Sports Medicine Advisor

How to Stay Healthy on the Trail

Mountain Bike Injuries

by Luigi F Rende, M.S., A. T. C,
Director, The Center for Sports Medicine

Bicycling is probably one of the most popular recreational sports, and with the advent of new technology and lower costs, more people are purchasing and riding mountain bikes than ever before.

The fat tire craze has reached every age and lifestyle. More people find that mountain bikes are more comfortable, are easier to ride and are more versatile than their skinny tired counterparts. Although these bikes can be ridden through just about anything, 80% of these bikes purchased never see a trail or a wooded path. But, those of you that venture into more challenging terrain, the risks of injury may become more prevalent.

Off road riding is more demanding to the cyclist than on road. There are several factors why: terrain, whether it is steep, wet or dry, off road is challenging to the novice as well as the experienced. Soft and sandy ground is demanding to the legs as well as the cardiovascular system. But this type of terrain can also be risky when steering through it. This type of riding is also demanding and risky because of obstacles such as rocks, logs and puddles that off road riders usually encounter, it takes good skills and strength to overcome some of these road blocks. Never ride terrain out of your skill level, or if fatigue is limiting your skill do not attempt difficult obstacles. Fatigue is what leads to injury in any sport, be smart, ride smart.

We can classify mountain bike injuries in two categories:

• Acute and overuse injuries
• Acute injuries are caused by one specific episode or traumatic force.
• Overuse injuries are a result of repetitive stress and prolonged microtrauma.

The most common of those injuries are contusions (bruises) and abrasions caused mostly by colliding with other riders, or obstacles in the riders path, such as branches trees etc.

Some of the more severe acute injuries are caused by failing on an outstretched hand and arm. Which reminds me of an accident one of my staff had more than a year ago on her bike. She was riding her bike on a paved trail and was traveling at a pretty fast speed, one of her pedals fell off, making her lose control of her bike, she fell on an outstretched arm and hand, and fractured a small bone in her wrist, and a bone in her forearm. Needless to say she still has problems with both.

Falling on the outstretched hand can cause injuries to the wrist, and elbow and shoulder. That is why it is important to always check your equipment before you ride, and to always ride in control. If you are one that spends a lot of time on the trail especially in demanding terrain, prepare yourself physically. Be sure that your cardiovascular system is fit, and that you have done some type of strength training for your legs, hips, low back, arms and shoulders. This will help you avoid injury and lessen the severity if one happens.

Overuse injuries also occur in mountain biking. Over use injuries are caused by repetitive stress to certain areas, and or the overtaxing of certain structures when those structures are not physically ready. These types of injuries usually occur to the over zealous individuals that train and ride to hard without giving the body time to recuperate in between workouts. There are also overuse injuries that are caused by mechanical forces that sometimes cannot be avoided, especially those forces involved in controlling the bike, from braking and shifting, to stabilizing the bike going over and through obstacles.

Here are some overuse injuries specific to mountain biking:

• Caused by repetitive shifting, most mountain bikers will shift up to 100 times per hour 
• It is an irritation to the thumb tendons, and is more prevalent in those riders that have shifting levers mounted on top of the handle bars
• It may also be caused by aggressive braking on down hills and going around turns
• Pain will be specific to inside of wrist with any wrist and thumb movement
• The condition will become disabling if not managed properly
• May need to see a physician and to change position of shifting levers

Patellofemoral Pain (PFP) 

• Generalized knee cap pain, an irritation of the cartilage on the back of knee cap and the surrounding structures

• Caused by overworking and quadricep muscle group, by training on up hills to much, and training in high gears to much.
• Pain will also be caused by sitting for long periods of time (driving, watching a movie, sitting at a desk)
• Stiffness is also a symptom

• To prevent this form happening be sure to strengthen the quadricep muscles and stretch out the hamstring group.

• Gradually increase hill workouts, be patient
• Give your body time to rest

Low back pain (LBP)

• Sometimes riding position will predispose an individual to LBP
• Stabilizing the bike on rough terrain is accomplished by the muscles in the low pack, hips and stomach
• The low back pain may also be caused by your bike not fitting properly

• Prevention of LBP can be accomplished by strengthening the abdominals lumbar musculature, and to keep the hamstrings flexible

Mountain biking is a very enjoyable activity. There are some risks involved if one plans to ride in challenging terrain. Preparation against any of these injuries can be accomplished by being fit, listening to your body, and riding smart.

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