Sports Medicine Cycling FAQs with Matt Tinkey, Cycling Performance Specialist By Sports Medicine, September 5, 2015 Cycling is an incredibly popular form of exercise, especially since it torches calories and it’s much easier on your joints than running. Whether you’re into competitive racing or you’re a casual enthusiast, you may have questions that hold you back from performing at your best. To help address some common questions, we sat down with Matt Tinkey, MS, ATC, a certified athletic trainer with cycling performance services at UPMC Sports Medicine. 1. What do you do if you can’t ride a bike anymore? I used to bike all the time, till my legs got too weak to pedal — not good for a 64 yr. old woman with osteoporosis. There are a variety of different bicycle types available. For example, recumbents, adult tricycles, hand cycles, and pedal-forward designs that may fit your specific needs. If you’d like to talk more about some possible solutions, contact me at email@example.com. 2. When it comes to leg length discrepancies, how extreme does it need to be before you use a shim? And what are the best practices for measuring leg length? For measuring leg length, the gold standard is a standing x-ray. However, this may be cost-prohibitive, so we typically start with a cloth measuring tape. We’ll start at the hip and down the leg to the ankle bone for the true leg length. For the functional leg length, we’ll start at the belly button and go down to the ankle bone. If the discrepancy between the two measurements is more than 1 cm, we will correct with a plastic shim which is typically half of the discrepancy. 3. I’m a runner, and I was thinking of starting some cross-training on a bike. Are there any tips on how I can best warm up or cool down? Biking is an activity that you can typically warm up on the bike. I usually do 15-20 minutes of light to moderate pedaling, raising your heart rate and pace slightly as you go. At the end of 15-20 minutes, if you’re feeling any tightness, get off the bike and do some light static stretches to work out your hip flexor and hamstrings. For cool down, do the opposite and taper from high intensity to low. Focus on stretching any tight areas at this time, which may also include the chest and upper body. 4. I wondered if there’s any benefit to getting my bike tuned-up every year. Is it worth it? Yes absolutely! Having your bike in good working order will make your ride safe, enjoyable, and hopefully free from injury. 5. Barring a bike crash/falling off my bike, what can I do while riding to make sure I don’t get otherwise injured? The number one way to avoid an overuse injury while riding is to make sure you have the saddle (seat) adjusted to the proper height. This can help you avoid any injury or discomfort in the knees, hips, or ankles. Most quality bike shops can help you adjust the seat. If you can’t find one, UPMC Cycling Performance can help you get the right saddle adjustment. 6. I’ve heard cycling shoes can really improve your performance, is that true? Would you recommend investing in a pair or should I just look for a sturdy cross training shoe instead? It’s true that the right shoes can improve your performance! Research suggests that cyclists can be up 20 percent more efficient with a good pair of cycling shoes and clip-less pedals. So I would recommend looking for a good pair of shoes. In fact, now is a great time with end-of-season sales at bike shops. If you plan on getting on and off the bike frequently, then use a good pair of cross-trainers. 7. I just got a road bike and want to make sure all the measurements and settings are correct. How can I make sure of this? For starters, make sure you have the correct size bike. Before the purchase, go to a reputable bike shop and ask the sales staff for recommendations. After you are confident you have the correct size, get a professional bike fit. Our performance experts can give you a flexibility assessment, musculoskeletal screening, and knee angle measurement! 8. I’m an avid mountain biker but was considering getting into road cycling. What are some of the big differences I need to be aware of? Most mountain bikers changing to road biking will have difficulty with the narrower handle bars and the more aggressive positioning of the upper body. Another thing to be aware of is because the terrain is smoother, it’s much more critical to have the proper bike fit. Mountain biking is more forgiving since you are standing more and moving with the terrain. Also, it’s important to know that road biking can put more emphasis on an existing injury. If you need any additional information, we’d be happy to assist! 