THE RIGHT WAY TO CYCLE
Dr.Alan Cheung, Consultant Orthopaedic Surgeon and founder of the International Orthopaedic Clinic (IOC) and official Team Doctor for Singapore Cycling Federation events, reveals expert advise for a safe and problem-free cycling experience
What are the most common cyclingrelated injuries you attend to in Singapore?
As the team doctor of the Singapore Cycling Federation, the cycling injuries that I commonly see are ones resulting from repetitive overuse injuries or direct trauma. Common overuse injuries include neck and backache (‘slipped’ or prolapsed disc), hip pain (trochanteric bursitis), wrist pain and hand numbness (compression neuropathy), knee pain (patellofemoral syndrome, and foot pain (plantar fasciitis, achilles tendinosis). In Singapore’s hot and humid environment, I commonly encounter heat exhaustion and dehydration in my competitive athletes too.
Common traumatic injuries that I see as an orthopaedic surgeon include broken bones, especially of the collarbone, shoulder dislocations, rib fractures, lacerations, contusions, and concussion. For new cyclists, what common mistakes do they commit that usually results in an injury?
Common errors are not wearing a helmet and other protective equipment, riding a poorly set up bicycle, overestimating your fitness, and not allowing enough rest and recovery between rides. Underestimating the demands of a challenging trail can also result in injury from falls for mountain bikers. Whether a beginner or a seasoned cyclist, how should one prepare to ensure an injury-free cycling experience?
Wear the right protective equipment. Always use a well fitting helmet and consider gloves, padded shorts, and bright and reflective clothing.
Consider seeing an experienced bike fitter to adjust your bike set up if you are a new rider, returning to cycling with a new bike, or have old injuries. Bike size, seat height, handlebar reach, and cleat setup are major factors on whether you will experience neck, back, hip, knee, and foot pain after riding for some time. Choose your route and time of ride carefully — a ride without heavy traffic or excessive number of pedestrians is much more enjoyable.
Remember to use lights if you are cycling early or late in the day, and bring enough water to stay hydrated. Check your brakes and tyre pressure regularly, and see an orthopaedic surgeon or sports medicine doctor experienced with cycling if you do pick up any injuries. Does the choice of apparel/saddle/ shoes matter?
A modern cycling kit is designed to fit tightly and minimize drag caused by air friction. In a hot, humid environment like Singapore, most cycling apparel is lightweight and designed to wick sweat away from the skin quickly. A knitted material construction with good stretch, comfort, and fit is often used for the main body. Mesh is normally located in the side panelling and under the arms to further aid ventilation, as does the front zipper, which can vary in length. One very important area that should not be overlooked is the UV rating of the garment. Despite being lightweight, technical fabrics can still offer a high level of protection against harmful rays.
Saddle choice and set up can reduce risk of painful buttocks (due to sustained pressure of over the ischial tuberosities), ‘saddle sores’ (skin chafing), or even numbness of the groin and impotence due to compression of pelvic nerves (pudendal / cavernous nerves).
Meanwhile, a good cycling shoe can make a big difference in your comfort and performance, but should be based on a number of different factors like your style of riding, fit, and comfort. But if you are new to cycling, stick to normal shoes first. More experienced riders may use a dedicated cycling shoe that clips into the pedal as this generates more power and enables you to use more of your muscle groups — i.e. the hamstrings and gluteal muscles, instead of just relying on the quadriceps.
The type of riding you do (road, mountain, commuting) will influence your shoe choice. Best to go to a specialist cycling shoe shop rather than buy online. Is cycling an advisable form of exercise for people who have preexisting health conditions or those who recently had an operation?
This depends upon the pre-existing health condition and type of surgery. Always consult a medical professional before starting a new exercise program to assess whether you are medically ready to participate. Starting an exercise program that is more strenuous than you are ready for can result in injury and serious medical problems. That said, a supervised graduated exercise program involving cycling can be an excellent way to improve aerobic fitness, cardiovascular health, and general well-being, as well as reduce impact and pressure on joints compared to activities like running. Are there certain groups of people who should avoid cycling altogether?
Anyone with a pre-existing health condition such as heart disease, lung disease, osteoarthritis (worn out joints), or osteoporosis (fragile bones) should consult a medical professional to assess their suitability for a new exercise program. Perhaps they might not have to avoid cycling altogether, but should avoid cycling at a high intensity, and might benefit from seeing a physiotherapist should any musculoskeletal problems arise.
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