PREVLANCE OF MUSCULOSKELETAL DISORDERS AMONG

CYCLISTS: A SURVEY STUDY

A PROJECT

Submitted to the faculty of medical sciences for fulfillment of the

requirements for the degree of
Bachelor of Physiotherapy (BPT)

(4.5 years course)

Supervisor Submitted by

Dr. Ajay Kumar Bikram singh maan

(Assistant Professor, Department of Physiotherapy) (19204136)

MARCH, 2023

DEPARTMENT OF PHYSIOTHERAPY

SRI GURU GRANTH SAHIB WORLD UNIVERSITY

FATEHGARH SAHIB
 DECALRATION

This is to clerify that the work entitled “ Prevelance of musculoskrletal disorders among cyclists”
is an outcome of the original research work undertaken and carried out by me under the guidance
of Dr. Ajay kumar. I have not submitted this work partially or wholly to any other university or
institution.

Candidate Supervisior

Bikram singh maan Dr. Ajay kumar

CERTIFICATE
This is to verify that the work entitled “Prevalence of musculoskeletal disorders among
cyclists” is being submitted by Bikram singh maan (19204136) for the award of the degree of
Bachelor of Physiotherapy to Sri Guru Granth Sahib World University, has been carried out
under the supervision. This work has not been submitted to any other university or institution.

Supervisior

Dr. Ajay Kumar

Assistant Professor

Department of Physiotherapy

Date:

CERTIFICATE
This is to certify that the work entitled “Prevalence of musculoskeletal disorders among
cyclists” submitted by Bikram singh maan (19204136) for the award of the degree of Bachelor
of Physiotherapy to Sri Guru Granth Sahib World University has been carried out under the
supervision of Dr. Ajay Kumar. This is an original work submitted only to Sri Guru Granth
Sahib World University.

Date: Department Incharge:

 ACKNOWLEDGEMENT

I would like to express my heartfelt gratitude to my supervisor, Dr. Ajay Kumar for the
continuous support and guidance throughout the project work. His support has always
encouraged me and led ne to new perspectives. I have been able to carry out my research project
with dedication and patience with enormous motivation by sir.

Secondly, I would extend my special thanks to my family for their immense support and
believing in me at every step.
INTRODUCTION

Musculoskeletal disorders (MSD) are a wide spread and increasing occupational health
problems worldwide (Luxembourg 2010). A wide range of inflammatory and degenerative
conditions affecting muscles, tendons, joints, peripheral nerves etc. are categorized as
"musculoskeletal disorders" (Laura et al., 2004).

The first successful steered two-wheeler was the wooden running-machine invented by
Baron von Drais in 1817 (chan et al., 2005)

We tend to take the bicycle too much for granted, forgetting the important role it played in
the evolution of modern technology. The first machine to be mass-produced for personal
transportation, the bicycle figured prominently in the early development of the automobile.
Thus, in addition to its own considerable direct by (Wilson et al) impact on society the
bicycle was indirectly responsible for substantial social and economic changes. A remarkably
efficient machine both structurally and mechanically, the bicycle continues to offer distinct
advantages as a means of personal transportation in both developed and underdeveloped
countries. When one considers how long the wheel has served in transportation (more than
5,000 years), it seems odd that the first really effective self-propelled wheeled vehicle was
developed only about 100 years ago. (Ceceralli at al., 2002)

Cycling is a popular source of recreation, transportation, and physical activity for children
and adults (Mcadams et al., 2018).

