In the animated film, Les Triplettes de Belleville, the boy who loves his new bicycle so much that he rides incessantly and later becomes a Tour de France champion is depicted with a spider-thin frame perched on huge, muscular legs. It’s an exaggeration, of course, but if you ride a bicycle regularly, you probably understand the boy’s obsession. Mounted on your steel horse, you power effortlessly through city and countryside, feeling as if you could ride forever. It’s an exercise that develops powerful leg muscles while putting little or no stress on the weight-bearing joints of your legs and feet.
Like other aerobic activities, bicycling develops a strong heart muscle capable of pumping blood efficiently to all parts of the body. It lowers blood pressure, improves cholesterol, burns calories, controls weight, and lowers the risk of heart disease and diabetes. What may be even more appealing to most bike riders is the calming yet exhilarating emotional effect of wheeling down a winding country road or a wooded path.
A bicycle offers a fitness challenge...and a fun way to spend an afternoon. For the boy in the film, a bicycle is a great present and toy. For both children and adults, it is an inexpensive, environment-friendly way to get from point A to point B. Unfortunately, there are also risks involved in biking. Each year about a half million Americans are treated in emergency departments for bicycle-related injuries. Collisions with motor vehicles account for 90 percent of deaths, but fractures and head and spinal injuries frequently occur as a result of falls.
The best remedy is to wear a helmet. A properly fitted helmet–resting no more than two finger widths above the eyebrows–can reduce by 85 percent the risk of suffering a head injury. Also recommended are elbow, knee and shoulder pads plus a chest protector and goggles to protect your eyes from small stones thrown up by tires. Many cyclists fail to recognize that they are obliged by law, as well as common sense, to follow the same rules as other drivers–obeying all traffic signs and lights and driving with the flow of traffic rather than against it.
When pedestrians are forced to use the roadway, they are advised to walk on the wrong side of the road so they can see vehicles headed in their direction. The same is not true for bicycles. Riding on sidewalks is also unsafe–both for pedestrians and cyclists. Many accidents occur when a motorist backing out of a drive or making a turn fails to see a fast-moving bicycle traveling down the sidewalk. A pedestrian has the right of way in such situations; a bicycle does not. A cyclist must also give trucks plenty of room and be alert for a driver who may open a car door or pull out from a parking space without looking for cyclists.
Serious bicycle accidents have increased with the popularity of off-road trail and mountain biking. While the majority of these injuries are minor, one study found that 20 percent of mountain bike injuries involved internal organ rupture, head injury, neck injury or fracture of an arm or leg. Mountain bikers tend to be risk takers, traveling at high speed on perilous terrain. Use of helmets and other protective padding is essential...along with common sense caution.
Males who engage in long-distance road cycling face another, more subtle danger. Several studies have found an association between long-distance cycling and erectile dysfunction. The authors of these studies attributed this to the design of bicycle seats. These seats cause abnormally high pressure and pinching of nerves in the perineal area (between the scrotum and anus). A more recent study found that about 90 percent of males logging more than 3,000 miles a year on mountain bikes had lower sperm count and decreased sperm motility. They also had lower semen volume and more scrotal abnormalities than non-bikers. A later, somewhat conflicting study found higher skin temperatures in the scrotum but not enough to affect sperm quality.
Most males don’t need conclusive evidence before exercising some caution regarding this area of the body. The first step is to avoid long periods of riding that cause numbness in the perineal area. Irwin Goldstein, M.D., of Boston University, author of one of the studies linking biking and ED, stated that the narrow design of bicycle seats was “archaic.” Re-designed seats started appearing within a year and are now available. Co-author Frank Sommer, M.D., Ph.D., said that the width of the saddle is more important than the padding in preventing the pinching of penile arteries and nerves. Dr. Sommer also recommended a recumbent or reclining seat position–a feature found on many stationary and some road cycles.
Another study, in fact, concluded that bike riding improved sexual function in men with weak heart muscles who, because of their heart condition, were unable to take oral ED medications (Viagra, Cialis, Levitra). Although blood vessels serving the genitals showed more normal blood flow, the biggest benefit for these men, according to the researchers, was probably the increase in aerobic fitness and overall improvement in health brought about by cycling.
There are many good ways to exercise, and the ideal probably includes as much variety as possible. If bicycling is an activity that could get and keep you moving on a daily basis, there’s no reason to let the hazards listed above get in your way. In many cities in Denmark and The Netherlands, about half of all short journeys are by bicycle, and there’s every indication that people are healthier and safer as a result. The ideal is to have bicycle paths that are separated from both motorized and pedestrian right of ways. With regular use of a helmet and cautious respect for motor vehicles, a bicyclist can expect to have strong legs, a strong heart and a relatively long, healthy life.
Michelle Herbert Thomas, PharmD, CDE
Clinical Director
