Cycling Injury Prevention Workshop

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1 Cycling Injury Prevention Workshop Focus on Thoracic-Shoulder & Associated Conditions Ian Wee Occupational Therapist / Cycle Coach Chris Thompson Physiotherapist / Cycle Coach/ Exercise Physiologist

2 Workshop Program Overview on cycling based injuries Types of Thoracic- Shoulder Conditions treated Types of associated conditions Bike Ergonomics Stretches Application Sponsors Questions & Answers

3 Common cycling injuries Acute vs Chronic Acute normally caused by accidents Acute 50% & more: with motor vehicle Acute 12-24% due to mechanical problems with the bicycle, road damage & obstacles Minor acute include lacerations, abrasions & contusions Major acute include fractures, dislocations, head injuries and internal injuries This scope is not covered during this workshop

4 Chronic conditions Otherwise called Overuse Injuries In survey conducted in South Africa, 520 cyclists: 85% report one or more overuse injury with 36% of these requiring direct clinical intervention Yet research also points out that cyclists are generally poor at seeking clinical intervention until conditions become very chronic and affects their functional performance on the bike directly

5 Common sites of chronic injuries Neck (48.8%)* Knee (41.7%) Groin / Buttock (36.1%) Hands (31.1%) Lower Back (30.3%) This workshop is focusing on the upper quadrant of the body which includes the neck & hands due to its association with the shoulder region & nervous system

6 Scapulothoracic Rhythm Overstrain caused by incorrect bike ergonomics Extensive shoulder-wrist static positions over long duration of time Existing poor biomechanics of the shoulder / existing underlying injury Importance of all rotator cuff muscles working in unison and not merely so called site of pain or pathology Active and Passive Range of Motion can assist practitioner determine the scapular rhythm or lack thereof.

7 Paraspinal Imbalance or Strain Lack of core strengthen development Overuse syndrome & lack of cross training Poor bike positioning Neuromuscular issues Biomechanical issues Ligament & Deep Tissue conditions Associated neck-mid back-lower back pain

8 Kyphotic Conditions Consider Lance Armstrong s mid thoracic spine Amendments can be made in bike ergonomics in the presence of musculoskeletal conditions Development of strength in associated muscles and ligaments as well as synergistic muscles are crucial to stabilisation

9 More of Lance positioning, conditioning so called limitations.. Even one of the greatest cyclists can conqueror odds with biomechanics differences Consider the biomechanical requirements of each rider and the importance of bike ergonomics vs a bike fit Consider the clinical knowledge of your health professional when consulting for your cycling based conditions which should also include at post treatment phase fitness & exercise physiology training After all Lance spends 40-45% of his time with other fitness workouts and not merely on the saddle

10 Ligamentous Conditions Two major ligaments assist with shoulder joint stability namely the GH and AC ligaments. Stretches needs to be effected by cyclists to achieve pre-ride and post ride movement to ensure ligaments which have less blood supply get the mobilisation they require Important also to stretch while riding

11 Rotator Cuff Conditions Muscles around the shoulder joint Three dimensional namely anterior-posterior and lateral Balance required by all rotator cuffs Normally associated with Ligamentous based injuries Superficial injuries sustained normally with side falls during rides Once again imbalance created by poor conditioning and bike ergonomics

12 Cyclists Palsy & Carpal Tunnel Syndrome Pain & numbness in fingers Cyclists Palsy associated with ulnar nerve compression- ring & little finger Carpal tunnel associated with median nerve thumb & forefinger Tingling sensation in hands and fingers which may include numbness Causes hands compressed against handlebar or brake lever hoods riding with wrists cocked & angled towards the thumb-fixed positions on flat bars saddle tilted downwards too much thus too much weight on hands Need to consider usage of proper gloves properly anatomically padded gloves Need to change hand, arm and shoulder positions

13 Bike Ergonomics

14 Appropriate Stretches

15 PIHC Methods Used Key Module Treatment for acute / post operative care including muscles, ligaments and tendons Hands On Soft Tissue techniques involving muscle mobilisation and adjustments to assist with muscle fibre realignment and feedback to nervous system Huber Dynamic Treatment Systems Vibration Science with WBV 3000 Exercise Physiology Feet Biomechanics through Podiatry Therapeutic Massage

16 Key Module Techniques Reverse Pressure Roller & Suction Pressure to prevent ischemic compression of soft tissue Pressure hence intensity is variable Recovery rate up to 70% faster than conventional hands on approach

17 Huber Dynamic Systems

18 WBV 3000 Use of science of vibration Varying the intensity of the vibration (harmonic frequency) can assist with thoracic / shoulder strengthening Use of various positions by a qualified clinician can assist with the rehabilitation of areas such as the shoulder, mid back and para spinals

19 Our sponsors

20 How we can help. Speak to one of the PIHC practitioners present in the room this evening Use the PIHC-Cycling WA screening card for your complimentary shoulder-thoracic assessment (valid to end of June 2009) Grab a brochure about the various techniques & technologies available for a copy of our stretch brochure If you are keen on our cycling training program take the lime green brochure that says Cycling Ian Wee at: His card is enclosed in the pack provided. Check our website: WE ARE WELCOME YOUR FEEDBACK VIA SO WE CAN HELP BY IMPROVING ON OUR WORKSHOP & PROGRAMS

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