Competitive road cycling is an increasingly popular sport, both in Norway and internationally. The number of registered racers increased by 82% from 2006 to 2007, with the total number of cyclists holding a competitive license increasing by 357% between 1995 and 2007 (Norges Sykkelforbund 2008). Whilst recreational cycling is generally considered to be a low-impact and safe form of exercise appropriate for example in many rehabilitation settings, there are several anecdotal reports of a predisposition of competitive cyclists to various patterns of overuse injuries (Mellion 1991, 1994, Holmes et al. 1994).
The incidence and severity of such injuries is poorly reported in the literature. A majority of epidemiological investigations in cycling have been conducted on recreational cyclists, often those competing in mass-participation tours (Kulund and Brubaker 1978, Weiss 1985, Wilber et al. 1995, Dannenburg et al. 1996) however there are several reasons why highly competitive cyclists may experience a different pattern of overuse injuries than the subjects in these studies, including a much higher training and racing volume, an altered body position on the bicycle to improve rider aerodynamics and an altered choice of equipment. This hypothesis is somewhat supported by the few studies that have been published on elite cyclists (Callaghan and Jarvis 1996, Barrio et al 1995), however various methodological issues in these papers prevents meaningful conclusions to be drawn.
The purpose of this study is therefore to ascertain more valid measures of the location, prevalence and severity of overuse injuries in this cohort.
In addition, several other variables that may have a relationship to overuse injury will also be investigated, including the strength training, core-stability training and stretching practices of professional cyclists and the degree of float they use in their pedal/cleat systems.
The design is a retrospective cohort study. Members of several professional teams will be asked to give information about the location, severity and duration of overuse injuries sustained during the 2008 season, as well as to complete standardised questionnaires on low-back pain, anterior knee pain and other information relating to their training volume and practices. Data collection will take place during the winter 2008-2009 at the training camps of participating teams.
The previous investigations into competitive and recreational cyclists, as well as the anecdotal literature suggest that knee pain and lower back pain are significant problems in road cycling. We will therefore also administer questionnaires specifically on pain and function in these two regions of the body. The lower back pain questionnaire has been previously administered to other sporting cohorts including cross country skiers, rowers and orienteerers (Bahr et al 2004) and the knee questionnaire has been administered to beach volleyball players (Bahr 2008 – unpublished). We will therefore be able to compare professional road cyclists to the results of these previous investigations.
This study will provide increased knowledge of the type and severity of overuse injuries that male professional road cyclists sustain. This knowledge may assist in the formulation of interventions to both treat and prevent overuse injuries in competitive cycling.