June 15, 2008
Tips for Healthier Bicycling
By Larry Bingham
PORTLAND, Ore. - About 85 percent of more than 500 recreational cyclists involved in a Department of Kinesiology study at California State University reported one or more injuries from what doctors call "overuse." The most common complaints involved pain in the neck, knees, groin and buttocks, hands and back.
All this suffering from riding a bike?
It might seem like sacrilege to bring up the dark side of cycling but aches and pains are not exactly new to some of those who ride year-round.
As fair-weather riders return to the bike lanes, and as more folks take to their bikes as the cost of gasoline rises, it's a good time to learn how to bike better and avoid the most frequent injuries.
Before the moaning begins, though, the virtues of cycling:
You save money by commuting on two wheels. You reduce your carbon footprint and help the planet. You burn calories, build cardiovascular strength, improve endurance, tone muscles and increase your overall fitness, reducing your chances of obesity and heart disease.
You also should know that only 36 percent of the 85 percent who groaned in the California State study required medical treatment.
That said, you could wind up schlepping around a heating pad if you're not aware of how you ride.
"Being on a bike is no different than sitting at your computer," says Dr. Mark Hoffman, a certified athletic trainer and associate professor at Oregon State University's Sports Medicine Laboratory. "You need to make sure you are sitting properly or you will face problems."
Soreness in the back, neck and shoulders - some of the most common complaints - may mean you are bent over too far and your handlebars or seat are in the wrong position.
Numbness in your fingers might be telling you that your handlebars are too low and you're putting too much pressure on your hands.
That pain in the front of the knees says you should look hard at the height and placement of your seat. It also could be telling you that your saddle is too far forward or too far back.
Knee pain is the most common cycling-related complaint that physical therapist Anna Saltonstall sees in her work at Oregon Health & Science University's Rehabilitation Services. She advocates a good fit and strengthening the muscles that hold a person in better posture, as well as building the muscles that stabilize the spine.
"So many things on the bike can be adjusted to help, and so many things can be done in terms of exercise," she says. "Those are the two things we can play with."
Another common injury is what doctors know as the "iliotibial band syndrome," which involves stress on the fibrous tissue that runs from the pelvis to the shin bone and around the knee. The problem presents itself with a snapping in the hip or knee that tells sports medicine experts such as Dr. Charles Webb, who practices at OHSU's Family Medicine Center at Gabriel Park, that something is amiss in the pedal adjustments.
One way to address many of the problems, experts say, is to have a fitting at a reputable bike shop. A fitter will evaluate how you fit your bike, and then make adjustments. Good fitters pay attention to the angles of your knees, trunk and shoulders as you pedal, among other things.
Along with a good fit, another way to prevent common cycling injuries from overuse is to stretch before and after a ride, Webb says.
"Get up and get in the shower and do a little stretching as the warm water hits the muscles," he says. "And then, ideally, go out and warm up: Run in place and do some calisthenics before you hop on the bike. Commuters are primed for overuse injuries from riding all the time. These are the people who need to work on flexibility."
Less common than neck, back and knee pain, but frequent among male riders, is complaints of numbness in the groin area, as well as temporary erectile dysfunction after a long ride. While a lot of money and research is being spent on creating high-end saddles, Webb suggests a simpler solution, drawn from watching professional bike riders.
"They shift position on their saddle a few millimeters or centimeters - more to the left or right, further forward, further back - and they get up out of their saddle every few minutes to regain the blood flow and relieve the pressure in the area," he says. In other words, move around.
The same advice will address tingling in the hands. Move them around on the handlebars more often, he says. Gloves with gel padding may help take some of the pressure - a double whammy on the hands, with pressure coming from the weight of the body and from the vibrations in the road traveling up to the handlebars.
Commuter cyclists can do plenty of simple things, Webb says, "that will prevent a lot of the aches and pains you have on a daily basis."Essentials for a good bike fit
While a good bike fit is a lengthy and involved process, four of the keys to a better fit involve measurements, says Anna Saltonstall, a physical therapist at Oregon Health & Science University's Rehabilitation Services:
1. Knee over pedal: This measurement is taken with a plumb line dangled from the front of the knee to the ball of the foot when the rider is in midstride. The result could lead to moving the seat forward or backward.
2. Knee angle: A fitter likes to see a bent knee angle between 30 and 35 degrees at the bottom of the pedal stroke on a recreational cyclist. The closer the angle is to 35 degrees, the less pressure on the knee. Adjustments in seat height correspond to this measurement.
3. Trunk angle: Back, neck and shoulder pain can be caused by leaning too far over and may involve handlebar placement. A good trunk angle is between 40 and 80 degrees from horizontal.
4. Shoulder angle: The handlebars and saddle may be moved after examining the shoulders. Saltonstall likes to see a 90-degree angle. Anything more or less could lead to pain in the hands, neck, back and shoulders.