterns knee joint loads and moments in cyclists pedalling using different saddle heights. Ten recreational cyclists pedalled using three saddle heights (Preferred, High and Low) during a single session. High and Low saddle heights were determined based on dynamically measured knee flexion angles (±10° from their Preferred height). 3D angles for the hip and knee and knee moments and forces were computed using a musculoskeletal model driven by 3D full-body motion and pedal forces. Knee flexion angles presented significant differences between saddle heights for the full crank cycle, without differences for hip adduction/abduction. Patellofemoral force was less for the Preferred compared to the High and Low saddle heights and for the High compared to the Low saddle heights between ~70-160° of the crank cycle. Right tibiofemoral anterior-posterior shear force was reduced for the Preferred compared to the Low saddle heights, without significant effects for the left tibiofemoral joint (p = 0.29-1.00). Large differences in temporal patterns for knee flexion due to changes in saddle height were followed by differences in patellofemoral force mostly when low force magnitudes were being transmitted between the femur and the patella.
Collapse
Affiliation(s)
- Rodrigo Bini
- La Trobe Rural Health School, La Trobe University , Bendigo, Australia
| |
Collapse
|
25
|
Stone AV, Beck EC, Nho SJ. Hip Injuries in Endurance Athletes: The Runner and Cyclist. OPER TECHN SPORT MED 2019. [DOI: 10.1053/j.otsm.2019.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
26
|
González-Sánchez J, Barranco-Gil D, Fernández-Luna Á, Felipe JL, García-Merino S, Barbado-Villalba C. Impact of rider position and pedaling cadence on power output and bilateral asymmetry in indoor cycling. J Sports Med Phys Fitness 2019; 59:2009-2014. [PMID: 31062947 DOI: 10.23736/s0022-4707.19.09639-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study examines the effects of pedaling cadence and the rider's position on power output and pedaling asymmetry during indoor cycling. METHODS Participants were 25 male indoor cycling instructors (32.4±4.8 years; 75.7±4.9 kg; 174±4.2 cm) with at least 3 years of cycling experience. In a single session, participants completed 9 training intervals consisting of different combinations of position (standing, sitting), pedaling cadence (75, 100, 120 rpm) and training intensity (75, 80, 85% maximum heart rate, HRmax). RESULTS During standing intervals, power output was lower (132.4±72.6 W vs. 197.5±53.5 W; P<0.05) and the bilateral leg asymmetry index was greater (52.2±76.6% vs. 12.4±9%; P<0.05) than when subjects pedaled while sitting for a similar work intensity. In contrast, higher power outputs (238.1±46.3 W vs. 153±52.7 W; P<0.05) and lower asymmetry indices (30.4±39.2% vs. 12.6±11%; P<0.05) were recorded in intervals performed at 75 rpm versus 120 rpm despite similar exercise intensities. CONCLUSIONS Our findings indicate that at similar training intensities, pedaling while standing during indoor cycling generates fewer watts and greater asymmetry than pedaling while sitting. We also observed that a slower pedaling cadence (75 rpm) gives rise to greater generated power and a lower asymmetry index than a faster pedaling cadence (120 rpm).
Collapse
Affiliation(s)
| | - David Barranco-Gil
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain -
| | | | - Jose L Felipe
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | | | | |
Collapse
|
27
|
Effects of a prophylactic knee bracing on patellofemoral loading during cycling. SPORT SCIENCES FOR HEALTH 2018. [DOI: 10.1007/s11332-018-0482-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
28
|
Haeberle HS, Navarro SM, Power EJ, Schickendantz MS, Farrow LD, Ramkumar PN. Prevalence and Epidemiology of Injuries Among Elite Cyclists in the Tour de France. Orthop J Sports Med 2018; 6:2325967118793392. [PMID: 30202769 PMCID: PMC6124184 DOI: 10.1177/2325967118793392] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Cycling injuries are increasing, particularly among elite athletes during
major events such as the Tour de France. Many athletes miss considerable
time from sport and require surgical intervention. Little is known about the
epidemiology of injuries to guide practice participation strategies,
return-to-competition expectations, and injury prevention protocols. Purpose: To evaluate the injury epidemiology, operative incidence, and
return-to-competition timeline among all elite cyclists participating in the
21-stage Tour de France race over a span of 8 years. Study Design: Descriptive epidemiological study. Methods: All injuries sustained during 1584 unique rides by cyclists participating in
the Tour de France from 2010 to 2017 were evaluated. In the absence of an
established Tour de France injury database, demographic, injury, surgical,
and return-to-competition details from all athletes who withdrew because of
a traumatic injury were retrospectively compiled using publicly available
data, which were cross-referenced for validity. The inclusion criterion
consisted of any cyclist who withdrew from the Tour de France because of an
injury; cyclists who withdrew for noninjury reasons were excluded.
