Major orthopedic injuries can significantly impair an athlete’s quality of life; therefore, these conditions warrant careful consideration in exercise prescription. Caleb Schultz discusses how cycling loads the body and provides clarity on its weight-bearing effect.
Cycling - Tour de France Singapore Criterium - Singapore - Astana Qazaqstan Team’s Mark Cavendish crosses the line to win the race REUTERS/Edgar Su
This question may seem simple to some, yet upon closer inspection, it appears there is more to it than meets the eye. The hypertrophic effects of cycling can be observed in many recreational and elite cyclists, as it tends to promote muscular development in the legs(1). However, we know that well-developed muscles are not a good indicator of bone health, as osteopenia is common amongst elite cyclists, with many elite Norwegian cyclists showing diminished bone health despite performing strength training(2,3). These findings have led several authors to describe cycling as non-weight bearing (NWB), yet this may not be entirely true, as there is evidence that cycling exerts a gravitational load on the body(4,5).
Clinicians may prescribe a period of NWB as part of the initial treatment for many lower limb injuries, such as anterior cruciate ligament (ACL) ruptures, ankle sprains, Achilles tendon ruptures, and fractures(6). Major injuries such as ACL and Achilles ruptures often require surgery too, which introduces an additional risk in that one should take care not to dislodge the surgical site.
Weight is the product of a body’s mass and the perpendicular gravitational force acting on the body(7). Thus, gravitational force is maximized through the limb when it is perpendicular to the ground, as with full weight-bearing activities such as running, hiking, walking, and traditional strength training(2). Full weight-bearing activities are superior in stimulating bone growth, also known as osteogenesis, compared to weight-supported activities such as swimming and cycling(2).
Diminished bone mineral density is evident in elite road cyclists. However, cyclocross, a different discipline of cycling, might exert similar gravitational forces on the body to running(5). Cyclocross involves cycling off-road using a bicycle with similar architecture to a road bicycle(5). The ground reaction force (GRF) during cyclocross can exceed two times bodyweight, unlike road cycling, which usually exerts gravitational forces less than two times bodyweight(5). American researchers measured forces during seated, standing, uphill, and downhill cyclocross(5). All positions on the bicycle during cyclocross exerted GRFs greater than body weight, suggesting that cyclocross at least involves a degree of weight-bearing. It must be noted, however, that they studied elite cyclocross cyclists, and the results may differ in recreational athletes(5). Furthermore, although cyclocross demonstrates some weight-bearing, these gravitational forces might be considerably lower during stationary bicycling.
Cycling biomechanics can differ significantly depending on the force exerted on the pedals and the posture assumed by the cyclist on the bicycle(8). For example, less weight is transmitted through the upper and lower limbs when seated on the bike than when standing on the pedals(7-9). As the weight of the body is more perpendicular to the ground when standing on the pedals, greater gravitational force will act on the cyclist’s limbs, thus increasing weight-bearing on the legs and arms However, when seated, the legs and arms are more parallel to the ground, meaning that less gravitational force is transmitted through the limbs of the cyclist(10,11).
"Cycling is often described as a non-weight-bearing activity, but the reality is more nuanced."
The weight of the cyclist is mainly distributed along the bicycle’s frame and the two bicycle wheels, with only some of the cyclist’s body weight being distributed along the upper body, lower body, and spine(12). The GRF is divided between the two bicycle wheels, which is further dissipated along the frame and further via the rotational motion of the bicycle wheels and chain (see figure 1)(12).
While not without risk, cycling is still a low-impact activity and has multiple benefits during early post-operative rehabilitation(6). However, cycling can cause increased knee rotation, which might aggravate certain conditions such as ACL sprains, meniscus tears, or ankle sprains(6,9). Therefore, when considering cycling in the early stages, flat pedals may allow for greater degrees of freedom and less impact on the ankle, hip, and knee compared to cleats. As athletes progress, cleats should be professionally fitted to ensure the correct biomechanical load and optimize joint positions, particularly for longer rides. It is thus advisable that the bicycle is comfortably fitted for cyclists(8). Generally, the saddle height, or seat height, should be equal to the length of the inseam of the cyclist (see figure 2)(9).
Athletes and clinicians commonly describe cycling as an NWB activity due to its negative impact on bone mineral density. While it is clear that swimming is NWB, the weight-bearing effects of cycling are not as obvious. Although the bicycle supports most of the cyclist’s bodyweight, cycling is nevertheless a partial weight bearing (PWB) activity as there is evidence that cycling exerts gravitational forces greater than two times bodyweight, which is increased when standing on the pedals(5). Thus, while cycling is a largely safe and low-impact exercise, it is advisable to confirm with the attending surgeon whether cycling is warranted as part of a strict NWB protocol.
Clinicians need to clearly define the different cycling modalities (stationary bicycles, road cycling, indoor training, and mountain or cyclocross cycling) when managing athletes. Categorizing cycling as a single modality overlooks the multiple factors that influence the forces placed on each joint. As the answer is not clear, clinical reasoning is vital. For example, based on the current understanding, remaining seated with low resistance appears to provide the lowest weight-bearing effects compared to standing on the pedals and exercising at high resistance due to the force required to move the pedals. Additionally, stationary-fixed versus free-standing cycling may reduce the forces required, as the skill requirements (e.g., balance, environmental changes, and external stimuli) are lower, allowing the athlete to maintain safe joint positions with minimal resistance. Depending on the athletes’ training history, clinicians can progress their cycling discipline to meet their individualized goals.
Cycling is often described as a non-weight-bearing activity, but the reality is more nuanced. While it does not exert the same gravitational forces as activities like running or hiking, certain cycling modalities—such as cyclocross and standing pedaling—do involve PWB. This has significant implications for rehabilitation, as clinicians must carefully consider the type of cycling prescribed in relation to an athlete’s condition and recovery goals. Ultimately, cycling remains a low-impact exercise with numerous benefits, but its inclusion in a rehabilitation program should be guided by a clear understanding of its biomechanical demands and weight-bearing effects.
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