Case report: Professional cyclist diagnosed osteoarthritis o
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Professional cyclist (29 years old), apart from the hours of cycling training, runs continuously 2 hours a week on a treadmill, strengthening both the upper and lower train muscles. He presents with progressive pain in his right knee; this pain has progressively increased with the passage of time in training. The pain prevents him from preparing competitions correctly and with a guarantee. BMI: 20.3

Patient points out that he currently sleeps more hours than in previous months, and there has been no change in any activity or behavior. Also refers to increased general fatigue. As for the diet is correct and varied, he eats a large amount of fruit and that he makes the five meals a day. Before consulting, the patient has taken (NSAIDs) to reduce pain; these were effective during the time of action, but have not been able to eliminate the discomfort. He has performed knee muscle stretching and cryotherapy twice a day for 10 minutes each exercise.

Physiotherapy intervention plan:
The treatment must be as effective as possible to achieve a recovery as quickly as possible. The treatment is 20 sessions, 5 days a week during the first part of the treatment and alternating days during the second phase. The first 8 sessions will be shortened, in which the treatment focuses more on analgesia and joint range. During this phase, which lasts eight sessions, this treatment will be repeated daily.

-TENS: 20 min. The electrodes 25 mm by 25 mm electrodes.
Passive stretching of quadriceps, hamstrings, and adductors. There are 3 series of 10 repetitions with 15 seconds of stretching.
-Cryotherapy for 10 minutes, with an ice pack applied to the area.
-Kinesiotapping: The kinesiotape is applied on fridays to reduce the pain on knee.
-Ultrasound 1 W/cm2, during 9 minutes continuous mode.
Strengthening of the musculature. Kotz electrotherapy. For quadriceps and hamstrings.

The patient undergoes an MRI scan to check for knee injuries. The study shows a grade 3 osteoarthritis that is accompanied by narrowing of the joint space and mild bone sclerosis, in addition to a slight joint effusion.

Biomechanical studies are increasingly used by athletes to prevent injuries and improve sports performance. For its use in cycling, a specific material is needed that is formed by a set of cameras and sensors, which analyze the posture of the cyclist at first; from this first data collection, a specialized software makes an analysis of them and gives some guidelines to correct the posture. To complement this biomechanical study, a cycloergometer is sometimes used to analyze the pedal in depth, to see the dead points of the same one and thus to be able to see the losses of power in the phase of the pedaleo.

Above all, the height of the seat post, the distance from the handlebars to the saddle, and the position of the cleats can have a negative impact on the patient and present discomfort in the spine and/or knees.

In this case it is reduced by 9 mm in the first case and reduced by 12 mm in the second. It is to reduce the tension in the area of the lumbar spine and in the area of the back of the lower limb. With regard to the modification of the cleats, a delay was made and a small rotation of the cleats on the support surface; the gap was 3 mm and 4° of right rotation for the right cleat; in the left cleat, the delay was 2 mm and the rotation was 7° to the left. With the rotation what is obtained is that the knee; this as centered as possible so that it transmits the power correctly.

Source: https://onlinelibrary.wiley.com/doi/full/10.1002/ccr3.3555?af=R
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