Cycling is for everyone, not just the sporty or able-bodied. When you think about it, all bicycles and tricycles are mobility aids: they enable us to move more efficiently – and more enjoyably – than we could without them.
Cycling solutions for those with disabilities or ailments aren’t widely known. So here’s an A to Z of common issues.
Hands, spine, hips, and knees are the most affected areas. To take the pressure off them, adapt your bike to sit more upright or buy one that lets you do so. Lower gears will avoid stressing knees and hips, while wider, softer tyres will limit the impact of bumps and vibrations.
Acquired brain injuries are often the result of a stroke or an accident. Common symptoms, on top of speech problems, include weakness and a lack of mobility on one side of the body. An upright or semi-recumbent tricycle, with electric assistance if required, can be ridden with one arm and/or leg doing little or no work.
The solution will depend on your mobility level. Options range from an upright bicycle with specific features, such as a step-through frame and foot straps, through to pedal tricycles and handcycles. Again, electric assistance is useful.
Adults with restricted growth are heavier and have different proportions from equivalent height children. So an adapted child’s bike isn’t the best choice. Islabikes is launching restricted growth bikes. Or you could get a bike custom built. Features to look for include a low step-over, short cranks, and easy-to-reach controls; electronic shifting can be helpful for riders with shorter fingers.
You can’t drive in the UK unless seizure-free for at least a year, so a bike provides useful mobility. Everyday cycling is feasible if you suffer from ‘absence seizures’ or have warnings of impending seizures. If your seizures render you unconscious, a tricycle is a better option since it won’t fall over. Use segregated, traffic-free cycle tracks where practical.
Assuming it’s not so bad that you’re housebound, an electric bike is the answer. E-bikes come in all cycle varieties these days. Get a reliable, big-brand model that has a choice of assistance levels.
Stiffness or weakness in the hands might be a result of carpal tunnel, rheumatoid arthritis, or trigger finger. Flared, ergonomic hand grips can help with comfort, as can raising the handlebar. Twistgrips or push-button electronic shifters may make gearshifting easier than with levers, while hydraulic disc brakes or a back-pedal coaster brake don’t depend on grip strength.
Fit a handlebar mirror to your bike, on the righthand side, to give you an early warning of traffic approaching from behind. You may also want one on the other side. Garmin’s Varia is a radar rear light that alerts you to approaching traffic.
This sounds like a minor complaint but if it affects your nether regions it can cause boils and saddle sores that stop you cycling. British Cycling specifically advised its Olympic cyclists to avoid shaving or waxing their undercarriages to prevent this problem!
For cyclists, hips and knees (see below) are the common trouble spots. With one or more stiff hips, it can be hard to mount the bike. A step-through frame is simplest solution; lightweight versions are available. A dropper seatpost, designed for mountain bikes, may also help.
For knee pain or stiffness, use lower gears so you’re not putting as much force through the knee. Sliding the saddle back can help, as it shifts some bodyweight from the feet to the backside. Change the cranks if necessary. Swing cranks reduce knee bend, as do shorter cranks. Use conventional flat pedals or clip-in pedals with lots of float to prevent pedalling in a way that’s painful to your knees.
With one arm, you’ll need either a coaster brake or a twin lever like Hope’s Tech 3 Duo to stop your bike safely. Rear derailleurs and hub gears can be shifted with only one hand. For a front derailleur, you’ll need to add a different kind of shifter on the same side of the handlebar – for example, a twistgrip for the front, a trigger shifter for the rear.
With no arms, you need a recumbent trike with shoulder steering, automatic gear shifting, and a coaster brake – Hase’s Kettwiesel can be specified like this. Upright cycling is possible with one leg but you’ll want a clip-in pedal or toe-clip to be able to drag the crank around, and possibly a low step-over for ease of stopping/starting. Foot retention is essential if you have a prosthetic leg too, in order to keep the artificial foot on the pedal. With two prosthetic legs, a trike is the best option; with no legs, a handcycle is.
