"); // Deactivate Cloaking -->
  Home Reference/Search About Dr. Bragman Related links Audio Library Free Press Column Library


CHAPTER 20:
Cycling

Almost everyone learns to ride a bicycle as a child and owns a bicycle at some point in his or her life. It may be just pieced together, but it has two wheels and pedals and gets you from one place to another. For most children, bicycling is the primary means of independent transportation.

      With the emergence of the U.S. cyclists in the top ranks of the Olympics, the prominence of Greg LeMond in European road racing, the increased interest in triathlons, and the popularity of mountain bikes, cycling has become a much more widespread sport. More than 85 million Americans now consider themselves cyclists.

      The construction of bicycles has improved tremendously. Not only have engineering changes made cycles more efficient, but new materials have led to the creation of stronger and lighter-weight frames. Advances in technology have produced bicycles with up to 18 gears and mountain bikes that can be used in the countryside on rough terrain.

      Studies have shown that up to 20 percent of cycling injuries result from collisions with cars. The rest are due to collisions with stationary objects or to the rider being thrown from the cycle. Falls result from skidding on slippery pavement or from hitting a pothole, a rut, or an object in the road that you don't see in time.

SCRAPES AND BRUISES

Scrapes and bruises are the most common cycling injuries. Although sport cyclists usually wear bicycling pants and long-sleeved shirts to protect their skin, most children don't. They usually just wear shorts and T-shirts, and they can lose large patches of skin in falls. No matter what you wear, however, there is nothing you can do to prevent a bruise if you hit the hard surface of the roadway at a fairly high speed.

      Scrapes should be washed clean and disinfected and then treated with an antibiotic cream. Treat bruises with ice for 20 minutes at a time until the swelling goes down.

BROKEN BONES

If the force of your fall is great, you can break almost any bone in the body. The bones most likely to break in a cycling accident are in the hands, wrists, arms, ankles, or legs as you attempt to break your fall.

      Any injury that causes severe pain or an apparent deformity could be a fracture and should be examined, x-rayed, and treated by a doctor.

DEHYDRATION

Cyclists are susceptible to dehydration problems. Make sure to drink plenty of fluids before you go out for a long ride and carry a filled water bottle. Take a drink every 15 minutes or so. For rides longer than two hours, you may want to mix an electrolyte drink with the water.

HEAD INJURIES

Head injuries are all too common among cyclists and account for two-thirds of hospital admissions from cycling accidents. More than 1,000 people die each year while cycling, and three out of four die as a result of head injuries.

      I see somewhat fewer head injuries among serious cyclists, who are more careful to wear helmets. However, only 10 percent of all cyclists wear helmets, and only 2 percent of children under age 15 wear them. A cycling helmet is of the utmost importance. Because of the high incidence of head injuries, many states are considering cycling helmet laws similar to those governing motorcyclists.

      Falling and hitting your head on a paved road can cause a concussion or even a skull fracture. A concussion can be mild or severe, depending on how hard you fall. If you lose consciousness or are disoriented after a fall, get to a doctor's office.

NECK AND SHOULDER PAIN

Neck and shoulder pain is quite common among cyclists and is usually due to the horizontal position the body must assume on a bicycle with dropped handlebars. When riding in this position you have to extend your head up to see in front of you. You also have to support a great deal of your weight with your arms and shoulders, which leads to muscle fatigue.

      This combination of strains causes pain in the back of the neck that spreads down through the trapezius muscles, the broad muscles in the upper part of the shoulder above the shoulder blade. A stretching and strengthening program for the neck and trapezius muscles will help relieve the pain. You can also raise the handlebars to allow you to sit in a more upright position.

BACKACHE

In addition to causing neck and shoulder pain, cycling with your body in the horizontal position can lead to pain in the upper and lower back muscles. Again, stretching and strengthening exercises and a higher handlebar position should alleviate the pain.

HAND PROBLEMS

Pain, numbness, or weakness in the hand from cycling usually occurs along the side of the hand and may extend into the fourth and fifth fingers. This is due to the position of the hand on the handlebars, which compresses a nerve at the base of the palm.

      Padded cycling gloves can help relieve the pressure on this nerve. If the pain persists, put your handlebars in a more upright position.