Independent variables included injury demographics, missed days, and whether
the injury required surgery. Injury prevalence, relative frequency
distributions, and sample proportions were dependent metrics for this
investigation. Results: Among the 1584 cycling entries evaluated over the 8-year study period, there
were 259 cyclists (16%) who withdrew (17 cyclists/year). A total of 138
withdrawals were caused by acute trauma, 49% of which were fractures (n =
67), which represented the most common reason for withdrawal. A total of 29
(43%) cyclists with fractures underwent surgery. The most commonly fractured
bones were the clavicle (n = 21), followed by the wrist (n = 6), hand (n =
5), femur (n = 5), humerus (n = 5), and ribs (n = 5). Cyclists who underwent
operative fracture fixation had a longer time between the injury and their
next race compared with those who did not undergo surgery (77 vs 44 days,
respectively; P = .065). Conclusion: The most common injury leading to withdrawal from the Tour de France over the
study period was acute fracture, comprising 49% of all injuries. Almost half
of the cyclists with fractures underwent surgery. The clavicle was the most
commonly fractured bone. For cyclists who underwent operative treatment of
their fractures, return to competition was more than 1 month longer than for
those who did not. A prospective database is warranted to catalog injuries
among these elite cyclists.
Collapse
Affiliation(s)
- Heather S Haeberle
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Sergio M Navarro
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Eric J Power
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, Texas, USA
| | | | - Lutul D Farrow
- Orthopaedic and Rheumatologic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Prem N Ramkumar
- Orthopaedic and Rheumatologic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| |
Collapse
|
29
|
Kruschewsky AB, Dellagrana RA, Rossato M, Ribeiro LFP, Lazzari CD, Diefenthaeler F. Saddle Height and Cadence Effects on the Physiological, Perceptual, and Affective Responses of Recreational Cyclists. Percept Mot Skills 2018; 125:923-938. [DOI: 10.1177/0031512518786803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Saddle height influences cycling performance and would be expected to influence cyclists physically, perceptually, and emotionally. We investigated how different saddle positions and cadences might affect cyclists’ torque, heart rate, rate of perceived exertion (RPE), and affective responses (Feeling scale). Nine male recreational cyclists underwent cycling sessions on different days under different conditions with a constant load. On Day 1, the saddle was at the reference position (109% of the distance from the pubic symphysis to the ground), and on Days 2 and 3, the saddle was in the “upward position” (reference + 2.5%) and “downward position” (reference − 2.5%) in random order. Each session lasted 30 minutes and was divided into three cadence-varied 10-minute stages without interruption: (a) freely chosen cadence (FCC), (b) FCC − 20%, and (c) FCC + 20%. We assessed all dependent measures at the end of each 10 minute stage. While there was no significant interaction (Saddle × Cadence) for any of the analyzed variables, torque values were higher at lower cadences in all saddle configurations, and the FCC + 20% cadence was associated with faster heart rate, higher RPE, and lower affect compared with FCC and FCC − 20% in all saddle positions. At all cadences, the saddle at “downward position” generated a higher RPE compared with “reference position” and “upward position.” The affective response was lower in the “downward position” compared with the “reference position.” Thus, while cyclists perceived the downward (versus reference) saddle position as greater exercise effort, they also associated it with unpleasant affect.
