Heat & Hydration

June 2024

Every day from June through September, Santa Rosa’s historical average high temperature exceeds 80º F. Let’s talk about cycling in the heat! 

I first learned about the concept of heat acclimation when a message popped up on my Garmin bike computer after a ride: “You are 12% acclimated to the heat.” According to Garmin, it takes up to four training days in the heat with a break of no more than 3 days to become fully acclimated. Turns out there is a whole body of literature about training for heat. This article provides an academic overview:

https://www.stmarys.ac.uk/blog/physiology/heat-acclimation-training.aspx 

The basic takeaway for heat acclimation is that your performance and comfort in the heat will improve as you repeatedly expose yourself to riding in the heat. Give yourself shorter rides of an hour or so each during warm afternoon weather over the course of a week or two, in anticipation of a longer days in the heat of summer. After reading a bunch of scientific articles with precise prescriptions, I uncovered the (fairly obvious) truth that people’s physiology relating to heat and acclimatization vary wildly. So please take the recommendations below and tailor them to serve you and your physiology. The goal here is maximizing your enjoyment, comfort, and performance in hotter weather. 

Research shows that being well hydrated has general health benefits. Getting dehydrated on the bike can result greater pain and the loss of endurance and power. On a long enough ride, dehydration may cause you to “bonk” with a substantial reduction in effectiveness. Once this happens, you can only limp home. Recovering from dehydration on a ride is pretty much not possible. Especially on a hot day, you cannot afford to get behind. 

Reaching 1% dehydration means that you have lost 1% of your body weight. A 150-lb rider would have lost 24 ounces of body weight. 2% dehydration is associated with significant reduction in performance and physical comfort. 

Be aware of the stages and symptoms of heat emergency: heat cramping, heat exhaustion and ultimately heat stroke and death. Dehydration leads to heat exhaustion with symptoms that include cramping, cool-clammy skin with goose bumps, heavy sweating, weak and rapid pulse, elevated temperature, head-ache, nausea, vomiting, dizziness, fatigue, weakness, anxiety, decreased urine output, confusion, fainting. Medical treatment should be sought if symptoms of heat exhaustion emerge and usually includes receiving intravenous fluids.

TRAINING PRESCRIPTION 1: HYDRATION PRE-LOADING

Routinely, get in the practice of drinking two to three cups of water after you rise in the morning. Then, take on another cup of water 20 minutes before the start of your ride. For longer rides, hydration pre-loading over the course of two days can be beneficial. One of SRCC’s champion riders habitually consumes several liters of water a day and his high level of hydration has make it possible to win double-century rides without getting behind the hydration curve. 

TRAINING PRESCRIPTION 2: TRY INFUSIONS

Though water is the key ingredient to hydration, the body does not absorb straight H2O very well. There are numerous products on the market, but if you’re out of your favorite product, do not fear! The hydration-boosting effect can be achieved with infusions of small amounts of substances in your kitchen cupboards. Adding just 1/16 to 1/8 teaspoon of salt per pint of water increases the absorption rate. Carbohydrate additives can also help absorption. For example, adding just a teaspoon of maple syrup per pint of water helps. Milk, tea, and fruit and herb-infused water are also ways to improve on straight H2O. 

TRAINING PRESCRIPTION 3: BRING A SCALE TO YOUR NEXT RIDE

Weigh yourself before the ride. Then, keep track of how much you drank during the ride. At the end of the ride, weigh yourself again to determine how much you need to be drinking to stay sufficiently hydrated. If you’ve lost weight, that’s a message that you need to be absorbing more. Naturally, this is most accurately performed with naked weighing, but the dryness of Sonoma County makes it fairly accurate weighing clothed.

RIDE LENGTH & HYDRATION

Up to 1 hour:  Hydrating before the ride reduces your need to worry about drinking during the ride. 

1-3 hours:  Drink on a schedule rather than to thirst.  A large bottle (24-28 oz) each hour with less than 1/4 teaspoon of salt added or another infusion.

Longer rides: Increase your hydration rate. Try drinking 16 ounces of strong electrolyte drink the night before the event. Then, drink one to two bottles an hour will help you keep hydrated. 

NOTE: There is a condition called hyponatremia where over-hydrating can result in improper electrolyte levels. Consuming too much plain water in pre-loading can cause this.  