9. My friend just started bike commuting, and he (at first) didn’t want to wear a helmet. Can you give me some facts and stats to help me convince him? And if I lend him mine, is it better than nothing, even if it’s not especially fitted for him? Head injuries are the leading cause of mortality in cycling. Helmet technology and safety has really improved over the years, and there a few helmets on the market that are specially designed to protect both your head and brain. A properly fitted helmet is most certainly the preferred option, but if you can get him to wear yours until he buys his own, go for it! Today’s options for helmets look better, are lighter, and more cost-effective than ever before. Tell your friend to use his head and protect his head! Also, I recommend wearing sunglasses or protective eyewear while biking. 10. My hands go numb while cycling. Am I doing something wrong or is there anything I can do to prevent this other than shaking my hands every so often? Depending on the type of bike you have, there are many options – anything from gel handlebar tape to ergonomically designed grips. This can help decrease vibration and distribute pressure more evenly over a greater surface area. If this does not work, I would suggest seeing a bike fit specialist who can help with handlebar tilt or other mechanical issues to help alleviate pressure on the hands. 11. Any recommendations for keeping growing riders safe? As Pittsburgh implements more bike safe transit routes, teens and tweens can more actively and effectively use cycling as transportation. But, since they are still growing, are there are any “rules of thumb” from a bike fit perspective to help ensure their safety? From a bike fitting perspective, it is challenging because younger people grow quickly and getting them on a good fitting can be difficult. However, many bike shops in the Pittsburgh area have “grow with you” programs. Also, UPMC sponsors Team Citius, which is a youth program that helps teach youth be more safe on the roads. Have fun and be safe! 12. I was wondering, in addition to a properly fitted helmet, are there any other safety equipment must-haves? It’s important to be visible while riding on the road and to have basic repair skills like being able to change a flat. If riding off road, be sure to use gloves, safety glasses, and good shoes. And of course never bike without a helmet. 13. What are some exercises or areas I should target for strengthening if I want to get faster or better on the bike? In the 10 years I’ve been working with cyclists, I would say almost everyone needs to be mindful of the hip flexors, hamstrings, and core stability. This can help avoid injury and make you more powerful on the bike. 14. I last shopped for a bike about 15 years ago… going into a bike shop is a little overwhelming. With all the choices out there, I was wondering if you had any insight into a solid bike (type, model, etc.) for commuting to from the office. I agree, it can definitely be overwhelming. I would say do your research before you walk in. Check out the forums on BikePGH.org to help answer some questions. Ask some other commuters on how long it takes them to get to the office, because length of commute can impact the type of bike you’d be looking for. Assess your goals, expectations, and interest before you make your purchase, and be sure to talk to some experts who can point you in the right direction. Best of luck! 15. I find that as an Ironman distance athlete I get hot spots sometimes on the balls of my feet. I can’t pin down exactly what I may be doing to get them as its never a pattern. I have been fitted on my bike and feel very comfortable on it but every now and then I get hot spots/ numbing in my toes and it’s not a pattern. Do you have any tips? Feet are sometimes the most difficult body part to fit properly due to the number of variables, such as cleat position, shoe type, and how the shoe fits. The first thing I would try is to slide the cleat slightly (1mm) toward the heel, go for a ride and observe what happens. Keep notes on how you feel, and see if it gets any better. I specialize in cleat consults, so feel free to shoot me an email at firstname.lastname@example.org and we can talk more! 16. Any cross training suggestions to help increase endurance while mountain biking? Especially on those long, extended climbs? For mountain bike endurance, road riding would be my suggestion. Get out there and put in some miles on the road. It can help build stamina and can really help gauge your power output more accurately due to fewer obstacles and less resistance. 17. What are some of the more common cycling injuries I should be aware of? The knees and lower backs are the most common complaints I have heard over the past 10 years. Most of these issues can easily be corrected or alleviated with simple adjustments of your position on the bike. 18. I’d like to get started in competitive cycling. Any advice for a beginner? Jump right in! In my experience the racing community is very welcoming to new racers and most are willing to answer questions and concerns. Number one rule of racing is to have fun! For more information, visit the Cycling Performance section of the UPMC Sports Medicine website.