Collapse
Affiliation(s)
- Alberto B. Kruschewsky
- Departamento de Ciências da Saúde, Universidade Estadual de Santa Cruz, Ilhéus-BA, Brasil
| | - Rodolfo A. Dellagrana
- Centro de Esportes, Universidade Federal de Santa Catarina, Florianópolis-SC, Brasil
| | - Mateus Rossato
- Centro de Esportes, Universidade Federal de Santa Catarina, Florianópolis-SC, Brasil
- Faculdade de Educação Física e Fisioterapia, Universidade Federal do Amazonas, Manaus-AM, Brasil
| | | | - Caetano D. Lazzari
- Centro de Esportes, Universidade Federal de Santa Catarina, Florianópolis-SC, Brasil
| | | |
Collapse
|
30
|
Menard M, Domalain M, Decatoire A, Lacouture P. Influence of saddle setback on knee joint forces in cycling. Sports Biomech 2018; 19:245-257. [DOI: 10.1080/14763141.2018.1466906] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Mathieu Menard
- Research Department, Rennes Institute of Osteopathy, Bruz, France
- Prime Institute and Sport Sciences Department, University of Poitiers, Poitiers, France
| | - Mathieu Domalain
- Prime Institute and Sport Sciences Department, University of Poitiers, Poitiers, France
| | - Arnaud Decatoire
- Prime Institute and Sport Sciences Department, University of Poitiers, Poitiers, France
| | - Patrick Lacouture
- Prime Institute and Sport Sciences Department, University of Poitiers, Poitiers, France
| |
Collapse
|
31
|
Bini RR, Flores Bini A. Potential factors associated with knee pain in cyclists: a systematic review. Open Access J Sports Med 2018; 9:99-106. [PMID: 29872355 PMCID: PMC5973630 DOI: 10.2147/oajsm.s136653] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The potential factors associated with overuse injuries and pain in cyclists that are supported by evidence remain unclear. Our study aimed at assessing, using a systematic search of the most updated evidence, the main factors related to overuse knee-related pain and/or injuries in cyclists. The search assessed any potential mechanism related to knee pain or injury that could be used in the clinical practice. Databases were searched (i.e., PubMed, Scopus, Web of Science, and EBSCO). Studies were included if they presented results from original studies. They had to include, preferably but not limited to, recreational and/or competitive cyclists with or without knee pain. Quality of articles was assessed. Eleven articles were deemed eligible for full text appraisal. Studies involved generally the assessment of biomechanical outcomes associated with knee pain in cyclists. Overall, studies showed that cyclists with knee pain present larger knee adduction and larger ankle dorsiflexion and differences in activation for hamstrings and quadriceps muscles. Unclear results were observed for knee moments and no differences were observed for knee flexion angle, tibiofemoral and patellofemoral forces. It is important to state that varied types of knee pain were mixed in most studies, with 2 focused on anterior-related pain. Cyclists with overuse-related pain or injuries on their knees presented an increased medial projection of their knees and an altered activation of the Vastus Medialis and Vastus Lateralis muscles. However, this limited evidence is based on retrospective studies comparing cyclists with and without pain, which limits the conclusion on how cyclists develop knee pain and what are the main options for treatment of knee pain.
Collapse
Affiliation(s)
- Rodrigo Rico Bini
- La Trobe Rural Health School, La Trobe University, Flora Hill Campus, Bendigo, VIC, Australia
| | - Alice Flores Bini
- La Trobe Rural Health School, La Trobe University, Flora Hill Campus, Bendigo, VIC, Australia
| |
Collapse
|
32
|
Abstract
With the increasing popularity of mountain biking, also known as off-road cycling, and the riders pushing the sport into extremes, there has been a corresponding increase in injury. Almost two thirds of acute injuries involve the upper extremities, and a similar proportion of overuse injuries affect the lower extremities. Mountain biking appears to be a high-risk sport for severe spine injuries. New trends of injury patterns are observed with popularity of mountain bike trail parks and freeride cycling. Using protective gear, improving technical proficiency, and physical fitness may somewhat decrease the risk of injuries. Simple modifications in bicycle-rider interface areas and with the bicycle (bike fit) also may decrease some overuse injuries. Bike fit provides the clinician with postural correction during the sport. In this review, we also discuss the importance of race-day management strategies and monitoring the injury trends.
Collapse
Affiliation(s)
- Majid Ansari
- 1Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran; and 2Department of Family Medicine, University of Colorado School of Medicine, AFW Clinic, Denver, CO
| | | | | |
Collapse
|
33
|
THE INFLUENCE OF EXTRINSIC FACTORS ON KNEE BIOMECHANICS DURING CYCLING: A SYSTEMATIC REVIEW OF THE LITERATURE. Int J Sports Phys Ther 2017; 12:1023-1033. [PMID: 29234554 DOI: 10.26603/ijspt20171023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The knee is susceptible to injury during cycling due to the repetitive nature of the activity while generating torque on the pedal. Knee pain is the most common overuse related injury reported by cyclists, and intrinsic and extrinsic factors can contribute to the development of knee pain. Purpose Due to the potential for various knee injuries, this purpose of this systematic review of the literature was to determine the association between biomechanical factors and knee injury risk in cyclists. Study Design Systematic review of the literature. Methods Literature searches were performed using CINAHL, Ovid, PubMed, Scopus and SPORTDiscus. Quality of studies was assessed using the Downs and Black Scale for non-randomized trials. Results Fourteen papers were identified that met inclusion and exclusion criteria. Only four studies included cyclists with knee pain. Studies were small with sample sizes ranging from 9-24 participants, and were of low to moderate quality. Biomechanical factors that may impact knee pain include cadence, power output, crank length, saddle fore/aft position, saddle height, and foot position. Changing these factors may lead to differing effects for cyclists who experience knee pain based on specific anatomical location. Conclusion Changes in cycling parameters or positioning on the bicycle can impact movement, forces, and muscle activity around the knee. While studies show differences across some of the extrinsic factors included in this review, there is a lack of direct association between parameters/positioning on the cycle and knee injury risk due to the limited studies examining cyclists with and without pain or injury. The results of this review can provide guidance to professionals treating cyclists with knee pain, but more research is needed. Level of Evidence 3a.
