September-November 2011: Cycling

Expert View

Christina Opava is a Professor of Physiotherapy at the Karolinska Institute, Stockholm, Sweden

Below is general advice for people with rheumatic and musculoskeletal diseases (RMDs), but individuals may have specific problems. Always check with your doctor or physiotherapist before you start a new form of exercise.

Cycling involves low impact and controlled movement in a stable position.  Because much of the weight of your body is taken by the bicycle there is less strain on your lower back and hips.  Cycling regularly at a moderate to high level will increase your heart rate and breathing, and is a good way to improve your cardio-vascular health and strengthen your legs.  With a calorie controlled diet, it can also help with weight loss.

If you’ve never ridden a bicycle before or are worried about your balance, you can use an indoor bike.  Most gyms will offer exercise bicycles, or you can find a wide range for home use.  Before buying a home exercise bicycle seek advice from your physiotherapist or a reputable dealer.  It is also possible rent home exercise bicycles.

Is it safe to cycle if you have problems with your knees?

The pain of arthritis in the knee can put people off exercising, but inactivity can lead to joint stiffness, muscle weakness, weight gain and fatigue.  Compared to some other forms of exercise, cycling is relatively knee-friendly and is often used in knee joint rehabilitation.  

It’s best to avoid hills if you have knee problems and to shift gears to as low as possible.

If you have had knee or hip replacement check with your doctor or physiotherapist before taking up any kind of exercise.

How can you avoid putting a stress on your upper back, neck, shoulders, elbows, wrists and hands?

Avoid racing style bicycles and choose an upright bike or, if your upper back, neck, shoulders, elbows, wrists and hands are affected, use a recumbent bike.  Many gyms will have recumbent bikes and you can also find road versions.

Does stretching help avoid stiffness after bicycling?

Warming up and stretching before and after going on a bike can help mobilise joints and prevent stiffness, especially in the neck, shoulders and back.  If you feel any of your joints straining when you’re cycling, take a break and do some gentle stretches.

How long should I cycle for when I start?

Start off slowly on flat ground and build up gradually.  Start with short rides until you feel comfortable and confident and gradually increase the distance and time you cycle for, depending on how you are doing.  Providing the cycling is not exacerbating your pain for long periods, you can start to build up the pace and length of your cycling sessions, until you reach a ‘maintenance level’.    If you stop cycling for a while start off slowly and build up again.

What should I do if pain is stopping me from exercising?

Many people with RMDs find that their pain is preventing them from taking up exercise.  Talk to your doctor about pain control that will make it easier for you to start exercising.  In many cases the need for extra pain control will wane over time if you are engaged in regular exercise.

Equipment

Choosing a bicycle

• Choose a bike that keeps you in an upright or recumbent position to minimise the strain on your neck, shoulders and wrists
• A tricycle is good for people who have not ridden a bike before and/or are concerned about balance
• A tandem offers a fun way to cycle with a friend or partner and can provide extra stability and pedal power!
• Motorised bicycles have an attached motor and transmission which can either power the vehicle unassisted, or to assist with pedaling
• A lightweight bike will be easier to handle and gears will help with hills
• Seek expert advice before investing in a bicycle

 Cycling clothes

• It is always advisable for outdoor cyclists to wear a strong, lightweight, well fitting helmet
• Properly padded gloves can help with grip and decrease the shock of riding over bumpy surfaces
• Padded cycling shorts can add extra comfort and protection

 Bicycle seat

• Make sure you choose a well fitting wide and well padded seat 
• You can buy seat covers such as gel or sheepskin to give extra comfort and protection for the spine and hips