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Top 5 Most Common Mountain Biking Injuries

Top 5 Most Common Mountain Biking Injuries

Image taken by Tim Foster

Mountain biking injuries have increased with the rise in popularity of mountain biking. Competitive mountain biking involves off road riding over tracks with variable surface conditions. The high speeds achieved during downhill sections can lead to falls and serious injury. There are several published reports of serious head injury as a result of falls, which makes a helmet essential.

Thankfully, most mountain biking injuries are not serious the majority of falls result in relatively minor cuts and grazes. Abrasions on the outside of the knees, hips and elbows are common when a rider falls, especially on a hard surface. The majority of mountain biking injuries occur during downhill riding, with the shoulder region, upper arm and wrist most often injured. A broken Collar bone and Acromioclavicular joint sprain (shoulder separation) are two frequent mountain biking injuries.

Not all mountain biking injuries are traumatic. Overuse injuries can occur due to the repetitive nature of cycling. If the bike set up is incorrect for the rider, then it is quite easy to suffer from back pain and knee pain. Some research suggests that 25% of cyclists suffer from knee pain that comes on due to overuse on a bike that is not set up properly.

1. Cuts & Grazes

What are Cuts & Grazes?

Cuts and Grazes are damage to the skin and superficial soft tissues and are the most common injuries to occur following a fall from a mountain bike.

A cut or ‘laceration’ is a penetrating tear in the skin. A shallow cut will usually heal quickly without any problems, while deeper cuts may cause more serious damage to nerve tissue or larger blood vessels, which would mean that they require hospital treatment.

A graze or ‘abrasion’ occurs when the skin is scraped off. Usually this only affects a small area and the wound heals very quickly. However, large grazes that penetrate beyond the skin layers can be serious injuries, requiring input from a doctor.

What can you do to prevent Cuts & Grazes?

Staying on your bike and avoiding falls is the surest method of steering clear of cuts and grazes. Always maintain a balanced posture with your weight shifted back and look out for tree stumps and rocks that could cause a fall.

Wearing protective padding over the elbows, hips and knees can help to reduce the extent of any cuts and grazes. elbow pads, sports knee supports and padded shorts can be all provide protection to prevent cuts and grazes, even if there is a fall.

What should you do if you suffer Cuts & Grazes?

Always carry a first aid kit. Any profuse bleeding, loss of sensation, or signs of infection (pain, redness, swelling) should be checked out by a doctor. If bleeding is controlled and there are no complications, then most cuts and grazes can be treated at home. The wound should be cleaned thoroughly then dressed with a sterile dressing.

2. Broken Collar Bone

What is a Broken Collar Bone?

The Collar Bone or Clavicle is one of the most frequently broken bones in the body. A broken Collar bone (broken Clavicle) is a very common shoulder injury in mountain bikers. A broken Collar bone usually occurs during a downhill section if the rider falls onto an out stretched hand. The force transmitted up the arm is often enough to cause this painful shoulder fracture.

What can you do to prevent a Broken Collar Bone?

Try not to fall! If the front wheel comes to an abrupt halt the rider typically goes over the handlebars – this is known as an ‘Endo’. Be aware that this is more likely to happen on a descent, because you’ll be moving faster and you’re tilted forward. Look out for rocks and tree stumps as these are the obstacles that will cause a sudden stop. Also make sure that your pedals are level with weight distributed evenly between left and right pedal, because if you’re unbalanced then you’re more likely to go over the handlebars.

What should you do if you suffer a Broken Collar Bone?

Apply ice packs (never apply ice directly to the skin) to the shoulder for pain relief. Pain killing drugs prescribed by a doctor can provide relief for the intense shoulder pain. Any suspected fractures should be assessed and treated at hospital. A figure of 8 shoulder support and sling can immobilise the shoulder and provide pain relief.

Once the treating doctor is satisfied that the collar bone is sufficiently healed then shoulder range of movement exercises can be progressed to gradually increase shoulder movement. These exercises may be a little uncomfortable, but with some encouragement from a Physiotherapist this discomfort should quickly resolve as normal movement returns. Shoulder strengthening should then begin using resistance bands to regain full function.

