Cycling Challenges: Avoiding Common Injuries

Cycling Challenges: Avoiding Common Injuries

Tuesday, August 9, 2022

Looking after your points of contact with the bike.

This blog is about avoiding common injuries, those which you might expect or not expect to get on a multi day endurance ride, especially if this would be your first time riding long distances.

So some of these tips may be obvious to you; some may be just a pause for thought because  you may be already be seasoned cyclists getting in long kilometres.

Either way, three long days in the saddle is enough for little niggles to become major issues. Prevention is much better than cure.

So without further ado, let's go through some of the most common issues that we can experience on endurance type rides, and what to do to prevent them.

Contact Points

I will cover three main areas of contact on the bike, ie your feet your hands and your bottom

You obviously can also get injured by falling off the bike or having an unplanned dismount, but I'm not going to cover that in this blog.

Feet of Endurance

So the first thing is your feet. Perhaps in your training you have noticed that you have some pain in your feet, maybe some buzzing or numbness.

There are a few potential reasons for this.

Shoes Size. If your shoes are not the right size then that could ultimately cause you to have blackened toenails or blisters or hot foot especially on the balls of your feet.

One common problem is to choose road cycling shoes that are too narrow....most are made in Italy and developed from ice skating shoes and hence are narrow (you don’t see too many burly ice dancers), so make sure your feet are not cramped in your shoes and choose wide fitting if you feel that this could be a problem.

The most expensive shoe is not always the right shoe for you and remember that your feet will swell over the course of the day, if they are little tight in the morning, expect trouble by the afternoon.

Bike Fit.  The fit should include an assessment of the angle of your ankle to the pedal and if you are either pronated or supernates this be corrected using shims between the shoe and the cleat.  Make sure you get the cleats fitted correctly and aligned to avoid knee problems.

A good bike fit will ensure that not only are the cleats set so that your knee is over your axle on the power stroke, but takes account of how your feet naturally fall, either turning out or in....it is a myth that your feet need to be parallel as this will put pressure on your knees if your feet natural turn in or point out.

Finally, and I hope that is common sense, do not buy brand new shoes the day before you start your ride, as you might find that's a problem if they are not right for you.

Hands and Wrists

Most people at some time experience numbness in their hands when riding especially for long periods of time over the course of a day. Ultimately you can lose feeling, which can be dangerous not only in the immediacy, for example braking safely on descents, but for the future health of your hands.

Do not take it lightly. It can be serious. If you get what is called handlebar palsy it can take weeks if not months to get full feeling back in your hands due to the damage done to the nerves.

This can be alleviated to some extent by using use all the available positions on your bars, including the drops, the hoods, and the tops of the bars, keep changing hand position to remain comfortable.

Glove choice is key. Make sure you have a good fitting glove that is not so tight that it cuts off the blood supply or too loose that they begin to rub. They need to feel comfortable with not too much or too little padding. There is no one glove that will be right for everyone, so experiment and you will find on your longer training rides what is most comfortable for you.

Remember that the higher the price does not guarantee the better they are for you.

Consider taking two or more pairs of gloves. I certainly do for these types of event. Not just because the padding on the gloves will get worn, sweaty and will get damp on the ride, but if you are starting to get an issue with a particular part of your hand, having another pair of gloves can alleviate that problem, offering relief to the problematic pressure points.

Brake Lever Positioning.  If you find yourself stretching for the brake or gear levers, this can cause soreness problems with the skin between your index finger and your thumb as you continuously move and rub that tender part of your hand, you may need to change the position of the levers or adjust the reach if that is an option. Your local bike shop and you bike fitter should be able to help.

Road Vibrations. Your hands, wrists and arms act together as shock absorbers and if your wrist are bent, and/or the arms are straight the vibrations will be transferred meaning your your wrists will take the brunt of the force.

Similarly, do not grip the bars too tightly especially going downhill, allow your hands, wrists and arms to be relaxed so that they can absorb the road vibration. A tip is to pretend to play the piano and wiggle your fingers regularly.

If you start to experience problems with trapped nerves in your hands then you must get that checked.

Blazing Saddles

Now the big problem, the perennial problem : saddle sores, infections, blisters, pain, discomfort and numbness in the nether regions.

This is mainly down to either lack of ride readiness (ie not enough time in the saddle as preparation for the ride), or the saddle is wrong for your body type, and of course its position is too high, too low, or the angle is incorrect.

It is no coincidence that you can buy saddles of all shapes widths and lengths. We have women’s saddles and men’s saddles for a reason, the gap between our sitting bones is very different. Similarly, body size and flexibility will have an impact on the type and position of the saddle.

Most good bike shops will lend you a saddle that you can try to see how you get on and will certainly advise you on the ones they believe will be the best fit for you.

Bear in mind that you also want a saddle that gives you a few sitting positions that you can use during the day, rather than a specialist saddle that locks you into one position (eg a time-trial saddle).

