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Cycling is great exercise but requires good traffic sense

by Dr. Anthony L. Komaroff
| September 29, 2013 9:00 PM

DEAR DOCTOR K: I'd like to start biking to work. Any advice before I get back on my bike?

DEAR READER: Cycling is great exercise. For one thing, it gets you breathing harder and your heart rate up. That pays cardiovascular dividends. Cycling stacks up well against other forms of exercise when it comes to burning calories, too. And it isn't as hard on the knees as running.

Perhaps the biggest advantage of cycling is that it can perform double duty as a form of transportation. A number of my patients, and my colleagues here at Harvard Medical School, bicycle to and from work every day.

One of my colleagues once said: "I don't need to go to the gym, and I don't need to pay the gym or pay for parking. I have bike paths most of the way, so during rush hours it takes no longer than driving. Except on a rainy day, the advantages are obvious." During blizzards, he takes the car. "I'm not a complete nut about cycling," he assured me.

Now and then, cyclists injure a muscle. But the main risks of cycling are not from the physical activity but from traffic. The vast majority of the fatalities from bicycle-related injuries are caused by accidents involving motor vehicles. Drivers will often say after an accident that they never saw the cyclist.

Reckless cycling can be a factor, too. Being on two wheels doesn't mean that traffic laws don't apply to you. Running red lights and weaving in and out of traffic is courting disaster. And it's surprisingly common, at least in Boston. I sometimes wonder if part of what makes some cyclists enthusiastic about cycling is the sense that they are courting danger.

And of course, wear a helmet. The worst injuries to cyclists are head injuries. A patient of mine couldn't find his helmet, was in a rush and went cycling without it. He hit a pothole and sustained a severe concussion. Fortunately, he fully recovered, but it took six weeks.

Be especially wary about cars parked along the side of the street: Running into a car door that has opened suddenly is a common way to get hurt. Sure, drivers should be looking in their side-view mirrors before opening the door, but they often don't.

Bad technique or positioning, or a bike that's the wrong size, can make cycling uncomfortable to the point of pain and may eventually result in injuries. High-end bike stores offer fitting services for a fee. It will be money well spent if you're cycling a lot. If any problems come up -- knee, lower back or buttock pain, or numb hands and wrists are among the more common - a bike store should be able to make adjustments to your bike or help you tweak your technique.

On my website, AskDoctorK.com, I've put an illustration of some basic cycling tips that should help you ride safely and comfortably. So, enjoy your ride!

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.