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Bicycle, Bike, Bicycling, Bicycling Injury

  • Technique
  • Bicycle Fitting
  1. Frame Size: Clearance from frame to crotch
    1. Sports or touring Bicycles: 1 to 2 inches
    2. Mountain Bicycles: 3 to 6 inches
  2. Saddle
    1. Height
      1. Extended Leg (pedal 6 o'clock): knee flexed 25 deg
      2. Inseam with bike shoes from floor to crotch x1.09
      3. Other measures
        1. No side to side rocking when pedaling
        2. Lower in mountain bikes for stability
    2. Fore to aft position
      1. Place pedals at 3 and 9 o'clock
      2. Front of Patella in line with front of crank arm
    3. Tilt Angle
      1. Option 1: Level with carpenter's level
      2. Option 2: Front end of seat slightly elevated
  3. Arms
    1. Handlebar height
      1. Normal height rider: 1-2 inches below saddle top
      2. Tall rider: up to 4 inches below saddle height
    2. Reach to handlebars
      1. Place elbow at tip of saddle
      2. Extended fingers should reach transverse handlebar
      3. Handlebar should be directly over bike front axle
        1. Hold handle bar hoods while sitting on saddle
        2. Glance down without flexing neck
        3. Confirm that handlebars are over front axle
    3. Width of handlebars
      1. Touring bikes: Shoulder distance
      2. Mountain bikes: Wider than Shoulder distance
  4. Foot position on pedal
    1. Foot neutral with toes pointing forwards
    2. Ball of foot sits over pedal axis
  • Prevention
  • Bicycle Protective Equipment
  1. See Bicycle Helmet
  2. Cycling gloves
    1. Prevent nerve compression
    2. Prevent hand injuries and provide warmth
  3. Padded riding shorts
    1. Reduce saddle irritation
    2. Increase rider visibility to motor vehicles
  4. Specialized cycling shoes with toe clip or sole cleat
  5. Polycarbonate Eye Protection
  • Causes
  • Common Acute Bicycle Injuries
  1. Head injuries (22 to 47% of bike injuries)
    1. Accounts for 60% of Bicycle related deaths
  2. Eye injuries
  3. Road Rash
    1. Superficial abrasions or Lacerations
    2. Traumatic Tattooing
  • Causes
  • Common Overuse Bicycle Injuries
  1. Neck Pain recommendations
    1. Shorten handlebar reach
    2. Angle saddle 10 to 15 degrees (front higher)
    3. Change arm and hand positions on handlebars
    4. Keep elbows flexed slightly
  2. Back pain recommendations
    1. Stomach Muscle Strengthening program
    2. Jordaan recommends Pilates or Core body training
      1. See reference below
  3. Arm pain recommendations
    1. Shoulder Pain suggests handlebars too close
    2. Biceps and triceps pain suggests handlebars too far
    3. See handlebar set-up above for prevention
  4. Compression Neuropathy of the Hands
    1. Ulnar Neuropathy (Ulnar Tunnel)
      1. Affects deep palmar branch
    2. Median Neuropathy (Carpal Tunnel)
      1. Less common than Ulnar Tunnel in Bicycling
    3. General Recommendations
      1. Frequent hand position changes
      2. Increase handlebar padding
      3. Wear padded gloves
  5. Compression Neuropathy in the groin
    1. Nerve compression with penis and scrotal numbness
      1. Pudendal nerve dorsal branch
      2. Cavernous nerve
    2. Recommendations
      1. Stop Bicycling until symptoms resolve
      2. Ensure proper saddle positioning
      3. Optimize seat type
        1. Increase seat firmness
        2. Increase seat width
          1. Wide enough to support ischial tuberosities
          2. Wider seat effectively lifts groin off saddle
          3. Soft, cut-out saddle is no longer recommended
        3. Reference
          1. Jordaan (2002) Personal Correspondence
  6. Foot Paresthesias
    1. Consider shoes that are less tight
    2. Loosen toe clips
  7. Saddle related problems
    1. Problems
      1. Buttock pain from ischial tuberosity pressure
      2. Saddle sores (chafing or open sores)
      3. Calluses over ischial tuberosity
        1. May develop into painful deep fibrous swellings
    2. General recommendations
      1. Talcum powder or Vaseline to skin irritation
      2. Ensure proper seat height and angle
      3. Wear padded bike shorts
      4. Firm saddle recommended
        1. Cushioned saddle may cause to other problems
  8. Hip Pain from Trochanteric Bursitis
    1. Iliotibial band Stretching
    2. Lower saddle height slightly
  9. Knee Pain from Patellofemoral Pain Syndrome
    1. Adjust saddle position higher and further back
    2. Strengthen vastus medialis
    3. Stretch hamstrings
  10. Foot Pain
    1. Metatarsalgia
      1. Correct shoe position
      2. Use cushioned insoles
    2. Plantar Fasciitis or Achilles Tendonitis
      1. Raise saddle
  • References
  1. Jordaan (2002) Personal Correspondence
  2. Pfeiffer (1995) Sports Med 19:311-25 [PubMed]
  3. Silberman (2005) Clin J Sports Med 15:271-6 [PubMed]
  4. Thompson (2001) Am Fam Physician 63(10):2007-14 [PubMed]
  5. Weiss (1985) Am J Sports Med 13:187-92 [PubMed]