Bicycle Anatomy

Bicycles consist of a frame, handlebars, brakes, wheels, pedals, gears, and other components.
The key part is the frame, made of metal or metal alloys such as titanium, aluminium, steel,
or carbon. Frames can be thought of as two triangles: the front triangle consists of the top
tube, the seat tube, and the down tube, the chain stay, seat stay, and seat tube compose the
rear triangle. Handling and manoeuvrability are affected by the angles within each of these
triangles. Racing bicycles have a more upright geometry, with larger angles for increased
manoeuvrability. Touring bicycles have a flatter geometry, with much less pronounced
angles for easier handling and comfort. In contrast, mountain bikes, designed for
manoeuvrability and stability, have a geometry that provides for a lower centre of gravity,
resulting in much smaller angles in the frame (Ericson et al., 1986)

There are more than 800 million bicycles in the world and this is twice the number of motor
vehicles (Mcadams et al., 1990)
Physical activity is a factor affecting the quality of life and longevity by, for example,
recuing the risk of obesity, metabolic syndrome and cancer. One of the most commonly
practiced forms of physical activity by society at large is cycling (Zang et al., 2014)

Bicycle types used vary widely, ranging from mountain to road to stationary exercise
bicycles. As a readily available and efficient form of aerobic nonimpact exercise,
considerable health benefits can be gained from bicycling, including cardiovascular health.
(zang et al., 2014)

Cycling also has been found to be the most common sports-related activity associated with
injuries among cyclist. Cycling injuries can be classified into three distinct areas: Bicycle
contact, traumatic, and overuse disorders & injuries (Silberman et al., 2012).

The body regions most commonly involved by overuse injuries are the hand and wrist, neck,
lower back, knee and buttocks/ saddle region with reported incidence of symptoms consistent
with overuse injuries of up to 35–90%

Although traumatic injuries are high in incidence in cyclists, overuse injuries are more
difficult to anticipate because of their multifactorial nature. The knee joint is one of the most
affected body parts by overuse injuries (Callaghan et al., 2005).

A two-wheeler rider along with the two-wheeler can be considered as a constrained work
station (chan et al.,2005). During a journey, the rider will sit nearly in the same posture
throughout the ride. The factors like design parameters of two-wheeler such as height,
location and angle of foot, seat, handle bars and the physical dimensions of rider decides the
posture. A human operator will experience discomfort on any work station on continuous
exposure to a single posture. Two-wheeler riders are exposed to a more static position with
restriction in movements, for a very long period of time depending on the usage (willson et
al., 2006). Sitting in the same posture for a long time will results in restriction in blood
flow, which causes distress to body parts causing muscle stiffness and thereby discomfort.
Two-wheeler postures are physically demanding in nature, which may lead to fatigue.
Improvising the rider posture will eventually lead to improved rider comfort and thereby
reducing accidents. Usage of two wheelers for prolonged time can cause musculoskeletal
disorders. This can be generally designated as Driving related Musculoskeletal Disorders
(MSDs) (willson et al.,2006). Some examples of MSDs include lower back pain, disc
dislocation and spinal injury. MSD is prominent in situations where improper riding posture
present. Deviation from normal joint angles for long periods causes stress and thus pain.
Changing the lumbar curvature, thus deviating from standard lumbar angle will lead to non-
uniform disc pressure which causes pain that leads to disorders

Overuse disorders occur in bicycle riders who regularly ride their bicycle (Virtanen et al.,
2008).
MSDs can be caused by unsuitable preparation for cycling (lack of warm-up, use of wrong
equipment), poor riding technique, including inappropriate body position. The nature of the
terrain used for riding a bicycle also affects the musculoskeletal disorders incidence by
falling from a bicycle or vibration (Kirkley et al., 2002).

Bicyclists have 2.3 times as many fatalities and 1.8 times as many nonfatal injuries as motor
vehicle occupants per 100 million person-trips. For every two million trips, 600 injuries and
one crash fatality are estimated to occur. With regard to the total number of sports injuries
per year, cycling has the highest absolute number of injuries per year in the United States
(US) population (Callaghan et al., 2005).

