Avoiding Moto Injuries

Dr. Cunningham: Beware of common injuries in motocross

Dr. Rick Cunningham
Ask a Vail Sports Doc

Appopriate training, equipment and proper maintenance of one's dirtbike can all help avoid injury.

The snow has already melted off many of the trails downvalley, and with that comes mountain biking, hiking and trail running for some and motocross for others.

Motocross is a very strenuous sport that is gaining popularity with more dirt tracks being made. Although motocross athletes wear protective gear, injuries are not uncommon.

Just this week, I saw a young male patient that had been involved in a head-on collision with another motorcyclist on a trail. Most motocross injuries involve the forearm, clavicle, femur and tibia. Head trauma and concussion is also seen.

Get the Gear

The American Motorcyclist Association says the following equipment is required:

Motorcycle helmet

Shatterproof googles or faceshield attached to helmet

Protective pants

Boots that protect the ankle and foot

Gloves, chest protectors, neck braces and knee braces are recommended by the AMA.

Having seen a number of bad knee injuries in motocross athletes over the years, I would personally recommend a good motocross knee brace that prevents knee hyperextention and which has a knee cap protector.

Several studies have looked at the rate of motocross injuries in a pediatric population.

One study showed that 95 percent of injuries were orthopedic in nature. Chest injuries were also reported to be 18 percent in one study and consisted of lung contusions, spleen lacerations or a pneumothorax (where there is a puncture of the lung). In another pediatric study, there was a 18 percent incidence of loss of consciousness. Adolescents who have suffered a concussion require more recovery time than adults.

Spine injuries are less common, but these injuries can be more serious.

In one study, spine injuries accounted for 5.8 percent of fractures in a motocross population, but one-third of these resulted in permanent neurological loss. Spine fractures were more common on human made tracks compared to natural tracks outside.

Most spine fractures occur in the thoracic region (the mid-portion of the spine). These injuries are thought to occur as a result of sudden hyperflexion of the spine when landing from a jump.

Finally, there has been found to be increased degenerative changes in the spine of those participating in motocross compared to aged matched controls playing other sports.


Motocross is a sport enjoyed by many. To avoid injury, especially in kids and young adults, there should be appropriate training, the use of protective clothing and equipment (including a proper fitting helmet), and proper maintenance of one's dirtbike.

Kids must be counseled on proper safety techniques and riding techniques to avoid injury. With kids, there should be direct adult supervision at all times.

As for concussions, many riders don't report these injuries and they may not get the proper treatment following a concussion.

Dr. Rick Cunningham is a knee and shoulder sports medicine specialist with Vail-Summit Orthopaedics. He is a physician for the U.S. Ski Team. Visit his website at For more information about Vail-Summit Orthopaedics, visit



Exercise may be the best medicine for chronic achy knees.

The Best and Worst Exercises for Bad Knees

  • By Michele Stanten

"Strengthening the muscles around the joint protects you from injury by decreasing stress on the knee," says Willibald Nagler, MD, chairman of rehabilitation medicine at New York Presbyterian Hospital-Cornell Campus in New York City.

But you must use good form and technique.

The First Commandment

Never bend your legs to a point where your knees stick out past your toes. That puts a lot of pressure under the kneecap. This not only applies to the following exercises but also when you're stretching or doing aerobic activities such as step aerobics.

Except where stated, do 10 to 12 repetitions of each of the following, two or three times a week.

Best Exercises to Do

Partial Squats

Stand about 12 inches away from the front of a chair with your feet about hip-width apart and your toes forward. Bending at the hips, slowly lower yourself halfway down to the chair. Keep your abs tight, and check that your knees stay behind your toes.


Using an aerobic step bench or a staircase, step up onto the step with your right foot. Tap your left foot on the top of the step, and then lower. As you step up, your knee should be directly over your ankle. Repeat with your left foot.

Side-Lying Leg Lifts

Wearing ankle weights above the knee, lie on your left side, legs straight and together, with your left arm supporting your head. Keeping your right foot flexed and your body straight, slowly lift your right leg to about shoulder height, then slowly lower. Repeat with your left leg.

Inner-Thigh Leg Lifts

Wearing ankle weights above the knee, lie on your left side, slightly back on your butt. Bend your right leg and place it behind your left leg with your right foot flat on the floor and your left leg straight. Support your head with your left arm. Slowly lift your left leg about 3 to 5 inches, then lower. Repeat with your right leg.

Calf Raises

Using a chair or wall for balance, stand with your feet about hip-width apart, toes straight ahead. Slowly lift your heels off the floor, rising up onto your toes. Hold, then slowly lower.

Straight-Leg Raises

Sit with your back against a wall, left leg straight and right leg bent with your foot flat on the floor. Slowly raise your left leg straight up about 12 inches off the floor. Hold, then slowly lower. Repeat with your right leg.

Short-Arc Knee Extensions

In the same starting position as the straight-leg raises, put a ball (about the size of a basketball) under your left knee so that your leg is bent. Slowly straighten your leg. Hold, then slowly lower. Repeat with your right leg.

