How to prevent common cycling injuries

Cycling is more popular than ever in the UK with two million of us hopping on a bike at least once a week.

Touted as ‘the new golf’ it has become particularly popular among male professionals aged 40+.

As healthy a pastime as cycling is, it can lead to a variety of injuries, particularly for the older cyclist.

And if you’re not careful, these injuries can take you out of the office with your business suffering as a result.

The good news is the common injuries listed below can be avoided by following some simple advice:

Achilles Tendonitis
Typically brought on by over-training, Achilles Tendonitis manifests itself as a sharp pain in the Achilles tendon (the tendon connecting the calf muscles to the heel). Applying ice to the area will reduce swelling and take away some discomfort but to truly recover, you need to take some time off the bike.

Other causes of Achilles Tendonitis include a bike that’s poorly fitted to your frame, or shoe cleats that aren’t properly aligned. Check with your local bike shop to ensure everything is in order.

Lower back pain
The usual cause of lower back pain for cyclists is poor bike setup. If your saddle is so high that your knees are almost straight at the bottom of the stroke, it will cause your pelvis to rock leading to pain at the base of the spine. If your bike frame is too big, you will have to stretch too far forward to reach the handlebars, also resulting in pain.

Seek professional advice on your bike fit to ensure you aren’t putting unnecessary strain on your muscles and joints. If you have existing lower back pain, a course of physiotherapy can help loosen stiff joints and strengthen weak muscles.

Neck pain
Neck pain is caused by a tightening of the muscles that run along the base of the skull and down into the shoulders (which become tired due to the strain of holding your head in extension for a prolonged period of time).
Try sitting in a more upright position and loosening your grip on the handlebars to allow your neck muscles to relax.

Iliotibial Band Syndrome (ITBS)
The continuous motion of bending and straightening the knee can lead to irritation of the iliotibial band which runs down the leg from the hip to the knee. When irritated, the IT band can cause pain and tightness in the knee, resulting in an uncomfortable ride.

ITB syndrome is typically caused by riding a bike that has not been properly adjusted for the rider. In this case, the height of the seat is usually the cause. It has to be set just right to ensure the knees are not overextending or over-bending.

Black Pear Physio can help!
We want you to enjoy your bike riding but also ensure it does not cause you any problems. That is why at Black Pear Physio we offer a range of treatments to help both professional and leisure cyclists stay injury free.

Contact us on 01905 611 010 to find out how we can help.

How to avoiding injury and enjoy ‘sustainable sport’

One of the most important things we do here at Black Pear Physio is help people who enjoy sport – keep enjoying it.

This means we help them protect against injury and, if they have been injured in the past, reduce the likelihood of any injury returning.

Whether you are an amateur or a professional, that’s what ‘sustainable sport’ is all about!

Here are a few tips to help with this:

1: Don’t overdo it

Ensure that, whilst you may from time to time strive to achieve a higher level, you avoid the ‘Bust-Boom-Cycle’.

Be realistic therefore in terms of the number of days you’re training each week and the length of each session. Three to five activity sessions each week at a comfortable level are much better than one weekly session where you really push yourself.

2: Step up steadily

Following on from the above, whilst it’s great to set yourself a fresh goal, do ensure it is realistic. A good goal should be challenging but also achievable, so ensure each ‘step up’ is appropriate for your current level.

3: Listen to your body

It is surprisingly easy for us to ignore what our body is telling us. This can for example be a niggling muscle pain or our minds subtly telling us that we ‘fancy’ certain foods. Don’t ignore your body’s signals; this is your body telling you that you must do something, before an issue becomes serious.

4: Take the long view

By making a long-term commitment to your fitness and health you won’t rush into trying to get from ‘unhealthy to healthy’ or ‘unfit to fit’. Instead, by seeing the bigger picture you’ll find ways to improve your habits and make a lifestyle change that will stay with you for years to come.

5: Seek professional support

In any sport a professional coach will ensure you continue to work at a sustainable level. They’ll also help you improve your performance techniques which will then enable you to achieve so much more without, a huge amount of additional effort.

Black Pear Physio can help!

At Black Pear Physio we offer a range of treatments and services to help you stay injury free and to ensure you continue to enjoy your sport.

Contact us on 01905 611 010 to find out more about the people we help and the difference we make.

Physio is one of the best ways to get your life back following a skiing injury

One of the most popular holidays during the early part of the year is a skiing trip.

