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Use precaution to avoid cycling injuries

By David Johnson, M.D.

Bicycle riding is a popular form of recreation and exercise for people of all ages. It is a great, low-impact way to stay fit.

Off-road bicycles (mountain bicycles) now account for approximately 60 percent of new bicycle sales in the United States and are popular on both city streets and rough trails. Other types of bicycles include sport/touring, racing, bicycle motocross (BMX) stunt bicycles, as well as increasingly popular stationary bicycles. Bicycling is a great form of exercise, but as with any sporting activity, it carries a risk of injury. This article will review some of the more common bicycle-related injuries and means to prevent and treat these injuries.

Head and other serious injuries

Head injuries make up one of the most serious types of bicycle injuries, and often occur as a result of collision with a motor vehicle. Wearing a well-fitted bike helmet is recommended to reduce the risk of a serious head injury while biking.

Other serious types of injury can occur to other regions of the body, including neck, thorax, abdomen and pelvis, but these usually occur as a result of high speed riding and collision with motor vehicles. Other injuries which can occur in bicycle crashes include clavicle (collar-bone) fractures and separated shoulders, as well as other upper and lower extremity fractures.

Observing traffic laws and paying close attention to road conditions, other traffic, and animals (especially dogs), which can affect your ability to safely control your bike, are important ways to prevent these serious injuries.

Overuse injuries

Other injuries that occur over time are sometimes called overuse injuries. They are caused by repetitive stresses and strains to various regions of the body.

Neck aches and backaches are common complaints resulting from the cyclist’s upper body position with hyperextension of the neck and flexion of the lower back. Proper adjustments to the handlebar height as well as seat height and frequent stretching can reduce these types of problems. Prolonged pressure on the handlebars and the position of the wrists may cause compression of the median nerve, a condition known as carpal tunnel syndrome. This is manifested by recurring numbness in the hands, especially the thumb, index and long fingers. The use of handlebar padding and wearing padded gloves can help prevent these symptoms.

Prolonged pressure on the pudendal nerve in the pelvic region can cause numbness in the genital area. Proper seat positioning and seat type, as well as frequent rising to a standing position on the bike, can help prevent this problem.

Hip pain in cyclists is usually caused by trochanteric bursitis, a painful condition caused by repetitive sliding of a tendon over the point of the hip. Knee pain is usually due to the saddle (seat) too far forward or too low. Correction of the bicycle setup, stretching the hamstrings and strengthening the medial side of the quadriceps muscle, as well as occasional use of ice and anti-inflammatory medications, usually is effective in treating this condition.

Foot pain is commonly the result of metatarsalgia (pain in the forefoot), plantar fasciitis (heel-spur) and Achilles tendonitis. These conditions also are commonly caused by improper setup of the bike.

Other precautions

Although not unique to cycling, sun and heat can prove hazardous, and cyclists should be aware of sun protection and appropriated fluid and electrolyte replacement. Eye protection, usually with sun- glasses, is recommended to prevent flying insects, dust and debris from getting in your eyes and causing a loss of control of the bike.

When a bicycle is set up properly, many of the overuse-type injuries can be prevented. This can be done by bicycle specialists at quality bike shops, or information can be found on the Internet about doing your own setup.

The use of proper safety equipment and vigilance in watching out for motorists, road conditions and animals can help prevent serious injury from crashes. When done properly, bicycling can be a safe, enjoyable form of exercise to help you stay physically fit.