Thoughts on Injury, Pain, Nutrition and Recovery

I participated in a cycling race where I cycled 3,000 km in 18 days without any training or ever having ridden a sports bike before. I did a 60K ultra run 10 years ago where I ended up with a hip flexor injury that lasted six months, so I knew there was a big risk of injury going in. I just didn’t know or underestimated how much it would affect me afterward.

This post is a reminder not to repeat the same mistake again.

Knee Pain #

On the third day, I started feeling some discomfort around my right knee. This got worse over time, and I started taking 400 mg ibuprofen every morning and evening. I would wake up not feeling any pain in the morning sometimes, but the pain would come back during the day while riding, always around after 150km, especially on days with a lot of elevation. I started using kinesiology tape, which helped a little to stabilize my knee. I also felt less pain in my knee after two weeks of riding. I’m not sure if this was because my legs were getting used to the riding or because I got used to the pain.

I tried everything: putting the saddle up, putting the saddle down, changing the seat position, changing the handlebar position, the tilt of the handlebar. The problem was that I didn’t get a professional bike fit, it was a very new bike, and I had never ridden a bike with drop-down handlebars or clipless pedals before.

After the bike trip, with a bit of rest, the pain is very noticeable when I go down stairs or need to step on a big step. I feel it when I have to put pressure or force while bending my knee.

Bike fitting #

After the bike trip, I went to see a professional bike fitter to try to figure out the cause of the knee pain. The main culprit seems to be the crank length —the crank was too long for my height. I am 155 cm tall and have relatively shorter legs than average and I was using a 165cm crank length which seems to be the shortest that bikes come in by default. The bike fitter suggested that I get max 150 mm cranks (apparently the most typical manufacturer for this is ROTOR, 150mm is also the shortest they offer)

This video was very helpful too:

Other recommendations:

wider saddle
narrower handlebar

I am always sad that the cycling industry is really catered towards average white male body size and that it’s very hard to find things that fit me. Brands like Liv, Canyon, Specialized and Cannondale seem to have options though. Notes to future self.

Ankle Pain #

I started the bike trip with a brand new pair of Shimano clip-on shoes that were a bit too big for me, especially when it rained and the shoes got wet. I decided to buy a new pair on the way, which turned out to be too small, and I think I bruised my Achilles a little bit. This was painful and still is a few weeks after the bike trip. Maybe I need to get better-fitting shoes and I don’t think Shimano shoes work for me in general, something to remember.

Cyclist’s palsy #

I started noticing that I was losing grip strength after a week or two into cycling, but I didn’t think too much of it because I assumed it was normal to have numb, weak hands after gripping onto the handlebars for so long. It was also cold, so I didn’t really notice it. I started noticing it more in the last week when I got a flat tire and was not able to change my tire on my own. I started really struggling to shift gears and needed to use my entire hand to push the shift levers, but I thought if I stopped cycling, this would go away.

It’s been three weeks since I stopped cycling, and I’m still feeling numbness in both hands, weakness in both hands, and some discomfort and tightness around the guyon tunnel and wrist. I might have a bad case of cyclist’s palsy.

I know that hand numbness is quite common and takes a few weeks or months to recover. I think the cause of the hand issues is a combination of different things:

I wasn’t trained for this, so after long days of cycling, I didn’t have enough core strength to keep my body upright and leaned heavily against my hands, which put a lot of pressure on my palms
I didn’t have aero bars, which would’ve significantly reduced the pressure on my hands
This is an assumption, but because of the long cranks, I felt very unstable on my bike and had to balance with my hands a lot, which meant putting a lot of pressure on my hands
It was a gravel bike, but on the first day, I changed the 38mm tires to 25mm slick tires just to keep up with my friend who had a road bike. This significantly increased the vibration from the road. In hindsight, I should’ve bought a bike for the specific occasion
The handlebar was a bit too wide, which led to me rolling my hands inward, increasing pressure on my palms. Also, halfway into the trip, I tilted the handlebars slightly upward to reduce reach, which may have been too extreme and tilted my wrist angle too much, putting it in an awkward position that could’ve worsened the condition
I’ve never been able to let go of my right hand when riding a bike in general, all my life, which meant I was constantly holding the bike with my right hand without ever letting go. This makes sense as to why my right hand is worse—my ulnar nerve is significantly compressed to the point that I cannot extend my ring and pinky fingers, whereas I’m only feeling numbness and weakness in my left hand.
I also have imbalances between my right and left sides, as does anybody, and this is something I could definitely work on for better performance and health. I am right-handed, and I noticed I was getting sores only on my right side of my butt and knee pain only on the right knee, which is something I need to figure out. I also know my right arm is significantly stronger, and I can even see the imbalance from behind when I’m climbing—I am more stable on the right side. I think this is a good time to assess my body imbalances and work on weaknesses to prevent further injuries.

I didn’t notice any of the above symptoms while riding the bike, so it would’ve been helpful if I hadn’t had the knee pain, which really focused my attention on the knee and prevented me from giving attention to other parts of my body. I was also constantly on painkillers, which numbed me out. In hindsight, I should never continue with any kind of endurance race if I have to be on painkillers—I think this should be a new rule in my rulebook.

Recovering from the Injury #

I never had a nerve injury, so this has been a very scary experience—not having motor function in my right hand and not being able to do day-to-day activities like opening a jar, opening a door, or holding onto things. Also, the fact that symptoms seemed to worsen every day was very scary.

Nutrition and Recovery #

Through this experience, I learned how important nutrition, fueling, and recovery are, especially in a long-distance endurance event like this.

Takeaways #

When getting into a new sport, always assess injury risk. Preferably prepare as much as I can, train for it, and get a coach for better feedback
Do not continue any activity if I have to take ibuprofen continuously. Make a rule for when to continue and when to push through. Not finishing is not a bad thing—sometimes it takes courage to stop and choose health over dealing with long-term consequences of an injury
I’ve always been scared of injuries and am a little hypochondriac, but maybe this is a good time to learn to deal with injuries better, which is part of the game. I need to learn to deal with injuries if they happen in the future

How to Deal with an Injury #

Give yourself a moment to grieve, but set a time limit
Diagnose aggressively
Create a recovery plan
Record the progress

Focus on the Positives #

Everything can be a blessing in disguise if you choose to look at it that way. I really got scared and panicked after losing sensation in my hands and not being able to do daily tasks. I was already used to having pain in my knee and feet, but not being able to work on the computer without pain or hold things and open things—normal things—was a really humbling experience that made me realize things I just took for granted.

Now that I can’t really use the keyboard, I am using my voice more, and that’s been an interesting journey. For example, I wrote this whole thing without typing. Pretty cool! Will keep posted on my recovery journey here.