The only problem with skiing or snowboarding is, that whilst they can be exhilarating and fun, for some people they can lead to an accident.

Doing all you can to guard against this is therefore, terribly important.

Preventing injury

As any experienced skier will tell you, accidents are most likely to occur when you’re not fully prepared or when your concentration is waning.

Failure to prepare means not taking the right kind of pre-trip exercise such as boosting your knee, leg and back muscle fitness and concentration is most likely to be lost when you’re tired and it’s the end of the day.

Frustrating injuries

Common injuries on the piste include torn or bruised leg or arm ligaments, tendons and muscles as well as painful twisted knees and broken limbs.

Frustratingly, anyone who is injured may find it takes them a long time to get well.

The quickest way back

The best and fastest way to get your life back to normal after a skiing injury is to hire a professional physiotherapist.

Here at Black Pear Physio we’ve been treating professional and amateur sportsmen and women for over 25 years.

Bespoke therapies

Our extensive range of therapies include joint manipulation, rehabilitation, acupuncture and pain management and they can all be adapted and integrated to meet your requirements.

We’re proud therefore to have one of the best track records in the region for getting people back to normal health.

Call today

If you’ve suffered a sports injury and you’d love to get back to your usual levels of physical activity, then call Black Pear Physio today on 01905 611010.


Common Rugby Injuries

Rugby is a fast-moving and high intensity team sport. Although historically dominated by males, the sport is gaining popularity among females.

As many as 1 in 4 rugby players will be injured during the season. On average each player performs 20- 40 tackles per match. Rugby injury rates are reported to be nearly three times higher than football.

When Do Rugby Injuries Occur?

  • More injuries occur during matches (57%) than in training, and more often in the second half of the game.
  • Approximately half of all injuries occur while a player is tackling or being tackled.

Which Rugby Players Suffer the Most Injuries?

  • Statistically Hookers and flankers sustain the most injuries.
  • Forwards are more frequently injured than backs because of their greater involvement in physical collisions and tackles.
  • In the backs, wings, fullbacks and centres are at the highest risk of injury.
  • In the scrum, the locks are at greatest risk of facial cuts and cauliflower ear (external deformity to the ear caused by repeated blows).
  • Players in rucks and mauls commonly suffer injuries to fingers and thumbs as well as abrasions and lacerations from cleats.

What Kinds of Injuries Occur in Rugby?

  • Over 40% of injuries are muscular strains or contusions (bruising), 30% are sprains, followed by dislocations, fractures, lacerations, and overuse injuries.
  • Sprained ankles are a common injury with ankle sprains representing almost 1 in 7 rugby injuries.
  • Between 5-25% of rugby injuries are head injuries, including concussions.
  • In youth aged 10-18 years, 35% of injuries are fractures, of which 24% involve the clavicle.
  • Superficial injuries represent 20% of rugby injuries, followed by head injuries and sprains (16%).
  • Of the head injuries, 44% are concussions.

Prevention strategies in Rugby

More injuries occur at the beginning of a season, suggesting that pre-season conditioning could reduce injuries.

A pre-season conditioning program should gradually increase in intensity and duration to prepare athletes for competition.

Injury prevention strategies to reduce the incidence, severity and cost of rugby injuries could include coaching on defensive skills, correct tackling technique, correct falling technique and methods to minimize the absorption of impact forces in tackles.

To reduce scrummaging injuries at lower rugby levels, props should crouch, touch, pause and then engage. This technique is called Depowering the Scrum. Another alternative is Sequential Engagement where the front rows engage first and then the second row joins in, so that a stable scrum is established.


As the rugby season approaches, make sure you stay safe.

Black Pear Physio are proud to be a Worcester Warriors affiliate partners, so for any season ticket holders check out your special offer on discount for treatment.


Physiotherapy and Cycling Injuries


Cycling regularly brings benefits your health at all ages in many types of ways, whether riding for recreation, as a serious competitor, or professionally.

Physiotherapists can use their knowledge and expertise to provide guidance on cycling posture and the setup of your bike to ensure you enjoy those benefits in a pain and injury free way.

Cyclists may incur many injuries that would benefit from seeing a physiotherapist. Broadly, these injuries fall into two main categories: overuse and traumatic.

Overuse injuries most commonly includes knee pain, back pain, and Achilles tendon problems.

Cycling is a highly repetitive sport – an average cyclist might perform well over 4,000 revolutions an hour depending on what level they are performing at so it is quite understandable how small problems can become big issues over time.