      Usually, the hand pain goes away with rest. Because this is a nerve injury, there's nothing you can do about it except to stop doing what caused it.

SEAT PAIN

Cycling with your body in a horizontal position also puts all of your weight at the cycle's saddle on the ischial tuberosities. These are the bones that form the bottom of your pelvis. You can feel these bony knobs on either side of the rectum, where the hamstring muscles and other structures attach to them. As these bones press against the saddle, the structures attached to them are crushed between the bone and the seat, as are the buttock muscles (gluteals) and fat pads that cover these bones. This causes pain and soreness in the area.

      Padded cycling pants are helpful, but they may not be enough to relieve the symptoms. You can change the shape of the cycle's saddle or add a padded seat cover. Raising the handlebars to move your weight further back may help. If all else fails, you must rest until the symptoms clear and then reduce your cycling time to prevent a recurrence.

      Beginning cyclists may develop "saddle sores," which can be mild or severe. If you experience chafing on your buttock, use talcum powder or a lubricating ointment to reduce the friction between your body and the cycle's saddle.

PENILE NUMBNESS

An injury that befalls some serious male cyclists is penile numbness. The nerve behind the scrotum can become compressed against the cycle's saddle, causing numbness of the scrotum and penis.

      This is usually due to the front of the saddle being too high. You simply need to lower that part of the saddle. Because this is a nerve injury, the only treatment is to rest until the symptoms disappear and then change to a more comfortable seat position.

HIP PAIN

Hip pain due to iliotibial band (ITB) syndrome is fairly common. The rotation of the hip and knee as you pedal causes this thick band to rub on the bony prominence of the hip and the outer side of the knee. About 20 minutes into a ride you will feel pain in your hip or the outer side of the knee, and the pain will get progressively worse until you are forced to stop. Once you stop, the pain quickly disappears. The ITB responds fully to stretching.

RUNNER'S KNEE

The malady known as runner's knee (chondromalacia patella) is very common among cyclists. This is usually due to excessive pronation of the foot and the use of the quadriceps muscles in a bent-knee position.

      The U.S. Olympic training center in Colorado Springs corrects for pronation in elite cyclists by wedging the pedals. There are several good cycling shops that can do the same for recreational cyclists.

      Raising the seat to decrease the amount of bend in the knee is also helpful. The higher the seat, the less stress is exerted on the kneecap and the less pain you feel.

      To compensate for the pronation, you can support your foot with an arch or orthotic. You can strengthen your quadriceps muscles with the program of 30° Leg Extensions described in Chapter 11, which puts the leg through only the last 30° of the lift.

FOOT PAIN

Pain and numbness in the foot are usually caused by strapping your cycling shoe to the pedal too tightly. Adjust the strap so that it does not put pressure on the top of the foot. Or you can switch to the type of pedal that has an attachment for the sole of the shoe, which eliminates straps.

STATIONARY CYCLING

Stationary cycling is a convenient aerobic exercise outlet. It is widely used by avid cyclists when the weather prevents outdoor exercise and by those who want to work out at home. Rows of stationary cycles, or exercycles, have become part of the standard equipment found in good health clubs.

      A basic stationary cycle sells for $150 to $300 and easily fits into the corner of a room. On the simplest cycles, you sit upright and pedal. Pressure against the wheels provides resistance as you pedal. On some models, a fan substitutes for the front wheel and creates resistance by blowing air. The faster you pedal, the more air that blows. Typically, a device attached to the cycle measures your time, distance, speed, and revolutions per minute.

      Another type of stationary cycle combines both leg pedals and arm levers to propel the cycle's wheels. This cycle allows you to exercise both the upper and lower body at the same time. There are also upper body cycles where only the arm levers move the pedals. These are especially useful for people who have a lower-body injury or disability.

      Among the newer stationary cycles are the recliner or recumbent cycles. For these cycles, you sit in a chair with your legs stretched out in front of you to pedal. This cycling position eases tension on the back and is recommended for people with lower back problems. These cycles also work the buttock and thigh muscles harder than upright cycles.

      In the higher price range ($1,000 and up), you can find cycles that measure the rider's pulse rate. A wireless device picks up the heart rate when you place your hands on metal plates embedded in the cycle's handlebars. The machine automatically speeds up or slows down based on your heart rate.

