Fear, Anxiety, and Return to Sport After Cycling Crashes: A Survey of Cyclists.

After cycling crashes, orthopedic and neurologic complaints are often the focus of evaluation and management. However, the trauma sustained may not be limited to physical injury; psychological issues brought on by or comorbid with the crash also warrant treatment. In this original research, we evaluated the presence of fear or anxiety after cycling crashes and examined factors associated with this mechanism of injury through a survey. Post-crash fear or anxiety was associated with female gender, a history of depression, and greater crash severity. Few cyclists received treatment and most returned to cycling at their previous level, but the timeline varied.

Unique Concerns of the Woman Cyclist.

Previously a male-dominated activity, female cyclists now make up nearly half of all cyclists in the United States. Although cycling provides a significant number of health benefits, it is an activity that carries risk of injury, both traumatic and nontraumatic. Sex differences are seen in chest trauma and breast injury, as well as pelvic, given the inherent differences in anatomy. Understanding the relationship of the bicycle to the anatomy of the rider can help mitigate risks for injury.

Triathlon Considerations.

Triathlon is an increasingly popular sport that includes swimming, cycling, followed by running. The triathlete should not be seen merely as a cyclist who also swims and runs. Notable differences are seen in the type of bike used, training patterns, lower extremity demands, and cumulative nature of the sport. Injury prevention and treatment strategies need to take into account the triathlon distance, the type of bike used, athletic experience, prior injuries, risk factors, and a thorough understanding of the demands placed on the body through all 3 disciplines (swim, bike, and run).

Return to Cycling Following Brain Injury: A Proposed Multidisciplinary Approach.

Cycling is an important form of exercise, recreation, and transportation. Following traumatic brain injury, the benefits of cycling for health, fitness, and community mobility must be considered alongside potential risk for recurrent injury. In addition to medical concerns and exercise tolerance, key domains include motor function, attention, and visuospatial and executive function, which have previously been explored with regard to driving. Cycling skill is a combination of cognitive and motor function, and can be trained with appropriate education and intervention. We discuss the relationship of brain injury rehabilitation to specific features of cycling, including case studies.

Reporting of Concussion-Like Symptoms After Cycling Crashes: A Survey of Competitive and Recreational Cyclists.

CONTEXT: Cycling crashes are common among recreational and competitive riders and may result in head and bodily trauma. Information is limited regarding the signs and symptoms of head injury (HI) after cycling crashes, medical treatment, and recovery. OBJECTIVES: To evaluate concussion-like symptom reporting after cycling crashes with or without HI in recreational and competitive cyclists and to assess crash characteristics and follow-up medical care. DESIGN: Cross-sectional study. SETTING: Voluntary online survey. PATIENTS OR OTHER PARTICIPANTS: A convenience sample of 780 cyclists residing in the United States: 528 males, 249 females, 2 gender queer/nonbinary, and 1 transgender female. MAIN OUTCOME MEASURE(S): Survey-based, self-reported signs and symptoms of HI, including the third edition of the Sport Concussion Assessment Tool (SCAT3) symptom checklist, loss of consciousness, posttraumatic amnesia, and helmet damage. RESULTS: Of the participants, 403 reported crashes in the previous 2 years. Cyclists who self-reported no significant injury after their crash were excluded, leaving 77 HI reporters (HI group) and 260 trauma controls (TC group). The HI group more frequently reported experiencing 17 of the 22 symptoms on the SCAT3 symptom checklist. The HI group described a 4-fold higher incidence of loss of consciousness (HI = 13/77 [16.9%] versus TC = 11/2600 [4.2%]) and memory loss immediately after the crash (HI = 44/77 [57.1%] versus TC = 37/260 [14.2%]). The HI group reported major, noncosmetic helmet damage 2.5 times more frequently than the TC group (HI = 49/77 [63.6%] versus TC = 67/260 [25.8%]). CONCLUSIONS: The findings suggest that a standardized concussion assessment is needed for cyclists who experience major trauma.

Core Training in Low Back Disorders: Role of the Pilates Method.

The Pilates method is a system of exercises developed by Joseph Pilates, which emphasizes recruitment and strengthening of the core muscles, flexibility, and breathing, to promote stability and control of movement. Its focus bears similarity to current evidence-based exercise programs for low back disorders. Spinal stability is a function of three interdependent systems, osseoligamentous, muscular, and neural control; exercise addresses both the muscular and neural function. The "core" typically refers to the muscular control required to maintain functional stability. Prior research has highlighted the importance of muscular strength and recruitment, with debate over the importance of individual muscles in the wider context of core control. Though developed long before the current evidence, the Pilates method is relevant in this setting and clearly relates to current evidence-based exercise interventions. Current literature supports the Pilates method as a treatment for low back disorders, but its benefit when compared with other exercise is less clear.

Dancers' Perceived and Actual Knowledge of Anatomy.

Dancers are highly susceptible to musculoskeletal injuries and frequently require interaction with medical professionals. While many dancers have a finely tuned awareness of their bodies, their knowledge of the fundamentals of human anatomy is not uniform. There is a paucity of literature on the benefits of human anatomy education in dancers, though it seems intuitive that there should be a relationship. The purpose of this study was to assess dancers' perceived and actual knowledge of basic musculoskeletal anatomy and its relationship to function. Adult dancers at the undergraduate, pre-professional, and professional levels were surveyed through an anonymous online questionnaire. Questions included demographic information, dance techniques studied, anatomy training, and injury history. Subjects rated their perceived knowledge of anatomy and were tested with 15 multiple-choice questions on basic musculoskeletal anatomy. Four hundred seventy-five surveys were completed. Ordinal regression showed a correlation of perceived to actual knowledge of anatomy (p < 0.001). Factors that correlated with increases in both perceived and actual knowledge of anatomy included having taken an anatomy course of any type (p < 0.001) and increased age (p ≤ 0.001). Years of dance training and professional dancer status both significantly correlated with increased knowledge of anatomy (p < 0.001) but not perceived knowledge. Chi-square analysis showed that dancers with training in either modern or jazz dance had a significantly higher perceived, but not actual, knowledge when compared to those without training in those styles of dance (p < 0.001 and p = 0.011, respectively). In conclusion, dancers generally scored well on questions pertaining to basic musculoskeletal anatomy, and their perception correlated with their actual knowledge of anatomy. Factors that contribute to dancers' knowledge of anatomy include age, years of experience, professional dancer status, and anatomy training.

Prevention, Evaluation, and Rehabilitation of Cycling-Related Injury.

The unique quality of the bicycle is its ability to accommodate a wide variety of injuries and disabilities. Cycling for recreation, transportation, and competition is growing nationwide, and has proven health and societal benefits. The demands of each type of cycling dictate the necessary equipment, as well as potential for injury. Prevention of cycling-related injury in both the athlete and the recreational cyclist involves understanding the common mechanisms for both traumatic and overuse injury, and early correction of strength and flexibility imbalances, technique errors, and bicycle fit.