I’ve added a few things to my wardrobe for hot-weather riding. Light-weight arm covers relieve me of the need for sunscreen and make it possible to squirt water on my arms for evaporative cooling. Levi’s Grand Fondo provided free “brow gutters” one year. These adhere to your forehead and direct your sweat away from your eyes (salt burning my eyes is one of my problems in the heat). This feature has been incorporated into the Head-Sweats do-rags. I like to keep one bottle with straight water to enable this kind of evaporation. I’ll alternate drinking out of my spiked water bottle and my plain water bottle and up the level of additive in the spiked bottle to compensate.

THE TAKE AWAY:

• Hydration improves performance
• A dash of salt or an infusion of ginger or watermelon will aid your absorption
• Drink a pint of water when you rise and a cup 20 minutes before a ride
• Take frequent sips during your ride; drink on a schedule. Don’t drink to thirst; if you’re thirsty, you are behind on hydration.
• Heat acclimation is possible and can be planned into your regime. 
• Body shape and characteristics such as % body fat, size, weight, and skin characteristics will all factor into above recommended quantities so that you have proper targets for your own hydration. 
• Refine your hot-weather cycling kit.

LINKS:

Bike Radar article: https://www.bikeradar.com/advice/fitness-and-training/cycling-in-hot-weather 

GCN video: https://youtube.com/watch?v=T9Ok_sSTJ50 

Training Peaks article: https://www.trainingpeaks.com/blog/how-to-avoid-hyper-hydration/ 

Paper on Inter-individual Variation https://www.sciencedirect.com/science/article/abs/pii/S0306456518300275

GCN How Salty is Your Sweat https://www.globalcyclingnetwork.com/brand/precision-fuel-and-hydration (promotes a company’s approach)

Santa Rosa CityBus and Paratransit agencies just hired Sonoma County Bicycle Coalition to develop and deliver training to all their drivers on “Best Practices for Driving Around Bicycles.”  I drove a bus in Seattle for King County Metro while writing my doctoral dissertation, so it was a fun assignment for me. The trainings were  completed this month with a nod to Bike to Work Month, and we hope to take the show on the road to more bus agencies and other professional drivers in the future. 

I always feel safer riding near professional drivers than private motorists. Even though they are usually in much larger vehicles, their standard of care is greater and the consequences of a mistake make them more attentive. Professional drivers are judged on the factor of “Preventability” and not “Fault”.  

My main message for the drivers was that they can use the presence of bicyclists on the roads as a means to make themselves better drivers. By always working to see bicyclists, a driver is elevating the level of attentiveness with which they are practicing their craft. Take the TfL Awareness Test to get an idea of what I’m talking about: https://youtu.be/xNSgmm9FX2s 

A power hierarchy on the streets affords the greatest respect to tractor trailers and the least to the pedestrian.  But in some ways people on bicycles are both more exposed and more vulnerable than pedestrians. To become the best drivers we can be, we must not wield the power in our hands. We must instead drive empathically toward vulnerable road users. You can achieve this by driving with your attention on high alert for the least visible people (those on foot or on bike) and giving them plenty of space. Our greatest desire should be to never hit anyone, and to exercise sufficient attentive that we can avoid people who are dressed in all black, at night, crossing the street outside crosswalks.

As bicyclists, we do best by ourselves when we are highly visible and friendly to motorists. I usually lead rides from the rear. My conduct at the rear of a ride helps to put the driver in a good frame of mind when they encounter my SRCC club mates riding ahead of me. People who ride with me will notice me giving a friendly wave to almost every driver who passes. Though I ride further left than most of you due to my training (something I’ll write about in a future post), I also show consideration by moving rightward when the driver is nearing.

As a driver, you should be aware of the three most frequent ways drivers inflict injuries upon bicyclists:  the right hook (turning right without yielding to a bicycle traveling in your blind spot), the left hook (crossing the path of an oncoming cyclist), and the drive out crash (where the driver is distracted by other activity on the roadway and doesn’t see the cyclist).  Each of these crashes are made more likely when there are other motor vehicles in the environment competing for your attention as a driver. 

