Road Grime Road Cycling Forums forum - Topic - Welcome to Cycling Related Injuries and Rehabilitation with Anouska

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Welcome to Cycling Related Injuries and Rehabilitation with Anouska

Who Is Anouska?
'Anouska graduated from the University of Wollongong in 1999 with a degree in Exercise Science then went on to complete her Physiotherapy degree at Griffith University in 2003. Currently she is completing her Masters in Sports and Musculoskeletal Physiotherapy at Griffith University and is due to finish in 2008.

Anouska is the Australian Paralympic Cycling Team Physiotherapist and is also an international Paralympic cycling classifier with the United Cyclists Internationale (UCI). She regularly works with Cycling Qld (CQ) junior development squads and QAS and AIS cyclists. Anouska is a member of Balmoral cycling club and has represented QLD for track cycling in endurance events. Currently she is working at Revive Physiotherapy in the city (Mary St) and Ashgrove (Highpoint Plaza Waterworks Rd) as well as No More Knots in Greenslopes (Juliette St).

http://www.revivestudio.com.au/

http://www.nomoreknots.com.au/

Disclaimer
All viewers should be aware that any advice Anouska gives on Road Grime is a guide only and that it is important for cyclists to visit their Physiotherapist or Doctor in person to receive information specific to their condition.


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Beagle

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Welcome to Cycling Related Injuries and Rehabilitation with Anouska

Dear Anouska,

I broke my collar bone 5 weeks ago, in a tragic incident invovling a sudden gust of gravity, and a road surface spontaneously changing from dry to wet without warning.

My question is what are the risks if I fall on the same collarbone shortly after I start riding on the road / track / trail again? Or to put it another way, should I avoid racing for a few more weeks after I start riding again?

Sad

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ame

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Beagle...PM sent Smile

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Welcome to Cycling Related Injuries and Rehabilitation with Anouska

Dear Anouska,

6 Months ago i twisted my knee at Indoor netball and although its all but healed now, I am having trouble fully extending the joint. I have otherwise full movement and it doesnt lock or do anything like that. I had x ray done of the knee and no bone fragments were found, although at the time, the joint wouldnt bear any weight and even then fully extending it caused extream pain. Thats why the doctor at the er decided to plaster rather than splint and I spent the next month in hip to ankle cast. This caused my leg to wither away and I have spent the last 6 months trying to build back the muscle ( thats the cycling link) It still gives me some greif as it aches and if I have more than a couple of days off the pedals, it tends to seize up again. I can handle this as it gives me more inspiration to keep on the bike, but the problem is I have a Physical exam to start a new job on wednesday ( I'm an underground miner ) and when they check my body functionallity by the dreaded "duck walk" I already know whats going to happen to my knee.

My question is, is there something I can do or take before my medical on wednesday to help me through the duck walking? I operate an underground loader and although my job involves no moving in such a mannor, they still like to check that I can do it (which I cant)

Will the "magic spray" I see on the cricket do anything for me and if so, where is this purchased from?

Cheers, Nic

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ame

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Hi Nic, PM sent Smile

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Welcome to Cycling Related Injuries and Rehabilitation with Anouska

Anouska, I cycle 200km per week, and get pain over the (R) lateral condyle of the femur. My physio tells me it is ITB. She has RICE'd, stretched, lowered my saddle, and asked me to keep toes in and heel straight or toes and knee in.

An old cycling physio told me it is more an issue with too much weight being applied to the lateral part of the forefoot, and I should get a cleat wedge under my (R) forefoot. No one in Brisbane seems to do cleat wedges. Any ideas?

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Welcome to Cycling Related Injuries and Rehabilitation with Anouska

Bruce, PM sent

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Welcome to Cycling Related Injuries and Rehabilitation with Anouska

Quote: ame

Bruce, PM sent

Thanks Anouska. Your PM was very insightful and helpful. I shall PM you tonight.

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Welcome to Cycling Related Injuries and Rehabilitation with Anouska

Dear Anouska,

I have had a history of problems with my lower left leg since my comeback from a fat & lazy retirement a couple of years ago. As a 20 something triathlete, I had no calf issues, but plenty of shin splint issues. Since starting running and cycling again, I have had on & off calf problems in my left leg (though strangely no shin issues), along with a couple of badly sprained ankles. It came to a head a year ago when I damaged my Achilles for the 2nd time after increasing the intensity of my running training.

Since then I have hardly run, but found that even with a lot of stretching & strength exercises, I still have the occasional niggling feeling in the Achilles after hard riding (especially hills), and running can cause pain if I do more than an easy 7km. Cycling is my main buzz now, but I'm worried the problem may flare & impinge on my enjoyment on the bike.

