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SPORTS

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John Carden

on 2 December 2012

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Transcript of SPORTS

classifiaction of
sports contact limited contact sports in which the rules are specifically designed to prevent contact
between players either intentionally or unintentionally non-contact sports where participants compete alternately, in lanes, or are physically separated such as to make nearly impossible for them to
make contact during the course of a game without committing an out-of-bounds offense, or more likely, disqualification John Carden
sports injury project
cycling sports in which players may directly or indirectly have physical contact with an opponent. cycling cycling is split into 3 main disciplines.
road, track and mountain track Track cycling encompasses races that take place on banked tracks or velodromes. Events are quite diverse and can range from individual and team pursuits, two-man sprints, to various group and mass start races. Competitors use track bicycles which do not have brakes or freewheels. road road cycling is done on open and closed road with races ranging in length from 1hr long criteriums to 21 day stage races like the Tour de France and time trails ranging in distance form 15km to 60km or more. Common Injuries most injuries in cycling are caused by crashes, over training and improper training habits.injuries are split into 2 types of injuries acute and chronic. Mountain mountain biking is mainly done off road and is
split into many different disciplines. Cross country,
Marathon,free ride, downhill, trails and dirt jumping for this presentation i will only
focus on injuries and issues
form road and track cycling chronic Chronic pain and injury refers to the sort of physical injury,
illness, or disease that develops slowly and is
persistent and long-lasting, or constantly recurring
over time. Many chronic injuries have mild symptoms and
low-grade pain, and are often ignored or simply
overlooked for months or even years. Ignoring such mild aches and
pains can lead to a persistent chronic injury that is difficult to heal. acute an acute injury is an injury that occurs suddenly usually the result of a specific impact or traumatic event that occurs in one specific area of the body, such as a muscle, bone, or joint. acute and chronic types of acute injuries 1.abarsions
2.contusons
3.lacerations
4.fractures/dislocations
5.sprains
6.dental injures
7.internal bleeding
8.concusions types of chronic
injuries causes of injury injury is caused by either crashing,
over training and improper training techniques clavicle fracture chronic biceps femoris strain biceps femoris strains are very common
in cycling due to the nature of the sport of cycling most acute cycling injuries are caused by
accidents between cyclist and motor vehicles
and or another cyclist or cyclists. acute head and neck injuries are the most serious injuries suffered in cycling and count for most deaths caused by cycling chronic injuries or over use injuries are very frequent in cycling 85% of cyclist have had one or more overuse injury.the main parts of the body that cyclist get these injuries are the neck, knee, groin/buttocks area,hands and lower back. 1.Iliotibial Band Syndrome
2.Tendonosis
3.Patellofemoral Pain Syndrome
4.penile numbness, prostrate irritation or inflammation for men and vaginal pain for women
5.strains
6.Handlebar palsy
7.Sciatica
8.Repetitive Head Injury Syndrome
9.Post-concussion syndrome cause signs symptoms treatment return to competition physical conditioning for preventing injuries protective equipment what we wear rules for safety what there are rules a clavicle fracture is one of the most common injuries in cycling. A clavicle fracture is defined as a bone fracture in the clavicle, or collarbone. It is often caused by a fall onto an outstretched upper extremity, a fall onto a shoulder, or a direct blow to the clavicle. the clavicle is divided into 3 groups based on location of the break to help with classification location Group 1: is the middle 1/3 of the clavicle it is where 80% of clavicle fractures occur.
Group 2: is the distal 1/3 of the clavicle where 12-28% of clavicle fractures occur.
Group 3:is the medial 1/3 of the clavicle. types groups 2 and 3 are farther subdivided into into different types. clavicle fractures in cycling are usually caused by a crash when the rider lands on there outstretched arm or shoulder and or gets run over during a crash it can be very painful for the athlete. there is usually an obvious deformity, or "bump," at the fracture site. Gentle pressure over the break will bring about pain. patient will also be unable to elevate the arm of the affected side. Although a fragment of bone rarely breaks through the skin, it may push the skin into a "tent" formation.In order to pinpoint the location and severity of the break, an x-ray will be order . X-rays of the entire shoulder will often be done to check for additional injuries. If other bones are broken, your doctor may order a computed tomography (CT or CAT) scan to see the fractures in better detail. what do we see what does the athlete feel non-surgical surgical Surgery is employed in 5-10% of cases. However, a recent study supports primary plate fixation of completely displaced mid shaft clavicular fractures in active adult patients right after injury occurs Pre hospital Care an EMT or athletic trainer is trained to Identify and treat associated life- and non life- threatening injuries. they will
•Initiate ATLS protocol, and stabilize the patient.
•Perform a careful secondary survey.
•Apply a cold pack to the injury.
•Immobilize the upper extremity with a sling. the biceps femoris makes up the lateral side of the hamstring group . The biceps femoris has two heads, so in some ways it may be considered two separate muscles. The long head of the biceps femoris originates on the ischial tuberosity and the short head originates along the linea aspera on the posterior side of the femur. Both heads of the biceps femoris share a common insertion on the lateral aspect of the fibular head.contracting concentrically, the hamstrings produce knee flexion long head of the biceps femoris also contribute to hip extension. The short head of the biceps femoris is not involved in hip extension, as it doesn’t cross the hip joint. the biceps femoris also helps to laterally rotate the knee. Hamstring injuries almost always occur at the proximal myotendinous junction. In the biceps femoris, this junction extends over most of its entire length. Injury usually does not occur within the tendon itself unless there is preexisting pathology. grades of strains there are 3 grades of muscle strains what makes a muscle strain become a chronic injury? your about to find out more seriously damaged skeletal muscle or chronically damaged comes form grade II and grade III strains. tissue heals with the formation of fiberus tissue called scar tissue to replace the damaged myofibers.

