Injury Management for Endurance Athletes

You do endurance sports long enough and the odds are you are going to get hurt.  This may be an overuse injury (which is completely avoidable with basic maintenance on your body) or an acute injury from a crash, fall, or momentarily lapse of judgement (being glycogen depleted doesn’t always help clear thinking).  Recent studies have shown that 35 – 56% of all runners will get an injury each year.  Those numbers are lower for cyclists but injuries still happen.  Broken collar bones, tendonitis, saddle sores, and sore backs are all common issues in cyclists.  While a lot of this is preventable, some of this is inevitable.  Having a tool box ready on how to deal with injuries can make a huge difference in getting through these setbacks.

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Create a team around you.  This can be coaches, chiropractors, physical therapists, bike fitters, surgeons, nutritionists, or general practice MDs.  All of these professionals bring a slightly different perspective.  Most coaches that have been around endurance sports long enough have either had these injuries themselves or athletes that have worked through them.  Their experience can be invaluable in guiding an athlete through the healing process and managing expectations on returning to the sport.  Good coaches should also have their own network of professionals that they have worked with so they can help guide you to professionals with experience working with endurance athletes.  Nutritionist can give athletes recommendations to reduce inflammation and promote healing as well as reduce weight gain with reduced activity.  Chiropractors, Physical therapists, and surgeons all have a slightly different approach, and while one approach may net the most healing, they all may work synergistically to accelerate healing.    I often refer athletes to each of those to get different perspectives on treatment.  Generally speaking, we start less invasive and move to more invasive approaches in most athletes.

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If an athlete is having an overuse injury that may be caused by the bike the first stop should be to your local professional bike fitter.  Ideally the one with the most experience.

One member of this team that can be invaluable is a sports psychologist.  Being injured and prevented from doing the sport you love can be very hard on the head and having someone you can talk to can help reduce stress and keep you on track through the recovery process.  A good sports psychologist can help an athlete work through the feelings of loss, depression, and threat.  These emotions need to be channeled into positive thoughts, and the athlete needs to begin creating a vision of success even through the eventual setbacks that happen in the normal recovery process.  In the long-term, these are valuable skills to have in coping with any adversity.  This is also a good time to reexamine the difference in good versus bad pain.  Good pain is that of exertion and pushing your body to the limit, bad pain is that of injury or inflammation.  Recognizing the difference is key in the long-term rehabilitation of any injury.

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Setbacks and injuries are part of sport and life.  Creating a plan to deal with these setbacks is critical to achieving long-term success.  A good healthy outlook of trying to learn from every situation can increase your resolve, motivation, and resiliency as an athlete and as a person.  Stay positive and confident that you can come out of every setback a stronger person and athlete.

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Interbike 2015 Part 1

Vegas

 

Among the lights, glitter, and show girls every September Las Vegas hosts Interbike to show off the latest and greatest.  Interbike is by far the biggest cycling convention in North America and has continued to evolve from just a place where companies show off new products to a congregation of the smartest minds and companies in the cycling industry.  A good example of that was the Interbike Fit Symposium hosted on Tuesday afternoon before the indoor show began.  Among the presenters and attendees was Dr.Andy Pruit (arguably the originator of modern bike fitting and BG fit), Ben Serrotta (master fitter, owner of Serrotta Bicycles, and responsible for the original education program for bike fitting), Dan Empfield (owner of slowtwich and FIST fitting methodology), Paul Swift (owner of Bikefit and creator of the Lemond Wedges now used by almost all fitting philosophies), and Paraic McGlynn (owner of Cyclologic and creator of the Trek Bike Fitting system) among others.  It was an incredibly powerful collection of minds in the fit industry.  Not only were new ideas and concepts shared, but this also created a very good opportunity to network with other leaders in the industry.  

Interbike Fit Symposium

Interbike Fit Symposium

Monday and Tuesday of the week is Outdoor Demo Days.  It is an opportunity to take out the latest bikes and ride them in real world conditions to see how they perform.  I honestly ride very few road bikes while there mainly because the trail network in Boulder City is so phenomenal.  It really is a fun place to ride.  The highlights of demo days was the Jamis Defcon, which was by far the best all mountain bike I rode, and the Pivot Mach429 which was the best all around bike. Besides bikes on display, many companies have opted to also show components out at demo days and allow attendees another opportunity to check out their goods.  Speedplay and SRM were two such companies that took advantage of the opportunity.

