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Non-Traumatic Bicycle Injuries

A Review of the Literature

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Abstract

Bicycle riding is a popular form of recreation, fitness and transportation in many areas of the world. Traumatic injuries associated with bicycle riding have been documented and intervention strategies have been successful. This has not been the case for non-traumatic injuries. The prevalence of non-traumatic bicycle injuries can be as high as 85%. The most common sites for non-traumatic cycling-related injuries include the knee, neck/shoulder, hands, buttock and perineum. Two categories of injuries that may have the greatest impact on disability include ulnar and median nerve palsy, and erectile dysfunction. Injury prevention strategies have been proposed to reduce non-traumatic injuries but these strategies remain untested.

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References

  1. Paffenbarger RJ, Hyde R, Wing A, et al. Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med 1986; 314: 605–613

    Article  PubMed  Google Scholar 

  2. Paffenbarger RJ, Lee I. Physical activity and fitness for health and longevity. Res Q Exerc Sport 1996; 67 (3 Suppl.): S11–S28

    PubMed  Google Scholar 

  3. Siscovick D, LaPorte R, Newman J. The disease-specific benefits and risks of physical activity and exercise. Public Health Rep 1985; 100: 180–188

    PubMed  CAS  Google Scholar 

  4. Wenger H, Bell G. The interactions of intensity, frequency and duration of exercise training in altering cardiorespiratory fitness. Sports Med 1986; 3: 346–356

    Article  PubMed  CAS  Google Scholar 

  5. Tucci JJ, Barone JE. A study of urban bicycling accidents. Am J Sports Med 1988; 16: 181–184

    Article  PubMed  CAS  Google Scholar 

  6. Tinsworth DK, Polen C, Cassidy S. Bicycle-related injuries: injury, hazard, and risk patterns. Washington, DC: US Consumer Product Safety Commission, 1994 Jun

    Google Scholar 

  7. Baker S, Li G, Fowler C, et al. Injuries to bicyclists. Baltimore (MD): Johns Hopkins University Injury Prevention Center, 1993

    Google Scholar 

  8. Rivera FP, Thompson DC, Patterson MQ, et al. Prevention of bicycle-related injuries: helmets, education, and legislation. Annu Rev Public Health 1998; 19: 293–318

    Article  Google Scholar 

  9. Thompson DC, Rivara FP, Thompson RS. Effectiveness of bicycle helmets in preventing head injuries: a case-control study. JAMA 1996; 276: 1968–1973

    Article  PubMed  CAS  Google Scholar 

  10. Thompson DC, Nunn ME, Thompson RS. Effectiveness of bicycle safety helmets in preventing serious facial injury. JAMA 1996; 276: 1974–1975

    Article  PubMed  CAS  Google Scholar 

  11. Cohen G. Cycling injuries. Can Fam Physician 1993; 39: 628–632

    PubMed  CAS  Google Scholar 

  12. Hoyt CS. Ulnar neuropathy in bicycle riders. Arch Neurol 1976 May; 33: 372

    Article  PubMed  CAS  Google Scholar 

  13. Kulund DN, Brubaker CE. Injuries in the bikecentennial tour. Phys Sportsmed 1978; 6: 74–78

    Google Scholar 

  14. Weiss BD. Nontraumatic injuries in amateur long distance bicyclists. Am J Sports Med 1985; 13 (3): 187–192

    Article  PubMed  CAS  Google Scholar 

  15. Wilber CA, Holland GJ, Madison RE, et al. An epidemiological analysis of overuse injuries among recreational cyclists. Int J Sports Med 1995; 16 (3): 201–206

    Article  PubMed  CAS  Google Scholar 

  16. Dannenberg AL, Needle S, Mullady D, et al. Predictors of injury among 1638 riders in a recreational long-distance bicycle tour: cycle across Maryland. Am J Sports Med 1996; 24 (6): 747–753

    Article  PubMed  CAS  Google Scholar 

  17. Andersen KV, Bovim G. Impotence and nerve entrapment in long distance amateur cyclists. Acta Neurol Scand 1997; 95: 233–240

    Article  PubMed  CAS  Google Scholar 

  18. Salai M, Brosh T, Blankstein A, et al. Effect of changing the saddle angle on the incidence of low back pain in recreational bicyclists. Br J Sports Med 1999; 33 (6): 398–400

    Article  PubMed  CAS  Google Scholar 

  19. Sommer F, Konig D, Graft C, et al. Impotence and genital numbness in cyclists. Int J Sports Med 2001; 22 (6): 410–413

    Article  PubMed  CAS  Google Scholar 

  20. Patterson JM, Jaggars MM, Boyer MI, et al. Ulnar and median nerve palsy in long-distance cyclists: a prospective study. Am J Sports Med 2003; 31 (4): 585–589

    PubMed  Google Scholar 

  21. Dettori JR, Koepsell TD, Cummings P, et al. Erectile dysfunction after a long-distance cycling event: associations with bicycle characteristics. J Urol 2004; 172 (2): 637–641

    Article  PubMed  Google Scholar 

  22. Taylor III JA, Kao TC, Albertsen PC, et al. Bicycle riding and its relationship to the development of erectile dysfunction. J Urol 2004; 172 (3): 1028–1031

    Article  PubMed  Google Scholar 

  23. Simpson ET. A case of multiple neuritis due to a long bicycle ride. N Y Med J 1895; 672: 757

    Google Scholar 

  24. Capitani D, Beer S. Handlebar palsy: a compression syndrome of the deep terminal (motor) branch of the ulnar nerve in biking. J Neurol 2002; 249 (10): 1441–1445

    Article  PubMed  Google Scholar 

  25. Maimaris C, Zadeh HG. Ulnar nerve compression in the cyclist’s hand: two case reports and review of the literature. Br J Sports Med 1990; 24 (4): 245–246

