Why we could all do with a little physio
19 September 2016
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Hello and thanks for downloading another edition of our Old Mutual Live Mountain Bike podcast, it’s very kind of you to do so. I’m Gerald de Kock and the next while I’ll be talking about matters mountain biking. So often we talk about the races and the events and the trails and what goes into making good events, what goes into making a nice trail. We don’t often talk about the rider and what attention the rider needs to give to his/her body. Before, during and after a ride.
I thought it would be useful to come and get the views and opinions, expert opinion from Andri Smuts. Who is the Head Physiotherapist at the High Performance Centre in Pretoria. She specialises in sports physiotherapy and Andri is with me now, who is a mountain biker, aren’t you Andri?
Andri Smuts: Yes, I am. I’m not that serious like you at the moment –
GDK: I’m not that serous!
AS: I really enjoy my mountain biking, it gives you a new perspective on life and you get out and you see beautiful places, meet wonderful people. So yes, I’m very happy to be able to do that.
GDK: Let’s talk specifics about physiotherapy and treatment for mountain bikers. Is it a different science to that for a runner or a rugby or soccer player or whoever it might be?
AS: Not really Gerald, although we do get specific injuries that’s more associated with cycling or mountain biking. But not really, the same principles apply. Like prevention and then treatment and after care for your recovery.
Mountain bike specific injuries varies a lot, it depends on the seriousness of the rider and stage races are very demanding. So we strongly advise these riders to really look after their body and come for regular treatment before and after.
What you should be doing pre-ride
GDK: Let’s talk about before because so often it’s just about riding and you train and your legs feel a bit tired or your shoulders or whatever it is. But you ignore it overnight, sleep and carry on riding. Let’s talk about relatively serious because you’re preparing for a stage race, what should they be doing pre-ride?
AS: We usually prefer to see our riders once a week, if there is no specific injury, just for prevention. Then we do a full body treatment. Starting off, like you said, with the neck and shoulders, because of the position on the bike, moving down to the lower back that takes a lot of strain. Especially when you’re climbing because as you know, with mountain biking, you can’t really stand up a hill.
The lower back takes a lot of strain and then moving down to the glutes, the hamstrings because you’re cleated in, and calves. I’m not even talking about the quads – as we all know. So, we go through the whole body and try to loosen up the muscles, prescribe specific stretches. We pick up imbalances and weaknesses that we address via exercises or a stretching programme, then work our way towards the race. Help the planning for the race.
GDK: Would you, for example, pick up that a rider’s bike set-up isn’t quite right, through some of his persistent injuries and problems?
AS: Yes, definitely, especially when the rider starts riding longer distances. These small little changes can actually cause a significant injury and the longstanding problem. I had one incident where this cyclist, he was really getting more competitive and he battled for very long with a lower back pain. Then we decided to make use of our sports scientist who helped him with his bike set-up and that actually eventually helped to clear his injury. He had to get rid of, you have to get rid of that.
GDK: The night before, the morning before, is there anything specific that should be done around there?
AS: The night before, we prefer to not really treat. I would recommend about two days before to have your last deep tissue massage. The evening before, stretches and then the same with the morning. Just like a nice good stretch, maybe a little warm up walk before you get on your bike and off you go.
What to do after the day’s ride
GDK: Right, now I’ve done my ride and I’ve got to ride tomorrow and the next day and the next day, so, post-ride treatment massage?
AS: That’s very important. It helps you to recover. During these stage races, most of them are quite demanding on the body. Your muscles tend to develop trigger points because they get tired. They get dehydrated and these trigger points cause the muscle to shorter.
You wake up the next morning with a stiff, short muscle and now you have to put this body through the same paces. Maybe even worse in some stage races. So, it’s very important that you go for your deep tissue release so that we can get rid of it. It actually leaves you with a weak muscle and a shortened muscle and that makes you prone to injury and very prone to exhaustion and early fatigue.
GDK: What percentage of people that you tell to go and stretch do you think really do stretch?
AS: None! Myself, if I get off my bike, I will never stretch, I want to just chill, but it is important. As I said, it’s part of your recovery and it loosens up the trigger points and it helps you to be able to manage the next stage or the next day better. We should all do that.
GDK: The old ITB that we so often feel, you’re in a ride and just raise your saddle an inch or half an inch or a centimetre or something and it’ll help. Then I come in and my ITB is still there, but then I get off the bike and it’s not there. I don’t feel it. Should I be coming to you for some treatment around that?
AS: Yes, definitely, it does help to raise your saddle because then the knee doesn’t flex that much. But definitely, the ITB is a bugger. Because it starts in the glute, the glute medius, it can also affect your lower back, especially with cycling because it’s a close chain. You’re cleated in, it works through the whole chain.
We usually start with lower back release, going into the glutes and then through the whole ITB. Then zoom in to where it actually inserts on the knee with dry needling or different types of trigger point therapy. As you see in the Olympics, the latest is the cupping, like the swimmers do. We haven’t really used that on the mountain bikers, but it’s a possibility.
Don’t let your injuries linger!
GDK: I’ve got an injury, not so much the trauma injury where I’ve crashed, would I need your treatment. What’s the thinking there?
AS: We always suggest that you should look after your injuries as soon as possible. It depends on the seriousness of the rider, but one injury can lead to another one and especially with cycling. As I mentioned before, like if you have an ITB, it can work its way up to your lower back. Then work its way up to your shoulder. So rather have it sorted out before it becomes a serious injury. You might just have to come for once or twice to help you recover and not leave it until you are so badly injured that you can’t train for a month.
GDK: What are the most common issues that you’re dealing with as a physio, with regular people who come and see you? Firstly, what are the common injuries and secondly, perhaps, what are the common training faults that people are making?
AS: Common injuries, I would say it’s lower back injuries. I think it’s because of us being sedentary and our lifestyle, office lifestyle, sitting, sitting, driving, driving. We don’t tend to look at our core, we don’t stretch enough. So a lower back is very common. Then tend to, when you get excited and you’ve done well in a race, we overdo it, too much, too soon. That’s the biggest cause of many injuries, especially ITB like you’ve mentioned, too much too soon.
How to practice prevention
GDK: What are the things we should be doing to ensure that we only have to come see you once a week or we don’t have to come and see you? What are the things that we should be taking care of, that we can look after and ensure that we don’t have issues?
AS: I would strongly suggest that you get some help from a coach or have some type of programme and try and stick to the programme. Especially if you’re a novice or you’re just getting into the stage race thing, get some structure in your training. That’ll help you prevent injuries.
Then have some recovery strategy in place, either ice baths or massage or physio, whatever is available to you and then a stretching programme. It’s quite available on the internet, there’s very nice cycling specific stuff. But just a general programme will really help you a lot.
GDK: There you go, structured training programme, a recovery strategy and stretching should be part of that and you’ll be perfect mountain bikers. No, you won’t, but it’ll make it a lot less painful. Andri, thanks for chatting to us, what’s your next challenge on the bike?
AS: I think I’ll be competing in the Berg & Bush, not competing, I’ll be riding, so that’s in November. I’m really looking forward to that and then I have to check the schedule. There’s so many races now, it’s getting to popular and that’s maybe why we tend to overdo things sometimes.
GDK: Andri Smuts, the Head Physiotherapist at the HPC, the High Performance Centre in Pretoria. Which is a wonderful gathering point for elite athletes and those aspiring to be elite athletes because it’s got everything. It’s a self-contained HPC here, so they really look after you, great energy about the place. Thanks Andri and thank you for downloading another edition of our Old Mutual Live Mountain Bike podcast, do so again. Until then, cheers.