The common consensus in the past was that the saddle should be level from the back to the nose, however this is changing with moves to lower the nose just a few degrees down (between 1 and 3 degrees) thereby allowing your hips to rotate, which in turn gives you more power, allows you to get lower ie more aerodynamic and is much more comfortable on the perineum.

A small caveat on all things related to your bike fit, you might be what is called "macro-tolerant" like Geraint Thomas who can jump on almost any bike and it will be okay, or conversely "micro-sensitive" like Ben Swift who can tell if his saddle is 1mm too high or the wrong angle….hopefully you are one of the lucky ones like Geraint, but the bottom line is to make sure that you are comfortable in the saddle, and ahead of time change its position or its type if it isn't right for you.

During your training, if it isn’t right from the start, it is not going to get any better. It will get worse.

So how can we avoid saddle sores?

First of all. Appropriate clothes. Assuming you will wear lycra shorts, you shouldn't be wearing anything underneath them. They're designed to keep you fresh to wick away any sweat. Wearing underwear will compromise their effectiveness, trapping sweat and possibly having seams that will cut into you.

Secondly Chamois Cream: Lots of advice on various forums about this. Don't just use it in the morning, also use it during the ride. If you have room in your luggage, consider taking Sudocream and apply this in the evening and the morning.

Favouring a cheek. There will be times when you will free wheel while chatting to a friend or just taking it easy; what tends to happen is that you will favour a particular cheek over the other. As you are changing the balance on your saddle, over a period of hours and days you can start to build a pressure point on one side which can become a sore. So when freewheeling try not to favour one cheek over the other, keep your balance on the saddle as neutral as you can.

Showering. When you get the hotel at the end of each day you may be tempted to grab a beer and chat with your buddies, or tinker with your bike. All good things, but getting showered must be your priority, get clean and dry, apply some salve such as I mentioned before such as Sudocream will reduce the chance of sores developing.

If you do get a sore, there is a tendency to move around on the saddle due to the pain. In turn, as you will not be so relaxed, you may begin to create more tension in your back and in your shoulders, and so a domino effect begins to set in.

Knees and Shoulders

This is all really about the basic bike fit positioning. If we get this wrong then we are creating the situation for bringing on knee pain, shoulder pain, and muscle strains.

I am assuming most of you will have a road bike and you've been to your local bike shop maybe even to a professional and had a fit. I would suggest that if you haven't done that and you are experiencing some problems then go and get that looked into.

For example, if your saddle is too high then your hips will be rocking which causes back pain, and if it is too low then your knees will be splayed out impacting your pedal technique and causing knee injury. It is not always the saddle position, it could be your hips are not sufficiently flexible, or like most people, you have one leg longer than the other, so it is worth getting this checked early in your training to avoid possible injury.

When it comes to the bike fitter, it is better to choose one who is a registered physiotherapist over a self-trained fitter from your local bike shop.  Getting it wrong by using an amateur can have a huge detrimental impact on your wellbeing and your ability to ride without pain. It might be okay for a first off bike sizing guide, but for long rides such as this, you need to have the bike setup dialled into your specific needs and capabilities.

Other Considerations

Make sure you keep yourself well fuelled and hydrated. This is crucial on long rides to prevent you becoming weak or dehydrated. As you train over the coming weeks, develop your own fuelling strategy...get into the habit of eating little, but often...and don’t be tempted to neck too many gels, this can cause serious stomach cramps if your body is not used to having to absorb more than 60 grams of carbohydrate per hour - certainly don’t follow the advice on the gel wrapper and eat three per hour unless you are a highly trained athlete.

We also need to eat lots of protein to help build muscle, again little but often, your body cannot absorb huge amounts of protein at once, so saving it up as a 12 ounce steak in the evening will be wasted !

If you find that your heart rate increases dramatically during a long ride, it might be that you are getting dehydrated. We only need to lose 2% of our body mass through sweat to enter the state of hypo hydration, which will severely impact performance. As a rule of thumb, and everyone is different, but I find that by drinking about a bottle per hour and use electrolytes to replace salts lost in sweat I keep hydrated.

There is also a school of thought that suggests that you should only drink to your own personal level of thirst; by sticking to a strict hydration strategy irrespective of personal circumstances can lead to over hydration, in which case you suffer water intoxication, the salt levels in your body become too diluted. In this instance it is not unusual to require a saline drip.

In each case, find what works for you, drink regularly in small amounts, and avid taking on too much water unnecessarily.

Finally, you may find that your average heart rate drops after the first or second day and hitting your normal riding beats per minute becomes increasingly impossible.

It is simply a sign that you are getting fatigued and your body is naturally dialling you back. As long as you understand what is happening and back off your pace, stop attacking hills and sprinting for bragging rights with your buddies you will be fine.

Dealing with Injuries

Dealing With Injuries

If you do get into the situation where you have a problem with saddle sores then I'm afraid you are going to have to leave your dignity at the door.   As a first step you are likely to have the sore cleaned and then Compede plasters applied to the sensitive areas. .

