Danger zone: Cycling ranks among the most risky of sports

It's July and whether you're a fan of cycling and watch the Tour de France or just tune into ESPN, you are bound to see some crashes that rival NASCAR bang-ups.

Cycling is not a sport for the fearful or tentative. Besides the possibility of getting hit, even killed, by cars, cycling is rife with the potential for injuries largely because of relatively high-speed falls on hard surfaces.

And while in the blogosphere there are an array of lists of "most dangerous sports," a Loyola University professor in 2006 found that cycling ranked second, behind only basketball, for having the most injuries treated in emergency rooms.

Seven-time Tour de France winner Lance Armstrong suffered one of cycling's most common injuries, a broken collarbone, during a race in Spain this past March. Now he's back vying for the yellow jersey.

Other common injuries are traumatic brain injury, concussions, severe skin abrasions (aka "road rash"), erectile dysfunction and overuse injuries typically associated with running, such as knee pain, Achilles tendonitis and plantar fasciitis.

Some of it is preventable, and many cyclists can attest to the importance of wearing a helmet.

"A couple of years ago, I got run over by a car," says Coastal Cyclists member Stan Faircloth. "I know the best way to prevent, or at least mitigate, head injuries such as concussion, or worse, TBI (traumatic brain injury), is simply to wear a helmet. I have no doubt that my helmet saved my life when my head hit the pavement."

Local cyclist Carl Kabbe has crashed numerous times but has avoided injuries by learning how to fall.

"Early on, I was told to stay with the bike, relax and form the best

'ball' I could," says Kabbe. "The only concussion I have had was when I went off my bike. My bike hit another bike from a downed rider. My bike stopped and I kept going like a torpedo at 25 mph and took the full impact on the upper left part of my face.

"Besides being unconscious, I was bleeding badly because I was wearing wire-rimmed glasses, so get a pair of cycling glasses and you can avoid lots of stitches."

Coastal Cyclists President Jane West has experienced her fair share of spills and heard some horror stories. Besides a helmet, she recommends wearing gloves to protect hands and sleeved jerseys to protect the skin in the event of a fall.

But road rash happens and is always unpleasant, particularly during the first shower after the accident.

Kabbe says, "The messy (and painful part) of road rash is changing dressings. I started using the clear plastic dressings (most recommend 3M's Nexcare Tegaderm) a few years ago and they are wonderful. Leave them on for 5-7 days, take showers with them."

Another interesting observation by local cyclists involves the timing of accidents. Some say that trouble tends to happen at the end of long bike rides when tiredness sets in and when their guard may be down.

Local cyclist Mark Lamica says he suffered an injury "that should never happen."

"At the end of a century ride (100 miles), I dismounted, and walked around for a few minutes," recalls Lamica. "In a moment of fatigue, and lack of thought, I got back on my bike, and cleated my left foot (attached shoe to pedal). Due to fatigue and lack of concentration, I leaned to the left a little too much, and, with all of my weight on my left foot, I was unable to uncleat myself. I went over like a house of cards, with 200+ pounds landing squarely on my left shoulder (and separating it)."

As for overuse injuries and temporary numbness in the hands and groin area, many cyclists insist these can be avoided by having an expert perform a bike fitting to make sure your bike is the right size and that the seat and handlebars are adjusted appropriately, and by doing off-bike strength training.

Dr. Richard Vest developed severe patellofemoral syndrome, pain under the knee cap, after becoming an avid cyclist. "After spending a lot of time with physical therapy, rest and patience, I made a full recovery and became a stronger cyclist. I rode my first century a few months later and have run two marathons since then," says Vest, a fellow in cardiac electrophysiology.

"My advice to other cyclists and runners is the following: first, perform 'core strengthening' exercises ... (for) the abs, back and pelvis; second, work on flexibility; ... finally, training longer and harder can be great but should be done gradually."

Meanwhile, erectile dysfunction — usually an issue with smoking, alcohol abuse and obesity-related diseases, such as diabetes, heart and kidney diseases and atherosclerosis — can occur in male cyclists after prolonged pressure on the tissues of the groin, which can damage blood vessels and nerves responsible for an erection.

This damage can be from a cyclist's relatively heavy weight, the bike's saddle and/or high-intensity cycling and may become permanent if the tissues are continually damaged and not allowed to recover.

Some steps include shifting weight and getting out of the saddle, using a seat with a cutout for the area, avoiding seats with lots of padding (you sink farther down and actually experience more pressure), tilting the seat downward and wearing good, cushioned cycling shorts.

While there are serious and preventable issues with cycling, high-level cyclists are facing a new health issue.

A recent study released by the University of Oklahoma's health and exercise science department found that competitive cyclists had less bone density than active, yet noncompetitive, counterparts. The study looked at 32 male cyclists, most in their late 20s and early 30s. Some had osteopenia in their spines, a medical condition that is one step away from osteoporosis.

An earlier study, which followed racers ages 27-44, showed they had lost a significant portion of their total bone mass in their hips over the course of a race season.

The thought is that cycling, unlike running or weight training, causes little beneficial impact to bones, which respond to stresses by strengthening. Also, many serious riders, who are already relatively light, burn more calories than they consume and that imbalance may have an impact on bone loss.

The good news is that the bone-loss issue appears to be limited to high-level, competitive cyclists, such as the athletes in the Tour, and not the recreational cyclist going for weekend spins around town.