Speedplay

Speedplay

Wednesday morning started the convention indoors and allowed companies to show off their new products.  Being a coach and bike fitter, I tend to concentrate on the latest training gear and bike fitting products including shoes, saddles, and pedals.  For this article, we will just go over the latest in power meters.  In the next article I will go over the latest in contact points as well as other cool things seen at the show.

Seems like every year there are a handful of new powermeters on the market, most of which never make it to market.  One example of that is the Brimm Brothers cleat mounted power meter.  Shown last year at the show, it is still in a “pre-order” phase with no ship dates being shown.  It is important to keep that in mind when talking about a few of these new products.  

Powerbeat by Wattteam

Powerbeat by Wattteam

One brand new product shown was the Powerbeat by Wattteam.  It is a user installed, dual sided power meter, that is set to retail for $499.  The Powerbeat is compatible with almost any crank on the market including carbon cranks, and is both ANT+ and bluetooth compatible.  It features a rechargable battery with about 40 hours of ride time.  Considering that it took Stages quite a while to have a carbon product (more on this below), I am a bit skeptical they will be able to hit their 2% accuracy claim across all crank arms.  The install process is also quite interesting given that 4iiii decided on not following through with their original plan of letting users or bike shops do the install.  I didn’t get to see the install process first hand but the tools and videos online look to be pretty straight forward.  They are set to start shipping near the end of the year so expect to see some real world testing soon.  I am hoping this product lives up to its claims as it could be a very affordable way for athletes to get into a dual sided power meter.

Carbon Stages Options

Carbon Stages Options

The latest at Stages was they now have a carbon arm product and have dropped prices to a $529 entry point.  The carbon crank arm (with an interchangeable bottom bracket spindle for SRAM and FSA) starts at $629 for the crank arm and $70 for the bottom bracket spindle.  The carbon products are set to begin shipping this winter or spring.  Here is the full pdf of all their options and pricing.

Pioneer debuted a new left side only powermeter starting at $800 for an Ultegra version.  They were no changes for their awesome dual sided power meter for Ultegra and Durace cranks which retail for $999 if you already own a crank, and $1850 (Durace) or $1550 (Ultegra) with a complete crank.

Pioneer Power Meter

Pioneer Power Meter

 

There were no major changes over a Quarq but they were still showing the best option for a mountain bike power meter.  The Quarq XX1 power meter is light, reliable, dual sided, and is $1399 for a GXP and $1449 for a BB30 model.

Quarq XX1

Quarq XX1

SRM only attended demo days earlier in the week but there was not much new with them besides the fact that the Power Control 8 computer has finally begun shipping.  

Powertap had lots new with the not only small refinements to their hubs (enduro bearings and a new disc brake version), but the debut of their new chainrings (110mm 5-bolt spacing) and new pedals.  The Powertap C1 chainrings are only offered in a 110mm 5-bolt spacing as of now.  This is somewhat limiting but there are still multiple crank options that are compatible.  A full list of compatibility is available here.  At $699 these enter the market as a good lower cost option for a dual sided power meter.  

Powertap C1 Chainrings

Powertap C1 Chainrings

Power tap also released their new P1 pedal system.  This is a dual sided pedal based power meter system that has overcome some of the complexities of other pedal based systems.  It is literally an install like any other pedal without the need for torque wrenches.  It uses AAA batteries with approximately 400 hours of ride time.  Cost for the P1 is $1199.

Powertap P1 Pedals

Powertap P1 Pedals

Last but not least is the new RPM2 footbed based power meter system.  What is exciting about this system, besides being extremely portable, is its ability to give an athlete power for running and cycling as well as determining force distribution for other weight-bearing exercises like squatting. The insoles use 4 piezo electric strain gauges mounted in a left-right toe and heel pattern which would allow the athlete to see how they are running (heel striking and/or toe off patterns) and distributing their weight both on and off the bike.  Measuring power for running is very new, and something I am a bit skeptical about at this point, but it could be a huge leap forward in objective measurements of running performance.  Research is currently being done on how to best use power for running and how accurate it will be as a driver of running performance.  The system is currently expected to retail for $699 and be available near the end of the year.

RPM2

Two concerns I have with this system is that it doesn’t allow the customization of arch support, although they said it wouldn’t be an issue to add arch support above or below their footbed although overall shoe volume may be a major constraint.  The footbed is 7mm thick at the heel and 3.5mm thick at the toe making it hard to add additional support.  My other major concern, and really is a deal breaker until fixed, is that they aren’t ANT+ compatible and only bluetooth compatible with their own app which doesn’t allow for sharing of a data file.  This means no training peaks, strava, or other analysis software integration.  Most of the value from measuring power is done post workout and without that ability these really have limited use.