Collapse
|
34
|
Meyers A, Caldwell E, Hirsch J, Jacobs K, Pohlig R, Signorile J. Orthotic bicycle shoe insoles show no effects on leg muscle activation patterns or performance in recreational cyclists. FOOTWEAR SCIENCE 2017. [DOI: 10.1080/19424280.2017.1344327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A.C. Meyers
- Department of Kinesiology, Augusta University, Augusta, GA, USA
| | | | - J. Hirsch
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, USA
| | - K.A. Jacobs
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, USA
| | - R.T. Pohlig
- Dean's Office, College of Health Sciences, University of Delaware, Newark, DE, USA
| | - J.F. Signorile
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, USA
| |
Collapse
|
35
|
Pommering TL, Manos DC, Singichetti B, Brown CR, Yang J. Injuries and Illnesses Occurring on a Recreational Bicycle Tour: The Great Ohio Bicycle Adventure. Wilderness Environ Med 2017; 28:299-306. [PMID: 28781179 DOI: 10.1016/j.wem.2017.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 06/02/2017] [Accepted: 06/02/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Recreational multiday cycling events have grown popular in the United States; however, little has been published regarding the injuries and illnesses that occur during these events. The objective of this study was to describe injuries and illnesses that occur in the Great Ohio Bicycle Adventure (GOBA) and to examine associated risk factors. METHODS Injury and illness data collected from an on-site medical clinic during the 2013 and 2014 GOBA tours were merged with rider registration data for analysis. Diagnoses were classified as acute injury, overuse injury, or medical illness. The odds ratios of sustaining at least 1 injury/illness, as well as sustaining an acute injury, were assessed adjusting for riders' demographics. RESULTS A total of 4005 (2172 in 2013 and 1833 in 2014) cyclists participated in GOBA, with an an age of 50.7±17.6 (2-86) years (mean±SD [range]), of whom 59.8% were male. During the tours, 143 (3.6%) riders reported at least 1 injury/illness, which resulted in 220 clinical diagnoses, including 114 (51.8%) acute injuries, 27 (12.3 %) overuse injuries, and 79 (35.9%) medical illnesses. The lower extremities were the most commonly injured body site (n=71, 50.4%). "Superficial/Abrasions/Contusions" was the most common injury/illness type (n=68, 30.9%). Riders who had no previous tour experience or who were at least 50 years old had a greater risk of injury/illness than their counterparts. CONCLUSIONS The prevalence of injury and illness is relatively low in multiday recreational cycling events. Our findings provide important data for planning and preparing for medical coverage at mass recreational cycling events.
Collapse
Affiliation(s)
- Thomas L Pommering
- College of Medicine, The Ohio State University, Columbus, OH; Division of Sports Medicine, Nationwide Children's Hospital, Columbus, OH.
| | - Diane C Manos
- College of Medicine, The Ohio State University, Columbus, OH
| | - Bhavna Singichetti
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH
| | - Chelsea R Brown
- College of Medicine, The Ohio State University, Columbus, OH
| | - Jingzhen Yang
- College of Medicine, The Ohio State University, Columbus, OH; Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH
| |
Collapse
|
36
|
Pierce TP, Mease SJ, Issa K, Festa A, McInerney VK, Scillia AJ. Iliotibial Band Lengthening: An Arthroscopic Surgical Technique. Arthrosc Tech 2017; 6:e785-e789. [PMID: 28706832 PMCID: PMC5495937 DOI: 10.1016/j.eats.2017.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 02/06/2017] [Indexed: 02/03/2023] Open
Abstract
Iliotibial (IT) band syndrome is a common cause of lateral knee pain in runners and cyclists. Many can be treated nonoperatively; however, some may require surgical lengthening of their IT band to achieve optimal pain relief and a return to preinjury level of activity. Several studies have been published detailing surgical lengthening procedures and satisfactory outcomes after these procedures. However, it is important to continue to improve on and optimize outcomes. We present our arthroscopic IT band-lengthening procedure.
