Cycling is a worldwide sport passionately practiced and followed by millions of people across the globe. While many of us see it as an enjoyable leisure activity or a healthy way to commute to and from work, for some recreational cyclists it can become an obsession. Avid recreational cyclists oftentimes put their body through such rigorous and demanding training blocks in order to achieve peak levels of performance that they can reach workloads comparable to those endured by professional cyclists. Whether it is watching cycling pros battling fierce uphill inclines every summer at the Tour de France or trying to overtake a fellow cyclist on a local hill during a weekend Café ride, cycling enthusiasts live their sport with passion and an almost religious-like devotion.

Medically speaking, however (and stripping any romanticism from our thoughts), cycling may be viewed by many as a potentially dangerous activity. Besides the risk associated with sharing roads with motorized vehicles or riding a bicycle downhill into hairpin curves at fast speeds, there is also the heavy toll many recreational cyclists put their bodies through by pushing the limits of their functional threshold power and claim the KOM (king of mountains) at their local STRAVA segment. Besides the known cardiovascular adaptations endurance athletes (including cyclists) can sustain, resulting in the “athlete’s heart” syndrome,1 the cumulative workload exerted on different muscle groups, particularly the lower train, and the repetitive muscle engagement during rides and training exercises can lead to relatively uncommon but potentially dangerous medical risks.