Evaluation of elite British cyclists: the role of the squad medical

[Efficacy of kinesiotape treatment on mechanically induced neck pain: a systematic review]

BACKGROUND

This article provides a summary of the state of knowledge on the sport-specific use of a kinesiotape intervention for neck pain caused by the postural or sitting position in cycling. This review summarises the research literature on the effectiveness of kinesiotape (KTA) on pain perception, pressure pain threshold (PPT) and range of motion (ROM) in the neck muscles and trapezius muscle. The focus was specifically on studies in cycling.

METHODS

The literature search was conducted in the PubMed and Google Scholar databases. The search terms used in combination were "kinesiotape" and "back pain", "neck pain", "kinesiotape" and "trapezius muscle", and "kinesiotape" and "cycling".

RESULTS

In total, the combination of keywords returned 892 results. Of these, the Powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation search in the online database of PubMed returned 192 results and the search in the online database of Google Scholar returned 700 results. 874 publications were discarded due to a lack of specificity and a field of application that did not meet the requirements. Three additional studies were eliminated as "duplicate". Fifteen studies met the inclusion criteria. These were analysed in terms of content and in detail. Only one publication deals with the problem of mechanically induced neck pain during cycling. The effect of the kinesiotape refers to a reduction in pain perception and maintenance of the cervical range of motion.

CONCLUSION

Numerous studies deal with the problem of pain conditions and how these can be counteracted with the help of an appropriate KTA. Only a small number offer insights into the effectiveness of a suitable application of kinesiotape for mechanically induced neck pain.

A study on injury prevalence and pattern of injuries among velodrome cycling players

Velodrome cycling is a sport that requires cycling on an inclined surface, and this may increase chances of injury in players. The purpose of this study was to find out the injury pattern in form of injured part, injury time, severity, type and relation with gender, level of participation and training characteristics among velodrome cycling players. Injury pattern from the last 2 years was studied in 85 velodrome cycling players aging between 15-25 years from Punjab using a scheduled interview method. The study included players who were practicing cycling at least 3 times per week for more than 2 years. The mean age of the study participants was 19.39 years (range 15-25). According to the results of this study, 48 out of 85 cyclists had sustained 75 injuries in the last 2 years, in which 52% (39) injuries were due to fall, 66.67% were traumatic injuries and 84% occurred during training time. The most commonly injured parts were shoulder and knee. For the shoulder, the clavicle was the most frequently fractured bone (11 cases) among the 85 cyclists. The severity of injuries calculated according to Ekstrand’s 3-point scale based on absence from the sports activity depicted most injuries as severe (39.58%) followed by mild (33.33%) and moderate (27.08%). It can be concluded that females were injured more as compared to male velodrome cyclists. The most common injured parts were shoulder in upper limb and knee in lower limb.

The effect of low back pain on neuromuscular control in cyclists

This study was designed to identify neuromuscular adaptations of low back pain (LBP) cyclists , and the impact of a cycling effort on spinal shrinkage. Forty-eight trained cyclists rode their road bike on a smart trainer for 1-hour. Surface electromyography (EMG) recorded muscle activity of the lumbar erector spinae (LES), 3D motion analysis system recorded kinematic of the trunk, and stadiometry measured spinal height. Statistical comparisons were made using repeated measure ANOVAs. The LBP group presented increase in pain levels throughout the effort (p < 0.001). A significant group difference was only observed for the thoracic angle (p = 0.03), which was less flexed for LBP. The one-hour cycling effort (time effect) significantly increased the trunk flexion (p < 0.001) and thoracic flexion (p < 0.001) for both groups. Significant lower LES activation (35% less) was observed at the end of the effort  as well as a decrease in spinal height (p = 0.01) for both groups. Neuromuscular adaptations to cycling effort is identified by a decrease in LES EMG amplitude and an increase flexion of the trunk. Adaptation to pain is seen by an increase in thoracic flexion. Despite these adaptations, LBP cyclists could not ride their bike pain-free.

Quasi-Isometric Cycling: A Case Study Investigation of a Novel Method to Augment Peak Power Output in Sprint Cycling

PURPOSE

Peak power output (PPO) is a determinant of sprint cycling performance and can be enhanced by resistance exercise that targets maximum strength. Conventional resistance training is not always suitable for elite cyclists because of chronic spinal issues; therefore, alternative methods to improve strength that concurrently reduce injury risk are welcome. In this case study, quasi-isometric cycling (QIC), a novel task-specific resistance-training method designed to improve PPO without the use of transitional resistance training, was investigated.

