Help At Your Fingertips

Injuries that put a spoke in your wheel

Cycling is a well-loved sport that is getting more popular.

Yet, you may end up with more than just aches and bruises after an outing on your two-wheeler.

As with any physical activity, cycling can cause injuries that may morph into long-term problems.

Dr Benjamin Tow, an orthopaedic surgeon at Mount Elizabeth Hospital, outlines five cycling injuries that people may miss or ignore.


What it is: A repetitive stress injury at the knees. It stems from forces generated by the quadriceps muscles in the thighs that are transmitted through the kneecap to the shin bone.

Symptoms: Pain at the knee which gets worse when you straighten your leg. The lower edge of the kneecap may also feel tender.

What to do: Apply ice to the affected area. Try not to move around too much. Physiotherapy may improve muscle imbalance and strengthen the muscles.

If the problem persists after a few weeks, you may need an injection of platelet-rich plasma to the patella tendon sheath.

This substance is extracted from your blood, and contains growth factors that speed the healing of microscopic tears.

Prevent it: Lower the saddle height of your bicycle and ride with lower gears. Doing so decreases the load on the quadriceps.


What it is: A repetitive stress injury that occurs over the heel, where the Achilles tendon connects to the heel bone. This comes about when great forces travel from the calf muscles to the heel bone when you pedal the bicycle.

Symptoms: Pain in the heel, especially when you put weight on it. The heel bone may feel tender.

What to do: Apply ice to the affected area and keep the foot elevated to decrease pain and swelling.

Topical pain medication, gels or anti-inflammatory agents can help.

Surgery is rarely called for, as most people will recover in a few weeks. But if you experience chronic pain and inflammation, you may need to go under the knife.

Prevent it: Do stretching exercise before cycling. If you feel heel pain while riding, lower the saddle slightly. This way, your ankle will be in a less severe "tip-toe" position, which means less stress will be placed on your tendon.

Lower the gears when possible, so you can pedal less.


What it is: Numbness in the fingers from prolonged, constant pressure on the median nerve of the hand. This is aggravated by holding the handle bars tightly with the wrist flexed or extended, and elbows locked straight.

Symptoms: Numbness in the hand or fingers.

What to do: Relaxing your grip on the handlebars and moving your hands and fingers can immediately relieve the numbness.

In severe cases, a surgical release of the ligament that sits atop the median nerve may be needed. This procedure divides the ligament that is exerting pressure on the nerve of the hand.

Prevent it: Keep your wrists straight and elbows slightly bent while riding, and do not grip the handlebars too tightly. Shift your hand positions regularly.

Wear padded gloves or wrap the handlebars with bicycle tape to cushion the hand - this will lower the amount of force transmitted to the nerve.


What it is: Pain in the back, often caused by maintaining a posture that is not ideal for your spine for a prolonged period of time.

Your bike frame may be too big, causing you to reach forward too much. Or, you may be in a hunched position as the bicycle frame is too small for your size.

Symptoms: Pain, commonly in the lower back. The lower part of the back works harder to maintain one's body posture, and sustains a heavier load than the upper back.

What to do: Rest by lying down with your hips and knees slightly bent on a pillow. Place warm packs over the painful area.

If you experience pain in the back for several days, or a pulling sensation down your legs, seek medical help.

Prevent it: Do proper warm-up exercises and stretches before hopping on your bike. Take breaks every 30 to 45 minutes to stretch your back. Also, choose a bicycle frame that suits your size.


What it is: A skin disorder caused by prolonged pressure of the "sit bones" in the buttocks on the saddle, coupled with friction between the skin and shorts.

Symptoms: Skin abrasions in the groin area that comes into contact with the saddle. Sometimes, hair follicles may be inflamed, which appear as red dots.

What to do: Lower your bicycle saddle to reduce the side-to-side motion of the pelvis when cycling, which can lead to excessive friction on the skin.

Prevent it: Make sure your saddle is well-padded. Wearing padded cycling pants can also reduce the load and friction on the skin.

A version of this article appeared in the print edition of The Straits Times on January 05, 2016, with the headline 'Injuries that put a spoke in your wheel'. Print Edition | Subscribe