Muscle weakness and balance problems can be addressed with an electrically-assisted tricycle, ideally with a step-through frame. Some, like Van Raam’s Easy Go scooter bike, double as mobility scooters and don’t have to be pedalled. If you can’t cycle independently, you can still enjoy cycling on a wheelchair tandem (which has a wheelchair seat between the front wheels) or a wheelchair transporter trike (a cargo trike designed to carry a wheelchair passenger).
When you lean forward on a bike, you have to lift your head up to see where you’re going. This can exacerbate or create neck pain. The more you lean forward, the worse it is. Solution? Don’t lean forward! Sit more upright. You can do this by raising your handlebar, switching to a roadster, or riding a recumbent.
Avoid lightweight racing bikes. Even if they don’t have a weight limit – and many do – you’re likely to find them uncomfortable and over-geared. An inexpensive hardtail mountain bike, built from steel or aluminium, is a good bet: it will be strong, low-geared, and have decent brakes. Change the saddle to one you find comfortable and the knobbly tyres for slicks. An e-bike is another good option. A higher-torque motor, mostly found on e-mountain bikes and e-cargo bikes, is useful for hilly terrain.
Indoor cycling has been shown to be as effective as medication in alleviating the symptoms of Parkinson’s Disease. Parkinson’s sufferers may retain the ability to cycle well (outdoors) even when walking becomes difficult. A step-through frame will help with mounting, while a trike addresses balance issues. Riding a tandem with a more able-bodied pilot is another option.
Paralysis in all four limbs doesn’t necessarily preclude cycling. An electrically-assisted handcycle may be viable if the arm paralysis is partial. Head and chin movement alone is sufficient to control a Boma All Terrain wheelchair. A wheelchair tandem or wheelchair transporter enables you to cycle with an able-bodied companion.
Any form of exercise can be a trigger for asthma. A preventer inhaler may be sufficient to stop attacks but it’s important to carry a reliever inhaler when cycling, especially if there are aggravating factors like cold air, pollution, or pollen. More serious respiratory problems, such as COPD, demand an e-bike or an electrically-assisted trike.
Common symptoms from MS include problems with vision, sensation, balance, arm or leg movement, and fatigue. You can cycle with MS, and exercise has been shown to have a range of beneficial effects. The best cycling solution will depend on your symptoms but e-bikes, trikes, and tandems are all potential answers. Check the advice here for comparable problems.
Type 1 Diabetes
You can ride any bike with diabetes so long as you’ve got a strategy for keeping your energy levels up. For short rides, such as a half hour commute, sipping an energy drink halfway should stop your blood sugar falling. For longer rides, you’ll need to test your blood sugar as you go. Diabetes.co.uk recommends testing at 20 minutes, then every half hour.
Unable to balance
Any kind of tricycle will work. You can also be a stoker (the rider who doesn’t steer) on a tandem. If you can’t sit securely on a saddle, try a semi-recumbent tandem with a chair-style front seat like the Hase Pino. This can be fitted with a safety harness, if required.
You’re allowed to cycle even if you’re registered blind. You’ll know yourself if your partial sight – perhaps with mirrors to help – is good enough for solo cycling on quiet roads or cycle tracks. If it isn’t, you can still ride a tandem with a sighted partner.
Waist-down paralysis (paraplegia)
A handcycle is the answer. There are models for racing, for use off-road, and for everyday transport. There’s a good argument for electric assistance unless you’re fit or live somewhere flat, as arms can’t generate as much power as legs.
Back in 2018, the World Health Organisation used this as a placeholder name for a hypothetical virus capable of causing a pandemic. Covid-19 is arguably it. Cycling is a good way to avoid being exposed to Covid-19 when travelling, since it promotes social distancing. If you do contract it or are forced to quarantine because you might have it, the only riding that’s allowed is stationary cycling at home.
Hay fever is an annoyance when cycling but one that you can usually deal with. If you get such symptoms year-round, see your GP for advice. Your allergy triggers will affect when and where it’s best to cycle.
See under F, chronic fatigue.