"My right knee just started hurting about 4 days ago. I am having sharp pains on the lateral side of my knee. I had to bike the last couple days with just my left leg, which (wasn't a good thing)! Hopefully it will be better tomorrow!" David Shirley, taking a few days off in Portland, Oregon.

Asking the question implies the answer; of course cycling has its list of common injuries, which are amplified when a cyclist rides cross country over a period of several months-- which is the situation with David.

Head injuries are common among bicyclists who do not wear helmets, which comes as no surprise, considering it is not that difficult to hit a pothole while gazing at scenery or to be hit by a cellphone obsessed driver. About 540,000 cyclists in the U.S. visit the emergency room each year, and of those, 67,000 have head injuries.

According to The Bicycle Helmet Safety Institute, "The typical bicyclist killed on our roads is a sober male over 16 not wearing a helmet riding on a major road between intersections in an urban area on a summer evening when hit by a car."

Portland resident melancholic optimist reports on Portlandize, "it's collisions with automobiles that kill cyclists, not the lack of helmets."

The city of Portland, Oregon-- where David is hanging out hoping for his knee to heal-- has been a leader "in creating a walkable and bikeable city." Between 2007 and 2008, overall bicycle use in Portland, Oregon increased 28%, Portland's Office of Transportation reported.

Portland has its own bike website called bikeportland with a site for reporting crashes, a place for blogging and even a Jobs Board.

Fascinating bike safety statistics are found at Bikes Belong: statistics on why people do and do not wear helmets; automobile accident comparisons, and fun facts.

One that captured my imagination is the following from a British pdf, Safety in Numbers: The risk of fatality while cycling is just once every 32 million kilometers (20 million miles), or over 800 times around the world.

Okay, I am not a doctor nor am I a serious cyclist. I am reporting to you AS I am learning due to a concern for David and his fellow bikers, so bear with me.

RoadCycling.com stated the effects of poor bike position so clearly I had to copy it for you, and you are free to click on their site (above in blue) to discover more about this:

Chad Asplund, MD, writes, "Knee and hip pain are the most common cycling injuries, especially in the early season. The most common cause of knee and hip pain in cyclists is iliotibial band (IT band) syndrome. The IT band is a thick fibrous band of tissue, which runs on the outside of the leg from the hip to the knee. Pain is caused when the band becomes tight and rubs over the bony prominences of the hip (greater trochanter) and/or the knee (lateral epicondyle). Tight inflexible lower extremity muscles may worsen the condition. Pain may also be caused by inappropriate seat position, saddle position, cleat alignment, or by individual cyclist anatomy."

Dr. Asplund offers suggestions regarding how to adjust a bicycle to avoid these injuries- check them out if you are a biker!

However, Jim Bledsoe on Sports Injury Bulletin disagrees that this type of injury is the most common cycling injury location. He cites an article stating that 20% of all cycling injuries happen to the face. (Sports Causing Most Injuries in Hong Kong,” British Journal of Sports Medicine, Vol. 27(4), pp. 263-267, 1993.)

Sadly I have been unable to find this article for you. But I did find a fascinating study conducted at the University of Wales that describes cyclist facial injury frequency in an attempt to redesign helmets with aface bar. This study is called The circumstances and scope for prevention of maxillofacial injuries in cyclists.

Bledsoe, in that same Sports Injury Bulletin, describes a fascinating upper limb injury that occurs while cycling, called handlebar palsy:

"In general," he writes, "the ulnar nerve becomes inflamed, usually either at the elbow or the wrist, when it has to absorb vibration and shock transmitted to the arm via some apparatus or tool (it can also flare up when the hand and arm are maintained in a fixed position for a long time). In the case of cyclists, shock and vibration are transmitted directly from the handlebars to the arms – and to the ulnar nerves in each arm, raising the risk of ulnar neuropathy."

Again, more information regarding this upper limb condition and its prevention can be found at the site, Sports Injury Bulletin.

Bledsoe adds, "Specifically, it may be a good idea to have a professional evaluate your position on the bicycle and make adjustments to assure that your weight is not too far forward and supported excessively by the hands on the handlebars. You should definitely wear padded gloves and consider the addition of padding to your handlebars. During prolonged cycling, it is important, too, to shift the position of your hands regularly and to not stay in the fully “down” position for more than 10 to 15 minutes at a time."

This seems to be a good over all suggestion; if you plan to be on your bicycle for prolonged periods of time, get a professional to examine your position, the height of your seat, the pedal position, etc., to insure the most comfortable ride possible which will certainly support success in your venture!

!!!!!!!!!!And look both ways when crossing the street!!!!!!!!!

One more cyclist injury-- though not common in non-elite cyclists-- is called Iliac Artery Endofibrosis. If you are at this point in your cycling, you probably are or should be in touch with a professional who keeps tabs of your health.  From a lay point of view, I find it fascinating to even attempt to decipher this study.  I mean, people actually understand this?

Mostly what I get from reading about this injury is that by overstressing your body, it is possible to create symptoms more common to elder patients than to young and vital cyclists; by getting a professional like the one in the video above to evaluate your cycling position you may avoid compressing and kinking that causes this injury; and that the earlier this problem is detected the better. 

I decided to copy it for you to peruse according to your knowledge base... 

A very important study conducted by the European Journal of Vascular and Endovascular Surgery and cited in the article on Illiac Artery Endofibrosis found when clicking on the IAE in blue above states,

"Tethering of the iliac artery by the psoas arterial branch and fibrous tissue, and muscular hypertrophy predispose the vessel to kinking and compression during cycling. Symptoms may only be present on maximal exercise in the cycling position. Provocative exercise tests using a cycling ergometer with ankle brachial pressure index measuring has a sensitivity of 85% to detect arterial insufficiency. Magnetic resonance imaging is increasingly being used as the investigation of choice to confirm the diagnosis, although digital subtraction angiography and colour duplex ultrasonography may also help. Conservative measures including adjustments to the cycling posture and bicycle setup should be recommended to all patients. The evidence for surgical and endovascular treatments is limited and the use of prosthetic graft should be avoided.

*Iliac artery compression should be recognised as an important differential diagnosis in competitive cyclist presenting with lower limb symptoms. Although the optimal treatment strategy remains unclear, early diagnosis may reduce unnecessary investigations, and enable the cyclist to make appropriate adjustments and decisions in treatment management."

I could find more for you to read, but then I would exacerbate my own injuries gleaned over the past two months while David is cycling to raise awareness for prostate cancer: a spreading backside, sore back and carpal tunnel injuries, lol.