Dr. Scott Hofer Q & A About Cycling Injuries

Dr. Scott Hofer, an orthopedic surgeon on staff at Lake Charles Memorial Hospital, answers your questions about preventing and treating cycling injuries.

Cycling is a fun, low-impact way to stay fit-and save money with gas at today's prices-but it isn't without risk of injury.

Q. What type of injuries are cyclists at risk for?

A.  Just the nature of cycling puts us at risk for injury. It's estimated that 85 million Americans are cyclists, and that 540,000 of them end up in emergency departments each year. Among those injured, 67,000 have head injuries. But chronic conditions in the knees, neck, hands and feet can also develop from overuse, improper technique or ill-fitting equipment.

Q. What are some tips for preventing cycling injury?

A.  Proper equipment is the first step in preventing a cycling injury. Since one of the most serious of all bike injuries is a head injury, it's imperative that you wear a helmet while cycling.

It's also important to use a bike that fits you. For example, your bike's seat should be level to support your entire weight and allow you to move around on the seat when necessary. If the seat tilts upward too much, it can result in pressure points and saddle sores. If the seat tilts downward too much, you can slide forward while riding and put extra pressure on your arms, hands and knees. Your handlebar adjustment is important too. If they are too high, too low, too close, or too far away, you may develop neck, shoulder, back, and hand pain.

A bike that fits you can also improve your pedaling efficiency and aerodynamics and actually make you faster.

It is also important to recognize and treat the early warning signs of an injury so that it doesn't become worse.  

Q.  What are some of the early warning signs of a cycling injury?

A.   The most common complaints in cyclists include knee pain, neck pain, foot pain or numbness, and hand pain or numbness.

Q.  Can these injuries be prevented?

A.   Most chronic injuries can be prevented. For example, knee pain is usually associated with a seat or foot guard that is improperly positioned, or using too high a gear while pedaling. Yet an individual's anatomy may also be the root cause of knee pain. Cyclists with slightly different length legs may have knee pain because the seat height is only adjusted for one side. So using the right gear and ensuring the proper fit often prevents knee problems.

Q.  What causes a cyclist's neck pain?

A.   Neck pain is usually caused by riding a bike that is too long or having handlebars that are too low. Tight hamstring and hip flexor muscles can also cause low back pain by forcing your spine to round or arch, and your neck to hyperextend.

Q.  You mentioned that pain or numbness in the feet and hands are common complaint of cyclists.

A.  Foot injuries are often the result of wearing soft-soled shoes or using too high a gear, which results in more pressure where the foot meets the pedal. Specially designed cycling shoes have stiff soles that distribute pressure evenly over the pedal.

            There are also padded cycling gloves available that provide cushioning, and cyclists should ride with their elbows slightly bent, not straight or locked. Bent elbows will act as shock absorbers and help absorb the bumps in the road. Having a saddle too far forward or handlebars too low can make the problem worse.  Changing hand positions on the handlebars can also reduce pressure and pain.

Q.  When should a cyclist seek treatment for their injuries?

A.  Naturally, any acute injury with profuse bleeding, severe pain, or considerable weakness should be seen immediately. Any injury-whether acute or chronic-that continues to worsen, has pain associated with weakness, loss of sensation, should be seen by a healthcare provider as soon as possible.

Jabbing, throbbing, burning or stinging - any way you describe pain-you want it to stop. A good rule of thumb is if pain keeps you up at night or interferes with your daily activity, see your doctor. Otherwise, analgesics like ibuprofen, acetaminophen, or other over-the-counter pain relief agents, and alternating ice and heat may reduce pain and swelling caused by mild injuries.

Q.  What else can cyclists do to prevent injury?

A.   All cyclists, regardless of their age, need to learn good bike-handling skills. Knowing how to brake correctly will prevent a biker from skidding or flipping over the handlebars when stopping suddenly.

Learn good cycling technique. Change the angle of your back, neck, and arms often to avoid over-stressing muscles and to put pressure on other nerves. Riding with your hands on the curved part of the handlebars for a long time may cramp the hands, shoulders, and neck.  Proper bicycle fit is probably the most important measure to prevent overuse injuries.

Take a bicycle safety course to learn safety skills and the proper use and maintenance of the bicycle. Ride with traffic, obey all signs, and give the right-of-way to cars.

Use common sense. Don't wear headphones as noises can be warning signals for your safety. Don't ride side by side with another cyclist. Storm drains, cattle guards, and railroad tracks can catch front tires and are slippery when wet.

Wear proper clothing and equipment. Wear brightly colored and reflective clothing at night. Use a front headlight and rear strobe-type light for night riding.  

And be sure to wear an ANSI or Snell approved helmet.

For more information about cycling injuries or to schedule an appointment with Dr. Hofer, please call Orthopaedic Specialists at (337) 494-4900.