Collapse
Affiliation(s)
| | | | | | | | | | - Anthony J. Scillia
- Address correspondence to Anthony J. Scillia, M.D., Department of Orthopaedics, School of Health and Medical Sciences, Seton Hall University, 400 S Orange Ave, South Orange, NJ 07079, U.S.A.Department of OrthopaedicsSchool of Health and Medical SciencesSeton Hall University400 S Orange AveSouth OrangeNJ07079U.S.A.
| |
Collapse
|
37
|
Althunyan AK, Darwish MA, Abdel Wahab MM. Knee problems and its associated factors among active cyclists in Eastern Province, Saudi Arabia. J Family Community Med 2017; 24:23-29. [PMID: 28163572 PMCID: PMC5248430 DOI: 10.4103/2230-8229.197178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Bicycling is one of the most enjoyable aerobic exercises recommended for the promotion of an individual's health. The Eastern Province of Saudi Arabia has seen a huge increase in the number of people who cycle. People have different goals for bicycling, but the injuries they sustain are common. Most of them relate to overuse, particularly of lower body joints. This study was conducted to determine the prevalence of knee problems and factors associated with knee pain in cyclists. MATERIALS AND METHODS A cross-sectional study was conducted in October 2015, using an online self-administered questionnaire. The questionnaire was based on pertinent literature, was piloted, and validated. A web link was sent to 513 cyclists (professional and amateur) using E-mail, WhatsApp application, or SMS. Three hundred and eleven responses were received, 283 of which were included in the analysis. RESULTS The overall prevalence of knee pain was 25.8%; 27.6% for amateur cyclists and 15.9% for professional cyclists. Only 17.2% knee pain was attributed to cycling, whereas in 32.8% it happened spontaneously and in 25% of cases it occurred while running. Majority of the cyclists reported pain as mild (61.6%) or moderate (28.7%); anterior knee pain accounted for 58.1% knee pain. Different goals of cycling and different bicycle types had statistically significant difference on the rate of knee pain. Of underweight cyclists, 62.2% reported knee pain. Cyclists who run more or participated in football had a higher rate of pain. CONCLUSION Knee injuries are common with cyclists. Factors such as the type of the bicycle, the goal of bicycling, club type, body mass index, and participation in other sports play a significant role in the rate of knee pain.
Collapse
Affiliation(s)
- Abdullatif K Althunyan
- Department of Family and Community Medicine, University of Dammam, Dammam, Kingdom of Saudi Arabia
| | - Magdy A Darwish
- Department of Family and Community Medicine, University of Dammam, Dammam, Kingdom of Saudi Arabia
| | - Moataza M Abdel Wahab
- Department of Family and Community Medicine, University of Dammam, Dammam, Kingdom of Saudi Arabia; Department of Biostatistics, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| |
Collapse
|
38
|
Cyclists Have Greater Chondromalacia Index Than Age-Matched Controls at the Time of Hip Arthroscopy. Arthroscopy 2016; 32:2102-2109. [PMID: 27289277 DOI: 10.1016/j.arthro.2016.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 04/04/2016] [Accepted: 04/18/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the clinical symptoms and intraoperative pathology associated with hip pain in the cyclist compared with a matched hip arthroscopy surgical group. METHODS In an institutional review board-approved study, we retrospectively reviewed a prospective database of 1,200 consecutive hip arthroscopy patients from 2008 to 2015. Adult patients were identified who reported cycling as a major component of their activity. Patients were age, gender, and body mass index matched to a control, noncycling group. Pain symptoms, preoperative examinations, radiographic and operative findings were compared. Primary outcome variables included the femoral and acetabular Outerbridge chondromalacia grade. Additional outcome measurements included the involved area and the chondromalacia index (CMI; the product of the Outerbridge chondromalacia grade and surface area [mm2 × severity]). RESULTS A total of 167 noncyclists were matched to the cycling group (n = 16). Cyclists had significantly greater femoral head chondromalacia grade (2.0 [95% confidence interval (CI), 1.5-2.5] v 1.4 [95% CI, 1.3-1.6], P = .043), femoral head chondromalacia area (242 mm2 [95% CI, 191-293 mm2] v 128 mm2 [95% CI, 113-141 mm2], P < .001), and femoral head CMI (486 [95% CI, 358-615] v 247 [95% CI, 208-286], P = .001) assessed intraoperatively. Hip pain in cyclists positively correlated with an increased acetabular center-edge angle (R = 0.261, P < .001) and an increased Tonnis grade (R = 0.305, P < .001). Cyclists were also more likely to have a coxalgic gait on physical examination (R = 0.250, P = .006). CONCLUSIONS Cyclists had a greater degree of femoral chondromalacia than a matched group of noncyclists. Cycling activity positively correlated with the presence of femoral chondromalacia with clinically significant gait alterations. These data support the hypothesis that cyclists with hip pain have more chondral pathology than a similar group of other patients with hip pain. Ultimately, cyclists with hip pain should be identified as higher risk for more advanced chondral damage. LEVEL OF EVIDENCE Level III, case-control study, therapeutic.