Hamstring Stretch

Lie on your back with your left leg flat on the floor. Loop a towel or rope around your right foot and pull your leg as far as comfortable toward your chest, while keeping a slight bend at the knee. Keep your back pressed to the floor throughout the stretch. Hold for 10 to 30 seconds and then release. Repeat three or four times with each leg. Do this stretch five or six times a week.

Worst Exercises—Avoid These

A few of the following exercises can be done safely if you have chronic knee problems, but they're on this list because they're more likely to be done improperly. The exercises above are safer, while still giving you similar results.

  • Full-arc knee extensions
  • Lunges
  • Deep squats
  • Hurdler's stretches

Before You Run More, First Run Better


Maybe You Just Need a Bigger Bike!

Ride Your Gut Off with These 3 Training Tips

Here’s how to use your bike to shed that dangerous spare tire


Image result for belly fat pictures      Image result for belly fat pictures

Belly fat is bad news. While researchers debate the real health risks of a higher body mass index (BMI) or carrying a few extra pounds, everyone agrees that wearing too much weight around your waist is largely detrimental to your health. 

Research shows that a waistline over 40 inches for men and 35 inches for women puts you at risk for heart disease even if you’re not technically overweight and otherwise in good health. Belly fat has also been linked to high blood pressure, high cholesterol, high blood sugar and diabetes. Again, bad news.

The good news is that you already own the best tool for shedding that bad-news belly fat: your bike. The key is performing a variety of workouts that build your fat-burning engine, rev your metabolism and the production of fat-burning hormones, suppress your appetite, and help you burn more fat and calories all day long. Yep, your bike can do all that. Here’s how. (Read Bike Your Butt Off! for a fully guided weight-loss plan for cyclists.)

     Go hardDo interval training once or twice a week (no need for more; stick to one day if you race or go hard on weekends). Numerous studies have found that high-intensity training significantly reduces total abdominal fat, including dangerous visceral (belly) fat more effectively than lower-intensity exercise. There are endless ways to do interval training. One simple example:

•Warm up: 10 to 15 minutes
•Pick up your effort so you’re working hard (a nine on a One-to-10 scale; you’re breathing hard, but not gasping) for 30 seconds to one minute. 
•Go easy for one minute.
•Repeat a total of five times.
•Cool down for two to three minutes.

Research shows your body also unleashes human growth hormone, which helps you burn fat and maintain muscle, after just 10 to 30 seconds of high-intensity exercise. High-intensity exercise also appears to help curb your appetite and trigger hormones that regulate feelings of hunger and fullness better than lower-intensity exercise, so you’re less likely to overeat. 

Keep it controlled and comfortable. Yes. We just told you to go hard to burn off unwanted belly fat—but don’t overdo it. Going hard all the time stresses your body and leaves you chronically inflamed, which can backfire by contributing to belly-fat storage. Cap the intensity to a couple times a week and take the rest of your weekly rides at a controlled, comfortable pace. “Most recreational cyclists are doing too much high intensity training and they’re not getting leaner or faster,” says Iñigo San Millán, PhD, the director of the Exercise Physiology and Human Performance Lab at the University of Colorado School of Medicine. “Many of your rides should be in Zone 2,” he says. That’s an intensity where you can talk the whole time—about a five to six on that One-to-10 scale. “This is usually the intensity that elicits the highest fat oxidation for energy purposes,” says San Millán. These rides are not only good for burning fat, but also for building your slow-twitch, endurance muscle fibers; increasing capillary development; improving your ability to use lactate for energy; and making you a better fat-burner all the way around.

Aim for about 80/20. A number of coaches prescribe what is known as the “80/20 rule,” also called polarized training, for balancing training intensity. It’s definitely worth a try for burning off belly fat as well as for getting fitter and faster. The goal is to spend 80 percent of riding time at low intensity and 20 percent at moderate to hard intensity. That way, when it’s time to go hard, you have the freshness and energy reserves to go hard enough to maximize those interval efforts.

Hitting both intensities actually improves your abilities all around: Your slow-twitch muscle fibers do the work of recycling the lactate your high-intensity, fast-twitch fibers produce. so when you spend time building them, the payoff is being able to work harder at high intensity—which in turn stimulates more fat burning. Research shows this intensity combo also makes you faster. In a 2013 study published in the Journal of Applied Physiology, researchers found that when cyclists performed six weeks of 80/20-style training, they more than doubled their power and performance gains, such as lactate threshold, compared to when they spent more time in moderate training zones.


Late Moto Fade...Conditioning or Arm Pump?

The other day I was at the track listening to a couple of young guys explain to each other why they keep fading back in the last few laps. They were both using the classic moto excuse, the one we have all used at least once...ARM PUMP! Guys have been trying to eliminate arm pump for years with everything from drugs to the surgeon's knife. There is a bertter way, take a look at the 4Arm Strong device.

Arm pump is not only an ailment that causes poor performance, it is also extremely dangerous in an already risky sport/activity. Many motocross/motorcycle racers spend thousands of dollars on a motorcycle, kit, boots, helmet, etc. only to sit on the side of the track waiting for their forearms to loosen up.