Using the right gear, such as a helmet, proper shoes and bicycle lights, can prevent accidents.

Cyclists are among the most vulnerable road users.

Hence, even if you are just cycling to the neighbourhood shop, put on your helmet and other protective gear, said Dr Teo Li Tserng, a consultant trauma surgeon at Tan Tock Seng Hospital (TTSH).

Many recreational cyclists do not take road safety seriously, which is why, in the last three years, the hospital has seen more than 150 cases of serious cycling injuries requiring hospitalisation.

Victims include not just those in their 20s to 40s, but also those in their 50s to 70s.

About one in eight cyclists die, mostly from head injuries.

About a month ago, the organised a public forum on how to ride safely on the roads to avoid injuries caused by accidents.

In the first six months of the year, at least 12 people have died and 170 injured in accidents involving cyclists. Aside from traumatic injuries, the forum also covered injuries which can result from the act of riding itself.

TTSH also sees about 60 non-traumatic injuries relating to cycling every year, said Dr Lim Mui Hong, an orthopaedic surgeon, who spoke at the forum.

The doctors give tips on how to cycle safely to avoid injuries.

Wear a Helmet

The safety helmet absorbs some of the impact from a crash and reduces the chance of severe head injuries.

Make sure you wear the helmet correctly. It should be so snug that you would not be able to stick a finger inside it.

The helmet should cover the top of the forehead, without tilting forward or backward.

The side straps should form a V shape under each ear and the chin strap should be fastened below the chin and not to the side.

Wear Fitted Clothes and Protective Gear

Wear clothes that hug the body. Loose sleeves can get caught by the handlebars, while long pants can get caught by the pedals and cause you to lose your balance. Protective gear such as gloves and elbow and knee guards can help prevent serious injuries should a crash occur.

Use Bicycle Lights

Put bicycle lights (below) on your helmet or fix them at the front and rear of your bicycle to make yourself more visible. Do so even in the day.

Wear Proper Shoes

Wear sports sandals, shoes or cleats (clipless cycling shoes which provide a firm grip). Avoid flip-flops or sandals with no back straps as they can get caught in the pedals.

Traumatic Injuries

Head injuries are by far the most common type of cycling-related traumatic injuries, followed by limb injuries. Of the two, head injuries tend to be more serious. They can cause the brain to bleed or swell, which can lead rapidly to death.

Non-Traumatic Injuries

The act of cycling causes repetitive stress to the major joints of the body, including the hip, knee and ankle joints.

The majority of injuries are seen in the back, neck and knees.

To avoid injury and to make cycling more efficient, the correct bike set-up is of utmost importance. As there are many variables in the technical aspects of bike fitting, it is best to consult a trained bike technician.

Neck, Shoulder and Back Pain

These tend to occur because of the prolonged and sustained posture during cycling, especially when the cyclist keeps his body low and close to the bike.

As he needs to hyper-extend his neck and look forward while cycling, this creates stress to the neck, shoulders and back.
Tips: Adjust the handlebar nearer towards the cyclist or bring the saddle forward. Sit in a more upright position.

Arm, Hand and Wrist Pain

Gripping the handlebar too tightly and placing too much body weight on the upper limbs can compress the two main nerves in the hands and arms – the median nerve in the carpal tunnel and the ulnar nerve at the outer wrist, and lead to pain and numbness.

Tips: To avoid the arms having to support too much weight, raise the handlebar or shorten the bike stem, which connects the handlebar to the bike. Wear padded gloves and fit the handlebars of the bike with extra padding.

Pain Knee

Cycling can cause knee pain at three main areas: the front of the knee, below the knee cap and at the outer part of the knee.

Front of the knee

Pain at the front of the knee is usually due to chondromalacia patella, or CMP. This occurs due to deep flexion or bending at the knee, whic causes an increase in contact pressure between the patella (knee cap) and femur (thigh bone). This results in excessive loading and damage of the cartilage, which in turn causes pain and swelling of the knee.

The saddle (seat of the bike) may be too low or far forward. Or the gear combination is not optimal so the cyclist has to exert a greater force during pedalling.

Tips: Elevate the saddle height to avoid deep flexion during the upstroke of cycling. Avoid cycling uphill. Choose a gear combination that requires less effort during pedalling.

Below the knee cap

Pain below the knee is usually due to patella tendinitis, or pain in the tendon below the knee cap. This may occur because the saddle is too high or the gear combination is sub-optimal and requires more effort to be exerted.

Tips: Lower the saddle and choose a gear combination that allows peddling to be done with less effort.

At the outer part of the knee

Pain in the outer part of the knee, where the iliotibial band is, is usually due to the inflammation of the band. The iliotibial band is a superficial thickening of the tissue at the outer knee. Iliotibial band syndrome, or IBS, often occurs because of the friction between the band and the thigh bone.

Tips: Adjust the saddle lower or forward. Or if the cyclist is wearing cleats, adjust the cleat closer to the inner side of the shoes.

Safe Cycling Habits

  • Slow down at traffic junctions and pedestrian crossings such as zebra crossings. If you want to use a pedestrian crossing or cross at a traffic light, get down and push your bicycle across.
  • When riding in a group, ride in tandem, one behind the other.
  • Do not ride side by side and occupy the entire road and obstruct traffic.
  • Avoid weaving in and out among vehicles. Always ride on the left side of the road.
  • Keep a distance of at least 1.5m away from other cyclists or road users in front and behind you.

10/31/2012Lea Wee (The Straits Times's Mind Your Body)

Category: Trauma Education