3. Acromio Clavicular (AC) Joint Sprain

What is an Acromio Clavicular (AC) Joint Sprain?

The Acromio Clavicular joint (AC joint) is part of the shoulder complex. It is situated at the outer side of the Collar bone where it is attached to the front of the shoulder blade with strong ligaments. An AC joint sprain (Shoulder Separation) refers to damage to these ligaments. The AC joint ligaments are most commonly damaged through a fall onto either the tip of the shoulder or a fall onto an out stretched hand.

What can you do to prevent an Acromio Clavicular (AC) Joint Sprain?

Similar to a broken Collar bone – try to make sure you don’t fall! Avoiding an ‘Endo’ is very important, especially during fast descents. If your front wheel comes to an abrupt halt then you’re likely to go flying over the handlebars.

Keep an eye out for rocks and tree stumps as these are the most common causes of a fall. Always make sure that your pedals are level with your weight distributed evenly between left and right pedal, because if you’re unbalanced then you’re more likely to go over the handlebars.

What should you do if you suffer an Acromio Clavicular (AC) Joint Sprain?

Apply Ice Packs (never apply ice directly to the skin) to the shoulder for pain relief. Pain killing drugs prescribed by a doctor can provide relief for the intense shoulder pain. A Figure of 8 Shoulder Support and Sling can immobilise the shoulder and provide pain relief.

A shoulder brace will push the collar bone downwards and provide the support of a sling. When returning to activity a shoulder stabiliser will provide support and protection that can help to prevent re-injury.

4. Knee Pain

What is Knee Pain?

It may sound strange but Runner’s Knee is the most common knee injury in cyclists. Runner’s Knee is the common term for Ilio Tibial Band Friction Syndrome (ITBFS). Runner’s Knee is a painful overuse knee injury that affects the outer part of the knee. It is fairly common in cyclists due to the repetitive nature of cycling.

During cycling, where there is repeated bending and straightening of the knee joint, the IlioTibial Band can ‘impinge’ upon the prominent outer-side of the knee and the resultant friction can lead to inflammation of the tissues.

What can you do to prevent Knee Pain?

The most important consideration to prevent knee injury during cycling is the set up of the bike. The frame should be the correct size, with 1″-2″ of clearance between the crotch and top tube of the frame. In mountain bikes, this is not normally an issue as the top tube is lower. If the saddle is too high or too low then the stresses on the knee can lead to injury. The knee shouldn’t be over extended when the pedal reaches the bottom of its revolution. Another bad habit is to point your toes inwards when cycling as it increases the risk of developing IlioTibial Band Friction Syndrome.

What should you do if you suffer Knee Pain?

Physiotherapy treatment is effective for most cases of IlioTibial Band Friction Syndrome. It aims to reduce the amount of inflammation using Ice Therapy (never apply ice directly to the skin) and can be assisted by anti-inflammatory medication prescribed by a doctor. Anti Inflammatory Gel may be more appropriate where anti-inflammatory tablets are not well tolerated. For those who want to continue to cycle a knee strap can relieve symptoms and provide support.

5. Low Back Pain

What is Low Back Pain?

Repeated overuse and prolonged bending during cycling can lead to low back pain. A flexed posture while on the bike can lead to degeneration of the outer layer of the disc, which allows the gel-like centre of the disc to prolapse out. This is known as a Herniated Disc. This presses against structures in the back and can cause back pain and even pain down the back of the legs, which is known as Sciatica.

What can you do to prevent Low Back Pain?

It’s important that the bike is comfortable, with a correct set up. If the frame is too big then over reaching for the handlebars can lead to low back pain. Being hunched up on a frame that is too small can also lead to low back pain.

Research has shown that specific back exercises, known as core strength and stability exercises, can help to prevent low back pain. The Stabiliser Pressure Biofeedback device is very useful for learning these back exercises at home. More advanced core strength exercises using swiss balls can then be used to relieve and prevent back pain.

What should you do if you suffer Low Back Pain?

Pain-relieving medication prescribed by a doctor and heat packs are usually necessary during the first few days with low back pain. Research has shown that patients with low back pain should remain as active as they possibly can, so long as their symptoms are not aggravated. A back brace can be helpful to improve posture and relieve pain by preventing aggravating movements.