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Cycling Q&A With Our Experts
Group Health doctors, physical therapists, and other experts answer questions about health-related cycling issues.
Q: If I'm on a week-long bike trip, a severe rash develops on my inner thighs. It usually goes away a couple of days after the ride. I have tried skin lubricants (Vaseline, Bag Balm, etc.) with marginal success. The rash is less severe if I wear loose shorts, but I prefer tight-fitting bike shorts. What else can I do?
A: There isn't a simple answer. Your rash could represent many different things, such as mild irritant dermatitis, mechanical folliculitis (rubbing of hair follicles), or a variety of bacterial or fungal infections. All these have different therapies.
Generally speaking, it's a good idea to wash bicycling shorts after each use and to use a powder that will help with perspiration and prevent irritation. For example, Zeasorb powder that has some antifungal properties and is available over the counter.
If the rash is caused by mechanical folliculitis, laser removal of the hair follicles probably would solve the problem. However, you need to see a doctor for diagnosis and treatment recommendations.
Q: I'm trying to ride longer and faster but after two hours, I feel like I hit the wall. How can I prevent this?
A: After about two hours of riding, your muscles will run out of energy unless you continue to replenish the carbohydrate stores — the energy — in your system necessary for continuous activity.
To avoid hitting this wall, begin eating small amounts of easily digested carbohydrate about 30 minutes into a long ride and snack every 20 to 30 minutes.
Foods such as energy bars, fig bars, bananas, and bagels are great for cycling. Avoid high-fat foods that take a long time to digest, and avoid eating too much at one time. It's best to eat small amounts of carbohydrate frequently to prevent stomach discomfort. You should experiment with snacks during your training rides until you find what works best for you.
Q: When I ride for several hours, my hands get really sore, even when I change position. What can I do?
A: There are several things you can do to alleviate soreness in your hands. Wearing high-quality, padded cycling gloves can help immensely. Some even have gel inserts for comfort. And don't spare the cost — staying comfortable while riding is essential.
Riding "in the drops" — on the dropped part of the handlebars — may also help. Also try using padded tape for the handlebars and loosening your grip.
Q: If I have some aches or soreness after riding, can I use an over-the-counter pain reliever or anti-inflammatory? When should I take it: before riding to eliminate aches or afterwards to relieve soreness?
A: Taking over-the-counter anti-inflammatory medication such as aspirin, ibuprofen (Advil), or naproxen (Aleve) for prevention of aches can be effective if the bike ride is less than 4 to 6 hours. The effect of these medications usually lasts about 4 to 6 hours, so if the ride is longer, the dosing would need to be repeated.
In addition, these typically work very well after the soreness has developed. However, it may take up to 30 minutes for the full effect of these medications to work.
Acetaminophen (Tylenol) is not an anti-inflammatory agent, so it is not recommended for these types of aches and pains.
Q: Several years ago, I quit running because of back problems with a herniated disc. The severe pain went away when I switched to cycling. Is this a good alternative for me?
A: Bicycling is considered much less stressful to the back than the repeated impact from running. However, there are other issues to consider besides impact when you get ready to exercise after a herniated disk.
Flexion types of activity — such as riding a road bike in a forward leaning position — can increase the pressure on the disks, causing potential reinjury to a previously herniated disk. Instead, try a mountain bike which puts you in a more upright posture and may allow the disk to heal more completely.
If you use a road bike, purchase an adjustable stem and set it so that the handlebars are more upright. You sacrifice some of the aerodynamics, but increase your comfort and decrease strain on the back.
Hamstrings, quadriceps, and iliopsoas (deep hip flexor) muscles all need to be stretched regularly to prevent muscle imbalances from developing. Muscle imbalances cause restricted motion to the pelvis and low back.
Change positions frequently as you ride. Use the end bars to switch hand positions and reduce stress to the back muscles. When you first start to cycle after such an injury, use easy gearing and avoid steep hills that strain the leg and back muscles.
Bicycling is not a complete exercise for spinal health. Flexing and extending exercises, along with a few specific corrective exercises for each individual, may be necessary to complete the healing process. Talk with a physical therapist for more information about these exercises.
Q: I ride my bike for exercise. Do I still need to weight train?
A: While biking is a good way to get both an aerobic workout and an excellent lower body strength-training workout, a well-rounded physical activity plan will include both aerobic activity and resistance (weight) training. Biking will help strengthen your heart and lungs and increase circulation, while resistance training helps build muscle.
Doing some basic upper body resistance training two to three times a week combined with cycling will give you with a complete physical activity regimen. And resistance training helps strengthen your muscles, which will allow you to ride more effectively — that is, faster and longer.
Q: I just had surgery for a torn meniscus. How soon can I get back to cycling? Should I be extra cautious about anything once I'm back on the bike?
