Safe summer cycling: how to avoid common injuries
When we think of summer, visions of health-giving and life-affirming physical activities spring to mind for many of us, and for me that is cycling. As we prepare for an active summer, it is important to ensure our activities do not cause injuries that will hamper our future efforts at gaining and maintaining good health. Cycling safety is more than wearing bright clothing to ensure motorists can see you on the road. As a medical massage therapist I have treated many patients who have had avoidable cycling injuries. With this in mind, I decided to pull out my trusty old commuting bicycle and hit the road, but first I wanted to have an expert check out the fit so I could feel confident I wasn’t unknowingly doing unnecessary damage to my body.
I called Dr. Jeffrey Guindon of Kaufman Chiropractic in Bothell and asked him a few questions. He said the most common, and also avoidable, repetitive stress cycling injuries are:
Hand and Wrist pain including carpal tunnel syndrome
Thoracic outlet syndrome
Ulnar Neuropathy aka “Handlebar Palsy” Numbness, tingling, pain in the hands, and arms
Low Back pain (often caused by a shortened psoas muscle)
My Bike Fit Story
Some of my patients told me about how their time with Dr. Guindon’s Bike Fit training had helped out with recurring cycling pain, so I made an appointment to see Dr. Guindon at Kaufman Chiropractic. Honestly, as enthusiastic as I was, I also was a bit skeptical that I would be able to learn anything new regarding cycling, as I have been riding long distances for 33 years.
I met Dr. Guindon in the physical rehabilitation facility at his clinic for a lunchtime fitting. He told me it would take at least an hour. After he hooked my bike up to a trainer so I could pedal statically, I got on and he immediately started shaking his head. “He said your bike frame is too small for your human frame.” I said “No, I have been riding this bike for almost 20 years and have put many thousands of miles on it. He took some video and a few photos and showed them to me and asked if I had low back discomfort, neck pain, hand pain, and knee pain after longer rides. I confessed to the discomfort and after looking at the video and photos I had to admit that my old bike and my body simply did not fit together. I had never seen a picture of myself on this bike, and found it was more than a little embarrassing, especially considering I am a lifelong student of human geometry. It made me wonder what other things I might learn from this experience. Dr. Guindon convinced me to purchase a bike that fit well and would give us a better starting point. So, over the next week I looked at a few bikes and found one that I took to his clinic for an approval. We set up another lunchtime appointment for a fitting.
The second appointment was extremely enlightening. I thought it would mainly consist of seat and handlebar height and forward/aft adjustments – of which there were many. I did not expect him to pull out and aim laser plumb lines at my feet and knees.
After observing me pedal for a few seconds, my knees were obviously wiggling too much and he commented, “your pelvis is broad and you are reaching in towards the frame for the pedals. Let’s try putting a pedal extender on one side and see if you notice a difference.”
He put a 20 millimeter pedal extender on my right pedal. When I started pedaling I could not suppress the smile and exclaimed “Wow! I didn’t realize there had been fatigue and discomfort in my right knee until it was gone!” My right knee was now centered over my foot throughout the entire revolution and my left knee still angled out sharply at the top of the stroke with that familiar, (what I used to think of as normal), discomfort approaching a mild pain. It struck me that I had been doing unnecessary damage to my knees for decades and I had curtailed rides due to what I thought of as normal pains from riding. After putting the pedal extender on my left pedal as well, my knees were both aligned and felt great. I was sold on the whole Bike Fit protocol.
There were other adjustments to be made with the feet and ankles. Clip-in pedal(AKA clipless pedals) adjustments, including wedges, to adjust to foot supination/pronation (the roll of the foot medially or laterally), and inversion/eversion (foot twist at the ankle medially or laterally). I could not wait to get home and go for a ride. That evening I went on a 6 mile sprint and can honestly say that, with the proper knee alignment, after the ride my knees felt better than before. My knees actually felt strong for the first time in decades. I believe the medial/lateral muscle balance of my legs, especially around my knees, had improved from the intense ride with perfect knee/pedal alignment and resulted in my knee alignment off the bike being improved as well.
I highly recommend Dr. Guindon for Bike Fit fittings to all of my patients that are avid riders or are preparing to climb back on their bikes after a period of not riding. With the best fit anyone can ride his or her bicycle into summer fun and fitness without unnecessary pain or repetitive stress injuries. If you are going to do a serious amount of cycling, a professional bicycle fitting is one of the best investments you can make, and according to Dr. Guindon, some health insurance companies will cover the cost.
If you live in the Seattle or Eastside area and wish to make an appointment with Dr. Guindon for a fitting you can contact him at (425) 486-1122, or through the Kaufman Chiropractic website: http://www.kaufmanchiropractic.com/