Cyclist’s Tendinitis

Compared with activities involving more impact, cycling is a sport where you are generally spared from tendinitis. But this injury is still one of the possible injuries for cyclists. To understand it better and try to take control of it, here is a look at this condition that could well slow down your training.

By Jeff Tatard – Photos: Pixabay – Retul Fit Images / DR. Opening photo: https://www.injurymap.com/free-human-anatomy-illustrations

What is tendinitis? It is pain in the tendon caused by a structural change in the tendon and a reduced ability to withstand a given load. That’s the definition! The tendons that can be affected while pedaling are those of the knees, the Achilles tendon, the gluteus medius, and more rarely the wrists, elbows, or shoulders.

Tendon inflammation

By definition, a tendon is a connective tissue made up of a multitude of tendon fibers that connect the muscle to the bone, enabling movement of the joint. The tendon can absorb energy and then release it. If you give it a sufficient load, it can handle it and return it. However, if you give it too much, it will suffer damage of varying severity. That’s inflammation! In detail, it is mainly present at the start and often disappears after a few days. But real damage will stop you from riding for much longer or from performing the movement as you should.

Symptoms of tendinitis

The pain is very often located primarily in the body of the tendon. It can, however, occur at different times: before, during, after, “during and before,” “after and during,” or “before and after.” There are thus 3 levels of severity.

• Stage 1: you only have pain when you get up in the morning. Then it goes away after a few steps… in short, the pain or discomfort is mainly present in the first minutes of the day. But as soon as you bring some activity back into the tendon’s structure, you regain “normal” mobility.
• Stage 2: the pain persists beyond the first steps after waking. It continues even during the first minutes on the bike. Then it fades after 10 or 15 minutes and gives you the illusion that the tendinitis has gone, until the pain comes back once your body has cooled down. Sometimes in the evening, when you go from the sofa to bed.
• Stage 3: the pain is constant and flares up at the slightest overload. You can barely touch the tendon with your fingers without jumping through the roof. Pedaling is out of the question!

Causes

The primary causes of cycling tendinitis are mechanical. This is amplified by the fact that in our sport, the movement is multiplied enormously. Try counting the pedal revolutions over 100 km. At 80 rpm, that still means between 15,000 and 20,000 revolutions during a single ride. No wonder there is so much knee tendinitis among cyclists. So if your position is poor, you will inevitably irritate the tendon, because your pedal stroke simply isn’t ergonomically suited to your physiology. Keep this in mind! A bike fit is a real investment. A good fitter will give you the right settings: shoe cleats, saddle height, stem length, saddle setback, and so on.

A bike fit is a real investment.

The second cause of tendinitis can be linked to your weight or your condition (fitness, strength, flexibility). Even if you are “well positioned,” if you have gained weight, for example, your settings should no longer be the same. Your flexibility changes too. This creates tension in your muscle chain, and wherever there is weakness, irritation can occur, potentially in a tendon. We will come back to this, but the focus should be on the cause rather than the consequence. Once it has been identified, invest in the solution that eliminates the cause rather than treating the symptoms.

Invest in the solution that eliminates the cause rather than treating the symptoms.

The third cause of tendinitis can be diet. Have you ever heard of “gout”? Gout is a degenerative disease caused by an excess of uric acid. Have you read Honoré de Balzac’s La Comédie Humaine? Like Père Goriot, the most at risk are lovers of fine food. Uric acid comes from the digestion of purines found in animal proteins. The substance then passes into the blood, and everything comes down to concentration. Below 70 milligrams per liter, uric acid is mostly eliminated through urine. Above 70 mg/l, it forms small crystals that cause painful inflammatory flare-ups. These are called “gout attacks” when the pain is in the joints. But even short of that, if your diet is too acidifying, you will seriously stress your cells!

Solutions for tendinitis

It is best to see a doctor to confirm or rule out what you think is tendinitis, and to be fully thorough. For diagnosis, since we are dealing with tissues, ultrasound is the method of choice. To treat it, don’t try to fix it yourself! Long-term rest is not recommended either. It is indeed not the best solution. After anti-inflammatory treatment if needed, it is better to keep the tendon under load and gradually bring it back to proper function than to risk weakening it through inactivity, which will only cause it to lose strength and flexibility. Finally, this should be your first resolution! Reduce the acidity of your body. How? Keep it simple…

Building good habits to treat or prevent tendinitis

Not all is lost. There are still races to win and records to break. So, to address this situation:

1. It may seem obvious, but first you need to get back into the habit of drinking water regularly throughout the day. It’s a mental thing, but three small 50 cl bottles are much easier to get through than one large 1.5 L bottle.

2. End every training session with one or two glasses of Saint Yorre. Why? This water is much richer in bicarbonates than ordinary water. It is said to effectively counter acidosis and so help prevent a rise in uric acid.

3. You will therefore introduce a diuresis cure, drinking more than 2 liters a day (bicarbonate water from Vichy, such as Saint Yorre, but also still water: Evian, Vittel, Contrexeville, teas, herbal infusions) in order to keep flushing out plenty.

4. When it comes to drinking during training, you should also increase your water intake, especially in conditions that promote sweating.

5. You will squeeze two half lemons (one green and one yellow) every morning and mix them into lukewarm water. This helps control acidity by partially neutralizing it.

6. Finally, you will address your diet. Check which foods increase the concentration of uric acid in the blood and eliminate them or at least cut back on them.

Foods to avoid

As you’ll have gathered, certain foods contain purines. Here is a list of those to be wary of:

• red meat
• Offal
• cured meats
• dried (or smoked) meats or fish;
• bouillon cubes (330 mg of purines per 10 grams, the equivalent of one portion of offal);
• hard liquor
• beer (even non-alcoholic: brewer’s yeast provides 300 mg of purines per 10 grams)
• sodas and fruit juices high in fructose.

To conclude

You need to learn to listen to your body’s signals. Getting to know yourself is the key. Everyone is different, and even a tendinitis recovery protocol won’t work for everyone, because no two people are alike. Pain is therefore very useful information. Your own pain! The pain you feel! In fact, it is the best indicator.

If it hurts, something is wrong.

If it hurts, something is wrong. Still, prevention is better than cure. Pay attention to your position and your diet. Diet, at any age, is a factor in fitness and balance, but past a certain age you need to pay even more attention to it, especially since our needs and culinary tastes change. To sum up, whatever the cause (mechanical, physical, physiological, or your lifestyle), the aim is not to eliminate everything that seems to threaten your health. The key is balance! Since you pedal to keep your balance, the final word will be “balance and variety above all, and the rest…”

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