A: A stationary bike can be used within a few days after surgery for torn meniscus. Initially, the stationary bike may be used just to get back the range of motion in the knee. Pedaling back and forth with partial turns is a good way to begin to stretch the knee. Once you have good range of motion in the knee and the swelling is down, start building endurance and strength with easy pedaling — light resistance on a stationary bike or low gearing on a road or mountain bike.
Do your initial bicycling on a relatively level terrain. Be sure to stretch the quadriceps, hamstrings, and calf muscles to prevent any muscle imbalances from developing as you progress.
Seat height adjustment is crucial. To do a quick check for proper seat height, place the pedal in its most downward position. With the heel of your foot on the pedal, the knee should be close to straight, with just a slight bend. Be sure to use the back of the seat for good support of your back at all times.
Q: My wife and I ride every weekend, usually 40 to 50 miles. I'm in pretty good shape and exercise regularly, but I recently had a heart attack. How long should I wait before I start cycling?
A: All heart attacks are "not created equal." You should talk with your cardiologist, who knows your personal medical history, about when and how to resume exercise. Most patients can resume fairly normal, non-strenuous activities about two weeks after a heart attack. Some people may require a longer period of time; others much shorter, especially if the heart damage has been very minor.
More strenuous activity, such as a 40- to 50-mile bike ride, might require a longer period of recovery, about 3 to 6 weeks or longer. A treadmill test may help your doctor assess your recovery rate.
If you experience any unusual symptoms, such as chest discomfort or unusual shortness of breath, you should stop exercising and consult your cardiologist for advice.
Q: I run in the morning and do weight training 3 days a week. I'd like to include cycling. If I only have 30 to 40 minutes a day to ride, will it be worthwhile?
A: Absolutely. Biking for 30 to 40 minutes is an excellent way to get a great aerobic workout. To get the best overall workout with a limited schedule, mix things up. Cross-training — doing different types of exercise during the week — is a good way to achieve the most from your program. Plus, you reduce the risk of injury caused by muscle overuse and avoid getting bored with your workout.
Q: I've heard that taking glucosamine helps build cartilage in the joints. Can it prevent knee pain and injury?
A: Glucosamine is a sugar found in the body. The glucosamine supplements available on the market are either made synthetically or derived from the sugars produced in the shells of certain types of shellfish. They can be taken as a tablet, capsule, or liquid.
There are no good studies addressing whether glucosamine helps with the loss of cartilage in any joints, but there are numerous advocates for the use of glucosamine to minimize the joint pain associated with therapeutic exercise programs.
Glucosamine has been shown to improve symptoms of osteoarthritis of the knee. It has also been shown to reduce pain caused by osteoarthritis.
However, herbal supplements aren't regulated by the U.S. Drug and Food Administration for safety, effectiveness, or purity. You should talk with your health care provider before taking glucosamine or any other herbal supplement.
Q: How should I ride to increase my endurance?
A: To increase endurance, you will need to gradually increase the time and distance of your rides. A good rule of thumb is to increase your distance no more than 10 percent a week. Over time, adding a few miles each week will allow your muscles and cardiovascular system to adapt to longer rides.
Pedaling at a fairly quick cadence, about 70 to 90 revolutions per minute, may be more efficient because you expend less energy in each pedal stroke so your legs won't fatigue as quickly. A higher cadence is also less likely to result in knee pain. However, if you are new to cycling, you will have to slowly build to a higher pedal cadence over time.
Q: I've been a runner my entire life, as well as asthmatic. I'd like to change my routine — is cycling an option with my asthma?
A: Most definitely! If you've been able to maintain a running career without too much difficulty with your asthma, then making the switch to cycling should be no problem. The cross-training effect is highly beneficial; you may want to maintain some component of running as part of your fitness regimen.
Keep in mind: People who have a health condition, such as asthma, diabetes, or arthritis, should talk with their health care providers before starting an exercise program.
Q: Should I carry water or a sports drink while riding?
A: It really depends on how long and how hard you ride. If you go out for a casual ride, say less than an hour, drinking water during the ride is sufficient to hydrate your body. However, if you cycle for more than 60 minutes, you may benefit from a sports drink containing carbohydrate. Consuming carbohydrate during your ride will delay fatigue and provide energy to your muscles.
For people exercising at a high intensity for 90 minutes or more, replacing carbohydrate is even more critical and a sports drink is a convenient way to get what you need. Drinking fluids with 60 to 100 calories per 8 ounces helps to supply the calories required for continuous high intensity performance.
Try different drinks out on short rides to find out what works best for you.
Group Health Contributors
Steven Cole, PT, Physical Therapy, Spokane
Rachel Garton, MD, Dermatology, Seattle
Lee Amsler, MD, Cardiology, Seattle
James Bingham, MD, Family Practice, Spokane
Travis Abbott, MD, Family Practice, Seattle
James Carlson, Director of Pharmacy Clinical Services, Seattle
Compiled by Robyn Shean
Group Health staff writer
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