Lower extremity overuse in bicycling.

Overuse problems in cycling can be attributed to several factors. First, the symmetric design of the bicycle matched against the asymmetric variants of the human body produce, on occasion, abnormally directed stress loads on tendons and muscles. Second, cycling involves a high number of repetitions compared with other sports, often as high as 5000 revolutions per hour. Last, with the advent of advanced pedal systems, the cyclist has become more "fixed" to the bicycle. It is critically important that these factors be understood and addressed when treating overuse injuries in cyclists. Standard modalities and therapies are essential components of the treatment plan for cycling-related overuse injuries that should not be overlooked. Surgical intervention should only be considered after prolonged nonoperative measures have failed to relieve symptoms.

Iliotibial band syndrome in cyclists.

Iliotibial band syndrome is an overuse injury caused by repetitive friction of the iliotibial band across the lateral femoral epicondyle. Once considered an injury indigenous to runners, it is now frequently being seen in cyclists. The purpose of this paper is to identify iliotibial band syndrome as a significant problem in cyclists and to propose both operative and nonoperative measures for treating cyclists. Nonoperative measures specific to cyclists consist of bicycle adjustments and training modifications. These are adjunctive therapies to stretching, icing, rest, and oral nonsteroidal antiinflammatory drugs. For cyclists requiring operative intervention, a new surgical technique for excising or releasing the distal iliotibial band is presented. This technique, used by the senior author (JCH) since 1984, involves excision of an elliptical piece of the distal posterior band off the lateral femoral epicondyle.

Disassembly of the osteonics bipolar ring when used with a Howmedica femoral head. A report of four cases.

In 1980 Osteonics marketed their universal head replacement (UHR) as a universal head to fit 32 mm heads. The authors present four cases of ring disassociation in the Osteonics UHR when combined with Howmedica femoral heads.