On the other hand, bicycles are also a common source of significant injuries. Thompson and
Rivara referring to bicycle related injuries cited 900 deaths, 23,000 hospital admission,
580,000 emergency department visits, and more than 1.2 million physician appointments
resulting in an estimated cost of above $8 billion per year, in the USA alone (Callaghan et al.,
2005).
AIM OF THE STUDY
To find the prevalence of musculoskeletal disorders among cyclists.

OBJECTIVES OF THE STUDY

To identify MSDs that are more prevalent in cyclists.

To find the association of MSDs with various factors associated with cycling and cyclist.

To find the risk factors that contributes to MSDs among cyclists

NEED OF THE STUDY

Cycling is an appealing mode of locomotion and the adherence with cycling has increased
progressively through the years. Some people treat cycling as a passion and practice it at every
possible occasion, while for others it is a mean of transport or a form of relaxation at the
weekend (Callaghan et al., 2005).

Traumatic injuries occurred in cycling 48.5% of the time, while overuse injuries occurred 51.5%,
as reported in one study in top level professionals. (Bernardo et al., 2012).

As there is no data or studies on musculoskeletal disorders among Indian cyclist and thus is the
need of study

METHODLOGY OF STUDY

Study design: Survey study

Method of sampling: Convenience sampling

Sample size: 100

Research setting: Patiala

Tool for data collection: Self- reported questionnaire

Research duration: 3 months

The questionnaire consisted of the consent followed by demographic details of the subject
and few questions regarding experience, warm up, coping strategies. And for the prevalence
of Musculoskeletal Disorders the Nordic Musculoskeletal questionnaire was used.

Analysis was done using SPSS VERSION 26.

INCLUSION CRITERA –
• Both male and female cyclists were included in the study.

• Cyclists aged between 20-40 years were included.

• Those cyclists regular ride their cycle from 12 months and 1 hour or more per day were
included.

• Those who completed the forms were included.

EXCLUSION CRITERIA-

• Those who had any congenital deformity were excluded.

• Those have surgeries in the past were excluded.

• Those have any established or know joint deformity were excluded

CHAPTER 2

REVIEW OF LITERATURE

Table 2.1: studies regarding the anterior knee pain and spine pain among
cyclists.
AUTHOR TITLTE OBJECTIVE METHOD CONCLUSION

Piotrowska et al., Lower extremity The purpose of 167 people from Cyclists cite knee
(2017) and spine pain in this study is to different parts of joint and lumbar
cyclist. assess the Poland spine as the
incidence of pain participated in the locations most
in the lower study. Only commonly
extremities and amateur cyclists affected by pain.
spine caused by participating in
riding a bicycle, competitive
and to evaluate racing were
the influence of included. The
various factors studied group was
(such as age, selected
weight, training randomly. The
experience, interviewer also
presence of asked cyclists to
warm-up/stretchin indicate the
g) on injury location of pain
incidence. on a diagram of
human body
(view from front,
back, side).

Table 2.2: study regarding the prepatellar syndrome among cyclists.

AUTHOR TITLE OBJECTIVE MTHOD CONCLUSION

Claes et al., Prepatellar To determine the A group of 28 PPFS is a new

(2015) friction syndrome: surgical professionals clinical entity of
a common cause management of male elite cyclists the triple layered
of knee pain in prepatellar diagnosed with prepatellar fascia;
elite cyclist. friction syndrome. prepatellar structures. Correct
syndrome were diagnosis is
retrospectively critical and based
reviewed with on typical history
specific attention and clinical
for the typical findings partial
 history clinical pre patellar
finding and fasciectomy is the
treatment treatment of
modalities. choice in order to
regain the pre
injury
performance
level.

Table 2.2: studies regarding the prepatellar syndrome among cyclists.

