Table 1

Cycling-specific examples of classifying the mode of injury onset

Presentation
Sudden or gradual onset?*
Underlying mechanism
Single or cumulative transfer of kinetic energy?
Example
Sudden onsetAcuteA mountain biker crashes during a downhill competition, landing on her shoulder. X-ray shows a clavicular fracture.
Gradual onsetRepetitiveExample 1. Over a period of 1 month, a track cyclist feels an increasing pain below his kneecap. It starts as a slight discomfort at the beginning of training that disappears after warm-up. Eventually, the pain impedes pedalling during training. Ultrasound imaging shows patellar tendinopathy.
Example 2. Over the course of a single 2-hour training session, a road cyclist develops severe anterior knee pain. Based on clinical examination, she is diagnosed with patellofemoral pain syndrome.
Sudden onsetRepetitiveAn artistic cyclist is performing a routine when he feels a sudden pain in his right shoulder. Ultrasound imaging shows rotator cuff tendinopathy and subacromial bursitis.
  • *Sudden onset=instantaneous or developing over several seconds.

  • Gradual onset=developing over minutes, hours or longer.