 

Stayed tuned for all the other cool stuff we saw at interbike last week including this SWEET bike!

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Interbike Already?!

It is a bit hard to believe, but it is that time of the year again.  The time of the year where we make the annual pilgrimage to desert to see the latest and greatest from the cycling and triathlete markets.  Typically I go every two years but we are making an exception this year to participate in a bicycle fit symposium.  

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We will be sending out updates through the week from demo days, bike fit presentations, cross vegas, and on the show floor on our Facebook page and Instagram feed so make sure you are following us there to get the live updates.  Then check back here the week after to see a recap with all the hits and misses.GOPR0383

Here is the coverage from the previous years (It is funny what did and didn’t make it to market out of these):

Interbike 2015

Interbike 2013

Interbike 2011 Part 2

Interbike 2011 Part 1

Interbike 2010

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Hand Numbness

One of the most common complaints I hear from cyclists and triathletes is hand numbness while riding.  The symptoms can vary from mild numbness in a few fingers, to complete lack of feeling radiating up the arms.  Sometimes called “Cyclist Palsy,” hand numbness usually results from compression on the ulnar nerve (resulting in numbness in the pinky and ring finger), or the median nerve (resulting in numbness in the thumb, index, and middle finger).  If left unresolved, the inflammation from nerve compression can worsen and symptoms will last well after you are done with your ride.  I don’t know about you, but I like to have feelings in my hands when I am trying to reach for that bottle of recovery drink post ride.

Nerves of the hand

The most common cause and easiest to fix reason for hand numbness is from gripping the bars too tight, or not varying your hand position throughout a ride.  I recommend that cyclists relax their hands on the bar and keep their fingers loose in most situations.  Save the white knuckles for those situations where you are riding through that rock garden or over the local cobbled section.  Also, moving your hands slightly throughout a ride can relieve pressure points and help keep your hands relaxed.  It is all too easy to get locked into one position on the bike and not vary it for a 2 hour ride.  Try holding on to anything for 2 hours and see if your hands don’t go partially numb.  If you don’t feel comfortable moving your hands around then it might be more of a general fit issue (see below!).

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Another common cause of hand numbness is having too much weight on your hands. Fore and aft weight distribution on the bike is extremely important in overall comfort on the bike and can have a huge impact on hand numbness.  Many cyclists feel like this is just a case of the bars being too low, but saddle position being too far forward, too high, or the angle of the saddle being too far down can also have a huge impact on how much weight you are carrying on your hands.  Making sure your fit is as balanced as possible should always be your first step in trying to eliminate hand numbness.  It is also important to keep in mind that core strength is also a factor here, and having a cycling position that is taking into account the athlete’s ability to support their upper-body is a huge factor in finding that balanced position.

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It isn’t uncommon for cyclists to experience numbness in one hand versus the other as well.  This can often result from a cyclist having some sort of hip rotation and not sitting squarely on the bike.  Just like I stated above, the first step here is to dial in all the normal fit parameters including how well the feet are supported.  Unsupported arch or forefoot collapse can lead to internal rotation of the leg, changing hip orientation, and leading to an unbalanced position on the bike.  That can cause an athlete to carry more weight in one hand versus the other, and potentially result in hand numbness in only one hand.

What about gloves?!  From my experience, gloves can often be a cause of hand numbness as well as help.  Gloves that have a lot of padding at the base of the palm right over the ulnar or median nerve can often lead to more compression and hand numbness.  In my experience, gel padding seems to worse in this regard than general foam padding.  General even padding, or no padding, seems to work better for most people.  There are also new gloves designed by hand-specialist orthopedic surgeon Dr. Kyle Bickel M.D. and made by Specialized called Grail gloves.  The gloves only have padding in the center of the palm to even out the pressure across the hand and reducing compression on the ulnar and median nerves.  I have seen mixed results with these gloves but they are definitely worth trying if you have already gone through a proper bike fit.

Grail Gloves

In all of these solutions it is important to keep in mind that if you have been experiencing hand numbness for a while and experiencing symptoms off the bike, it may take a few weeks for any inflammation in the nerves to calm down to really see the full effects of the changes.  If these fixes are not helping with the symptoms or you are experiencing persistent numbness radiating up your arms past the wrist I would recommend seeing your doctor to make sure there isn’t a nerve issue in the upper back or shoulder.  

Happy cycling!

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