Traumatic injuries are most commonly as a result of accidents from falls and crashes at higher speeds or collisions with stable objects. Therefore, wearing safety equipment is vitally important.

The bike set up is also vitally important as one wrong adjustment could cause significant damage in light of the repetitiveness of the sport and potential distance travelled.

Inappropriate bicycle set up can often involve factors such as wrong seat height, poor foot and ankle position on the pedal causing an overload and incorrect distance from the seat to the handlebars creating stress on the back and neck.

Common injuries in cycling include:

  • Knee Pain
  • Neck Pain
  • Lower back Pain

Our Physiotherapists at Black Pear Physiotherapy can help with the above and advise you on your next steps to efficient and enjoyable cycling.

Boom Bust – Cricket

On average, 9% of crickets have an injury of some sort at any one time, although in fast bowlers 15% are injured at any given time. Therefore, chronic injuries in cricket are common at all levels. The pressures of squad selection whether it be at a social, amateur or professional level can contribute to players been selected if they are carrying an injury. Niggles can soon develop into full blown injures in cricket due to the repetitive nature of the sport in competition and in training.

There are very different physical demands involved in different types of cricket, which has meant the injury profile is slightly different between 5 day test matches, weekend to 4 day matches and one day matches. The launch of Twenty20 cricket has placed a new physical requirement on cricketers but it is difficult and too early to analyse the effects of these demands in sport injury research.

Lower back pain is particularly prevalent among young fast bowlers. The repetitive action of bowling for long spells places excessive stress on soft tissues, cause stress fractures of the vertebrae inducing conditions such as spondylolysis or spondylolisthesis.

Research has indicated that muscle injures such as hamstring and side strains are the most common cricket injures. These are due to the functional demands of the sport where occasional sprinting and ball throwing maybe repeated over a 7 hour day.

Common Cricket related injuries

  • AC Joint injury
  • Achilles Tendon rupture
  • ACL injury
  • Ankle ligament damage
  • Lower back muscle strain
  • Lower limb muscle strains
  • Rotator cuff tear
  • Shoulder impingement syndrome
  • Knee ligament damage
  • Neck and shoulder pain
  • Finger, hand and wrist fractures

How to resolve/treat these issues using the Boom-Bust theory

  • Take note of the previously issued blog about the cycling boom-bust theory and apply the same principles regarding physiotherapy lead treatment and advice.

Furthermore it is important implement preventative strategies to main your health and homeostasis.

Preventative strategies

  • Core stability control
  • Normal muscle length and strength ratios
  • Dynamic neural tissue mobility
  • Specific strengthening to large and regularly used muscle groups
  • Technique improvement and correction
  • General aerobic and anerobic fitness

Give us a call to discuss anything you need or check out our other Boom Bust articles.

Boom-Bust Cycle for Tennis

Tennis is a great sport; however, it can cause injury to many parts of the body due to the high speed of racquet impact, repetition and use of your spine, legs and especially your dominate arm. This can predispose you to a variety of shoulder, elbow, wrist, hip, knee and ankle injuries. All of which can quite easily become chronic in nature due to the repetitive nature, speed and impact of the sport.

The best known injury related to tennis is Tennis Elbow; however it is relatively uncommon in tennis. It’s a potentially difficult injury to manage as it is a muscle and tendon related injury that can become chronic quite quickly and persist for a long time if not managed well.

A slight niggle can exacerbate into a full blown debilitating injury inhibiting participation. Trying to play through the pain will only make matters worse and will require medical intervention from an experienced physiotherapist.

Common Tennis related injuries:

Lower limb injuries (thigh, knee and ankle) are the most common tennis injuries. They are caused by the sprinting, jumping, pivoting, stopping, jarring and pounding nature of tennis.

Upper limb (shoulder, elbow and wrist) injuries are usually caused by high velocity and repetitive movements required in tennis.

Back injuries and pain are common due to the rotation required to hit ground-strokes, and the combination of rotation, extension and lateral flexion involved in the serve.

How to resolve/treat these issues using the Boom-Bust theory

  • Take note of the previously issued blog about the cycling boom-bust theory and apply the same principles regarding physiotherapy lead treatment and advice

Furthermore it is important implement preventative strategies to main your health and homeostasis.

