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Cycling is a many-faceted, popular activity. It is thought that there are as many as 100 million bicyclists in the United States currently, with adults making up one-third of this number. The amateur bicycling league began in 1920/1921 in New York.1 In 1975, the name changed to the Unites States Cycling federation.1 In 1995, USA Cycling was incorporated in Colorado and the two organizations merged into USA Cycling as of today.1 USA Cycling is the official governing body for competitive cycling. This includes road, track, pro, mountain bike, BMX, cyclocross, and collegiate cycling. Membership in the USA cycling was about 54,000 members in 2008 and about 64,000 members in 2013.1 In 2013, there were 2760 clubs, 3107 sanctioned events in the US and 76,046 licenses.1

Cycling can be performed on a variety of terrains with different types of bicycles for different purposes. The goal of getting from one place to another requires some amount of energy expenditure. On land, cycling is an efficient means to accomplish this.2 In addition, the use of stationary cycling has been advocated by numerous physicians to rehabilitate patients following surgeries or injuries to their lower extremities.3,4,5

To fully understand the sport and treat recreational or competitive cyclists effectively, it is necessary to have a working knowledge of the cyclist, the bicycle, and the interaction of the two. By integrating knowledge of both the bicycle and the rider, optimal care can be given to cyclists. This chapter is designed to help clinicians understand basic bicycle function, elements of proper fit, basic muscle function used when cycling, injury prevention, common cycling injuries and their etiologies and treatment, and return-to-sport guidelines.

Participation in cycling can be done as either a sport or an exercise modality in the rehabilitation process (Table 17.1 and Video 17.1).

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Video 17.1: Stationary bike.

(From Prentice WE. Therapeutic Modalities in Rehabilitation. 4th ed. New York, NY: McGraw-Hill Education; 2011.)

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TABLE 17.1Energy Values for Select Leisure and Recreational Activities in METs

Cycling as a sport encompasses different types of riding as well as different types of bicycles. Four different types of bicycles can be identified: (1) sport/touring, (2) racing, (3) mountain, ...

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