AUTHOR TITLE OBJECTIVE METHOD CONCLUSION

Bailey et al., Kinematics of To find the risk ofParticipants The differences in

(2014) cycling in relation knee injuries Twenty-four coronal plane
to anterior knee active male shank angle
pain and patellar To find the effect cyclists with at between the
tendinitis. of cycling on knee least one year’s previously injured
pain. To study the experience of group and the
persons facing regular cycling group without a
knee joint were recruited to history of injury
injuries. the study. Their were in line with
age, height, body the results of
mass, experience previous studies.
and weekly This support arose
cycling. from the
consistently
greater abduction
shown by the
cyclists with a
history of injury,
which was found
to be significant at
the point of
maximum
adduction. The
support for
previous research
would have been
greater if the
greatest
abduction.
AUTHOR TITLE OBJECTIVE METHOD CONCLUSION

Fairclough et al., The functional To find the The presence of The term ‘ITB
(2006) anatomy of iliotibial band fat deep to the friction
iliotibial band syndrome among ITB, fibrous syndrome’
during flexion and cyclists connections suggests that there
extension of the anchoring the is a shear
knee: implication To find the tract to the femur movement of a
for understanding reasons affecting and any bursae fascial plane
iliotibial band cyclist by IT band were noted. A relative to the
syndrome in syndrome. well-defined lateral femoral
cyclist surface anatomy epicondyle. This
model, who gave has led to the
full written belief that a bursa
informed consent, is present between
was asked to the opposing
perform a series surfaces and that
of knee squats to bursitis is inherent
cycling players in the syndrome.
from full
extension to 90°
of flexion.

AUTHOR TITLE OBJECTIVE METHOD CONCLUSION

Ilan et al., (2004) The Vicious To identify the The search Traumatic injuries
Cycling: urogenital yielded overall 62 as well as overuse
Bicycling Related disorders in pertinent articles. injuries, many of
Urogenital cyclists We focused them directly
Disorders primarily on the affect the
To identify the most prevalent genitourinary tract
impacts of cycling related disorders causing genital
on andrological such as erectile numbness, ED,
disorders. dysfunction (ED) priapism,
and pudendal infertility,
nerve entrapment. hematuria and
The potential influence serum
effect of bicycling PSA levels.
on serum PSA Urologists should
level was also thus be aware that
discussed in depth bicycling is a
in view of its possible and not
recognized an infrequent
clinical cause of a variety
importance. of such urological
Sporadic and andrological
disorders, which disorders.
were represented
by a single
reference, were
still addressed
RESULTS

Fig 1.1

AGE

23%

77%

20-30 31-40

Fig 1.1 represents:

Out of the age group between 20-40 years, individuals with 20-30 years were 77% and 31-40
are 23%
Fig 1.2

GENDER

24%

76%

MALE FEMALE

Fig 1.2 represents:

Among 100 of the participants 76 are males and 24 are females.

Fig 1.3
 SMOKING HABITS

8%

92%

YES NO

Fig 1.4

ALCOHOL DRINKING

19%

81%

YES NO

Fig 1.5
 SLEEP DISTURBANCE

9%

91%

YES NO

Fig 1.6

EXPERIENCE IN CYCLING

10% 1%

32% 57%

1-3years 4-7years 8-10years more than 10 years

This pie chart represents experience of cycling among the cyclists 57% of cyclists have
experience of 1-3years and 32% have 4-7 years and 10% have 8-10year experience and 1%
are more than 10 years.
 PEDALING TIME

1%
16%
25%

58%

60 minutes 60-90 min 90-120 min More than 120 min

This pie chart represents the pedaling time of cyclists 58% of cyclists ride their cycle for 60
mins and 16% of cyclists ride cycle for 60-90 mins and 25% of cyclists ride their cycle for
90-120 mins and 1% of cyclists ride cycle more than 120 mins.

Fig 1.7

PEDALING DISTANCE COVERED PER DAY

7% 12%

81%

1-10 km 11-20 km more than 20 km

Above given pie chart represents that 81% cyclist in this study ride 11-20 km distance and
12%of cyclists ride 1-10 km and 7% ride more than 20 km of distance.
Fig 1.8

Frequency of cycling in a week

11%
26%

63%

1-3 days 4-6 days 7 days a week

Above given pie chart represents the frequency of cycling in a week by a cyclist 26% of
cyclists ride cycle 1-3 days a week and 63% of cyclists ride their cycle 4-6 days a week and
11% of cyclists ride cycle.