Preventative strategies

  • Use a tennis racquet suitable for your style of play, experience and size. Tennis players, especially those with arm and shoulder injuries, should seek professional advice when selecting a tennis racquet and choosing string tension. Ask an experienced tennis coach.
  • Check and maintain the playing surface to ensure it is in good condition and free of hazards.
  • Use tennis balls appropriate for your playing surface. Avoid using wet or flat/dead balls.
  • Seek professional advice on footwear. Most tennis shoes are more robust than running shoes due to the multidirectional requirements.

For further tips on our Boom Bust series check out our blogs.

How good is your back swing technique?

Do you have the right movement pattern to be able to perform at an optimal level?

It is important to breakdown the fundamental movements involved in the golf back swing so you can improve your distance and consistency while minimising strain on your body.

The majority of movement in your back swing should come from a rotational movement happening in your trunk, but this is a complex movement and it is very easy to cheat and end up moving your legs, arms and lower back, all to compensate for the lack of control and flexibility.

You need stability in your legs and remain free to move in your torso.

If you want to learn to isolate and improve the trunk rotation in your back swing…the key is to load your weight into your back leg properly as you start to turn.

Focus your attention on how your weight is balanced over the top of your feet. It should be evenly distributed through your mid foot and not all back on your heels.

Once you have properly used your legs to set up your address position, slowly initiate your trunk turn and try to keep your lower body relatively still. Keep the weight to the inside of your foot and stack your knee over your foot and your hip over your knee.

At the top of your back swing you should feel like your back leg is taking most of the load of your body. Your back knee should still be bent and feel like your strongly over the top of your back foot.

The back swing movement should create the natural but subtle weight shift to the back leg freeing up weight from the front foot which will allow the pelvis to rotate into the back swing too.

The combination of the twist and a strong stable back leg creates the foundation of power and consistency in your swing.


Ignoring the role of the legs for stability:

It is common to see people initiating the rotation by pushing their hip backwards and straightening their back knee, this will allow you to rotate from your ankles and get the club back, but it will take you off plane and eliminate all the power your legs can generate.

It creates more degrees of freedom to both screw up your swing and hurt yourself.

Tips for training

  • practice with no club
  • start the movement slowly
  • attempt only small amplitude or a half swing
  • as you get better push for further range
  • the further you rotate the more your legs should be doing to maintain stability in your knee


  • Hold full back swing for 20-30 seconds
  • You should feel your legs working and your hip and torso twisting and stretching.
  • This movement and static exercise and warm-up is a great warm-up before you play. Spend 2-3 minutes isolating these rotational movements and your back will thank you after the round.

GolfSwingTraining checklist….

Do you have the right postures?

Can you get into position and hold it?

Do you have the flexibility in your torso?

Do you have the strength in your legs?

If the answer is no, call us today for a physiotherapy assessment we can assist you in getting the right flexibility and strength that is needed to help you get back into the swing of things!!!




SteveRedgraveRowing is a great way to get fit as well as enjoying the beauty of your local river or lake.

It’s a fantastic sport for developing core, leg and arm strength plus all the cardiovascular benefits. It is a sport that utilises our body’s levers: arms, legs and back – to push the oars through the water.

The rowing stroke is a repeated continuous cycle, from a position with the legs flexed, elbows straight to a fully extended knee position and elbow flexion with the oar handle drawn into the body.

A strong back is a vital component to increase power and avoid injury. Poor technique is common and can lead to injuries.

To you rowers out there…you should always be looking to improve the way you row to reduce your risk of injury. Undertaking core and strength training will provide you with the muscular power to cope with the demands of the sport.


Common rowing injuries

  • Lower back pain – most common injury due to constant bending back and forth.
  • Upper back pain
  • Neck pain
  • Knee pain
  • Elbow pain
  • Wrist tendinopathies – from oar rotations
  • Rib fractures – tends to be in elite athletes who are over training.

To help prevent injuries:

  • Maintain a good level of general health and fitness.
  • Warm up thoroughly.
  • Ensure you are stretching as part of your cool down routine.
  • See a physiotherapist for assessment of your muscle strength, length and biomechanics to identify any weaknesses.

Injury advice:

  • Stop immediately if an injury occurs to help prevent further damage.
  • Seek treatment promptly from a physiotherapist.
  • Early management results in less time away from rowing.
  • Apply rest, ice, compression, and elevation until you seek treatment (for soft tissue injuries).
  • Do not resume activity until you have completely recovered from injury and have been advised it is safe by your physiotherapist.
  • Watch your technique and address any errors.

