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August 2004

By Sarah Schmelling

Beyond Expectations
With summer sunshine still lasting into the evening, and thanks to Lance Armstrong winning a record sixth Tour de France in July, more and more Americans are jumping on their bicycles and riding, not just for fun, but for exercise.

According to a recent essay by Gina Kolata in The New York Times,¹ sales of specialty bicycles increased by 13,800 from 2002 to 2003, and newly eager riders will only boost that number this year. Many of these enthusiasts are aging Baby Boomers with plentiful disposable income, she adds, leading to increased sales in custom bicycles as well.

What does this mean for the rehab community? Most likely, more clients complaining of lower back, knee, and neck pain due to ill-fitting bikes. In response to this trend, the American Physical Therapy Association (APTA) has issued several tips you can pass on to your cycle-happy clients (see www.apta.org). Of primary concern, APTA says, is to be sure the seat or “saddle” is level for endurance and recreational riding. Kolata notes that a common new rider mistake is to use seats that are too wide and cushioned. Cyclists should also take into account the location of handlebars and their own physical condition before seriously taking to the road.

This extra consideration needed for cycling equipment brings to mind many other trends in rehab that require more thought than first expected. Several articles in this issue address topics like this—where thinking outside of the box is not just helpful, but essential. In her story, “Not Your Parent’s Wheelchair,” Deborah I. Cox, MPT, stresses the importance of not viewing pediatric wheelchairs as miniature adult devices; in “Quantifying the Pain,” Karen Wientjes Albaugh, PT, MPH, CWS, describes pain assessment for wound care that goes beyond the usual zero-to-10 scale; and in our cover story ,“Independence Served Here,” we get a look at a brain injury facility that utilizes multiple treatment methods, from recreational therapy to psychoanalysis.

Just as a small seat or handlebar adjustment can mean the difference between an enjoyable or excruciatingly painful ride, a little thinking outside traditional practice can be extremely important for a client with injury or pain.

--Sarah Schmelling

Reference
1. Kolata G. Fast pace, hard seat: Now that’s cycling. The New York Times. July 6, 2004.

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