scar tissue adheres to neighboring muscle fibers to prevent them form sliding back and forth properly. it also adheres to connective tissues such as fascia and ligament.it also adheres to nerve cells causing chronic back and knee pain and other conditions

when the scar tissue has formed the athlete is stuck with for the remainder of there carrier.scar tissue is 1000 time more pain sensitive then normal healthy tissue. the result of this is chronic pain the healing process of muscles unlike bones that regrow through the process of ossification muscle fibers are permanent cells that do not reproduce with the exception of satellite cells that can regenerate some muscle 1.Inflamatory process
The inflammatory process is designed to protect, localize and rid the body of injury. And prepares the damaged muscle fibers for repair and regeneration. The inflammatory process is a crucial time during which rest and protection to the injured area is critical to prevent further injury to the muscle fiber or fibers. This process usually last 3 to 5 days and ends when the injured tissue has been removed. The inflammatory process is essentially a constriction (short up to 10 mins) of the muscles blood vessels followed by a dilation of the muscles blood vessels. During the dilation the blood vessels secret plasma proteins for clotting and antibodies such as histamine and serotonin which produces the swelling you see. A protein bradyklinn causes the pain the inflammatory process triggers to protect the injured area. A chemical process call phagocytosis removes the damaged tissue. The use of NSAIDs (Non-steroidal anti-inflammatory drugs) is to be used in a small dosage no sooner than 48hrs following exercise induced related muscle injures but prolonged use is to be avoided as it greatly hinders the inflammatory process as well as the healing process as a hole as it stops the chemical processes form happening.
2. muscle repair/regeneration
muscle fibers don't reproduce when injured unlike bones which regrow through the process of ossification.however reserve cells in each fiber can regenerate.these cells are called satellite cells when activated they proliferate(Reproduce rapidly) and differentiates(process by which a less specialized cell becomes a more specialized cell type) into myoblasts.when the muscle is undamaged the satellite cells do nothing.once they reach the injury site they fuse into a myotube (immature muscle fiber) then matures into a myofiber. the total repair and regeneration process takes 5 days to several weeks video symptoms what does the athlete feel? signs what can be observed or tested for? Treatment immediately after injury Injury to the hamstring muscle is diagnosed by the rapid onset of intense pain in the back of the mid thigh during running or similar activity. Athletes will often instantly grab in pain at the back of the thigh, being unable to walk without limping. There is often focal tenderness where there is pain that is aggravated by stretching the affected thigh. In most patients, imaging is not necessary. However, if imaging is done to more completely view the muscle, tendon, or bone involvement with the injury, MRI gives the best views, although CT and ultrasound studies have also been used. psychical tests are done on grade II strains in grade III strains it will obvious that the muscle is completely ruptured as they will be unable to stand and there is a bunching up of the muscle on both or one ends. physical tests physical test are perform by a sports doctor,trainer or other medical professionals testing usually starts by palpation to the affected area.they may feel a build up scar tissue in the area depending on how the injury occurred, they may also in some case be able to feel the hole in the muscle.they will also be looking to see where the patient is tender.