Collapse
|
39
|
Gardner JK, Klipple G, Stewart C, Asif I, Zhang S. Acute effects of lateral shoe wedges on joint biomechanics of patients with medial compartment knee osteoarthritis during stationary cycling. J Biomech 2016; 49:2817-2823. [DOI: 10.1016/j.jbiomech.2016.06.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 06/13/2016] [Accepted: 06/18/2016] [Indexed: 10/21/2022]
|
40
|
Loudon JK. The master female triathlete. Phys Ther Sport 2016; 22:123-128. [PMID: 27511062 DOI: 10.1016/j.ptsp.2016.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/17/2016] [Accepted: 07/27/2016] [Indexed: 01/08/2023]
Abstract
The world of triathlon has expanded to include all ages and both sexes. One of the largest growing age groups is the master female athlete. It is important for the physical therapist to understand the special needs of this population in order to adequately care for master female athletes so they can participate at a high level and injury-free. Biology of aging, injury prevention and a suggested training program are presented in this Masterclass article.
Collapse
Affiliation(s)
- Janice K Loudon
- Rockhurst University, 1100 Rockhurst Rd, Kansas City, MO 64110, United States.
| |
Collapse
|
41
|
Menard M, Domalain M, Decatoire A, Lacouture P. Influence of saddle setback on pedalling technique effectiveness in cycling. Sports Biomech 2016; 15:462-72. [PMID: 27239728 DOI: 10.1080/14763141.2016.1176244] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
42
|
Gardner JK, Zhang S, Liu H, Klipple G, Stewart C, Milner CE, Asif IM. Effects of toe-in angles on knee biomechanics in cycling of patients with medial knee osteoarthritis. Clin Biomech (Bristol, Avon) 2015; 30:276-82. [PMID: 25636248 DOI: 10.1016/j.clinbiomech.2015.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 12/19/2014] [Accepted: 01/13/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cycling is commonly prescribed for knee osteoarthritis, but previous literature on biomechanics during cycling and the effects of acute intervention on osteoarthritis patients does not exist. Due to their altered knee kinematics, osteoarthritis patients may be at greater risk of osteoarthritis progression or other knee injuries during cycling. This study investigated the effects of reduced foot progression (toe-in) angles on knee joint biomechanics in subjects with medial compartment knee osteoarthritis. METHODS Thirteen osteoarthritis and 11 healthy subjects participated in this study. A motion analysis system and custom instrumented pedal was used to collect 5 pedal cycles of kinematic and kinetic data in 1 neutral and 2 toe-in conditions (5° and 10°) at 60 RPM and 80W. FINDINGS For peak knee adduction angle, there was a 61% (2.7°) and a 73% (3.2°) decrease in the 5° and 10° toe-in conditions compared to neutral in the osteoarthritis group and a 77% (1.7°) and 109% (2.4°) decrease in the healthy group for the 5° and 10° conditions, respectively. This finding was not accompanied by a decrease in pain or peak knee abduction moment. A simple linear regression showed a positive correlation between Kelgren-Lawrence score and both peak knee adduction angle and abduction moment. INTERPRETATION For individuals who cycle with increased knee adduction angles, decreasing the foot progression angle may be beneficial for reducing the risk of overuse knee injuries during cycling by resulting in a frontal plane knee alignment closer to a neutral position.
Collapse
Affiliation(s)
| | | | - Hairui Liu
- Shanghai University of Sport, Shanghai, China
| | - Gary Klipple
- University of Tennessee Medical Center, Knoxville, TN, USA
| | | | | | - Irfan M Asif
- Greenville Health System, University of South Carolina School of Medicine Greenville, Greenville, SC, USA
| |
Collapse
|
43
|
Abstract
Running is often recommended by physicians to maintain a healthy lifestyle. As more individuals participate in running-related activities, clinicians must be increasingly aware of common injuries. Training errors leading to overuse are the most common underlying factors in most running-related injuries. Clinicians need to keep in mind that the presenting injury is frequently the result of an inability to compensate for a primary dysfunction at another site. Although imaging may be helpful in differentiating among diagnoses with similar clinical presentations, a detailed history and physical examination are essential in making a correct diagnosis.
