Written by Mary E. Gilmer, M.D. of OrthoAlabama Spine & Sports
The wind blowing your hair, the scenery and the freedom are all reasons to ride your bike during spring in Alabama. With so many different options for riding — road, mountain, gravel, BMX — all in our backyard, what are some of the problems that we see in orthopedics that prevent people from enjoying their ride to the fullest?
Why does my hind end hurt?
As we know, riding a bike involves sitting on the seat (called the saddle). The “sit bones” (aka ischial tuberosity) are the bottom part of the pelvis. The distance between the sit bones is different for different people. One of the most important things for comfort is having a saddle with the right width. The local bike shop has a tool that can be used to determine what saddle size you need. Gender-specific saddles are also very helpful to relieve pressure on the soft tissues. Another very helpful option is getting padded bike shorts.
For more advanced riders who put in hard efforts like racing or long-distance rides (and who have optimized their bike and gear), we can see hamstring tendinitis causing pain in the sit bone region. The tendons actually attach to the bone in that area. Tendinitis usually becomes an issue with heavy increases in training and racing when the body does not have adequate recovery time. Our teens who are racing (Alabama Cycling Association series, for example) are prone to tight hamstrings as they grow, which can cause sit bone pain or can cause problem number two.
Why does my back hurt?
For the average rider who does not have back pain at other times, the problem comes from two things — weak core muscles and tight leg muscles. When you are riding a bike, your hands are for controlling the handlebars, not holding yourself up. However, when the core muscles (abs, back and hips) are weak, the arms have to work harder. As the body gets tired (arms and core), the muscles start to ache from fatigue.
The long-term solution is stretching and strengthening. A physical therapist can be very helpful in creating a good plan to address the pain. The short-term solution (and part of the long-term as well) is to make sure your bike fits your body and the range of motion that you have today. Most bike shops can help adjust the bike to fit you better, which sometimes requires new parts but is worth it for improved comfort. There are also professional bike fitters here in Birmingham, and this is a very good investment for riders at any age who are looking to increase their training or start racing.
Why do my hands hurt?
Well, the same reasons your back does. Your core is not strong, and you are using your hands to prop you up. This pressure can cause pain and sometimes numbness from irritation of the carpal tunnel. If you already have some carpal tunnel symptoms, like waking up with numb hands or having tingling when driving, there are a few ways to help decrease the pressure on the nerve. Some gloves have padding in the palm that creates a channel of no pressure over the carpal tunnel, and many different brands have these options. There are also different grips that can go on the handlebar. Some are broad with a flat surface that can help spread the pressure over more of the hand, while some are softer and just bigger to do the same thing. Finding the best option can require a little bit of trial and error.
If the numbness is persistent or interfering with normal activities off the bike as well, this does need to be evaluated by an orthopedist, as carpal tunnel can lead to permanent loss of sensation and strength if untreated.
If you are looking to try cycling, there are so many options. There are beginner mountain bike rides on Saturdays at Oak Mountain State Park, and if you are in middle or high school, the Alabama Cycling Association season will start back up in the fall. Cycling clubs like the Birmingham Bicycle Club organize road rides throughout the year. Supported rides like Bo Bikes Bama and the BBC Century offer well-marked routes and snacks along the way. Then there is racing. The Alabama Cycling Association offers six spring races to its athletes. Birmingham Urban Mountain Pedalers, BUMP, puts on Bump N’ Grind, a weekend of mountain bike races at Oak Mountain every June. For road racing, we have the Cheaha Challenge, which is actually a world Gran Fondo qualifying event (long, long road rides).
Spring is the perfect time to try something new, from riding a bike to bike racing. Don’t let nagging aches and pains hold you back!