then will move on to more physical tests. some of popular tests for diagnosing this injury are the passive straight leg raise and passive knee extension with 90 degree hip flexion followed by manual muscle tests at 90 and 15 degree knee flexion .pain provoking test are also used such as single leg bridging at 45 degree hip flexion and 90 degree knee flexion and prone hamstring flicks plus an assessment of neural tension.this would be followed by a assiment of the lumbar spine and gutael trigger points. with a reassessment of hamstring strength and length. 1.REGENERATION OF MUSCLE FIBRES
New muscle fibres grow from special cells within the muscle.
2. FORMATION OF SCAR TISSUE
There is bleeding in the gap between the torn muscle ends, and from this blood a matrix, or scaffold, is formed to anchor the two ends together. This matrix eventually forms a scar within the muscle that makes the muscle more resistant to further stretch damage.
3. MATURATION OF THE SCAR TISSUE
The collagen fibres which make up the scar tissue become aligned along lines of external stress and are able to withstand more force. the stages of scar tissue formation these are the symptoms the athlete will feel.
A sudden sharp pain at the back of the leg during exercise - most probably during sprinting or high velocity movements. Pain on stretching the muscle (straightening the knee whilst bending forwards).
Pain on contracting the muscle against resistance.
Swelling and bruising. If the rupture is severe a gap in the muscle may be felt. early treatment
and
diagnosis so how do we get the athlete back riding surgery It is vitally important that treatment for a pulled hamstring starts immediately following injury. The most important phase for treatment is the first 48 hours post-injury to stop the bleeding and get the injury in to the inflammatory process as earlier as possible. In this time the following can be carried out by the athlete themselves. Use Cold Therapy (Rest, Ice, Compress, and Elevate) technique. Use a compression bandage to minimize intra muscular bleeding. With a chronic hamstring strain there is usually an underlying muscle imbalances and structural(one bone short then other) bone length discrepancy or functional (leg or limb looks short)bone length discrepancy all around the injured athlete’s body so you must take a holistic approach to treatment of the injury and see how the imbalances are pulling on the hamstring. Cyclists due to the nature of there sport and the posture of the cycling position and lack of bilateral movement are very prone to develop muscle and functional imbalances.First we must take into account how the biceps femoris tear happened and do assessments such as a passive straight leg raise. the athlete should visit a sports physician to have them perform such tests and to asses the injury . Then a MRI or ultra-sound (MRI is the method preferred by physicians) of the injured area should be done to concur with the physical assessments findings. If it is a grade 3 tear surgery will most likely be required to ensure proper healing and limited scar tissue build up. mobilization should be delayed for least 3-7 days to allow the inflammatory process to take place. Then an assessment of the muscle imbalance’s and skeletal alignment is done to check for underlying causes of the injury.it can take 3-6 weeks or longer to heal a grade 2 tear a grade tear heals in 3 months or more. pain will still be present if underlying causes aren't dealt with mobilization ultra sound used in the ealry stages Return to competition back in the game massage phase II Cycling Posture
and imbalances how riding affects the body
Pedaling places stress on the calves. Tight calves can cause the feet to flatten and place undue stress on the heel cord, plantar fascia and knees. The major muscles involved in cycling are the quadriceps. You can see that by looking at any professional cyclist. However, miles of cycling in the bent over cycling position can create tightness in the quadriceps and the psoas (hip flexors). These tight quads and hip flexors pull the pelvis out of optimal position into a forward tilt. This anterior tilt of the pelvis sets in motion a cascade of muscle imbalance. The forward tilt of the pelvis causes an increased arching of the lower back. This over loads the muscles of the lumbar spine while at the same time lengthens and weakens the abdominal muscles. Another muscle group negatively affected by these dominant quads and hip flexors are the gluteals. The glutes are a major pelvic stabilizer and the main hip extensors of the body. Tightness and over-activation of their opposing hip flexors cause the glutes to become weak and under-active. In this situation, because the glutes cannot effectively extend the hip, the hamstrings must pick up the slack. As a result, the hamstrings get over worked and become tight. Cyclist also suffer from extremely tight IT bands due to the lack of bilateral movement

