Bike injuries

Some very interesting reading in the Sports & Exercise Physiotherapy bulletin this month on mountain biking injuries. Below is a summary of points and a timely reminder that while we still have time left in the ski season, the Skyline bike park opening is just around the corner!

  • Although the number of mountain bikers is increasing each year and the total number of biking injuries are rising, the actual frequency of injuries per hour riding is decreasing.
  • But, the number of injuries are still high – 50% of recreational and 80% of competitive bikers report at least one severe/major injury related to the sport.
  • Bike park injuries have been reported to be as high as 15 in 1000 exposures with 87% of riders being male and 86% of injuries requiring local emergency attention.
  • Fractures made up a large portion of presentations to medical centres with a 2:1 ratio of upper limb to lower limb fractures seen.
  • As we move from XC –> Trail –> DH disciplines, relative injuries change from more overuse injuries towards an increased risk of trauma from falling.
  • The most common and often preventable overuse injuries are knee pain (patellofemoral pain or tendonopathies), arm/wrist nerve issues (cyclist’s palsy) and neck and lower back pain.
  • Improper bike fit is one of the top causes of overuse injuries in mountain biking.

It is a very interesting read with the full article being found here.

Let’s hope everyone has one of those injury free days like 985 per 1000 rides should be, but if you have one of the unlucky 15, make sure you get that injury dealt with promptly so you can get back on the bike and have fun again. Our team members are all highly experienced with optimising your recovery and getting you back on your bike quickly.

Plus, don’t let that niggle turn into an injury. If you want to get the most out of you bike, book in with Paul for a full bike fit to prevent injury and maximise pedalling efficiency.

Photo: Jimmy Pollard sending it on night pirate.  Photo credit: Si Williams

ALCOHOL -Optimising Injury Healing

Immediately after an injury there is bleeding from damaged tissue, which forms a bruise. There is also an influx of fluid from the blood stream (swelling), which brings nutrients and cells into the area to begin clearing away the damaged tissues and to fight any infection which may have entered through a break in the skin. Although this swelling is a necessary and important part of the healing process, the formation of new tissue to repair the damage cannot begin until the swelling has subsided and the bleeding has stopped. This process takes from three days to a week. Alcohol is known to increase the diameter of blood vessels, thus increasing blood flow, in a process called vasodilation. Increased blood flow can increase the amount of swelling and bleeding into the injured area, ultimately prolonging the duration of the healing process and recovery time.


Alcohol is an analgesic and can mask the pain and injury. Pain is an important indicator of injury severity – after an injury, pain serves the frustrating but useful purpose of stopping you from moving or putting weight on an area that can’t cope with the increased load. Drinking after an injury allows you to do things which would otherwise be limited by pain, and subsequently increases the amount of damage by overloading the injured area too soon.


Tissue healing requires vitamins, minerals, fluids and rest. Alcohol decreases the efficiency of nutrient absorption for the gut and is a diuretic, which means that it increases the amount of urine you pass. Consumption of alcohol after injury therefore depletes the body of essential vitamins and minerals and causes dehydration at a time when the body is most in need of good nutrition.


Unfortunately, the effects of alcohol consumption do not subside when you sober up. The repercussions of alcohol consumption on the body can last up to five days after two consecutive nights of drinking.

Are your knees holding you back?

Petellofemoral joint pain (the fancy way of saying pain behind your kneecap)

Are your knees holding you back from doing what you want? Whether it is going a bit further up Queenstown Hill, working on your time to get to the gondola, or doing massive all-day missions in the mountains, this is the time of the year that we get a lot of people in the clinic with signs of patellofemoral joint pain (PFJP).

PFJP often develops after a sudden increase in training load, starting a new activity, over training, or activity after an injury. The pain is often caused by incorrect tracking of the kneecap in the groove that it naturally sits in. The main factors your physio will focus on are injury, muscle imbalance and poor biomechanics (movement patterns).

Biomechanical issues of the leg:

1: Pelvis dropping, causing increase in load on the outside of the knee

2: Hip collapsing, and thigh rotates inwards due to poor muscle control

3: Knee shifting inwards, placing more outward stress on the kneecap

4: Foot rolling inwards, causing rotation of the lower leg

How can physio help?

  • Treating any underlying injury
  • Reducing pain through taping, braces, or foot orthotics
  • Releasing any muscle or fascia tension
  • Giving targeted exercises to strengthen specific muscles
  • Giving integrated exercises to work on biomechanics and movement patterns
  • Guiding your return to full activity levels
  • Working on injury prevention strategies to prevent re-injury

The team at Queenstown Physio can also do video based running and bike assessments to accurately analyse your technique in these sports to keep you in top form for the summer.

Have fun out there this summer and remember to gradually increase your training, starting slow with new sports, stretch after activity, and to get treatment for pain or poor technique early so you don’t turn a niggle into an annoying injury!

*Information adapted from La Trobe University resources


Locum opportunity

We are looking for a locum to cover for November and December 2017 due to staff injury. Hours are negotiable and pay is dependent on experience. If you have strong musculoskeletal skills and want a great working environment for a couple of months please contact either Debs ( or Paul ( for more info.

Post ACL repair: When to return to sport?

Post ACL repair: When to return to sport?

Returning to sport too soon after having an ACL repair gives a much higher chance or re-rupturing the graft, but when is the best time to return to sport? Recent research shows

  • 5 to 6 key performance indicators were used including quads strength, hop tests and timed mobility exercises.
  • Operated leg needs to be performing at 90% of non-operated
  • 38% of people who did not meet this went onto re rupture compared to 5% who did meet this criteria
  • Every month you delay returning to sport the rate of reinjury reduces 51%

Take home message?

1: make sure that before you return to sport that you have your knee assessed to make sure that you are not in the group that is at high risk of re-injury. Your physio will be able to assess your reediness to return to sport and make an exercise plan to address any deficits.

2: time is key! the earlier you return to sport less than 9months after the repair, the more likely you are to re-injure it.


A bit more on the studies for those geeks:

  • Grindem et al (2016) looked at 106 competitive athletes post ACL repair. 5 key performance indicators were performed where the patient needed to achieve 90% performance compared to their non-operated side. 38% of people who did not pass these criteria went on to re-injure their ACL as opposed to only 5% re-injury rates in those who passed. This study also showed that for every month that you delay returning to sport, the rate of re-injury reduces by 51%!
  • Krytsis et al (2016) looked at 158 athletes post ACL repair. 6 performance criteria were looked at in this study, once again with the expectation that they will achieve at least 90% performance compared to their in-injured side. Krytsis had similar results to Grindem with 38% of people who chose to return to sport before re-injuring their ACL as opposed to only 10% who passed. This study had an earlier return to sport period (8 months as opposed to 9) and may have had lower injury rates if they tested at 9months.

Grindem, H., Snyder-Mackler, L., Moksnes, H., Engebretsen, L., & Risberg, M. A. (2016). Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. Br J Sports Med50(13), 804-808.

Kyritsis, P., Bahr, R., Landreau, P., Miladi, R., & Witvrouw, E. (2016). Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture. Br J Sports Med, bjsports-2015.

Debs featuring in ‘Physio Matters’ about an article on snow sports injuries

Snow Sport Injuries

Smoking and how it affects your muscles

November 2015


Have you bumped, bruised, strained or tweaked your body? Wondering what you can do? Follow this advice for the first 48-72 hours, but nothing beats an actual diagnosis and specific recommendations for your injury.