Εισαγωγή
Με εξαίρεση τους τραυματισμούς από κάποιο πέσιμο/ ατύχημα οι τραυματισμοί στο γόνατο είναι οι πιο συνηθισμένοι στους ποδηλάτες – και συναγωνίζονται μόνο με αυτούς τη μέσης- αλλά και στους αθλητές μεγάλων αποστάσεων Τριάθλου. Θα μπορούσαμε να χαρακτηρίσουμε τους περισσότερους τραυματισμούς στο γόνατο ως τραυματισμούς υπέρχρησης.
Αιτίες
Υπάρχουν πολλές αιτίες που μπορούν να προκαλέσουν κάποιο ερεθισμό, ενόχληση, τραυματισμό ακόμα και μόνιμη κατάσταση πόνου στο γόνατο. Ας δούμε μερικές από αυτές :
- Λάθος ύψος στην σέλλα. Είναι η πιο βασική αιτία προβλημάτων στους αρχάριους ποδηλάτες που δεν έχουν κάνει ένα bike fitting. Ανάλογα που θα νιώσουμε τον πόνο ο προπονητής μας καταλαβαίνει εάν πρέπει να κατεβάσουμε ή να ανεβάσουμε την σέλλα.
- Λάθος θέση της σέλλας σε σχέση με το άξονα της μεσαίας τριβής.
- Λανθασμένο q-factor. Σε ξεχωριστό άρφθρο αναλύσαμε τι είναι το q-factor και τι ρόλο παίζει.
- Λάθος τοποθέτηση στα σχαράκια, δηλαδή εμπρός πίσω καθώς και λάθος κατεύθυνση της μύτης του παπουτσιού.
- Πρηνισμός.Ενώ στο τρέξιμο ο πρηνισμός θεωρείται βασική αιτία τραυματισμού και οι πάτοι αρκετά διαδεδομένοι στην ποδηλασία δεν υπάρχει σχετική γνώση και κουλτούρα.
- Βαριά πατήματα.
- Απότομη αύξηση χιλιομέτρων
- Βαριά πατήματα
- Απότομη αύξηση των χιλιομέτρων που κάνουμε σε ανηφόρες.
- Λανθασμένος τρόπος/ τεχνική πεταλαρίσματος με τα γόνατα να είναι στραμμένα προς τα έξω ή προς τα μέσα.
- Ανιση μυική ανάπτυξη με πιο φανερή την υστέρηση του έσω πλατύ.
Σε γενικές γραμμές μπορούμε να πούμε ότι :
- Εάν νιώθουμε πόνο στο μπροστινό μέρος αυτό οφείλεται πιθανόν ότι καθόμαστε χαμηλά ή πολύ μπροστά ή χρησιμοποιούμε βαριά πατήματα ή ανεβαίνουμε πολλές ανηφόρες (απότομη αύξηση)…
- Εάν νιώθουμε ενόχληση στο πίσω μέρος στο γόνατο αυτό μπορεί να οφείλεται στο ότι καθόμαστε ψηλά ή πολύ πίσω…
- Οταν νιώθουμε πόνους στο πλάι μπορεί να οφείλεται σε λάθος q-factor, λάθος τοποθέτηση στα σχαράκια, μη ισορροπημένη μυική ανάπτυξη..
Τα παραπάνω απλά αποτελούν μία κατεύθυνση και ο γιατρός σε συνεργασία με τον προπονητή μπορούν να κάνουν διάγνωση (ιατρός) και εντοπισμού των αιτιών (προπονητής)
Τρόποι πρόληψης
Συνεπώς για να αντιμετωπίσουμε τα παραπάνω πολύ απλά και πρακτικά μπορούμε να κάνουμε τα εξής :
- Να κάνουμε ένα bike fitting
- Να τοποθετήσουμε σωστά τα σχαράκια. Μια γενική οδηγία είναι ότι το κότσι πρέπει να είναι πάνω από τον άξονα του πεταλιού
- Να τοποθετήσουμε σχαράκια που μας δίνουν δυνατότητα περιστροφής του πέλματος, όμως όχι υπερβολικής περιστροφής.
- Να χρησιμοποιούμε πάτους ιδίως εάν έχουμε την τάση να πρηνίζουμε στο ποδήλατο.
- Να επιλέξουμε σωστό μέγεθος και τύπο παπουτσιού. Κάθε εταιρεία έχει την τάση να φτιάχνει συγκεκριμένες φόρμες παπουτσιού.
- Να εξετάσουμε το q-factor όπως και το μέγεθος του βραχίονα των πεταλιών
- Να δίνει κάποιος προπονητής της τεχνική μας πεταλαρίσματος.
- Να αφιερώνουμε επαρκή χρόνο στην προθέρμανση ιδίως πριν από προγράμματα υψηλής έντασης σε ίσισωμα ή ανηφόρα. Να μην ανεβαίνουμε ανηφόρες χωρίς επαρκή προθέρμανση. Πολλοί αθλητές ξεκινούν την προπόνησή τους ή την τελειώνουν με ανηφόρες λόγω τοποθεσίας του σπιτιού τους.
- Να στροφάρουμε επαρκώς τόσο στο ίσιωμα όσο και στις ανηφόρες.
- Να μην αυξάνουμε τα προπονητικά φορτία απότομα.
- Να κάνουμε διατάσεις μετά από κάθε προπόνηση και ιδανικά μετά την προθέρμανση.
- Να κλείνουμε τις μυικές ανισσοροπίες
- Να βάζουμε προληπτικά πάγο στα γόνατα
Τρόποι αντιμετώπισης
Εάν τυχόν υπάρξει ενόχληση ή τραυματισμός στο γόνατο αυτά που σίγουρα που πρέπει να κάνουμε :
- Να μην αγνοήσουμε τυχόν ενοχλήσεις . Τα σημάδια θα είναι συνήθως σταδιακά και όσο πιο γρήγορα αντιμετωπίσουμε την κατάσταση με σωστή διάγνωση και εντοπισμού της αιτίας τόσο πιο γρήγορα θα απαλλαχθούμε από τις συνέπειες.
- Πρέπει να βάλουμε πάγο επιστρέφωντας σπίτι (10-15 λεπτά κάθε ώρα) ή ακόμα καλύτερα να κάνουμε παγομαλλάξεις.
- Να απευθυνθούμε σε γιατρό ορθοπαιδικό που να γνωρίζει από αθλητισμό και ιδιαίτερα από ποδηλασία
- Να αποφύγουμε για κάποιες μέρες βαριά πατήματα και ανηφόρες
Κείμενο : Γιάννης Ψαρέλης, προπονητική ομάδα Smart Sport & συντακτική ομάδα TriathlonWorld/ CyclingWorld.gr
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