Moving up to the shoulders and mid-back, we see the back rounded. A rounded upper back causes the shoulder blades to elevate and protract. As a result, the muscles in the chest and upper trapezius become tight leaving the shoulders hiked up and pulled forward. Tight pecs major and upper traps weaken the mid-back and scapula stabilizers. Weak scapula stabilizers can place undue stress in the shoulder joint during overhead movements while tight upper Traps are a major contributor to neck tension and pain.

The last body part to look at is the head. Cycling posture pulls the head forward. As the head is pulled forward the distribution of its weight shifts and more force is placed on the vertebrae at the base of the neck. A forward head also leads to tightness of the neck flexors and weakening of the neck extensors. This places undue stress on the muscles in the back of the neck and commonly results in neck pain and tension headaches.

So inorder to correct all this and keep the cyclist pain form have a recurring hamstring injury.we must look at how they train and how they take care of there body and asses and correct there bike fit so it fits there body as cyclist send hours on there it very likely the way there bike is fit is causing problems for them as well.for cyclist to combat these imbalances that develop througth there sport they should insure they work to correct these imblances the support team behind the scenes case study example video runner Athletes should have a strong support team around them. A performance support team is vital to success as well as rehabilitation and prevention and diagnosis of injuries. The support team should include your coach, a sports doctor, exercise scientist, massage therapist or chiropractor, physiotherapist or athletic therapist and a strength and conditioning coach. phase 2 massage for hamstrings speeds up recovery and can be very help full with fixing functional skeletal length discrepancy and undo some muscle tightness in muscles around the body . massage is important in the treatment and rehab of hamstring muscle injuries as massage helps correct scar tissue realignment and minimizes the amount of scar tissue. In addition massage can increase the blood flow to the injured area. in saying that massage to the injured hamstring should wait till 5-8 days post injury as the hamstring will be very tender.massage is very helpful in the later stages of injury rehab as well as for preventing injuries to the scar tissue after the athlete has returned to competition all phases and post recovery the most important piece of protective equipment in cycling is a helmet to help protect your head form brain damage.another one is gloves to protect your hands from road rash shaving your legs all so helps with road rash. all course must be deemed safe by the head offical.field size is limited to 160 riders in uci road races and at uci track races the mass start fields are limited 36 riders max. Clavicle fractures can be very painful and may make it hard to move your arm. Additional symptoms include:
•Sagging shoulder (down and forward)
•Inability to lift the arm because of pain
•A grinding sensation if an attempt is made to raise the arm
•A deformity or "bump" over the break
•Bruising, swelling, and/or tenderness over the collarbone The arm must be supported by use of a splint or sling to keep the joint stable and decrease the risk of further damage. Usually, a figure-of-eight splint that wraps the shoulders to keep them forced back is used and the arm is placed in a clavicle strap for comfort.
Current practice is generally to provide a sling, and pain relief, and to allow the bone to heal itself, monitoring progress with X-rays every week or few weeks. Surgery is employed in 5-10% of cases. However, a recent study supports primary plate fixation of completely displaced midshaft clavicular fractures in active adult patients.
If the fracture is at the lateral end, the risk of nonunion is greater than if the fracture was of the shaft. The surgery is indicated when one or more of the following conditions presents.
1.Comminution with separation (multiple piece)
2.Significant Foreshortening of the clavicle (indicated by shoulder forward).
3.Skin penetration (Open Fracture).
4.Clearly associated nervous and vascular trauma (Brachial Plexus or Supra Clavicular Nerves).
5.Non Union after several months (3–6 months, typically)
6.Distal Third Fractures which interfere with normal function of the ACJ (Acriomio Clavicular Joint).

