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Former British 100-mile and 12-hour time-trial record holder Alice Lethbridge says thoracic outlet syndrome symptoms made outdoor riding difficult, while indoor racing allowed her to keep training and compete. Botox injections enabled a temporary return to outdoor riding this summer, but the effects have worn off and her treatment plan remains uncertain.
Alice Lethbridge, a former British 100-mile and 12-hour time-trial record holder, has used indoor training and virtual races to keep riding while symptoms of thoracic outlet syndrome made outdoor cycling difficult, according to an interview with Cycling Weekly. Botox injections helped her ride outside again for a time this summer, but she says the effects have worn off and she is back indoors.
Lethbridge told Cycling Weekly that her symptoms began during the East Cleveland Classic in spring 2024. Turning her head while riding made her feel dizzy and nauseated, and she experienced numb hands. She said she found it difficult to remain in the group. Later that summer, her hands became concerningly cold, prompting her to seek medical care. The source report says diagnosis took almost a year.
She could continue riding on an indoor trainer because she did not need to turn her head to check behind her. When treatment was delayed, she made indoor racing a priority rather than waiting to resume outdoor competition. Lethbridge had already raced on Zwift and represented Great Britain at the UCI Cycling Esports World Championships within two years of joining the platform in 2020.
During school holidays, she trained as much as 20 hours a week, she told the magazine; in term time, she said she generally trained 10 to 12 hours. Her indoor routine included higher-intensity intervals and group rides on Zwift and MyWhoosh with the FemmeCycle Collab community. She also said prize money from MyWhoosh racing helped pay for physiotherapy.
Indoor Racing Kept Her Competing
Lethbridge’s experience shows how a change in training setting can allow an athlete to continue competing when a particular movement or riding environment triggers symptoms. For her, indoor riding removed the need to turn her head to look over her shoulder, a movement she associated with dizziness outdoors. Her account is personal, not evidence that indoor cycling is suitable for everyone with the condition.
Virtual racing also provided a competitive and social structure. Lethbridge said riding with the FemmeCycle Collab group helped replace some of the motivation and companionship she missed while away from outdoor group rides. Prize money also made a practical contribution to her care, although she described it as a bonus rather than a substitute for treatment.
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Symptoms Changed Her Riding Routine
Thoracic outlet syndrome involves compression of nerves or blood vessels in the space between the collarbone and first rib. The Cycling Weekly report describes Lethbridge’s diagnosis as involving compression of arteries between her ribs and collarbone, and recounts her numb hands, cold hands, dizziness and nausea. The report does not provide further clinical details about her individual diagnosis.
Her restriction from outdoor cycling developed as medical assessment and treatment took time. Instead of stopping training altogether, she adjusted its format and structure, using indoor intervals and online group events in place of traditional long weekend rides. This was a response to her symptoms and circumstances, rather than a general treatment recommendation.
““I just couldn’t be in the bunch. It was making me feel very dizzy turning my head outside… I started to feel like maybe I was going to vomit.””
— Alice Lethbridge, speaking to Cycling Weekly
Treatment Benefit May Be Temporary
Lethbridge told Cycling Weekly that doctors have suggested a second round of Botox injections, which she said they had not prescribed before. The report does not give a date for that treatment or establish whether it will allow her to ride outdoors for a longer period. The effects of the first round have worn off, according to Lethbridge.
It is also unclear what longer-term treatment she may receive, how her symptoms will develop, or when she might return to outdoor racing. Her account gives no detailed medical timeline beyond the diagnosis taking almost a year and the injections providing a temporary period of outdoor riding.
Doctors to Consider Another Injection
Lethbridge said she is hopeful that a second injection round could allow her to spend more time riding on the roads. No treatment date or outcome has been reported, so a longer outdoor return is not confirmed. For now, she says she is back to indoor riding.
She also expects indoor training to remain part of her routine even if outdoor riding becomes possible again, because it fits more easily around her work as a biology teacher. She has encouraged riders who struggle to stay motivated indoors to join a team or commit to an event with others, drawing on her own experience rather than offering medical advice.
Key Questions
What condition has Alice Lethbridge been diagnosed with?
Cycling Weekly reports that Lethbridge was diagnosed with thoracic outlet syndrome. The article describes compression in the area between the ribs and collarbone and reports symptoms including numb and cold hands, dizziness and nausea.
Why could she ride indoors but not comfortably outdoors?
Lethbridge told the magazine that turning her head outdoors made her feel dizzy. On an indoor trainer, she did not have to turn around to check for other riders, so she could continue cycling.
Did she return to outdoor riding?
Yes, temporarily. She told Cycling Weekly that Botox injections enabled her to ride outdoors this summer, but the effects wore off and she returned to indoor training.
What treatment is planned next?
Lethbridge said doctors have suggested a second round of Botox injections. The report does not provide a treatment date or confirm whether another round will lead to a longer return outdoors.
Source: cyclingweekly.com
