Background In clinical practices, sports injuries are assessed using radiographic examinations, pain-related inquiries, or palpations, after which prescriptions are issued to patients.

Objective By combining anatomy, musculoskeletal simulations, and the concept of sports training, this study demonstrated a system for assessing sports injuries that improves biking strategies and prevents biking injuries. The applicability and accuracy of this study enabled the locations of muscle injuries to be statistically matched with biking strategies.

Design We built an instrumented bike which was a conventional road racing bicycle fitted with instruments for measuring the riding parameters: a crank torque sensor, an optical encoder, inclinometer, magnetic and reed switches, and an electromyographic system.

Setting A musculoskeletal modelling system of OpenSim (Stanford, CA, USA) was selected to wide use to cyclist.

Patients (or Participants) Twelve amateur bikers (12 males; age=26±2 y; height=176±5 cm; body weight=72±7.2 kg) of various ages, heights, and weights were recruited.

Interventions (or Assessment of Risk Factors) Cycling strategy suggestion of Patello-femoral and tibial-femoral syndrome.

Main Outcome Measurements Acute (Joint reaction) and chronic injury (Joint moment and muscle coordination) were calculated in real-time diagnosis.

Results Simulating cycling strategies reduced knee flexion and external rotations of the feet, increasing the force application in the plantar flexion toward the bottom dead center, improving muscle activities at 80°–120° angle, and avoiding excessive slippage improved the VL and VM activities and prevented excessive reaction force in the joints and moment output.

Conclusions The system was used to lower the possibility of injuries by providing improved cycling strategies and encouraging active training as well as facilitating sports and sports training performance. Overall, the developed system can be used to predict the possibility of lower limb injuries and lower the occurrence of such injuries.