A discontinuity in the bone shape often results from a clavicular fracture, visible through the skin, if not treated with surgery. Surgical procedure will often call for ORIF (Open Reduction Internal [plate] Fixation) where an anatomically shaped titanium or steel plate is affixed along the superior aspect of the bone via several screws. In some cases the plate may be removed after healing, but this is very rarely required (based on nerve interaction or tissue aggravation), and typically considered an elective procedure. Alternatively, intramedullary fixation devices (within the medullary canal) can be implanted to support the fracture during healing. These devices are implanted within the clavicle's canal to support the bone from the inside. Typical surgical complications are infection, neurological symptoms distal the incision (sometimes to the extremity), and non-union. Return to competion form time of injury for clavicle fractures for a cyclist can be quick but the rider has to be very consuce to avoid crashing
Before returning, an athlete should have full range of motion, normal shoulder strength, clinical and radiographic evidence of bony healing, and no tenderness to palpation.
Patients usually can return to noncontact sports and full daily activities six weeks after injury. Contact and collision sports should be delayed for two to four months until solid bony union occurs. If surgery is performed, some surgeons recommend removal of hardware before returning to sports. However, plate removal may delay return to sports and is not recommended by other surgeons grapevine supine briding Early mobilization of the injured lower limb is vital for the correct rehabilitation of the muscle. However there are some disadvantages too early to mobilization. As the scar tissue formed will be larger, and ruptures to the injured area will be more common. Therefore rest is advised during the first 3 to 7 days to allow the scar tissue to gain strength. The rehab process includes stretching for the whole body and strengthening exercises throughout the pain free range as while as progressive agility exercises which have been proven by in a study by sherry and best these such excerises reduced injury recurrence as a opposed to just the standart stretching and strengthening programs.Exercises to improve posture to the back by strengthen the erector spine muscles as while as the rhomboids to fix the posture problems and back muscle imbalances caused by cycling can start in this phase too as long as they don’t put stress on the hamstring. Excessive stretching of the injured hamstrings should be avoided, as this can result in dense scar formation in the area of injury prohibiting muscle regeneration. These can aid with decreasing the swelling in the area. This very important all exercises should be pain completed pain free
These initial exercises include isometrics of the lumbopelvic musculature, single-limb balance exercises, and short stride frontal plane stepping drills, while avoiding isolated resistance training of the injured hamstring muscle. The exercises should always be performed without pain, with the intensity of the exercises progressed from light to moderate as tolerated.

Excerises are performed daily in pain free range at a low intesity While a return to full range of motion is encouraged during this phase, end range lengthening of the hamstrings should be avoided if weakness persists. In the presence of a significant strength deficit, the musculotendon unit may not be able to guard against passive musculotendon lengthening, potentially limiting fiber repair
With an emphasis on neuromuscular control, agility drills, and trunk stabilization, as well as isometric strengthening exercise and more intense posture correcting exercises along with light strengthening of the areas of imbalances (gluteus, medial hamstrings, core muscles). Exercises are performed with a progressive increase in speed and intensity, respectively. Movements are begun primarily in the transverse and frontal planes to avoid overstretching the injured muscle. But progressively transitioned to the sagittal plane based on the patient's tolerance and improvement (. Sub-maximal Strengthening exercises near mid-length of the muscle are initiated as part of functional movement patterns rather than through exercises isolating the hamstrings. In preparation for the athlete's return to sport, anaerobic training and sport skills are initiated taking care to avoid end range lengthening of the hamstrings or substantial eccentric work. This would be performed on the athletes properly fitted road bike on a trainer with very little resistance at a pace below 50% of the threshold.