Patience is your super power as a driver. Each of us should be grateful that we are driving in a multi-modal environment. The presence of pedestrians and bicyclists are what make towns vibrant, vital, and worth visiting. 

California enacted the 3-foot passing law about ten years ago. Unless a travel lane is wide—say 14’ wide—it is really not possible to pass a bicycle legally without crossing the lane divider or centerline. This past year, California added a stipulation in the passing law that now requires drivers to execute a complete lane change to pass a cyclist when the lane is too narrow to share. Sometimes, it is simply necessary to wait to make a successful pass, even if that requires you to drive at 10 mph for a bit.

With eBikes and a myriad of new devices including scooters and electric unicycles, drivers are no longer simply sharing the street with road bikes. There include much slower and much faster users than we might expect based upon past experience with bicyclists. A driver needs to exert much more attention to understand what is going on in this new environment. Some of the bike-like road users may be able to overtake you even though they are using the bike lane.

My bottom line message is that driving should no longer be something you view as easy and effortless.  Instead driving is should be something that brings out your most conscientious, empathetic and patient self.

Everyone has a spare tube and tire levers in their saddle bag, but how many of you bring along a live goldfish? Just kidding, but there are lots of things that are smart and useful additions to the kit.  Here are a few things our members bring along: 

• tire boot or $1 bill (for tire holes or cuts)
• patch kit and/or tubeless repair kit
• valve extender
• multi-tool
• spare derailleur hanger (in case you drop your bike on its right side)
• inflation cartridges and applicator
• saran wrap (in case of road rash, it greatly reduces pain and bleeding)
• benedril (anti-histamine in case of bee stings)

By adding bungies on your seat rail, you can tidily fold and roll your jacket into a burrito-sized package that is completely out of your way.

Here are a few links to what the experts bring:

• https://www.thegeekycyclist.com/tips/essentials-bicycle-saddle-bag/ 
• https://velonut.com/blog/whats-in-my-saddle-bag-and-storage-bottle 
• Video: Bike Radar www.youtube.com/watch?v=zHiKYFSQqTc   

Ask your fellow riders what they bring and perhaps you’ll add another useful item to this list!

We're kicking off 2023 with a new SRCC monthly educational topic. In addition to these posts, expect for a discussion at the start of some of the rides addressing each month's topic.

Sonoma County’s winters are mild enough that one doesn’t have to contend much with snow and ice. It never seems to stay below 40º on even the coldest day. So the primary concerns are staying warm, contending with dampness and road grit, and staying visible. 

Warmth:  A really good tip is to warm up before you go outside or get on the bike.  Do jumping jacks or another routine to get the blood flowing. Of course, do dress in layers. A neck gaiter or buff allows you to adjust your head covering to match the conditions. Gloves and shoe covers round out the insulation for your extremities. If you have leg covers and a shell, you’ll protect against most of the wind effects of the cold. An SRCC member once showed me how to start my rides with medical gloves inside my bike gloves. After it warms up a little, these can be discarded, but they take the edge off on a cold morning. I have “cat ears” on one of my helmet’s straps. They reduce wind noise and also keep my ears protected from the cold wind.

Keep your bike clean:  More grit and moisture tends to get on your bike in the winter. Fenders, wet-weather chain lube (attracts less dirt) and more regular wash-downs are a good for cold riding. Keep a 5-gallon bucket with a thick car wash sponge in it outside for when you return. A quick sponge down of your bike is more effective and safer than spraying with a hose. Some people prefer to run larger tires and slightly lower pressure for added traction and confidence.

Visibility:  Not only are the days shorter in the winter, but the sun also sits lower in the sky. This means that you may want to dress brighter and keep front and rear lights on more while you’re riding. High visibility clothing is great year-round, but especially worthwhile in cold weather. When you’re bundled up, you may have more interfering with your vision. Remember that drivers may also contending with reduced visibility due to glare and dirty or wet glass. Compensate by being obnoxiously visible—it will be appreciated by those around you. 

Note to eBike Riders: Cold temperatures can cause your battery to be depleted, so it’s best to store the battery in a warm place. 

Some extra ideas:

• Nice GCN video on “Preventing Cold Feet”
  globalcyclingnetwork.com/video/how-to-prevent-cold-feet-when-cycling 
• I’ve become a fan of the oxygen activated hand and foot warmer packets. Buy a box and put a pair in your shoes or gloves.
• Bring your hot drink with you! Substitute a thermos for one of you water bottles, and it will really cheer you up to take a sip.

