Ask a Physical Therapist: Bicycling Safety Tips

Question:
I am interested to resume bicycling after several years away from the sport. How can I best prepare myself to avoid injury as a regain my fitness for cycling?

Answer:
First time riders may have to acclimate over time to achieve the elongated and flexed postures of the spine, knees and shoulders. Start with shorter rides before attempting longer endurance riding. To help you minimize the risk of injury, here are a few positional tips on avoidance of bicycle-fit related pain and injury:

Postural Tips

  • Back strength is important to assist with proper trunk position. To best develop the endurance to maintain the proper trunk alignment, it is first advised that you begin a core strengthening program. With proper abdominal and back extensor muscle strengthening exercises 2-3 times per week you will enjoy your training rides with less low back fatigue. Trunk position for the mountain or off road cyclist is often between 45 to 80 degrees angle of the trunk from horizontal. A road cyclist generally tucked tighter and maintains a 30 degree to 45 degree of the trunk from horizontal. It is important to avoid rocking your hips while pedaling. Achieving flexibility of the hamstrings (back thigh muscles), hip flexor muscles as well as the gluteal (buttock) muscles is important to minimize low back discomfort.
  • Change hand position on the handlebars frequently for upper body comfort. Neck pain is common and possible causes include poor handlebar position. A poorly placed handlebar might be too low, at too great a reach, or at too short a reach. Also, a saddle position that is too close to the handlebars may place extra weight upon your mid back and arms, putting extra strain on your neck. The width of the rider’s handlebars should allow the hands to be slightly wider than the shoulders. The preferred shoulder angle for riders is measured as the angle of the arm from the trunk, and a 90 degree angle is most suitable.
  • Keep a controlled but relaxed grip of the handlebars. It is important to avoid prolonged extension of the wrist while gripping the handlebars. This, along with changing position of the hands while riding, avoids excessive compression of nerves that supply sensation to the thumb and first two fingers of the hand. It you begin to experience tingling or numbness in this region of the hand, you may need to take notice of your hand and wrist position and adjust. Wearing padded gloves may also assist with providing protection to the hand.
  • Knee to pedal position is important for avoidance of knee pain. When pedaling, your knee should be slightly bent at the bottom of the pedal stroke. This equates to a 35 degree angle of the knee at the most extended position of the knee. Pedaling at a rate of 80 revolutions per minute will lessen your chances of injury to the knee by avoiding too low a cadence/too high a resistance or pedaling force. The harder you pedal, the more low back load you produce thus creating undesired low back strain. It is also important to have adequate hamstring strength to assure these muscles are working to achieve the “pull up” on the pedals from the bottom of the pedal stroke.
  • A stiff soled shoe is best for foot protection. In-shoe inserts can aid foot comfort allowing the rider to accommodate various foot differences. If using cleats, it is the most mechanically correct to position the foot so the cleat is at or behind the pad of the big toe (first metatarsal head) so the ball of the foot is over the pedal spindle. Cleats provide varying degrees of medial/lateral stability and some offer rotational adjustments. Misaligned cleats can create lateral knee pain (iliotibial band tendonitis) as well as foot pain, so be careful to assure you are properly positioned.

Safety tips

  • Wear your helmet!
  • Be visible! Wear bright or reflective clothing. Use lighting on the front and rear of the bicycle to aid increasing your visibility.
  • Ride in a predicable manner! Ride with traffic flow, obey traffic signals and always use hand signals to indicate your intended riding direction.
  • Be a defensive rider! Watch for doors opening on parked cars, be alert for cars pulling into traffic or entering a street from a driveway.

Physical Therapists can evaluate the way your body is positioned on the bike to make sure that your biking style “fits” your functional goals, whether they are for comfort, endurance or for speed and performance. If adjustments and equipment changes need to be made to your bicycle, contact your local bicycle dealer. You can also contact a physical therapist who treats orthopedic and/or sports conditions and who can work with you on a proper bicycle fit. For example you will find our office by visiting the American Physical Therapy Associations web site at www.apta.org and clicking on “Find A PT”.

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