Fig 2.1
 DO YOU PERFORM WARMUP EXERCISES

10%1%

14%

75%

1. no 2. Low impact aerobics

3. Stretching exercises 4. Both

Above given pie chart represents warm up exercises performed by cyclists before cycling
75% of cyclists do no perform warmup exercises and 14% do low impact aerobics and 10%
perform stretching exercises and 1% perform both.

Fig 2.2
 DO YOU PERFORM EXCERCISES APART FROM
CYCLING

3%
3%3% 20%

22%
5%

44%

1. no 2. Yoga 3. Walking 4. Gym

5. Running 6. Swimming 7. others

Above given pie chart represents the apart exercises done by cyclists 10% of cyclist do not
do any apart activity and 5% do yoga 44% do walking 22% do gym 3% do running,
swimming and others.

Fig 2.3
 TYPE OF CYCLE USED

1 % 11%
3%
12%
4%
4%

65%

1. Fat cycle 2. Hybrid cycle 3. Mountain cycle 4. Touring cycle

5. Fixed gear cycle 6. Downhill cycle 7. others

Above given pie chart represents the type of cycle used for cycling the 65% of cyclists use
hybrid cycle and 4% use mountain bike and 4% of cyclists use touring cycle and 12% of
cyclists use fixed gear cycle and 11% of cyclists use fat cycle.

Fig 2.4

Type of foot wear used during cycling

2%
5%
1%
37%

55%

1. Slippers 2. Sport shoes 3. Flat pedal shoes

4. Clipless shoes 5. others

Above given pie chart represents that 55% of cyclists wear sports shoes during cycling and
37% of cyclists wear slippers 1% of cyclists wear flat pedal shoes and 5% of cyclists wear
clipless shoes.
Fig 2.5

DO YOU WEAR SAFETY GEARS

7%

93%

yes no

Above given pie chart represents the safety gears used by cyclist during cycling 93% of
cyclists does not wear safety gears and only 7% of cyclists wear safety gears.

Fig 3.1
 Have you experianced any pain in last 12 months due to
cycling

19% 5%
3%
14%

24%
35%

neck one or both shoulders one or both elbow

lower back hips and thigh knees

Above given pie chart represents that 35% of cyclists are having lower back pain and
24% of cyclists have pain in hips and thigh region and 19% have pain in knees and 14%
have pain in elbows and 3% have pain in shoulders.

Fig 3.2

INTENSITY OF PAIN

3%5%

92%

1. Mild 2. Moderate 3. Severe

Above given pie chart represents that 92% of participants have mild intensity of pain and
3% of cyclist have moderate and left 5% have severe intensity of pain.

Fig 3.3
 AGGRAVATING FACTORS

7%5%
14% 43%

31%

1. cycling in same position for long duration of time

2. Bending or twisting your back during cycling
3. Riding cycling in different terrain in one day
4. Not enough rest breaks or pauses during day
5. Working with pain or any trouble
Above given pie chart represents the aggravating factors that are 43% is cycling in same
position for long time 31% bending or twisting back during cycling and 14% is riding
cycle in different terrain and 7% is not taking enough brakes and 5% is working in pain
or any trouble.

Fig 3.4
 COPING STATERGIES

1. By adjusting seat of cycle

2. I modify my position or
2%
2% cycle
15% 3. Regular warm ups and
40% stretching
4. I select techniques/pro-
19% cedures that will not aggra-
vate my pain
22% 5. Consulting with health care
professional
6. I took medications to re-
lieve my pain

Above given pie chart represents the coping strategies adopted by cyclists to get over the
pain or discomfort 40% is by adjusting seat of cycle 22% is modifying position of cycling
19% is regular warmup and stretching 15% is adopting techniques that don’t aggravate
pain and 2% is consulting health care professionals and taking medications.