This new clinic will focus on the many skills needed to ride safely and responsibly in a group. Led by Richard Anderson, Steve Backman, and Dave Smith, this clinic will be held from 9a-2p with the start at the Foss Creek School, 1557 Healdsburg Ave. in Healdsburg. This is another great opportunity to learn new skills, build confidence, and ride safely. Here is an outline of what you can expect...

SRCC - Cooperative Group Riding Clinic

General Guidelines

- Bike handling skills, situational awareness, consideration of others and the ability to adapt one's  riding behavior are far more important than "paceline rules".

- Be a student of the best riding skills and practices we observe in the riders around us.

Specific Skills  & Guidelines

1.  Establish & communicate group norms.

     ~ Before the ride - determine the type of ride, route, pace and regroups

2.  Relax, breathe and maintain a soft focus.

     ~ Keep eyes looking ahead;  look around and through riders in front of you

3.  Hold your line & ride predictably.

4.  Ride consistently, and continuously adjust to the group.

     ~ Maintain the group's pace and level of effort;  ride to encourage group cohesiveness

5.  Maintain constant omni-awareness.

     ~ Be attentive and cooperate with the riders around you

     ~ Be mindful of traffic, road conditions and the general environment

     ~ Be considerate of other riders, pedestrians and drivers

6.  Communicate.

     ~ Clearly point out hazards by gesture and voice (as appropriate)

     ~ Telegraph or signal changes by gesture and voice - be obvious

         - changes include starting, slowing, stopping, turning, starting up or down hill, etc.

     ~ Respectfully moderate surging riders, or let them go

     ~ Maintain "group think";  ride as a part of the group

7.  Focus on your riding; it is all that you can control

     ~ Challenge yourself to continuously hone your skills;  one never "arrives"- Don't:  

     ~ overlap wheels  ~ surge

     ~ make sudden changes ~ ride as an outlier"

Cat - Dog Analogy ~ Cat = individualistic, Independent, self selective 

~ Dog = cooperative, cohesive, adaptive to others

One of the classes offered by the SRCC education program is called Home Care for the Bike. The objective of the class is that participants learn how to check over their bike so that they can be proactive in maintenance -- notice a problem and address it before it causes a safety problem or a brakedown on a ride. We go through a checklist that participants can use at home and provide a handout that covers the material. There are two versions of the handout, one for rim brakes (mechanical only) and another for disc brakes (hydraulic or mechanical). Those handouts are provided below. Please remember these are designed to go along with in-person instruction, and they assume a certain level of experience and proficiency.

SRCC home care for the bike clinic – handout for bikes with rim brakes

Use this list to remind you of the steps we went through in the clinic. By doing a thorough check over of your bike you increase the chances your next bike ride will be safe and not delayed by mechanical problems. Consider doing this checklist every 250 miles, any time you’ve noticed any new sounds or problems while riding, any time it’s been a while since you’ve ridden the bike, or any time something happened to the bike such as a crash or being knocked over. Before every single ride check your tires have enough air, that brakes are functioning, that your quick release levers are closed, and scan for damage to frame, tires and cables.

1. Put bike on a bike stand if you have one. If your frame is made out of carbon fiber over tightening the clamp on the bike stand can damage the frame. If you have a metal seatpost you may wish to clamp it there to eliminate the possibility of frame damage.

2. Open the brakes and take off both wheels. If you do not have a stand you can try to hang the bike by the nose of the saddle, for example on a sturdy tree branch or by a strap hanging from the rafters. Otherwise you can rest the bike on the side without the gears, or turn it upside down protecting the seat with a rag and taking off handlebar accessories.

3. Clean frame, looking closely for any cracks or other signs of damage on the frame or fork. All cleaning on your bike can be done with a rag wetted with a dilute solution of a mild soap, such as Simple Green. Something which is designed for cutting grease, such as citrus degreaser, is helpful for cleaning the chain and all the parts it touches.

4. Inspect brake pads- if you can’t see the grooves they need replacing, if the wear is uneven they need to be filed down and adjusted, if they have bits of metal you can pick them out, if they are shiny you can file them.