Collapse
Affiliation(s)
- George G A Pujalte
- Department of Family and Community Medicine, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA; Department of Orthopaedics and Rehabilitation, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA.
| | - Matthew L Silvis
- Department of Family and Community Medicine, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA; Department of Orthopaedics and Rehabilitation, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA
| |
Collapse
|
44
|
Yeo BK, Bonanno DR. The effect of foot orthoses and in-shoe wedges during cycling: a systematic review. J Foot Ankle Res 2014; 7:31. [PMID: 24955129 PMCID: PMC4064526 DOI: 10.1186/1757-1146-7-31] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 05/16/2014] [Indexed: 11/16/2022] Open
Abstract
Background The use of foot orthoses and in-shoe wedges in cycling are largely based on theoretical benefits and anecdotal evidence. This review aimed to systematically collect all published research on this topic, critically evaluate the methods and summarise the findings. Methods Study inclusion criteria were: all empirical studies that evaluated the effects of foot orthoses or in-shoe wedges on cycling; outcome measures that investigated physiological parameters, kinematics and kinetics of the lower limb, and power; and, published in English. Studies were located by data-base searching (Medline, CINAHL, Embase and SPORTDiscus) and hand-searching in February 2014. Selected studies were assessed for methodological quality using a modified Quality Index. Data were synthesised descriptively. Meta-analysis was not performed as the included studies were not sufficiently homogeneous to provide a meaningful summary. Results Six studies were identified as meeting the eligibility criteria. All studies were laboratory-based and used a repeated measures design. The quality of the studies varied, with Quality Index scores ranging from 7 to 10 out of 14. Five studies investigated foot orthoses and one studied in-shoe wedges. Foot orthoses were found to increase contact area in the midfoot, peak pressures under the hallux and were perceived to provide better arch support, compared to a control. With respect to physiological parameters, contrasting findings have been reported regarding the effect foot orthoses have on oxygen consumption. Further, foot orthoses have been shown to not provide effects on lower limb kinematics and perceived comfort. Both foot orthoses and in-shoe wedges have been shown to provide no effect on power. Conclusion In general, there is limited high-quality research on the effects foot orthoses and in-shoe wedges provide during cycling. At present, there is some evidence that during cycling foot orthoses: increase contact area under the foot and increase plantar pressures under the hallux, but provide no gains in power. Based on available evidence, no definitive conclusions can be made about the effects foot orthoses have on lower limb kinematics and oxygen consumption, and the effect in-shoe wedges have on power during cycling. Future well-designed studies on this topic are warranted.
Collapse
Affiliation(s)
- Boon K Yeo
- Department of Podiatry, Faculty of Health Sciences, La Trobe University, Bundoora, Vic 3086, Australia
| | - Daniel R Bonanno
- Department of Podiatry, Faculty of Health Sciences, La Trobe University, Bundoora, Vic 3086, Australia ; Lower Extremity and Gait Studies Program, Faculty of Health Sciences, La Trobe University, Vic 3086, Australia
| |
Collapse
|
45
|
García-García O, Cancela-Carral JM, Martínez-Trigo R, Serrano-Gómez V. Differences in the contractile properties of the knee extensor and flexor muscles in professional road cyclists during the season. J Strength Cond Res 2014; 27:2760-7. [PMID: 23302746 DOI: 10.1519/jsc.0b013e31828155cd] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this study was to establish reference values of tensiomyography (TMG) in professional road cyclists and to examine how the planned periods of the Season produce differences in the muscles: vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF), and biceps femoris (BF), and to determine how these differences may depend on each cyclist, the assessed muscle, and the side of the body. Ten professional road cyclists (27.5 ± 5.5 years; 178.2 ± 7.8 cm; 65.6 ± 5.46 kg; 72.1 ± 3.7 ml·kg·min V[Combining Dot Above]O2; 6 ± 0.4 W·kg) were assessed by TMG, in microcycle recovery, at 2 moments of periods during the season: preparation period (PP) and competition period (CP). Student's t contrast for paired groups, Cohen's d effect sizes, and a repeated measures analysis of variance (ANOVA) was applied. We did not find significant differences (p < 0.01) between the lower limbs. The results showed a significantly large increment between the time contraction (TC) values of the PP and CP in the muscles VM (28.7 ± 5.5 vs. 40.6 ± 14.4 milliseconds; 41.4%, p < 0.05, d = 1.1), VL (28.3 ± 4.9 vs. 40.6 ± 10.2 milliseconds; 43.4%, p < 0.05, d = 1.53), and RF (35.9 ± 6.9 vs. 45.9 ± 16.2 milliseconds; 27.8%, p < 0.05, d = 0.8). Nevertheless, TC of the BF presents a significantly large decrease in the CP (35.9 ± 9.9 vs. 28.2 ± 5.2 milliseconds; -21.4%, p < 0.05, d = 0.97). Radial muscle displacement (DM) values are slightly lower during the CP, but the difference is not significant. ANOVA confirmed that these differences depend on the evaluated muscles (TC p = 0.02; DM p = 0.001) and on the cyclists (TC p = 0.001; DM p = 0.001) and does not depend on the side of the body. In conclusion, the TC values during the Season show marked differences between the knee extensors (large increased) and the knee flexor (large decreased). The DM has not changed significantly, keeping the muscular and tendon stiffness.
