Cycling Medicine: Acute Overuse of the Legs

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In the rush to cram cycling into our busy lifestyles, recovery is typically the first thing that gets thrown out the window. After all, it's easy to prescribe training programs but more difficult to prescribe, or adhere to, recovery programs. Dr. Rick Rosa provides us with a cautionary tale about what happens when we push our bodies too far by trying to do it all...

Bike-Run Transition

This year for my birthday, my good friend Dave and I rode 100 miles with over 8,000 feet of climbing. It was a hard ride, but I had fun. Once the ride was over, I went home to recover while Dave figured he would play a little coed soccer with his wife. I'm not sure if it was the lactic acid bath during the ride or the pressure to do things with his wife that clouded his otherwise rock solid judgment, but he set himself up for disaster.

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While playing soccer he was running up and down the field making quick accelerations and decelerations as well as lateral movements. At one point he felt a sharp pain in his hamstring, namely the semitendinosus muscle. Soon after that, he began to experience pain in the upper part of his rectus femoris muscle (the middle thigh.) He eventually came into my office after the injury did not improve, and he noted it was affecting his riding.

Dave is a seasoned, 16-year, Cat-3 cyclist and, like many cyclists, he is always trying to find time to train. He is well-versed on most things associated with cycling, including injuries, and he did take it easy for a while, limiting the amount of intervals and power level he was producing. The pain was not improving so he finally brought it up in conversation with me, so I scheduled an appointment to see my good friend and help him with this problem.

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Case History

In looking at his past medical history, I discovered that he had injured his ACL ligament in his left knee when he was a child playing soccer and started cycling to keep that knee stable and strong. The injury was a mild tear and more of a stretch of the ligament which left him with a bit of extra play in that knee than I would like.

Upon examination of the legs, I noted that he had some limited flexibility in the injured leg in multiple muscles and planes of movement. In other words, he was a bit tight, but he had been working on this since the injury, which means he was previously even more limited in movement.

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