rountine to be completed5-6 times weekly Phase III Range of motion is no longer restricted as sufficient hamstring strength without accompanying pain should now be present. However, sprinting and explosive acceleration movements should be avoided until the athlete has met return to sport criteria.
Riding should be done on a stationary trainer with light resistance below 50% of threshold for >45mins the empise at this stage should still be on strengthening and stretching and agility at a more intense level. Including: weighted hamstring curls, rowing exercises for back muscle groups, seated good mornings
Given the athlete's impending return to sport, agility and sport-specific drills should be emphasized that involve quick direction changes and technique training, respectively. Trunk stabilization exercises should become more challenging by incorporating transverse plane motions and asymmetrical postures. With the emphasis remaining on functional movement patterns, eccentric hamstring strengthening should be progressed toward end range of motion with appropriate increases in resistance (eg, supine single limb chair-bridge, single limb balance windmill touches with dumbbells, lunge walk with trunk rotation opposite hand dumbbell toe touch and T lift). Incorporating sport-specific movements that involve a variety of head and trunk postures, as well as quick changes in those postures is encouraged.
as in the pervius stage this should be done pain free if pain increases go back to stage 2
this stage usaully last4 weeks Phase IV return to full strength + coomplete
muscle imblance and posutre correction rebiulding cycling endurance/return to competition Phase IIV Ultrasonic waves (sound waves of a high frequency) are produced by means of mechanical vibration of the metal treatment head of the ultrasound machine. The treatment head is then moved over the surface of the skin in the region of the injury. When sound waves come into contact with air it causes a dissipation of the waves, and so a special ultrasound gel is placed on the skin to ensure maximal contact between the treatment head and the surface of the skin.
oneof the greatest proposed benefits of ultrasound therapy is that it is thought to reduce the healing time of certain soft tissue injuries.
Ultrasound is thought to accelerate the normal resolution time of the inflammatory process by attracting more mast cells to the site of injury. This may cause an increase in blood flow which can be beneficial in the sub-acute phase of tissue injury. As blood flow may be increased it is not advised to use ultrasound immediately after injury.
Ultrasound may also stimulate the production of more collagen- the main protein component in soft tissue such as tendons and ligaments. Hence ultrasound may accelerate the the proliferative phase of tissue healing.
Ultrasound is thought to improve the extensibility of mature collagen and so can have a positive effect to on fibrous scar tissue which may form after an injury. Return to Sport Criteria athletes be cleared to return to unrestricted sporting activities once full range of motion, strength, and functional abilities (eg, jumping, running, cutting) can be performed without complaints of pain or stiffness. When assessing strength, the athlete should be able to complete 4 consecutive pain-free repetitions of maximum effort manual strength test in each prone knee flexion position (90° and 15°). If possible, isokinetic strength testing should also be performed under both concentric and eccentric action conditions. Less than a 5% bilateral deficit should exist in the ratio of eccentric hamstring strength (30°/s) to concentric quadriceps strength In addition, the knee flexion angle at which peak concentric knee flexion torque occurs should be similar between limbs.and riding YOGA a very helpfull tool This phase injury should be close to 100% pain free and fully have a full range of motion, sprinting and explosive acceleration movements should be done with great care in a controlled environment. This phase is used to make sure the athlete won’t reinjure themselves when they take the step up to increasing riding time and subsequently again racing and prepare their body for their return to training. Athlete will have met Return to Sport Criteria there will be a focus on strength, agility, flexibility and of the bike condition.
Riding will stay at less than 45 minutes only two times a week at the max. The intensity of the strength and agility exercise will be at very high aerobic intensity. Weight lifting at a gym with a verity of different lifts and exercises work every muscle in the body with little rest between sets 1min-2mins max amount of rest with every exercise at 3 sets of 10reps for some exercises and ranging to 20-30reps for others at a very low weight or body weight only exercises. Core strength is huge in this stage. Gym strength work is done 3 times weekly. Agility 2 times weekly and yoga once a week.
before every strength work a 30 minute moblization warm up must be done
