Preventing Pain And Injuries From Bicycling
Bicycling as exercise has been proven to maintain weight and boost a person's overall health. Cycling is an intense cardio exercise that works out the entire body at once.
But do you know how to prevent injuries while riding?
Cycling Overuse Injuries
Overuse injuries often require "mechanical" as well as medical management. Bike fit and other padded equipment become necessary to prevent and recover from overuse injuries from cycling. Injuries stemming from repeated motions or overuse can be managed by improving the mechanical management, such as your body's position or the bicycle's position, and by medical management, such as exercises, over-the-counter medications or other treatments recommended by a physician.
Here are some of the more common overuse injuries among cyclists:
Neck And Back Pain During or After Cycling
Up to 60% of riders experience symptoms of neck or back pain. Increased handlebar reach or riding in the "hands low" position can exacerbate these symptoms causing the low back to flex and the neck to hyperextend.
- Mechanical management: Adjust bike fit. Decrease the reach by raising or adjusting the reach of your handlebars, moving the seat forward or using handlebars with less drop. Check to make sure your bike saddle doesn't have an excessive tilt, which places additional stress on your neck. It is encouraged to change arm position frequently and ride with "unlocked elbows."
- Medical management: Strength and flexibility exercises, ice and anti-inflammatories as recommended by your physician.
Handlebar palsy is a nerve injury caused by compression of the ulnar nerve as it goes through the palm – often from pressing the palms on the handlebars. It can cause numbness and tingling of the ring finger and pinky, along with weakness in some of the hand muscles. Handlebar palsy generally occurs after several days of long or intensive rides.
- Mechanical management: Bike fit. Padding hands or handlebars can be helpful.
- Medical management: Relative or complete rest of compression on the nerves as recommended by your physician.
Cyclists may suffer from saddle sores, nerve compression injuries, calluses or inflammatory nodules due to saddle compression and friction.
- Mechanical management: Wear padded racing-style bike shorts and adjustments of seat height, angle and position, using a saddle pad or changing to a different type of saddle.
- Medical management: Talcum powder or lubricating ointment, shaving, some medicated creams and "sitz baths" as recommended by your physician.
The repetitive sliding of the IT band over the hip bone can cause trochanteric bursitis, or pain on the side of the hip.
- Mechanical management: Adjust bike fit by lowering the seat or better aligning your bicycle cleat if you use clipless pedals.
- Medical management: IT band stretching, ice massage, physical therapy, anti-inflammatory medications and occasionally a steroid injection as recommended by your physician.
Knee Pain from Cycling
Patellofemoral pain syndrome can result from too much force repeatedly applied through the patellofemoral joint in the knee. This is typically due to errors in bike fit or cycling technique.
- Mechanical management: Change the bike fit by raising the seat or moving it back, or by adjusting the cleats. Ride at a lower pedal resistance and higher cadence.
- Medical management: Muscle strengthening, ice, anti-inflammatories, bracing and physical therapy as recommended by your physician.
Foot and Ankle Problems
Plantar fasciitis, metatarsalgia and Achilles tendinitis are all conditions that can occur when cycling. They are united in that they cause pain in the foot or ankle, and can be helped by changing certain mechanical issues on the bike.
- Mechanical management: Raising the seat height, adjusting cadence, proper toe clip size and cleat adjustment.
- Medical management: Ice, anti-inflammatories and stretching and strengthening of Achilles tendon as recommended by your physician.
Sun And Heat Issues While Cycling
Environmental exposures provide a variety of challenges for the cyclist, but of those, some of the most critical are exposure to the sun and heat.
Dehydration can occur because of loss of body fluid through sweat. Thirst is not usually a good guide to replace fluid. If a cyclist is adequately hydrated, they should pass clear or lightly colored urine every 1 to 2 hours.
Sunburn also is a common problem and can predispose to skin cancer. Wearing sunscreen is a must. Follow these tips on ensuring proper SPF coverage.
Preventing Injuries From A Cycling Crash
There are rules of the road that should be obeyed in order to stay safe and prevent crashes on your bicycle.
- Wear a helmet.
- Be visible – wear bright clothing with reflectors.
- Assume other vehicles DO NOT see you.
- Do a pre-ride check for bike maintenance and ensure brakes are functioning.
- Get your bike fitted by a professional.
- Stretch and strengthen your Achilles tendons and glutes.
Check out additional tips for bicycling safety from the American Association of Orthopedic Surgeons.
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By Catherine Reese, MD, CAQSM
Franciscan Physician Network CityWay Family & Sports Medicine