If you are thinking of applying Compede as a plaster over maybe a blister on your feet or your hands or your bottom yourself, then make sure that you have thoroughly cleaned and disinfected the area;  If the area is dirty or if it's infected and you put on Compede, given that the plaster will be in place for several days this could cause a major infection. So be very careful if you are thinking of patching yourself up.

For muscle or joint pain, apart from the obvious pain killers, the main tool is Rocktape. The purpose of this tape is to take pressure off the joint or muscle, but as before get it done by the medics.

Hit the pain relief drugs early on. Don't be a martyr, don't try to soldier through, hit the pain quickly and fast.

Poor Road surfaces. If you still believe that you need to have 120 or 130 PSI in your tubes then expect to be bounced all over the road....please be sensible and use tyre pressures that are suitable for the road conditions.

I will assume that most people are riding with disk brakes, meaning you have the luxury of being able to fit wide tyres to the bike. Personally I consider anything from 26 to 30m to be optimal for most types of rider.

If you are riding with rim brakes, get the widest tyres that your bike will manage. Wider tyres means that these can be ridden on lower pressures...long gone are the days when we rode 25mm tyres as the default.  

If your wheels are tubeless ready, it might be worth considering going tubeless as this allows you to further reduce the tyre pressures (no possibility of pinch flats), and hence helps with overall comfort. Tips: practise dealing with a flat on tubeless tires, ensure you have fresh sealant in the tyre and take a tubeless repair kit with you.

Overtraining and Fatigue

Having looked at the common physical injuries, i wanted to touch on the topic of overtraining and fatigue as I see it as a very common problem that can ruin the best laid plans.

While you are training for the event, bear in mind that your workouts and training rides will only give you the potential for fitness; fitness itself comes from what is called super-compensation.

When we exercise we are undertaking what is called a catabolic breakdown of the body; however when we rest our body goes into an anabolic state where we rebuild ourselves, stronger than before we exercised, which is why after an extended period of exercise and recovery we get fitter, stronger and faster.

But this super-compensation is predicated on rest to allow our bodies to recover and adapt.

If we fail to allow this we will begin to overreach our capabilities to recover, which is okay if it is deliberately planned for a short period of time, and you have planned in rest periods to recover, however if you just go gung-ho and train and train without rest, eventually you will go into a state of over-training, ultimately leading to illness, injury and a decline which can take 2 to 3 months to recover from, and ultimately can be irreversible.

I know former athletes who have trained for an event so hard that they overtrain and pick up viruses such as glandular fever (the Epstein-Barr virus) which ended their riding career.

To counter this, for your training, understand that while you need to train hard, you must also include periods of rest.

A typical training cycle would be four weeks of hard graft then a week of lower intensity workouts, with each week having rest days, which does not mean putting your feet up, but could be doing a very gentle recovery ride.

Some people may say, just get out on the bike and ride as much and as often as you can.

However you might get away with this strategy in your twenties and thirties, or if you are a natural athlete, but as you get older your VO2Max decreases and muscle mass declines, and just doing long slow rides is not going to cut it....see the previous session to learn more on how to train for the ride and of course follow a training plan, ensuring you include high intensity sessions and perhaps weight training sessions into your regime.

Rest is more important as we get older. For those of you beyond 50 for example, we need more much time for recovery than when we were in our youth, so the training cycle needs to be reduced to three weeks for the workouts followed by one for rest, with one or two recovery days per week.

Irrespective of age, by doing this you will follow best practise in what I call the Workout, Recover, Adapt and Perform cycle...there are variations on this theme, but hopefully you get the idea.

So, what about undertraining? For the undertrained, the Ibiza ride will put  your body through the mill. 

To avoid under-training or overtraining follow you chosen training plans, or if you think you need some extra help get a coach.

I can also recommend the use of measuring your heart rate variation (HRV), this is a simple test you can do each morning with your smartphone connected to a finger sensor and takes about 1 minute. It basically monitors the difference in time between heart beats over a one minute period and the lower the variation the more stressed your body is, and conversely the higher the variation, the more ready you are to train harder....it is a simple, but scientifically proven method to predict your readiness to exercise and indicates when you need to rest. 

As a mentioned earlier, training gives you the potential for fitness, however it is the rest that allows your body to recover and with super-compensation to adapt to the new stress levels and rebuild itself stronger each time.

If you train properly and listen to your own body then you will prepare yourself for the ride and not come out of the end of this feeling wrecked.

So there we have it, look after your contact points, your feet, hands, and bottom and get the training in with lots of rest and recovery to ensure that you are fit enough for the three days of cycling.

Last point, do not underestimate how you will feel once the ride is over, expect to become exhausted as the adrenaline levels drop, the euphoria wanes and the reality of the aches and pains being to kick in.

Look after yourselves and your fellow riders, prepare to be as good as you can get physically, by putting in the hard rides now will help give you the physical and mental toughness for whatever your adventure throws at you.

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