Collapse
Affiliation(s)
- Oscar García-García
- 1Faculty of Education and Sport Sciences, University of Vigo, Pontevedra, Spain 2Faculty of Sport Sciences and Physical Education, University of Corunna, A Corunna, Spain
| | | | | | | |
Collapse
|
46
|
Xu JY, Nan X, Ebken V, Wang Y, Pottie GJ, Kaiser WJ. Integrated inertial sensors and mobile computing for real-time cycling performance guidance via pedaling profile classification. IEEE J Biomed Health Inform 2014; 19:440-5. [PMID: 24833607 DOI: 10.1109/jbhi.2014.2322871] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Today, the bicycle is utilized as a daily commute tool, a physical rehabilitation asset, and sporting equipment, prompting studies into the biomechanics of cycling. Of the number of important parameters that affect cycling efficiency, the foot angle profile is one of the most important as it correlates directly with the effective force applied to the bike. However, there has been no compact and portable solution for measuring the foot angle and for providing the cyclist with real-time feedback due to a number of difficulties of the current tracking and sensing technologies and the myriad types of bikes available. This paper presents a novel sensing and mobile computing system for classifying the foot angle profiles during cycling and for providing real-time guidance to the user to achieve the correct profile. Continuous foot angle tracking is firstly converted into a discrete problem requiring only recognition of acceleration profiles of the foot using a single shoe mounted tri-axial accelerometer during each pedaling cycle. A classification method is then applied to identify the pedaling profile. Finally, a mobile solution is presented to provide real-time signal processing and guidance.
Collapse
|
47
|
Disley BX, Li FX. Metabolic and Kinematic Effects of Self-Selected Q Factor During Bike Fit. Res Sports Med 2014; 22:12-22. [DOI: 10.1080/15438627.2013.852093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Benedict Xavier Disley
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Francois-Xavier Li
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
48
|
Abstract
Exercise is universally recognized as a key feature for maintaining good health. Likewise, lack of physical activity is a major risk factor for chronic disease and disability, an especially important fact considering our rapidly aging population. Biking and running are frequently recommended as forms of exercise. As more individuals participate in running-related and cycling-related activities, physicians must be increasingly aware of the common injuries encountered in these pursuits. This review focuses on the evaluation and management of common running-related and cycling-related injuries.
Collapse
|
49
|
Chronic musculoskeletal conditions associated with the cycling segment of the triathlon; prevention and treatment with an emphasis on proper bicycle fitting. Sports Med Arthrosc Rev 2013; 20:200-5. [PMID: 23147089 DOI: 10.1097/jsa.0b013e3182688fa0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cycling-related injuries account for 20% of all injuries occurring during triathlons. Traumatic injuries caused by falls or accidents are thankfully rare but can be highly variable and very serious in nature. The best approach to these injuries is prevention. The majority of complaints arising from cycling are due to overuse or poor technique. The knee joint, lower back, neck, and Achilles tendon are the most frequently affected anatomic sites. Anterior knee pain, lower back and neck myofascial pain, iliotibial band friction syndrome, and Achilles tendonitis are the most common diagnoses. Initial treatment should always use rest, ice, compression, and elevation. Muscle strengthening and stretching as well as other physical modalities are helpful in the subacute setting. The need for surgery is rare. Improper bike fit contributes to the causation of a significant number of these conditions. Bike geometry may also be altered to alleviate symptoms.
Collapse
|
50
|
Bini RR, Hume PA, Lanferdini FJ, Vaz MA. Effects of moving forward or backward on the saddle on knee joint forces during cycling. Phys Ther Sport 2013; 14:23-7. [DOI: 10.1016/j.ptsp.2012.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Revised: 11/01/2011] [Accepted: 02/08/2012] [Indexed: 10/28/2022]
|