METHODS

A highly trained sprint track cyclist (10.401 s for 200 m) completed a 5-week training block followed by a second 5-week block that replaced conventional resistance training with the novel QIC training method. The replacement training method required the cyclist to maximally drive the crank of a modified cycle ergometer for 5 seconds as it passed through a ∼100° range (starting at 45° from top dead center) at a constant angular velocity. Each session consisted of 3 sets of 6 repetitions on each leg. The lab PPO was recorded in the saddle and out of the saddle.

RESULTS

Conventional training did not alter sprinting ability; however, the intervention improved the out-of-the-saddle PPO by 100 W (from 1751 to 1851 W), while the in-the-saddle PPO increased by 57 W from 1671 to 1728 W.

CONCLUSION

QIC increased PPO in a highly trained, national-level sprint cyclist, which could be translated to improvements in performance on the track. Furthermore, QIC provides a simple, but nonetheless effective, alternative for sprint track cyclists who have compromised function to perform traditional strength training.

Assessment of Three-Dimensional Trunk Kinematics and Muscle Activation during Cycling with Independent Cranks

Independent cranks (IC) are recently introduced bicycle cranks that are decoupled; therefore allowing each leg to pedal independent of the other. Despite this introduction, limited research has been conducted assessing biomechanical changes when cycling with IC. Therefore, the purpose of this study was to evaluate and compare trunk kinematics and surface electromyography (sEMG) during IC and normal crank (NC) cycling during a graded exercise test to volitional fatigue. Ten healthy, physically active men performed two tests (IC and NC) on a cycling ergometer on separate days. 3D motion capture data of the trunk and pelvis and sEMG of the latissimus dorsi, tibialis anterior, gastrocnemius lateral head, rectus femoris, vastus lateralis and the biceps femoris were collected bilaterally. The first 30 seconds (beginning) and the last 30 seconds (end) of each trial were analyzed with respect to external load (beginning vs end), crank type (IC vs NC) side (left vs right), and phase of the pedal cycle (push vs recovery). Mean load at volitional fatigue in NC (351 W) was significantly greater than IC (318 W; p < 0.001). As external load increased, there was a similar increase in spine flexion angle in the sagittal plane for both NC (8.2°) and IC (4.6°). The NC condition demonstrated significantly greater increase in muscle activation from the beginning to the end than the IC condition in the tibialis anterior, rectus femoris and biceps femoris in the push phase, and the rectus femoris and biceps femoris in the recovery phase. As IC demonstrated less increase in activation, they cause less variation in muscular contraction from beginning to end throughout the full pedal range of motion, yet do not alter gross trunk kinematics. Due to altered muscle activation patterns when cycling with IC, they are proposed as a potentially beneficial training tool to increase training diversity.

Vision and Visual History in Elite/Near-Elite-Level Cricketers and Rugby-League Players

BACKGROUND

The importance of optimal and/or superior vision for participation in high-level sports remains the subject of considerable clinical research interest. Here, we examine the vision and visual history of elite/near-elite cricketers and rugby-league players.

METHODS

Stereoacuity (TNO), colour vision, and distance (with/without pinhole) and near visual acuity (VA) were measured in two cricket squads (elite/international-level, female, n = 16; near-elite, male, n = 23) and one professional rugby-league squad (male, n = 20). Refractive error was determined, and details of any correction worn and visual history were recorded.

RESULTS

Overall, 63% had their last eye examination within 2 years. However, some had not had an eye examination for 5 years or had never had one (near-elite cricketers 30%; rugby-league players 15%; elite cricketers 6%). Comparing our results for all participants to published data for young, optimally corrected, non-sporting adults, distance VA was ~ 1 line of letters worse than expected. Adopting α = 0.01, the deficit in distance VA was significant, but only for elite cricketers (p < 0.001) (near-elite cricketers, p = 0.02; rugby-league players, p = 0.03). Near VA did not differ between subgroups or relative to published norms for young adults (p > 0.02 for all comparisons). On average, near stereoacuity was better than in young adults, but only in elite cricketers (p < 0.001; p = 0.03, near-elite cricketers; p = 0.47, rugby-league players). On-field visual issues were present in 27% of participants and mostly (in 75% of cases) comprised uncorrected ametropia. Some cricketers (near-elite 17.4%; elite 38%) wore refractive correction during play, but no rugby-league player did. Some individuals with prescribed correction choose not to wear it when playing.