Fig 3.5
 What treatment you have taken with respect to muscu-
loskeletal conditions due to cycling?

1. no
2. over the counter drugs
8%1% (painkillers without prescription)
3. chemists
20% 43% 4. orthopedic consultation
5. physiotherapy treatment

28%

Above given pie chart represents that 49% of persons with MSDs are taking over counter
drugs and 35% are consulting chemists and left 14% go for orthopaedic treatment and
only 2% of cyclists have taken physiotherapy treatment with respects to MSDs.

Fig 4.1

Are you aware of physiotherapy

33%

67%

Yes No
Above given pie chart represents that 67% of cyclists are aware of physiotherapy and
33% are not aware about physiotherapy treatment.

Fig 4.2
 would you like to consult a physiotherapist with regard to your
problem you are facing?

21%

79%

YES NO

Above given pie chart represents that 79% of cyclists want to consult a physiotherapist after this
survey.
Table-

Gender Yes No Total X2 P value

Male 28 48 76

Female 9 15 24 1.475 .994

Total 37 63 100

Age

20-30 23 44 64

31-40 4 19 14 30.600 .03

Total 37 63 100

Cycling
experience

1-3 years 22 35 57

4-7 years 9 25 34 27.094 .000

8-10 years 5 3 8

More than 10 1 0 1
years

Total 37 63 100

Distance
covered

1-10km 4 9 13

11-20km 30 48 78 9.229 .808

More than 3 6 9
20km

Total 37 63 100

Pedaling time
60 mins 8 8 16

60-90 mins 18 40 58

90-120 mins 11 14 25

More than 0 1 1
120 mins

Total 63 100

Warm up
exercises

No 27 49 76

Low impact 7 7 14 15.210 .028

aerobics

Stretching 3 7 10
exe

Both 1 0 1

Total 37 63 100

Cool down
exercises

Yes 11 16 27

No 26 47 73 15.430 .113

Total 37 63 100

Type of cycle

Fat cycle 4 7 11

Hybrid cycle 25 40 65

Mountain 2 2 4
cycle

Touring cycle 1 3 4

Fixed gear 4 8 12 30.122 .387

cycle

Downhill 1 2 3
cycle

Others 0 1 1

Total 37 63 100

Do you
perform exe
apart from
cycling

No 4 16 20

Yoga 2 3 5

Walking 15 29 44 39.932 .008

Gym 12 10 22

Running 2 1 3

Swimming 0 3 3

Others 2 1 3

Total 37 63 100

Do you wear
safety gears

Yes 4 4 8

No 33 59 92 6.689 .591

Total 37 63 100

Type of foot
wear

Slippers 13 24 37

Sport shoes 22 33 55 12.333 .760

Flat paddal 0 1 1
 shoes

Clipless 1 4 5
shoes

Others 1 1 2

Total 37 63 100

The above give tale states the value of answers along the association of each factor with
prevalence of MSDs among cyclists in Patiala
Discussion

Musculoskeletal disorders (MSDs) are common among cyclists due to the repetitive nature of
the sport, poor cycling posture, and overuse injuries. MSDs can affect any part of the body
but are most commonly observed in the lower back, neck, knees, shoulder and elbows. (Chen
et al., 2005)

Haworth et al., (2009) reported a high prevalence of LBP among cyclists as the highest
complaint in comparison to other body regions.

Piotrowska et al., (2017) concluded that the incidence of pain in the lower extremities and
spine caused by riding a bicycle, and to evaluate the influence of various factors (such as age,
weight, training experience, presence of warm-up/stretching) on injury incidence. The 167
people from different parts of Poland participated in the study. Only amateur cyclists
participating in competitive racing were included. Cyclists were asked to locate the of pain
area on a diagram of human body (view from front, back, side) during cycling. Cyclists cite
knee joint and lumbar spine as the locations most commonly affected by pain. The pain in the
back region is associated with the positioning of cyclist during cycling.

