Benefits, dangers of mountain biking

Dr. Conway McLean

The fitness craze in America has been one of trends, fads and fanatics. The statistics on obesity and heart disease would argue against this being a movement that has thoroughly penetrated the psyche of the general public. Still, many Americans do participate in some form of physical fitness on a regular basis. Which kind of physical activity varies tremendously, from martial arts to marathons, gym memberships to gymnastics. Each form of physical activity has its own benefits and drawbacks, its own inherent dangers and rewards.

Many popular pursuits are associated with the region’s geography. Here again, the old adage holds sway “location, location, location!” If one lives in California, you are much more likely to surf or swim than those living in the great plains. Colorado residents are much more likely to be skiers than those living in Iowa. Do they play much tennis in Canada, at least compared to hockey?

A sport popular in many parts of the country requires only hills and nature, although significant amounts of both. That would be mountain biking, which can occupy many acres of land. Thus, less developed regions are better candidates. In mountain biking, specialized bikes, employing shock absorbers and over-sized tires, are ridden along a course which leads over rough terrain, around trees and up boulders. The popularity of mountain biking has grown exponentially over the years. People knowledgeable about the bike industry have all seen a significant increase in mountain bike sales, while road bike sales have been flat or in decline. Some call mountain biking “the new golf,” meaning the more dedicated of participants will travel to other parts of the world to find exciting new trails.

Mountain biking is quite popular with many residents of the Upper Peninsula. Some have been riding the backwoods for years. Others have moved here only recently, sometimes because of the plethora of trails crisscrossing the region. But the word is spreading: the mountain biking community knows about the multiple riding attractions present in the U.P, from “perfect dirt”, to the beautiful tapestry of colors.

As is true with every form of physical activity, there are dangers to mountain biking. Cycling injuries are an unfortunate part of most rider’s experience with the pursuit. Crashes are an unfortunate side effect of this activity. Some people are more prone than others, but most cyclists will find themselves coming off the bike at some point. And no one likes to be forced off the trails because of injury.

The least serious form of trauma, but often most annoying, is road rash. This is a scrape of the skin caused by hitting, and often skidding along, the surface you are riding on. Obviously, a road rash from street riding is going to be more damaging than from a soft dirt trail. As much as it might sting, it’s important to carefully clean road rash as soon as possible. After a thorough cleansing, a simple light dressing with an antibacterial ointment is typically sufficient.

One of the most common injuries associated with this activity is lower back pain. Hours spent hunched over the handlebars will do that. This is exacerbated by jobs that require long periods spent staring at a computer screen. One structure often affected is the piriformis muscle, which helps the thigh to rotate outward. Inflammation of the piriformis may be experienced as hip pain, or pain traveling down the leg due to a pinching of the sciatic nerve. If this problem develops, your bike may not be properly set up for you. Look at your position on the bike. If your bike has a long stem or top tube and low handlebars, this may be placing you in an overly “aggressive” position.

Core strength is important to mountain biking, as it is to every activity one can imagine. Without sufficient core strength, your lower back will tend to collapse while riding, causing undue strain. Improving core strength will also make you a more powerful rider, since you will be pushing from a stronger foundation.

Knee pain can develop with any bicycling-type motion. The fit of the bike to your body, once again, is often the cause. If this is the case, it may be worth hauling your bike to a bike shop to consult with some professionals. Pain felt in the front of the knee may occur with low saddle placement, which puts excessive pressure on the knee cap. Conversely, pain experienced at the back of the knee may be from a saddle which is too high.

Foot pain is common in cyclists. A burning sensation in the ball of the foot is a common complaint. This may be accompanied by numbness or a cramping pain in the toes. Compression of a nerve, as it travels through the ball of the foot, causes chemical changes in the nerve, resulting in pain. Simply wearing a better fitting shoe can make a difference for some. A prescription arch support, aka foot orthotics, one specifically intended for cycling, can make all the difference.

Another common foot issue, experienced by both cyclists and non-cyclists alike, is the ubiquitous heel pain. The majority of the time, it’s the result of plantar fasciitis, a strained, over-worked arch ligament. Most cases can be resolved with stretches, prescription foot supports, and home therapies. When these measures don’t provide sufficient relief, surgery usually isn’t needed because of the development of shockwave therapy. A derivative of lithotripsy (for gall stones), sound waves re-start the healing process. Multiple clinical trials have demonstrated its benefits, with study results indicating an 80-90 percent success rate. Additionally, it has no side effects of consequence.

Of course, fractures can also occur, with the collarbone (the clavicle) being the most common. But if any injury is persistent, you should see a professional who can help identify and treat the cause. But even better than treating the injury is prevention. For one, always ride within your limits. But there may be times there is nothing you can do about it. If you ride a mountain bike, at some point, you are probably going to fall. It’s simply a matter of time. Yet some riders are able to walk away from fairly significant falls, while others are repeatedly injured. If you ride, you should know the specific tactics recommended which reduce the risk of injury when you fall from your bike. Obviously, proper protective gear is vitally important, with a good helmet being one of the most important. This is one area in which spending some money is worthwhile. Knee and shin pads, even shoulder pads, are available.

I would venture to say that most Americans aren’t really “on-board” with the concept of physical fitness, despite the plethora of diet plans, fitness programs, and exercise technology. Even the barrage of information concerning health and well-being hasn’t spurred the average citizen to make fitness a personal goal. But for some, mountain biking is an exhilarating form of exercise, stimulating both the heart and the imagination. Be prepared if you are heading out to the trails, wear proper equipment, start small, and enjoy. But regardless of the form of physical activity you pursue, know that should you persist in being active, you will reap benefits to both mind and body for years to come.

Editor’s note: Dr. Conway McLean is a physician practicing foot and ankle medicine in the Upper Peninsula, with a move of his Marquette office to the downtown area. McLean has lectured internationally on wound care and surgery, being double board certified in surgery, and also in wound care. He has a sub-specialty in foot-ankle orthotics. Dr. McLean welcomes questions or comments atdrcmclean@outlook.com.