Advice From A Physical Therapist & Injured Bike Racer

By Dr Shara Labelson, PT, DPT, CEAS

The last year and a half has certainly had its challenges. My 2020 began with a death in the family, leading to a diagnosis of “acute thyroiditis.” Just as I was getting my energy back, NYC got devastated by COVID-19 and a global pandemic. With New York shut down, I found more time to spend on my trusty friend, my bicycle. Why not make the best of an otherwise unfortunate circumstance?
Typically, in March, my bike racing season starts. That means, from January on, a program of very structured training including 4am wake ups to get on the bike for leg and lung busting workouts before work. I had no idea how I was going to be in shape to race after my thyroiditis, but as all racing got canceled, and cycling stayed an essential activity, I began to increase my miles and use the knowledge that I have acquired as a Physical Therapist and a certified level 3 cycling coach through USA Cycling to focus on my overall health and not just race shape.
The first thing I wanted to focus on was proper sleep. During sleep is when our body recovers and repairs to be ready for the next day. It is important for cognition, concentration, problem solving, reaction time, and overall performance (mentally and physically). On the flip side, poor sleep has been found to be correlated with an increased risk of type 2 diabetes, heart disease, depression and stroke.
The next item on my list was diet. With time to regularly go grocery shopping and cook proper meals at home, I wanted to make sure that I was eating a proper balance of fruits, vegetables, whole grains, healthy fats and lean protein. I had to make sure my body had the proper fuel for my daily rides. You cannot run your car on an empty gas tank. (It seems you also can’t take away my nightly ice cream fix though)
As a physical therapist, I always try to practice what I preach. I educate patients on the importance of stretching and strengthening in order to prevent injury. The most common injuries from cycling are tendinitis of the hamstring, quadriceps, and achilles tendons along with neck and low back pains. Some of these issues can be resolved with a proper bike fit. A saddle being even a few millimeters too high, low, forward, or back can lead to pain after miles of pedaling.
If the bike is not the issue, we must look at imbalances within ourselves. I began to pull out my yoga mat in the living room daily to foam roll and stretch my quads, hamstrings, calves and especially my tight hip rotators. With an increase in sitting during COVID, keeping the pliability of these muscles has become even more paramount. I also concentrated on trying to even out the strength imbalance between my right and left legs. Exercises for this included single leg bridging, clamshells and reverse clamshells, Bulgarian split squats and single leg calf raises.
To stave off back and neck pain from the increased miles being bent over on my bike and sitting in front of the computer, I challenged my friends to a plank challenge and added on other posture exercises including wall angels, shoulder external rotation with bands, and prone scapular stabilization exercises.
Heading into last fall, I was feeling like I was in the best shape of my life! I took a trip to the Catskills (not quite the Dolomites that I was planning for last summer to celebrate my birthday) to conquer a few mountain passes with some riding comrades who prefer the hills WAY more than I do. As a racer that usually competes in flat, sprint type races, this was quite the accomplishment. I did not have my companions waiting too long for me even at the top of the last over 4-mile climb with an elevation of 1,624 feet and gradients over 20% as we neared the summit.
Now you ask, the title of this is “Advice From A Physical Therapist & Injured Bike Racer,” so what happened? And after all of this if she is injured why should we listen to her? There is one BIG variable that you cannot account for in cycling. What happens when you do not, as we say, stay rubber side down? Last August, I was out riding and enjoying the sun on my face and wind through my helmet vents, when, as I crossed an intersection a young driver made a sudden right turn, cutting me off and knocking me off my bike. Of all the possible outcomes in this scenario, I am happy to report that I only suffered a separated acromioclavicular joint of my left shoulder and slightly sprained left wrist.
After 6 months of regular physical therapy (2-3 times per week) which included shoulder strengthening and scapular stabilization exercises, I was back on the bike. Now, I would be lying to you if I said my shoulder does not still bother me on a daily basis, but I continue to be diligent about keeping up with my strength training, avoid riding on the road by myself and every day the pain is a little less.
The moral of the story is stay as healthy as you can to prevent injury, but sometimes stuff happens and when it does, being otherwise in good shape, will help you return to sport as fast as possible. I will always wear the bump on my shoulder as a reminder of that unfortunate day, but I am back in the saddle and building back that fitness!