As in this study the prevalence of lower back pain is highest (35%) among cyclists from
Patiala. the study is consisted with our study and the (7%) is among knees and (9%) among
hips and thighs.

Studies have reported a high prevalence of MSDs among cyclists. For example, a study
conducted by Wilber et al. (2007) reported that up to (85%) of cyclists experienced some
form of lower back pain during their cycling career. Another study by (Clarsen et al., 2010)
reported that (62%) of cyclists suffered from neck pain, while (55%) reported lower back
pain.

In this study the prevalence of neck pain among cyclist is (05%).

Recreational cyclists are also at risk of developing MSDs due to their prolonged sitting
position on the bike, and repetitive motion of cycling. A study by Siu et al. (2017) reported
that recreational cyclists had a high prevalence of MSDs, with (69%) reporting lower back
pain and (59%) reporting neck pain. Due to the prolonged stable posture of neck the neck
pain becomes more prevalent as (59%)

Vibration exposure from the handlebar could lead to symptoms in the wrist and shoulder
(Pope et al., 1992). As in this study the prevalence of shoulder pain is (3%) and elbow pain is
(14%).
The vibration is not initiated from the seat alone; instead it also comes from the handlebar.
The prevalence of elbow, shoulder and neck pain in cyclists is also seen in this study.

The occurrence of MSDs among cyclists has also led to work inefficiency in term of work
absenteeism. Nevertheless, it does not reflect in the number of days/weeks/months. It was
found that there was a significant association between daily riding hours and LBP. Although
there is a lack of scientific evidences on the effects of riding hours to the occurrence of LBP
for cycle riders

The relatively high levels of MSDs among cyclists may be attributed to the fact that riding
requires excessive use of body parts. When riding a cycle, consistent use of shoulder, neck,
upper and lower back, and legs are important since all these body parts are needed to
maintain stability while riding. Besides that, prolonged sitting and fixed posture can lead to
muscular fatigue (Haworth et al., (2009). This can also be associated with the discomfort
experienced by cyclists. In addition, exposure to vibration may add to the severity of the
health problems experienced. Exposure to whole body vibration (WBV) has been proven to
be of an important factor associated with MSDs, with the most frequently reported adverse
effects being LBP (Xu et al., 1997)

Piotrowska et al., (2017) studied that there is high prevalence of MSDs among cyclists
underscores the importance of proper bike fit, good cycling posture, and adequate warmup.
Cyclists should ensure that their bikes are properly fitted to their bodies and that they use
good cycling posture while riding. They should also incorporate strength training exercises
that target the muscles used in cycling to reduce the risk of overuse injuries.

As in this study the prevalence of MSDs increases with lack of warmup exercises the (p
value 0.28) and a proper use of safety gear is also necessary.

According to a survey by (Mohamed), Malaysians, particularly young adults, prefer using

bicycles for recreational transportation. A Fixie bike is a specific type of bicycle. Youth
cyclists in Malaysia who ride Fixie bikes often range in age from 20 to 30 years old. young
cyclists between the ages of 20 and 30 years old are those who are at less risk of developing a
Musculoskeletal disorder and age groups 30 to 39, and 50 to 59 are more prevalent to MSDs

According to this study the prevalence of MSDs also increases with increase in age with (p
value .003)
Conclusion

In conclusion, cyclists from Patiala have a significant prevalence of musculoskeletal

disorders. In this study, there is a higher prevalence of lower back pain among cyclists.

The lack of warmup and cool down exercises increases the prevalence of having
musculoskeletal disorder. With increase in the experience in cycling is also increases the
MSDs in cyclists.