    Article  PubMed  CAS  Google Scholar 

  26. Noth J, Dietz V, Mauritz KH. Cyclist’s palsy: neurological and EMG study in 4 cases with distal ulnar lesions. J Neurol Sci 1980; 47: 111–116

    Article  PubMed  CAS  Google Scholar 

  27. Hankey GJ, Gubbay SS. Compressive mononeuropathy of the deep palmar branch of the ulnar nerve in cyclists. J Neurol Neurosurg Psychiatry 1988; 51: 1588–1590

    Article  PubMed  CAS  Google Scholar 

  28. Eckman PB, Perlstein G, Altrocchi PH. Ulnar neuropathy in bicycle riders. Arch Neurol 1975; 32: 130–131

    Article  PubMed  CAS  Google Scholar 

  29. Brandsma JW. Manual muscle strength testing and dynamometry for bilateral ulnar neuropraxia in a surgeon. J Hand Ther 1995; 8: 191–194

    Article  PubMed  CAS  Google Scholar 

  30. Richmond DR. Handlebar problems in bicycling. Clin Sports Med 1994; 13 (1): 165–173

    PubMed  CAS  Google Scholar 

  31. Weiss BD. Clinical syndromes associated with bicycle seats. Clin Sports Med 1994; 13 (1): 175–186

    PubMed  CAS  Google Scholar 

  32. Goodson JD. Pudendal neuritis from biking [letter]. N Engl J Med 1981; 292: 702

    Google Scholar 

  33. Desai KM, Gingell JC. Hazards of long distance cycling. BMJ 1989; 298: 1072–1073

    Article  PubMed  CAS  Google Scholar 

  34. Solomon S, Cappa KG. Impotence and bicycling: a seldom-reported connection. Postgrad Med 1987; 81: 99–100

    PubMed  CAS  Google Scholar 

  35. Oberpenning F, Roth S, Leusmann DB, et al. The Alcock syndrome: temporary penile insensitivity due to compression of the pudendal nerve within the Alcock canal. J Urol 1994; 151 (2): 423–425

    PubMed  CAS  Google Scholar 

  36. Ricchiuti VS, Haas CA, Seftel AD, et al. Pudendal nerve injury associated with avid bicycling. J Urol 1999; 162 (6): 2099–2100

    Article  PubMed  CAS  Google Scholar 

  37. Bohlmann TJ. Injuries in competitive cycling. Phys Sportsmed 1981; 9 (5): 117–124

    Google Scholar 

  38. Gregor RJ, Wheeler JB. Biomechanical factors associated with shoe/pedal interfaces: implications for injury. Sports Med 1994; 17 (2): 117–131

    Article  PubMed  CAS  Google Scholar 

  39. Holmes JC. Lower extremity overuse in bicycling. Clin Sports Med 1994; 13 (1): 187–203

    PubMed  CAS  Google Scholar 

  40. Farrell KC, Reisinger KD, Tillman MD. Force and repetition in cycling: possible implications for iliotibial band friction syndrome. Knee 2003; 10 (1): 103–109

    Article  PubMed  Google Scholar 

  41. Mellion MB. Neck and back pain in bicycling. Clin Sports Med 1994; 13 (1): 137–164

    PubMed  CAS  Google Scholar 

  42. Mellion MB. Common cycling injuries: management and prevention. Sports Med 1991; 11 (1): 52–70

    Article  PubMed  CAS  Google Scholar 

  43. Schwarzer U, Sommer F, Klotz T, et al. Cycling and penile oxygen pressure: the type of saddle matters. Eur Urol 2002; 41 (2): 139–143

    Article  PubMed  Google Scholar 

  44. Jeong SJ, Park K, Moon JD, et al. Bicycle saddle shape affects penile blood flow. Int J Impot Res 2002; 14 (6): 513–517

    Article  PubMed  Google Scholar 

  45. Dickson TBJ. Preventing overuse cycling injuries. Phys Sportsmed 1985; 13 (10): 116–123

    Google Scholar 

  46. Sommer F, Schwarzer U, Klotz T, et al. Erectile dysfunction in cyclists: is there any difference in penile blood flow during cycling in an upright versus a reclining position? Eur Urol 2001; 39 (6): 720–723

    Article  PubMed  CAS  Google Scholar 

  47. Braithwaite IJ. Bilateral median nerve palsy in a cyclist. Br J Sports Med 1992; 26 (1): 260–261

    Article  Google Scholar 

  48. Weiss BD. Skin creams for alleviating seat pain in amateur long-distance bicyclists. Sports Med Train Rehabil 1993; 4: 27–32

    Article  Google Scholar 

  49. Andersson K, Wagner G. Physiology of penile erection. Physiol Rev 1995; 75: 191–236

    PubMed  CAS  Google Scholar 

  50. Sheets BS. Considerations in cycling for persons with low back pain. In: Hochschuler SH, editor. Spine: state of the art review — spinal injuries in sports. Philadelphia (PA): Hanley and Belfus, 1990: 359–365

    Google Scholar 

  51. Rodgers GB. Part II. Bicycle and bicycle helmet use patterns in the united states: a description and analysis of national survey data. Washington, DC: US Consumer Product Safety Commission, 1992 [online]. Available from URL: http://www.cpsc.gov/CPSCPUB/PUBS/344.pdf [Accessed 2005 Apr 14]

    Google Scholar 

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No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this manuscript.

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Correspondence to Nathan J. Dettori.

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Dettori, N.J., Norvell, D.C. Non-Traumatic Bicycle Injuries. Sports Med 36, 7–18 (2006). https://doi.org/10.2165/00007256-200636010-00002

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