galena-juniors2Cycling is for everyone.  From a little one on a push-bike, to recreational cyclists, commuters, BMX tricksters, racers, randonneurs and touring cyclists, triathletes, recumbent-riders, those who ride on roads, dirt, and gravel, to Robert Marchand, 102 year-old French track cyclist who beat his own hour record in 2014.  An enormous range of personal preferences, injuries, and disabilities can be accommodated with relatively simple modifications in equipment and position.

Cycling and Aging

galena-juniorsLike it or not, we’re all human, and as we age, a lifetime of fighting gravity and walking on two feet puts some wear and tear on our bodies.  Based on a number of complex factors, including activity, genetics, medical comorbidities, we develop a variety of so-called “degenerative” changes.

I know.  I said “degenerative.”  But don’t panic!  You’re not falling apart!

Osteoarthritis develops over time, commonly in the knee and hip, and is influenced by genetics as well as a history of trauma.  It tends to flare with increased load through the joint, particularly impact activity, and improves with strengthening and balancing the muscles supporting the joint.  Strengthening the surrounding muscles reduces the forces transmitted directly through the joint itself.   Thanks to the low-impact nature of cycling, it can serve as both a component of rehabilitation, as well as an activity for fitness and recreation for adults with arthritis.  With regard to hip and knee replacement (arthroplasty), bicycling on level surfaces is one of the few activities nearly universally recommended by arthroplasty surgeons after total hip or knee replacement (Swanson, 2009).

ccc-mastersThe general health benefits of cycling have also been clearly established by research. A recent meta-analysis by Oja et al reported a consistent positive dose–response relationship between the amount of cycling and health outcomes, including increased fitness, and decreased risk of all-cause mortality, cardiovascular disease and colon cancer morbidity.  Decreased incidence of obesity was also seen with increased amount of daily cycling (Oja et al, 2011).

Cycling and the Spine

supercrit-sarahIt is clear that back pain is prevalent in the US today and is reponsible for a large proportion of doctor’s visits.  Back pain in athletes can be debilitating and severely impact both performance and enjoyment of sport, as well as altering mechanics and contributing to additional injuries and discomfort.  Degenerative disc disease, disc-mediated pain, lumbar spondylosis or arthritis, and other flexion-induced low back pain may pose a significant challenge to cycling during an acute flare.  However, with appropriate treatment (which may include a directional preference assessment or “mechanical diagnosis and treatment”, a core-strength training program, with a gradual return to flexion based on symptoms), as well as a proper bike fit and training regimen, these types of conditions should by no means end a cycling career.  A cyclist may benefit from some time off the bike, but will almost certainly return to riding once the pain subsides.  These conditions can be very painful, but are thankfully rarely dangerous, and very treatable.

Cycling and Pain

galena-men-rainThe scientific literature has clearly shown the benefits of exercise in the treatment of pain.  Exercise has been found to induce pain relief (analgesia) through the release of β-endorphins from the pituitary and hypothalamus, which activate opioid receptors (Nijs et al, 2012 ). That’s right, when we exercise, our body produces substances similar to narcotics!  Bedrest, for the most part, has fallen by the wayside in the treatment of most musculoskeletal and spine injury. However, depending on the injury, one may need to adjust their training regimen and bike fit to accommodate their current situation.

Cycling and Disability

Because cycling is dependent on a fairly straightforward machine, cranks and wheels, it is easily modifiable to accommodate a number of disabilities.

There are numerous styles of bicycle to accommodate limited range of motion in the hips, knees, and spine.  Amputees (both upper and lower extremity) can cycle with or without a prosthesis, with training in balance and stability.  People with impaired balance may use a three-wheeled bicycle or recumbent trike.  Those with lower body motor deficits can achieve a similar workout and sense of freedom using a handcycle.

Conclusion

Bicycling has benefits across all age groups, and many aspects of health, from fitness, to coordination, pain control, strength, mood, and sleep.  So go ride your bike.

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References:

  1. Johan de Hartog J, Boogaard H, Nijland H, Hoek G.  Do the health benefits of cycling outweigh the risks? Environ Health Perspect. 2010 Aug;118(8):1109-16.
  2. Nijs J, Kosek E, Van Oosterwijck J, Meeus M. Dysfunctional endogenous analgesia during exercise in patients with chronic pain: to exercise or not to exercise?  Pain Physician. 2012 Jul;15(3 Suppl):ES205-13.
  3. Oja P, Titze S, Bauman A, de Geus B, Krenn P, Reger-Nash B, Kohlberger T.  Health benefits of cycling: a systematic review. Scand J Med Sci Sports. 2011 Aug;21(4):496-509.
  4. Swanson EA, Schmalzried TP, Dorey FJ. Activity recommendations after total hip and knee arthroplasty: a survey of the American Association for Hip and Knee Surgeons. J Arthroplasty. 2009 Sep;24(6 Suppl):120-6.

All photos by Rick LaCour.