Alongside the growth of cycling has been a corresponding increase in the proportion of female-identifying cyclists on the roads and trails. Assumptions about anatomic differences have historically inspired specific equipment design for women cyclists, while most of the cycling research has included only male-identifying participants. More recently, the industry has shifted towards a more gender-inclusive design, in line with the heterogeneity seen in cyclists of any gender identity. There has been research into biomechanical and metabolic differences of female athletes, which can impact female cyclists’ performance and injury risk. However, women cyclists are not defined solely by their anatomy or physiology. Their experiences, needs, access, and goals must be considered in developing strategies for prevention and rehabilitation of cycling-related injury, as well as training and performance.

Exertional leg pain occurs with notable frequency among athletes and poses diagnostic challenges to clinicians due to overlapping symptomatology. In this case report, we delineate the clinical presentation of a young collegiate soccer player who endured two years of progressive bilateral exertional calf pain and ankle weakness during athletic activity. The initial assessment yielded a diagnosis of chronic exertional compartment syndrome (CECS), predicated on the results of compartment testing. However, her clinical presentation was suspicious for concurrent type VI popliteal artery entrapment syndrome (PAES), prompting further radiographic testing of magnetic resonance angiography (MRA). MRA revealed severe arterial spasm with plantarflexion bilaterally, corroborating the additional diagnosis of PEAS. Given the worsening symptoms, the patient underwent open popliteal entrapment release of the right leg. Although CECS and PAES are both known phenomena that are observed in collegiate athletes, their co-occurrence is uncommon owing to their different pathophysiological underpinnings. This case underscores the importance for clinicians to be aware that the successful diagnosis of one condition does not exclude the possibility of a secondary, unrelated pathology. This case also highlights the importance of dynamic imaging modalities, including point-of-care ultrasound, dynamic MRA, and dynamic angiogram.

Cycling is an increasingly popular activity, mode of transportation, and sport, with a growing body of literature on all three of these aspects. Research on injury risk and rate has been highly focused on localities or population subsets. We hypothesized that there would be no relationship between gender and any study variable (riding habits, racing, crash history, etc). This was an online-survey design study. We aimed to add to the literature by using an online, self-reporting questionnaire regarding riding habits, crash history, and traumatic and overuse injury history. 785 people completed the survey. The majority were road cyclists, and nearly half of respondents were active racers. 51.7% of respondents reported a crash in the 2 years prior to taking the survey, and 23.5% reported chronic discomfort when riding. Of those with traumatic or overuse injury, 84.5% and 63.1%, were satisfied with the medical care for that injury, respectively. Researchers and clinicians need to work together to investigate factors that impact riding habits, crash and injury incidence, and outcomes of medical care. Cyclists have complex medical needs that are not always adequately addressed by medical providers, particularly in the spectrum of overuse injury. We identify several gaps in cycling research and lay the groundwork for future questions that will contribute to the literature in the areas of medicine and cycling.

Previous studies have suggested variability in practice patterns for transforaminal epidural steroid injections (TFESIs) despite published safety guidance. The purpose of this study was to understand recent trends in periprocedural safety practices in TFESIs and how some aspects of interventional pain practice may have been influenced by the coronavirus disease 2019 (COVID-19) pandemic and related supply chain shortages. A 91-item survey was distributed to 111 program directors of Accreditation Council for Graduate Medical Education accredited Pain Management fellowships, 42 North American Spine Society and Interventional Spine and Musculoskeletal Medicine recognized fellowship directors, and 100 private practice interventional pain physicians to capture current practices in epidural steroid injections from March 2021 to March 2022. Additional responses were obtained through advertising on social media platforms consisting of interventional pain physicians. Cross sectional data from survey responses specific to TFESI-related practices were gathered and analyzed. Of 103 complete survey responses, 102 physicians perform TFESIs (cervical, 33.3%; thoracic, 40.2%; lumbar, 100%; sacral, 89.2%). There was variability in preprocedural imaging review, sedation practices, contrast and fluoroscopy techniques, and type and dose of steroid preferred. Many physicians saw a decrease in number of procedures performed weekly as a result of the COVID-19 pandemic. There remains practice variability in various periprocedural aspects of TFESIs despite existing safety recommendations. Further research is needed to identify ongoing barriers to adherence to established guidelines. Recent practice trends may have been affected by unique challenges posed by the COVID-19 pandemic, and these trends should be considered in the event of future supply chain limitations and/or need for disaster response.