CONCLUSIONS

Aside from near stereoacuity in elite cricketers, the basic visual abilities we measured were not better than equivalent, published data for optimally corrected adults; 20-25% exhibited sub-optimal vision, suggesting that the clearest possible vision might not be critical for participation at the highest levels in the sports of cricket or rugby league. Although vision could be improved in a sizeable proportion of our sample, the impact of correcting these, mostly subtle, refractive anomalies on playing performance is unknown.

Differences in the contractile properties of the knee extensor and flexor muscles in professional road cyclists during the season

The purpose of this study was to establish reference values of tensiomyography (TMG) in professional road cyclists and to examine how the planned periods of the Season produce differences in the muscles: vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF), and biceps femoris (BF), and to determine how these differences may depend on each cyclist, the assessed muscle, and the side of the body. Ten professional road cyclists (27.5 ± 5.5 years; 178.2 ± 7.8 cm; 65.6 ± 5.46 kg; 72.1 ± 3.7 ml·kg·min V[Combining Dot Above]O2; 6 ± 0.4 W·kg) were assessed by TMG, in microcycle recovery, at 2 moments of periods during the season: preparation period (PP) and competition period (CP). Student's t contrast for paired groups, Cohen's d effect sizes, and a repeated measures analysis of variance (ANOVA) was applied. We did not find significant differences (p < 0.01) between the lower limbs. The results showed a significantly large increment between the time contraction (TC) values of the PP and CP in the muscles VM (28.7 ± 5.5 vs. 40.6 ± 14.4 milliseconds; 41.4%, p < 0.05, d = 1.1), VL (28.3 ± 4.9 vs. 40.6 ± 10.2 milliseconds; 43.4%, p < 0.05, d = 1.53), and RF (35.9 ± 6.9 vs. 45.9 ± 16.2 milliseconds; 27.8%, p < 0.05, d = 0.8). Nevertheless, TC of the BF presents a significantly large decrease in the CP (35.9 ± 9.9 vs. 28.2 ± 5.2 milliseconds; -21.4%, p < 0.05, d = 0.97). Radial muscle displacement (DM) values are slightly lower during the CP, but the difference is not significant. ANOVA confirmed that these differences depend on the evaluated muscles (TC p = 0.02; DM p = 0.001) and on the cyclists (TC p = 0.001; DM p = 0.001) and does not depend on the side of the body. In conclusion, the TC values during the Season show marked differences between the knee extensors (large increased) and the knee flexor (large decreased). The DM has not changed significantly, keeping the muscular and tendon stiffness.

Oral health and impact on performance of athletes participating in the London 2012 Olympic Games: a cross-sectional study

BACKGROUND

Oral health is important both for well-being and successful elite sporting performance. Reports from Olympic Games have found significant treatment needs; however, few studies have examined oral health directly. The aim of this study was to evaluate oral health, the determinants of oral health and the effect of oral health on well-being, training and performance of athletes participating in the London 2012 Games.

METHODS

Cross-sectional study at the dental clinic within the Polyclinic in the athletes' village. Following informed consent, a standardised history, clinical examination and brief questionnaire were conducted.

RESULTS

302 athletes from 25 sports were recruited with data available for 278. The majority of athletes were from Africa, the Americas and Europe. Overall, the results demonstrated high levels of poor oral health including dental caries (55% athletes), dental erosion (45% athletes) and periodontal disease (gingivitis 76% athletes, periodontitis 15% athletes). More than 40% of athletes were 'bothered' by their oral health with 28% reporting an impact on quality of life and 18% on training and performance. Nearly half of the participants had not undergone a dental examination or hygiene care in the previous year.

CONCLUSIONS

The oral health of athletes attending the dental clinic of the London 2012 Games was poor with a resulting substantial negative impact on well-being, training and performance. As oral health is an important element of overall health and well-being, health promotion and disease prevention interventions are urgently required to optimise athletic performance.