Handy tips for training…

  1. For cardio vascular fitness – try running, rowing, cycling
  1. For strength and endurance- try lifting some weights both fixed and free – make sure all major muscle groups of your legs, bottom, arms, back and shoulders are considered.
  2. Make sure your core stability is good – maybe try Pilates. This is essential to maintain your good posture and technique and keep the boat well balanced.

>>>> Try these tips to help improve your performance and limit potential problems, a varied training programme is important.

Add all these components to your training programme together with skill and practice and who knows what you might achieve.

Contact us here at Black Pear Physiotherapy on 01905 611 010, visit our website for more tips or why not book an appointment to help you row your way to success!



Ouch, my knee hurts

Knee Injury RunningWhether you are a weekend warrior or a highly competitive athlete, you have likely experienced or come in contact with someone who has suffered from some sort of knee pain. Knee injuries, especially to those who are physically active can be extremely annoying and can hinder your activities greatly.  Particularly at this time of year when so many people are in training for the marathon season and are building up their running hours.

The knee itself is a large and complex joint that can be easily injured due to the number of forces that can act upon it.  It consists of four bones: the femur, tibia, fibula and patella.  Also in place are cartilage, meniscus, and several bursa, ligaments and muscles/tendons. All of these structures must work together to produce movement and provide stability to prevent injury

Knee pain can arise from a sudden injury or can progressively build up over a very long time.  Either way, the key to successful treatment lies in accurate diagnosis and treatment based on the best available evidence.

Knee Injury

Anterior knee pain is the most common knee disorder, affecting 1 in every 4 active individuals.  Women are 6-8 times more predisposed to knee injuries than male counterparts in sports that require jumping, landing, cutting, and pivoting maneuvers.  Anterior cruciate ligament injuries are one of most disabling injuries of the knee joint resulting in long term neuromuscular deficiencies. Of those who have sustained an ACL injury, approximately 70% will not return to full competitive sporting activities.  Non-contact ACL injuries account for about 80% of all ACL injuries, with 70% occurring during ground contact after landing from jump and the other 30% occurring while decelerating to change direction.

If your knee is swollen you should arrange for an appointment to be assessed.  It is important to establish what is wrong with the knee in order to treat it correctly in the early stages.

If your knee has started hurting for no reason it may be that local structures around you knee are weak or stiff causing an imbalance and pain. It is very common for remote areas to cause knee pain, for example dropped arches in your foot or weakness in your buttock muscles can create biomechanical problems that can lead to pain.

Knee Injury Prevention

By now you must be thinking “I’m doomed!”  It seems like it right? But have no fear, research shows that moderate physical activity and specific exercise regimens play a significant role in prevention of knee injuries.  Preventative exercise programs may lead to fewer injuries and the loss of your training hours.

Preventative Exercises

Here are some examples of basic exercises that should be incorporated in a knee injury prevention program.  It is important to always precede exercises with some form of warm-up and flexibility program.  All exercises should be performed with intensity and perfect body mechanics (i.e. head high, back straight, tight abdominals, and fast feet) and always allow for adequate recovery time.

  • Flexibility
    • Glutes, Hamstrings, Quadriceps, ITB, Gastroc-Soleus, Hip Flexors
  • Strength (Quadriceps, Gluteals, Hamstrings, Core)
    • Stiff-legged Deadlifts, Lunges, Squats, Monster Walks
    • Russian Twist, Abdominal Rollout, Woodchoppers
  • Plyometrics
    • Backward/forward/lateral jumps, box jumps, bounding, depth jumps, lateral box push offs
  • Balance/Proprioception
    • Cariocas, Wobble board balancing
  • Agility
    • Rope skipping, Agility T Drill, Sprint Lateral Shuffle, Illionois Course

To maximize the benefits of an injury prevention program, incorporate yoga and pilates into your exercise regime. When practiced regularly, the benefits are numerous.  Physically, a combination of yoga and pilates can improve muscular strength, endurance, flexibility, postural alignment, body awareness, circulation, digestion, hormonal balance, respiration, immune function, strengthen bones, normalize blood pressure and reduce or normalize body weight. Mentally, it can improve your alertness, concentration, sleep patterns; reduce stress and anxiety and improve your ability to relax.

Above all, don’t suffer in silence.  A knee injury can be easily treated and you can be back to full fitness and training again with the right information and the right pathway to recovery programme for you.