      Other types of computerized cycles vary resistance over the course of the ride. This reproduces the sensation of outdoor cycling with hills and speed changes. Some cycles add a video monitor that shows you the scenery as you pedal.

      One problem with stationary cycling is that it can get boring. I like to do two things at once when I use a stationary cyclelisten to music, read a magazine, or watch television. Try weight lifting, pumping light dumbbells overhead to strengthen the shoulders (in a manner similar to the Military), the Arm Curl (sitting) and Triceps Curl for the arms, and a sitting version of the Flat Fly for the chest muscles.

INDOOR CYCLING INJURIES

Stationary cycling leads to many fewer injuries than outdoor cycling. Dogs, cars, and potholes are not a problem, and there are no traumatic injuries from falling off. Stress to the back, neck, shoulders, and hands does not usually occur.

      What I have seen are two injuries common to regular cyclistskneecap pain in those prone to runner's knee, and hip pain due to iliotibial band syndrome.


How to Improve Your Cycling

Strength Training

To increase your cycling efficiency, you should work on your leg strength first and foremost, since this is your means of locomotion.

      Strengthen the quadriceps muscles by doing the Leg Extension, Leg Press, and Squat, which are illustrated in the strength-training program in Chapter 1. You can also do 90-90 Wall Sitting ().

      Cycling also calls for strong buttock muscles as well as solid calves for pedaling. To strengthen the buttocks, nothing is better than squats. For calves, do the Toe Raise described in Chapter 12, while holding weights on your shoulders as you would while doing Squats.

The Bicycle

There are literally hundreds of cycles on the market, and you need to choose the proper style and gearing for the terrain you intend to ride on. To cycle in hilly or mountainous country, you need a mountain bike, with its fat, knobby tires and low gears. If you plan to ride on broad, flat streets, choose a touring bike or one of the new hybrids, which combine the features of mountain and touring bikes. If you want to race, obviously you should buy a road racer.

      A properly fitting cycle is extremely important. There is no other sport in which the athlete and the machine are so close to being a single entity. Ask your cycle shop owner to adjust the seat, handlebars, and pedals for you. Not only will this make you a better cyclist, but it will reduce your down time due to injuries.

      The frame is the right size if you can straddle it with your feet flat on the floor and with an inch of clearance at the crotch. For a mountain bike, there should be two or three inches of clearance. As for proper seat height, you should be able to extend your leg fully while standing on the bottom pedal. If the frame is too short or the seat too low, you may develop chronic knee pain.

      If your shoulders cramp up, the bicycle's stem, which is the bar between the seat and the handlebars, may be too short. Riding a bike with too long a stem can cause lower back pain. To correct either of these problems, adjust the seat height or install a stem of the proper length.

Safety Gear

Bicycling gear can help protect you from injury. Wear bright-colored clothes so you can be seen. If you ride on the street, goggles can protect your face from stones or small objects thrown into the air by cars. Wear biking pants and long-sleeved shirts to cover your skin and prevent cuts and scrapes. Proper padding in biking pants can also ease buttock pain. If you are among the more than 3 million people who cycle to work, wear clips on the cuffs of your pants to prevent them from flapping and getting caught in the pedals.

      A good-fitting helmet is a must. The helmet should have spongy pads attached to the inside with Velcro so that they can be adjusted. The helmet's strap should adjust easily, and both the chin strap and buckle should remain securely fastened when you ride.

      There are two basic types of bicycle helmets. Helmets with hard shells tend to be heavy and don't offer as much protection from serious injury as those with thin, elastic shells. The lighter thin shells, which are covered by a thin layer of semirigid plastic, resist penetration by sharp objects and absorb impact better than hard shells.

      Two organizations conduct tests and set safety standards for bicycle helmets: the American National Standards Institute (ANSI) and Snell Memorial Foundation. Look for a helmet bearing a sticker by ANSI or Snell. That means it has passed tests on impact protection and strapping.




Home I Medical Reference/Search I Who is Dr. Bragman? I Health-related links
Prescription for Health Radio
I Detroit Free Press Column

Copyright © 2000 BragmanHealth.com. All rights reserved. This site best viewed at 800 x 600 resolution.
Designed by C2G Media Group, LLC