this phase ends only when all muscle imblances are fixed and total body strength is at an acceptable level for athele in any sport. Yoga once a week is a very helpful to improve flexibility and strength it should be done after the start of phase 3. helps in perventing reinjury if done rigth In this phase strength and agility train intensity are reduced to 2-3 times weekly and are done in the same workout to avoid overtraining when frequency and duration are slowly built back up. Training duration should only increase 5-10% weekly or a reinjure is likely. Limit your training to 5 days a week, and take at least one day off. Not all of your rides should be at the duration or intensity. Training in cycling usually fallows this pattern, one high mileage day equal to the event distance one long slow recovery day and 3 intermediate mileage days 1 or 2 rest days (off the bike or short recovery rides). Since all the riding up to now has been at 45 mins at 50% below threshold. This means over 3 weeks the athlete builds up to an hour as their longest ride at 50-60% below threshold. With 3 more intense rides at 30mins or less with a few intervals at 70% of thershold.this process repeats it shelf till the athlete has got back to their normal perjury training intensity level and duration. Once they have got back to full training depending the type of racing they do (pro races are 150-240km+).the rider will need a couple more weeks to be able to handle that type of distance. The rider showed be able to ride 125% of the distance of their first race with zero pain before even attempting to do said race. the return back to racing after a choric hamstring strain is very long ,painful and frustrating process one which many an athlete have not made it through and back into competition which can’t be rushed back to competition . That being said it can be done, but they will have to be very careful to not reinjure there hamstring they must continue to take preventive measures to combat the injury. The athlete should complete all stages of the injury rehab program before returning to competition and be 100% pain free and be able to ride 125% of the distance of their longest race and have zero sign and symptoms of reinjure before competing again. The nature of the sport and the posture of cycling as well as the culture of the current training practices and the way riders are developed in cycling lead to cyclist be very susceptible to injury. Pedaling places stress on the calves. Tight calves can cause the feet to flatten and place undue stress on the heel cord, plantar fascia and knees. The major muscles involved in cycling are the quadriceps. You can see that by looking at any professional cyclist. However, miles of cycling in the bent over cycling position can create tightness in the quadriceps and the psoas (hip flexors). These tight quads and hip flexors pull the pelvis out of optimal position into a forward tilt. This anterior tilt of the pelvis sets in motion a cascade of muscle imbalance. The forward tilt of the pelvis causes an increased arching of the lower back. This over loads the muscles of the lumbar spine while at the same time lengthens and weakens the abdominal muscles. Another muscle group negatively affected by these dominant quads and hip flexors are the gluteals. The glutes are a major pelvic stabilizer and the main hip extensors of the body. Tightness and over-activation of their opposing hip flexors cause the glutes to become weak and under-active. In this situation, because the glutes cannot effectively extend the hip, the hamstrings must pick up the slack. As a result, the hamstrings get over worked and become tight. Cyclist also suffer from extremely tight IT bands due to the lack of bilateral movement Moving up to the shoulders and mid-back, we see the back rounded. A rounded upper back causes the shoulder blades to elevate and protract. As a result, the muscles in the chest and upper trapezius become tight leaving the shoulders hiked up and pulled forward. Tight pecs major and upper traps weaken the mid-back and scapula stabilizers. Weak scapula stabilizers can place undue stress in the shoulder joint during overhead movements while tight upper Traps are a major contributor to neck tension and pain. The last body part to look at is the head. Cycling posture pulls the head forward. As the head is pulled forward the distribution of its weight shifts and more force is placed on the vertebrae at the base of the neck. A forward head also leads to tightness of the neck flexors and weakening of the neck extensors. This places undue stress on the muscles in the back of the neck and commonly results in neck pain and tension headaches.

Most cyclist the pros included only train by riding there bike and don’t do regular posture correcting exercises and yoga that will help to prevent injury to reverse the negative effects of riding for 6+ hours does to their body and the imbalances it causes. This where a strong support team around them that can see what is done wrong where there are weaknesses in there body and give a injury prevention training program. A performance support team is vital to success as well as rehabilitation and prevention and diagnosis of injuries. The support team should include your coach, a sports doctor, exercise scientist, massage therapist or chiropractor, physiotherapist or athletic therapist and strength and conditioning coach. Surgery is used for grade tears and some grade 2 tears there very little written and reshraeched about surgery for hamstring tears and what is the best strategy for how surgery is to be done. Recently there have been attempts to use the injection of growth factors(PRP) to healing grade 2 tears or used in conjunction with surgery to reduce scar tissue the results of test of use prp in muscle strain treatment are inconsistent.
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