5. Clean and look closely at each wheel – check the condition of the tread and sidewall of the tire, too many cuts in the tread or cracks in the sidewall mean tire is at the end of its life. Clean off rim, using fine sand paper if necessary to remove brake pad material. Check condition of rim, if it is very worn in the center (concave) rim may be at the end of its life. Check for cracks near the spokes. Clean gears on back wheel by ‘flossing’ with a rag, make sure they are securely attached to wheel, check for excessive wear.

6. Clean the two jockey wheels on the rear derailer, check for excessive wear. Occasionally put a drop of lube in the center of each.

7. Put wheels back on. Put the bike right-side-up on the ground, open and close both quick release skewers to make sure the wheels are in straight. Make sure both brakes are in the closed position. Put bike back on workstand.

8. Check all bearings to make sure none are too loose (or too tight).

9. Spin each wheel looking at a brake pad as it goes around. If the wheel appears to move back and forth double check that the wheel is in straight. If that does not fix the problem, the wheel may need to be trued. A minor wobble is okay, but a larger one should be addressed. Squeeze all spokes, checking for broken spokes. All of the spokes on the same side of a wheel should be about the same tension.

10. This step cannot be done with bike right-side up and tires on ground. While turning the pedals shift through all gears making sure they work smoothly and well. If it is missing a shift, or making a clicky-clicky sound when in certain gears it may need the cable tension or limit screws adjusted. Take a look at the cables and housing that connect the shifter to the derailers, cables that are rusted, frayed or kinked may need replacing. Occasionally drip some lube into all housing.

11. Spin each wheel and test the brakes. If you have to squeeze the lever too much before it stops the wheel the cable may need adjustment. Your brakes need adjustment if you notice any of these problems: brake shoes rubbing the rim when brakes are not depressed, brakes rubbing tire, only part of brake shoe is hitting the rim, other part hangs below the rim, left and right side do not hit the rim at the same time.

12. Clean your chain using citrus degreaser and a rag, an old toothbrush can help too. If the chain is too stretched out, has a stiff link or a link that has any other problem you need to replace the chain. One way to check if it is stretched out is with a ruler- 12 links should measure between 12 and 12 1/8”, if they are longer than that it is time for a new chain. Use chain lube to lube your chain. You may wish to wipe off excess lube with a dry rag.

13. Ensure tires have enough air. Check accessories such as rack, bag, pump, or computer are firmly attached and functioning.

SRCC home care for the bike clinic – handout for bikes with disc brakes

Use this list to remind you of the steps we went through in the clinic. By doing a thorough check over of your bike you increase the chances your next bike ride will be safe and not delayed by mechanical problems. Consider doing this checklist every 250 miles, any time you’ve noticed any new sounds or problems while riding, any time it’s been a while since you’ve ridden the bike, or any time something happened to the bike such as a crash or being knocked over. Before every single ride check your tires have enough air, that brakes are functioning, that your quick release levers are closed and tight, and scan for damage to frame, tires and cables. If you have hydraulic brakes check all hoses and fittings for leaks.

1. Put bike on a bike stand if you have one. If your frame is made out of carbon fiber over tightening the clamp on the bike stand can damage the frame. If you have a metal seatpost you may wish to clamp it there to eliminate the possibility of frame damage.

2. Take off both wheels. Do not squeeze brake lever with the wheel out if you have hydraulic brakes, if you think you might do this by accident, stick a piece of cardboard where the rotor (that’s the round metal thing a little smaller than a plate on one side of your wheel) normally goes; If you do not have a stand you can try to hang the bike by the nose of the saddle, for example on a sturdy tree branch or from a strap hanging from the rafters. Otherwise you can rest the bike on the side without the gears, or turn it upside down protecting the seat with a rag and taking off handlebar accessories. If you have hydraulic brakes they will feel squishy afterwards for a little while if you turn the bike upside down or on its side and if there is an existing problem with the brakes turning it upside down or putting it on its side may make it worse.

3. If you have hydraulic brakes, inspect all hoses and fittings for leaks, if you find one do not ride bike until this has been repaired. Consider having the entire system bled once a year. If pulling the brake lever does not feel firm or if it becomes more firm with repeated pumping of the brake lever, you may have air in the system, have them bled before using.

