Staying healthy while biking

It’s summertime in Portland, Oregon, and what a wonderful summer it is. The Tour de France has just started, and I see many cyclists out enjoying the nice weather. Portland is known for its year-round outdoor activities and having a wonderful biking community with people of all ages and diverse biking interests. Whether mountain, road biking, or riding a unicycle, there is a sense of freedom that comes from outdoor riding.  

Unfortunately, biking can also bring an increased risk of injury rates. It’s estimated that there are more than 500,000 bicycle injury visits to US emergency rooms each year. Personally speaking, I’ve been to the ER once for a road bike crash and probably should’ve gone one other time but didn’t.  Common traumatic injuries from biking include head injuries like concussions, facial injuries such as abrasions, musculoskeletal injuries like fractures, and handlebar injuries affecting the abdomen.  When it comes to abrasions, most cyclists know about “road rash”. Road rash can be mild, moderate, or even severe. These are commonly treated with topical treatments, such as Hydro, active dressings, Silvadene, cream, or antibacterial ointment, and dressings. After a road rash, consider updating your tetanus immunization. 

Some strategies to prevent trauma when bicycling include always wearing a bicycle helmet as they reduce the risk of head injury by 60%.  Always use protective eyewear to protect from the sun, flying objects, and other irritants like wind and rain.  I still remember having a bee get stuck between my sunglasses and nose and stinging me while riding.  Also, wearing cycling gloves is very important to prevent and protect from hand injuries during a fall. I recall crashing my road bike while cornering a little too fast and laying down my bike on my left hand. The area of my hand that didn’t have cycling glove protection got a significant road rash that took months to heal and years later, still has scarring.

It’s also very important when riding a bicycle to anticipate errors of others on the road such as vehicle drivers, who may not see you or may just be impatient. Several years ago, I was towards the end of the bike leg of a triathlon when I came upon a crash involving a fellow participant, who had just passed me seconds before and was now involved in an accident with a car that entered a controlled intersection illegally. I still remember the officer shouting at the driver to put their car in park and shut it off while rendering aid to the cyclist until EMS arrived.  Fortunately, my fellow triathlete survived and eventually returned to riding after surgery for a couple of broken bones.  

In addition to acute injuries, overuse injuries are also common. Neck aches and back aches are common problems among cyclists. Usually, these are muscular from muscle tension or frequent turning to look for traffic. There can be other bike-related fitment issues that can also contribute to neck and back pain. Additionally, handlebar fitment problems can result in nerve-related symptoms affecting the hands and fingers of cyclists. Additionally, lower extremity injuries to the hip and knees are common overuse injuries for cyclists, and hip problems include tendinitis along the front and outer aspect of the hip. This can sometimes occur if the seat is too high or the bike frame is too large. Knee problems, such as cyclist knee that affect the anterior part of the knee can be associated with bicycle fit problems, or training errors related to paddling. Treatment for hip and knee problems like these typically starts with correcting the training errors and bicycle fit problems, evaluating for the anatomic variance of the lower extremities, correcting those, and pursuing aggressive rehabilitation of the affected areas. 

Other common problems for cyclists can include dehydration. Dehydration commonly happens with rapid sweat and evaporation, which results in underestimating the fluid needs for your body. The best way to prevent dehydration is to be focused and conscientious about hydrating several days before an event and having standard approaches to hydrating while riding depending on the various riding conditions you expect. Also, it’s important for cyclists to utilize sunscreen as sunburn can be a common problem.

At Sports Health Northwest, we want to help you enjoy the outdoors and biking as much as possible.   If you have experienced a biking related injury, we are here to help you recover from that injury and get back to riding.

Author

David Westerdahl MD FAAFP RMSK Sports Medicine Physician and owner Sports Health Northwest, Inc.