Is this simply a result of slow healing at 46 years old, or should I be looking for something else?

Thanks

Has been.

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ame

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PM sent 'Has Been' Smile

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Welcome to Cycling Related Injuries and Rehabilitation with Anouska

Hi Anouska,

Just a quick question about core exercises.

I'm currently recovering from a broken outer left clavicle and upper humerus. I have a heap of screws & a plate in there, and am having surgery in a couple of weeks to remove it all.

Upshot is I still can't really do any weight-bearing exercises that use my left arm/shoulder. I had been trying to do 'planks' (both front & each side) two-to-three times a week as a basic core exercise for cycling.

Its been 3 months now since I've been able to ride my bike, and I've been essentially 'sedentary' all that time (apart from the very occasional spin on the mag trainer). I'm looking to start putting some more serious hours in on the trainer - but lately I have had some minor back soreness, which I suspect is a very poor 'core' due to my total lack of exercise... The 5-ish kilo's I've added in weight probably isn't helping either...!!

SO - after that long story, my question is: can you recommend some good core exercises for cycling performance that do NOT utilise, or require weight-bearing on, my left arm/shoulder??

Thanks!!

Abby.

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Hey Abby,

Thanks for the post. Hm...sounds like a nasty break for sure. Thought I would post here as others may have a simiar problem.

In terms of your general fitness (after 3 months off) I would suggest you do some cross training in the next 2 months while you build up your cycling fitness/ability to ride for longer periods. Unless there has been a specific incident your lower back is probably a little stiff from a lack of activity and stretching...if you are like most others you have probably forgotten to stretch because you arent riding! So I would suggest, walking, swimming, running etc...tapering off over the 2 months until you can ride more. Bring back all your stretching as well....daily.

You may find you get more from these things at the moment rather than the normal core work you do. You may need to do some specific shoulder strengthening exs first with a theraband as well as some upper back strength e.g. seated row, standing row, upright row, back extensions, swiss ball- superman, back extension. You will also be able to do some general abdominal work such as crunches, obliques, leg liftsand other basic pilates type exercises on the bosu or swiss ball. Begin with these to balance out any imbalances you may have acquired in the last 3 months....then start back with the your standard core work. Ir you are having problems still with pain and discomfort after 6 weeks you may need to visit your physio. Try and fit some massage into that 2 month period as well.

Hope that helps Smile

Cheers

Anouska

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Welcome to Cycling Related Injuries and Rehabilitation with Anouska

Hi Anouska

On Saturday I had an altercation with a kangaroo and ended up with an AC Type 3 Shoulder Separation. I have the arm in a sling atm, what does this injury mean and at what stage should I get back on the bike.

I am already painfully on the ergo

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Hi Mickncat,

Hmm..do you live in Gladstone or are there 2 angry kangaroos around atm ?

In type III injuries both the AC and coracoclavicular (CC) ligaments are torn, but the deltoid and trapezial fascia are intact. So you’ve done a good job, but it could be worse Smile This results in the distal clavicle being relatively unstable in both the vertical and horizontal planes. So in regards to what you do in the next few weeks (wk 1-3/4)….avoid pressure through the arm i.e. on the windtrainer and avoid lifting or carrying as much as possible. You should ride on the windtrainer as tolerated over the next few weeks….best if you don’t hold on or can find something for your arm to rest on. Or….crosstraining instead. Stay in the sling as and keep it done up quite tightly but ensure you are having breaks from the sling as well and moving your arm around (out of pain). I would recommend a massage at around 1-2 weeks to make sure you aren’t getting too tight anywhere.

Generally non- operative treatment is typically indicated in type I and type II injuries. Type III injuries are evaluated on a case-by-case basis with regard to treatment. Management of an AC joint problem is dictated by the severity and chronicity of the injury and the patient’s needs and expectations. The trend in recent literature is towards the initial non-operative management of these injuries. However, consideration of other factors such as: type of sport or timing of the injury relative to the athletic season play a role in the decision-making process. In the small group of patients who have persistent pain and are unable to return to work or sports after non-operative treatment, then surgical stabilisation is encouraged.

At around the 2-3 week time frame you will need to visit the physio to begin some strengthening, stretching and most likely scapular stabilization exercises. You may be able to return to the bike around the 4 week mark however everyone is different and this could vary 1-2 weeks. Depending on your recovery you may need to strengthen the shoulder up with some heavier weight exercises down the track to improve shoulder stability as well.