4. Clean frame, looking closely for any cracks or other signs of damage on the frame or fork. All cleaning on your bike can be done with a rag wetted with a dilute solution of a mild soap, such as Simple Green. Something which is designed for cutting grease, such as a citrus degreaser, is helpful for cleaning the chain and all the parts it touches.

5. Brake pads should be checked periodically for wear, typically once the remaining pad is the thickness of a dime it is time to replace pads though manufacturers differ on this; do not touch or spill fluids on brake pads; check that bolts that hold caliper onto frame/fork are tight.

6. Clean and look closely at each wheel. Avoid touching or getting oil on rotor. If rotor is dirty it needs to be cleaned with isopropyl alcohol, if it is bent it needs to be straightened or replaced, if it is cracked or damaged it needs to be replaced. Rotors which are concave or thinner than 1.5 mm are worn out and need to be replaced. Check that bolts that hold rotor onto wheel are tight. Check the condition of the tread and sidewall of the tire, too many cuts in the tread or cracks in the sidewall mean tire is at the end of its life. Check for cracks in rim near the spokes. Clean gears on back wheel by ‘flossing’ with a rag, make sure they are securely attached to wheel, check for excessive wear.

7. Clean the two jockey wheels on the rear derailer, check for excessive wear. Occasionally put a drop of lube in the center of each.

8. Put wheels back on. Put the bike right-side-up on the ground, open and close both quick release skewers to make sure the wheels are in straight. Disc brakes put more stress on hubs than rim brakes, skewers need to be tight and checked regularly. Make sure both brakes are in the closed position. Put bike back on workstand.

9. Check all bearings to make sure none are too loose (or too tight).

10. Spin each wheel looking at rotor as it goes around. If the rotor appears to move back and forth double check that the wheel is in straight. If that does not fix the problem, the rotor may be bent. Squeeze all spokes, checking for broken spokes. All of the spokes on the same side of a wheel should be about the same tension.

11. Spin each wheel and test the brakes. Pads should not rub rotor. If you have noticed squishiness or reduced braking power or brake lever can be squeezed all the way without activating the brakes pad spacing may need to be adjusted, cable may need adjustment or hydraulic system may need to be bled.

12. This step cannot be done with bike right-side up and tires on ground, though you could do it by riding the bike in a safe place like an empty parking lot. While turning the pedals shift through all gears making sure they work smoothly and well. If it is missing a shift, or making a clicky-clicky sound when in certain gears it may need the cable tension or limit screws adjusted. Take a look at the cables and housing that connect the shifter to the derailers, cables that are rusted, frayed or kinked may need replacing. Occasionally drip some lube into all housing.

13. Clean your chain using citrus degreaser and a rag, an old toothbrush can help too. If the chain is too stretched out, has a stiff link or a link that has any other problem you need to replace the chain. One way to check if it is stretched out is with a ruler- 12 links should measure between 12 and 12 1/8”, if they are longer than that it is time for a new chain. Use chain lube to lube your chain. You may wish to wipe off excess lube with a dry rag.

14. Ensure tires have enough air. Check accessories such as rack, bag, pump, or computer are firmly attached and functioning.

Having moved to Santa Rosa from Boulder, I am very familiar with Flagstaff Mountain. It's a very popular climb for local riders. At 3.7 miles long with 1,174 vertical feet of climbing, it is not unlike a number of climbs in Sonoma County. What happened to this ex-professional cyclist on Flagstaff yesterday illustrates the need to always be aware of where you are on the road and reinforces the need not to drift toward the midline on descents...

http://www.dailycamera.com/news/boulder/ci_29644529

CYCLING and CONCUSSION

PART ONE: TEN QUESTIONS

While the data is a little old, it does underscore the degree of risk involved in cycling as it relates to sports-related injuries. In 2009, the American Association of Neurological Surgeons reported that of the 447,000 sports-related head injuries that were evaluated in U.S. emergency departments, 86,000 of them were related to cycling accidents. That made cycling the biggest cause of sports-related head injuries with football being a distant second with 47,000 head injuries reported. A common result of these head injuries is what has been historically referred to as a “concussion”. Let’s look closely at what this term and it’s implications means.

1) What is a concussion?

