cycling · fitness

New research on injuries in women cyclists: a step toward better healthcare for women in sports

For decades, women were largely ignored in research studies about sports injuries. Most treatment recommendations were based on extrapolations from work done on male populations. Times are a-changing, though. Last week, a new research article called “Unique concerns of the woman cyclist” came out, addressing particular types of cycling-specific injuries and conditions, with recommendations on identification, treatment, and… wait for it… prevention, too!

Yay! in white letters on an orange background

Full disclosure: Rozanne Puleo, the lead author on the article, is a friend of mine. Yeah, it’s a small world, which I definitely like. In addition to being a nurse practitioner working in sports medicine, Roz is a long-time road and mountain bike cyclist and racer.

One more note on the use of the word “female” in the article: the authors point out that the words used (women/female) don’t accurate represent the population of cyclists who don’t identify as cisgender males. They note that, in one study on women’s and gender-diverse participation in the cycling community, respondents in a questionnaire reported 12 different gender identities in addition to cisgender woman. They point readers to their bibliography for details on the study populations used.

On to the article. Here’s what Puleo and her coauthors had to say– as usual, I’ll start with a list, this one of the key points in the article:

  • Anatomical differences between male and female cyclist in cycling-specific areas (head, breast, hip/knee, upper extremities, and perineal area) may change the incidence, presentation and treatment of cycling specific injuries.
  • Concussions and traumatic brain injuries in female cyclist may present differently, both at time of injury and as time progresses.
  • Bicycle design specific for women is controversial; optimizing the bike fit to the rider is of greater value for injury reduction, comfort and safety (CAW: huzzah to this)
  • Saddle design and choice can influence the overall health of the cyclist.
  • Pelvic pain in female cyclists can have many different presentations (CAW: you got that right).

Puleo and her coauthors cover the research on cycling-related injuries literally from head to toe, addressing issues including breast injury, bone health, and pelvic pain. What sets this article apart for me, though, is two things:

  • It identifies bike fit, saddle selection, and vulvar care as so important for female cyclists.
  • It educates health care providers on the importance of addressing these issues.

For instance, they provide a table with treatment categories and strategies for dealing with pelvic pain. This is a very good thing.

This article is definitely among the things that make me say yay!
This article is definitely among the things that make me say yay!

If you’re a cyclist, definitely read this article. Again, the link is here.

I’m psyched that articles are coming out that address injuries and issues with those injuries specific to women, and also pleased at the identification of a variety of ways to address them. We need more of this.

Hey, readers: do these sorts of articles help you in your physical activities? Do you have a favorite one? Did you read this and have something to add? I’d love to hear from you.

5 thoughts on “New research on injuries in women cyclists: a step toward better healthcare for women in sports

  1. Catherine, I can’t read the article which seems to be behind a paywall. But from what you’ve given here, I have questions and concerns about whether and to what extent sex and gender are naturalized in this article. If, for example, there are no “natural” differences between the brains of men and women, that is, if cognitive and behavioural differences between women and men are the products of culture, not nature, can there be differences between the brain injuries and concussions of women and men, as well as their presentation? Brain injury and its presentation, too, I (and others) have argued, is a social construction. Is there something in the article that would assuage my concern?

    1. I should have made explicit (what is only implicit in my comment above) that I’m also concerned about the extent to which this article naturalizes brain injury.

    2. Hi Shelley– I’ll send you the pdf, as it is both detailed and issues lots of qualifiers in its citations of studies. In the section on head injury, the authors are careful to note lots of potential confounders in the current state of research on concussion and traumatic brain injury in females (the term they use for reasons they state earlier in the article). For instance, they acknowledge that sports-related head injuries are frequently under-reported. They also say there’s a lack of sex-specific epidemiological data, but noting general differences in e.g. cortical bone density, make recommendations like endorsing better helmet-fitting for female cyclists.

      From my reading, their discussions don’t assume either binary divisions (they explicitly reject that earlier on) or make reifying claims about any of the injury types they discuss. The authors see a need for better clinical treatment of women cyclists. This means educating other clinicians about e.g. the many cycling-specific causes of pelvic pain (a very common problem) and the many ways it can be treated (using many different modalities).

  2. Thanks so much for sharing this. Awesome that your researcher friend Roz is a cyclist and knows her stuff on the saddle. I appreciate the link to her original paper. Hopefully it will inspire other researchers to investigate women’s injuries in other sports.

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