Good luck with it !

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Welcome to Cycling Related Injuries and Rehabilitation with Anouska

Quote: ame

Hi Mickncat,

Hmm..do you live in Gladstone or are there 2 angry kangaroos around atm ?

In type III injuries both the AC and coracoclavicular (CC) ligaments are torn, but the deltoid and trapezial fascia are intact. So you’ve done a good job, but it could be worse Smile This results in the distal clavicle being relatively unstable in both the vertical and horizontal planes. So in regards to what you do in the next few weeks (wk 1-3/4)….avoid pressure through the arm i.e. on the windtrainer and avoid lifting or carrying as much as possible. You should ride on the windtrainer as tolerated over the next few weeks….best if you don’t hold on or can find something for your arm to rest on. Or….crosstraining instead. Stay in the sling as and keep it done up quite tightly but ensure you are having breaks from the sling as well and moving your arm around (out of pain). I would recommend a massage at around 1-2 weeks to make sure you aren’t getting too tight anywhere.

Generally non- operative treatment is typically indicated in type I and type II injuries. Type III injuries are evaluated on a case-by-case basis with regard to treatment. Management of an AC joint problem is dictated by the severity and chronicity of the injury and the patient’s needs and expectations. The trend in recent literature is towards the initial non-operative management of these injuries. However, consideration of other factors such as: type of sport or timing of the injury relative to the athletic season play a role in the decision-making process. In the small group of patients who have persistent pain and are unable to return to work or sports after non-operative treatment, then surgical stabilisation is encouraged.

At around the 2-3 week time frame you will need to visit the physio to begin some strengthening, stretching and most likely scapular stabilization exercises. You may be able to return to the bike around the 4 week mark however everyone is different and this could vary 1-2 weeks. Depending on your recovery you may need to strengthen the shoulder up with some heavier weight exercises down the track to improve shoulder stability as well.

Good luck with it !

Thank you

off to physio this thursday to get it assessed and a return to bike plane happening

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Welcome to Cycling Related Injuries and Rehabilitation with Anouska

Hi Anouska,

I started riding in January and love it, i have done over 1500kms which is good considering this is the first exercise for me in 15 years. (i am now 3Cool

When i did the mt Coot-tha ride around the 70km mark I got a bad pain in my left need which i was told is ITP. i had physio and stretched more than usual and thought it was gone. i then did another 100km ride two weeks after and it was back around the 50km mark.

i had a two hour bike fit before my last 100km ride so i thought this may help.

Can you recommend a training program as i want to do the 100 - 165km rides and also how i get over this ITB.

Thanks

Richard

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Richard...pm sent

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Welcome to Cycling Related Injuries and Rehabilitation with Anouska

Hi Anouska

i was recently involved in a nasty crah involving a tree at 50kmph resulting in me punching my femer through my pelvis 09bawl.

i just got out of surgery and that went well. i am just wondering if i will ever return to racing at the same level and also what recovery times are like.

cheers matt

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Hi Matt,

Hm...sounds like a very nasty crash, I assume that was the one 2 weeks ago ?

Your recovery will be dependant on the severity of the fracture through the acetabulum and the head of femur as well as the associated joint/labrum disruption. So it is difficult to estimate your time of recovery without seeing you however I would say minimum 6 weeks for healing time from the surgery before you step back onto the bike again. In terms of getting back where you used to be ? A few factors are involved with that. Sometimes after a hip injury the labrum can be problematic as a result of the trauma as well as some of the biomechanical changes that can occur at the hip. Some people complain of hip impingement which may result from labral discomfort or a structural/bony block. This will often present as pain in the front of the hip at the top of the pedal stroke or in the TT position. Some people may also find they have increased muscle tigtness in this area.

I would assume you are going to return to where you were and see how it pans out. Cycling is the perfect rehab for you. I know of quite a few elite cyclists who have had some pretty traumatic injuries to their hip and have returned to their previous function. You may just need to work harder on your recovery.

Good luck with your recovery. PM me if you need any help or have any other questions.

Cheers

Anouska

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caad9

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Welcome to Cycling Related Injuries and Rehabilitation with Anouska

Hi Anouska

About four weeks ago I had a bit of a crash mountain biking resulting in a fractured tibia and fibia as a result i now have a tibial nail and a few screws in my right leg.

Also from the same stack i fractured my left acetabular-anterior column, left scapula and a few ribs as well.

I realise I have done a fair bit of damage to myself but was just wondering if you had any idea when i should get out of the wheelchair and start using crutches and also how long until i can resume some sort of cycling again?

Cheers Baz

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