There are many definitions. There are formal detailed medical definitions and there are functional definitions. I prefer the latter of the two. I like the following, “a concussion is an injury to the brain that results in temporary loss of normal brain function and is usually caused by a blow to the head”.  Many people assume that concussions involve a loss of consciousness. That is a misconception. Often, a person with a concussion never loses consciousness. Another misconception is that that one can have a “minor” concussion. There are no “minor concussions” , as we will discuss in question #9.

2) How do they occur?

The brain is cushioned inside the skull by cerebrospinal fluid. In the setting of an abrupt, violent blow to the head, or even rapid deceleration, the brain can collide with the inner surface of the skull. This puts the brain at risk for tearing of blood vessels, pulling or shearing of nerve fibers and bruising of brain tissue.

3)Who gets them?

The contact sports of football, ice hockey, boxing, rugby, and soccer are often cited in the press as having a high incidence of concussion. The study referred to earlier obviously implicates cycling as an at-risk activity. When you consider the mechanism of injury outlined in question 2, we are all at risk pretty much all the time. Motor vehicle accidents, falls, assaults, and occupational accidents are other other events that can result in concussion. 

4)What are the symptoms of concussion?

Confusion is a primary symptom. It’s principal features include an inability to maintain an organized stream of thought, lack of awareness, easy distractibility, and an inability to carry out goal-directed movements. Confusion, however, is only one of the symptoms in a long laundry list of uncomfortable disorders. Prolonged headache, visual disturbances, dizziness, nausea or vomiting, impaired balance, memory loss, ringing in the ears, and light sensitivity can all occur. 

5)How can you recognize that someone may have a concussion?

Signs observed in someone with a concussion may include a vacant stare, slow response to questions or instructions, easy distractability, disorientation, slurred or incoherent speech, incoordination, memory deficits, and a period of loss of consciousness. Seizures are uncommon for this degree of brain injury and, if present, would suggest a more severe condition.

6)What should be done

If the symptoms and signs outlined in questions 4 and 5 occur after a blow to the head, a health-care professional should be consulted as soon as possible. A loss of consciousness or change in mental status requires a 911 call.

7)How is a concussion diagnosed?

The acute evaluation of an individual with possible concussion includes neurologic assessment and mental status testing. Prolonged loss of consciousness, persistent mental status changes, or abnormalities on neurologic examination require neuroimaging, specifically, a cat scan of the brain. It is possible to have a normal CT scan and still have a concussion.

8) How is concussion treated?

For those with an uncomplicated concussion a period of physical and cognitive rest is often recommended for at least 24 hours and sometimes longer depending on the symptoms present. This means avoiding general physical exertion and limiting activities that require thinking and mental concentration. Headaches should be treated with Tylenol. Pain relievers like Advil and aspirin should be avoided as they may increase the risk of bleeding.

9) What are some of the residual problems associated with concussion?

Postconcussion syndrome may include headache, dizziness, disrupted thought processes, and mental disorders resulting from disease of the nervous system. “Postconcussion Syndrome” will be the topic of Part 2 of “Cycling and Concussion”.

Post-traumatic vertigo includes dizziness that may be accompanied by hearing symptoms and balance problems and contributes significantly to disability after concussion. 

A very rare complication exists that is generally fatal. This occurs when there is diffuse swelling of the brain following a second concussion while someone is still symptomatic from an earlier concussion. Again, this is very rare.

There is evidence that individuals who have had one head injury are at increased risk of recurrent head injury with some studies showing a six-fold increase in risk. 

10)Can concussions be prevented?

Bicycle helmets can reduce the severity of accident-related head injury but concussion can still occur. Being visible to drivers, being predictable with your behavior on the road and communicating well with your fellow cyclists will all contribute to avoiding an injury in the first place.

Additional free bicycle maintenance clinics are available at the Santa Rosa Performance shop, 1993 Santa Rosa Avenue. Two clinics per month are offered and the posted schedule extends out to July as of this writing.

http://www.performancebike.com/webapp/wcs/stores/servlet/Content_10052_10551_-1_SpinDrClinics

Check out these photos from the Group Cycling Skills for "A" Riders taught on February 28, 2016 by Steve Kroek, Bob Owen, Richard Anderson and Darrin Jenkins.