Comparing lower lumbar kinematics in cyclists with low back pain (flexion pattern) versus asymptomatic controls--field study using a wireless posture monitoring system

The aim of this study was to examine lower lumbar kinematics in cyclists with and without non-specific chronic low back pain (NS-CLBP) during a cross-sectional cycling field study. Although LBP is a common problem among cyclists, studies investigating the causes of LBP during cycling are scarce and are mainly focussed on geometric bike-related variables. Until now no cycling field studies have investigated the relationship between maladaptive lumbar kinematics and LBP during cycling. Eight cyclists with NS-CLBP classified as having a 'Flexion Pattern' (FP) disorder and nine age- and gender-matched asymptomatic cyclists were tested. Subjects performed a 2 h outdoor cycling task on their personal race bike. Lower lumbar kinematics was measured with the BodyGuard™ monitoring system. Pain intensity during and after cycling was measured using a numerical pain rating scale. The NS-CLBP (FP) subjects were significantly more flexed at the lower lumbar spine during cycling compared to healthy controls (p = 0.018), and reported a significant increase in pain over the 2 h of cycling (p < 0.001). One-way repeated measures ANOVA revealed a significant main effect for group (p = 0.035, F = 5.546) which remained just significant when adding saddle angle as a covariate (p = 0.05, F = 4.747). The difference in posture between groups did not change over time. These findings suggest that a subgroup of cyclists with NS-CLBP (FP) demonstrate an underlying maladaptive motor control pattern resulting in greater lower lumbar flexion during cycling which is related to a significant increase in pain.

Overuse injuries in professional road cyclists

BACKGROUND

Little epidemiological information exists on overuse injuries in elite road cyclists. Anecdotal reports indicate anterior knee pain and lower back pain may be common problems.

PURPOSE

This study was conducted to register overuse injuries among professional road cyclists with special focus on anterior knee and lower back pain.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

We attended training camps of 7 professional teams and interviewed 109 of 116 cyclists (94%) on overuse injuries they had experienced in the previous 12 months. Injuries that required attention from medical personnel or involved time loss from cycling were registered. Additional information on anterior knee pain and lower back pain was collected using specific questionnaires.

RESULTS

A total of 94 injuries were registered; 45% were in the lower back and 23% in the knee. Twenty-three time-loss injuries were registered-57% in the knee, 22% in the lower back, and 13% in the lower leg. Fifty-eight percent of all cyclists had experienced lower back pain in the previous 12 months, and 41% of all cyclists had sought medical attention for it. Thirty-six percent had experienced anterior knee pain and 19% had sought medical attention for it. Few cyclists had missed competitions because of pain in the lower back (6%) or anterior knee (9%).

CONCLUSION

Lower back pain and anterior knee pain were the most prevalent overuse injuries, with knee injuries most likely to cause time loss and lower back pain causing the highest rates of functional impairment and medical attention.

CLINICAL RELEVANCE

Future efforts to prevent overuse injuries in competitive cyclists should focus on lower back pain and anterior knee pain.

Spinal kinematics and trunk muscle activity in cyclists: a comparison between healthy controls and non-specific chronic low back pain subjects-a pilot investigation

The aim of this pilot study was to examine whether differences existed in spinal kinematics and trunk muscle activity in cyclists with and without non-specific chronic low back pain (NSCLBP). Cyclists are known to be vulnerable to low back pain (LBP) however, the aetiology of this problem has not been adequately researched. Causative factors are thought to be prolonged forward flexion, flexion-relaxation or overactivation of the erector spinae, mechanical creep and generation of high mechanical loads while being in a flexed and rotated position. Nine asymptomatic cyclists and nine cyclists with NSCLBP with a flexion pattern disorder primarily related to cycling were tested. Spinal kinematics were measured by an electromagnetic tracking system and EMG was recorded bilaterally from selected trunk muscles. Data were collected every five minutes until back pain occurred or general discomfort prevented further cycling. Cyclists in the pain group showed a trend towards increased lower lumbar flexion and rotation with an associated loss of co-contraction of the lower lumbar multifidus. This muscle is known to be a key stabiliser of the lumbar spine. The findings suggest altered motor control and kinematics of the lower lumbar spine are associated with the development of LBP in cyclists.