By performing regular warm-up and cool-down activities and proper use of safety gears both
decreases the risk of developing musculoskeletal disorders (MSDs).

Regular warm-up and cool-down exercises, as well as the right use of safety gears, are
essential for cyclists and will reduce their risk of injury.
Limitations of The Study
The size of sample is small.

Area take for survey is limited.

Size of male and female cyclists’ participants have big difference.

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Questionnaire

Consent
Yes
No
Demographics
Name __________
Age__________________
Gender-Male/Female/prefer not to say

Occupation

Private Job/Government Job

Business/Entrepreneur
Student

Sports person

Address _____________

Height (CMS)_____________

Body weight ____________

Life style factors

Do you smoke?

1. Yes
2. no
Do you consume alcohol?

1. yes
2. no
Do you have any sleep disturbance?

Yes

no

Years of experience in cycling

Pedalling time per day

60 minutes
60-90 min
90-120 min
More than 120 min

Pedalling distance per day

Pedalling frequency per week

1-3 days
4-6 days
7 days a week

Do you perform warmup exercises?

1. no

2. Low impact aerobics

3. Stretching exercises
4. Both
5. If others then mention
Do you perform cool down exercises after cycling?
1. Yes
2. no
Mention if yes ____________
Do you perform exercises apart from cycling?

1. no

2. Yoga
3. Walking
4. Gym
5. Running

6. Swimming

7. others

Type of cycle used

1. Fat cycle

2. Hybrid cycle

3. Mountain cycle

4. Touring cycle

5. Fixed gear cycle

6. Downhill cycle

7. others

Type of foot wear used during cycling

1. Slippers

2. Sport shoes

3. Flat pedal shoes

4. Clipless shoes

5. others
Do you wear safety gears?

1. Yes

2. no

If yes then mention ___________.

Type of cycling

1. Low pace
2. racing
3. Combination

Have you ever experienced any pain in last 12 months with respect to cycling?

1. No
2. Neck
3. One or both shoulders
4. One or both elbow
5. One or both wrist/ hands
6. Upper back
7. Lower back
8. One or both hips/ thighs
9. One or both knees
10. One or both ankles/feet

Have you experienced any trouble or pain in below region from a week due to cycling?

1. No
2. Neck
3. One or both shoulders
4. One or both elbows
5. One or both wrist/ hands
6. Upper back
7. Lower back
8. One or both hips/ thighs
9. One or both knees
10. One or both ankles/feet
Have you experienced any trouble or pain in below region during cycling?

1. No
2. Neck
3. One or both shoulders
4. One or both elbows
5. One or both wrist/ hands
6. Upper back
7. Lower back
8. One or both hips/ thighs
9. One or both knees
10. One or both ankles/feet

What is intensity of pain?

1. Mild

2. Moderate

3. Severe

What is nature of pain?

1. Dull pain

2. Throbbing pain

3. Nagging pain

4. Aching pain

5. Sharp shooting pain

What factors aggravates your pain

1. cycling in same position for long duration of time

2. Bending or twisting your back in awkward way
3. Riding cycling in different terrain in one day
4. Not enough rest breaks or pauses during day
5. Working with pain or any trouble

Relieving factors

1. Rest

2. Medications

3. Stretching

4. Exercises

5. Others
What are the coping strategies to reduce your pain? Yes/no

1. By adjusting seat of cycle

2. I modify my position or cycle
3. Regular warm ups and stretching
4. I select techniques/procedures that will not aggravate my pain
5. Consulting with health care professional
6. I took medications to relieve my pain
Have you taken any treatment with respect to musculoskeletal conditions due to cycling?

1. no

mention if yes

2. over the counter drugs (painkillers without prescription)

3. chemists

4. orthopedic consultation

5. physiotherapy treatment

Are you aware of physiotherapy management?

1. Yes

2. No

would you like to consult a physiotherapist with regard to your problem you are facing?

1. Yes

2. no