share the road

Amen to that!

It’s #BikeToWork week, a time to celebrate….by getting on your bike!

When I’m not on the bike, but instead wandering the ‘twittersphere,’ I have come upon some gems this week.  @NerdWallet posted a great set of slides profiling such data as the top American cities where people bike commute (Davis, California tops the list; but my previous home town of Santa Cruz, California is in the top 10–it’s number 5).

We publish frequently on the subject of cycling and sport medicine in the journal.  On the blog, too, we profile cycling:  from the Tour de France to the contentious issue of bicycle helmet use as injury prevention.

In celebration of this week (allowing me more time on the cycle, and less on the computer) I thought I’d direct you to my personal blog for a post I made a couple of years ago on the joys of discovery on the local bike paths here in Columbus, Ohio.

Enjoy your week, and make it better with an active commute!



Le Tour et La Corse


Les montagnes de L’Île de Beauté: La Corse

…et La Centieme:  The 100th edition of Le Tour, the Tour de France, begins today, with the Grand Start in Corsica for the first time in the race’s history.


Who needs the Tricolor? The Flag of Corsica: once an independent republic, now part of France, still with its own language and distinct customs.

What a way to celebrate the centennial of the Tour!

Corsica, or La Corse, is a French island in the Mediterranean, and is comprised of two of that nation’s departments: Haute-Corse and Corse-du-Sud.  It is the only region of France which has not previously hosted a stage of Le Tour.

The island has a long history, perhaps best told in one of the finer travel books I have ever read, The Granite Island, by Dorothy Carrington.  The island has passed through many hands over its history:  the Carthaginians, Romans, Genoans and others have all claimed the island for their own.  The island even enjoyed an independent existence for some years:  the Corsican Republic was formed in 1755 under the leadership of Pasquale Paoli.  Corsica’s most famous son, Napoleon, was born there in 1769.  And it was during the time of the “Napoleonic wars” that he set loose on Europe that the island became part of France.  It has remained a part of that country ever since.

I have a special fondness for this land, known by the French as  L’Île de Beauté:  the Isle of Beauty.  I have visited Corsica twice, and was smitten with the island from the first my eyes lay sight on the port of Calvi. (Some readers may recognize Calvi as the site of the 2011 IOC Advanced Team Physician course.)

Corsica is quite simply arresting:  from its mountains and trails, to its beaches, to the very smell of the island (its vegetation, known as the ‘maquis’, has a distinctively lovely fragrance), it can put anyone under its spell.

That said, I suspect the cyclists in Le Tour this year may be smitten in a different way than I was on my visits.  Like any beauty, Corsica has its caprices.  The mountains I found lovely will almost certainly pose extraordinary challenges to the competitors.


Cirque de la solitude: in the mountains of central Corsica


The capital of Corsica: Corte, through which the 2nd stage of the Tour will pass











The second stage of the Tour this year will traverse the mountains that form a spine through the center of the Island, heading from Bastia on the east coast, through the mountainous capital of Corte, and ending on the west coast in Ajaccio, the birthplace of Napoleon.  The Tour’s website describes the ride as a rollercoaster; “Expect some real damage,” the site boasts menacingly!    Let’s hope no one meets his ‘Waterloo’!

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France, Le Tour, cycling injuries and cycle helmets

Welcome back following a short break in France, during which I spent a week in the Languedoc admiring the scenery and enjoying the French hospitality. Not everyone was as lucky as I was to be taking things easy, however, and Le Tour was in full swing during my time there, this being the 98th edition of the race since it was first held in 1903. The gruelling 21 stages run over 23 days covers a distance of 3430 km, and the race is a real test with a chequered and interesting history.

This year’s Tour was won by an Australian for the first time, Cadel Evans, who gained the lead on the penultimate day.

As usual, there were a number of casualties, mostly from crashes involving some high profile riders. These included Britain’s Bradley Wiggins who crashed out on stage 7 of Le Tour with a fractured clavicle during a pile-up which can be seen in this Guardian UK video footage . Others injured during the race included Andreas Klöden, Alexandre Vinokourov, Janez Brajcovic, Jurgen Van Den Broeck and Chris Horner who were all unable to continue the race due to their injuries.

Again this year, a large proportion of serious  injuries were caused by collisions with vehicles, including an incident with a car involved with TV coverage which resulted in injuries to Juan Antonia Flecha and Johnny Hoogerland and led to Christian Prudhomme, Tour organiser, to say ‘It’s a scandal.’ Hoogerland’s dramatic lacerations following his collision with barbed wire can be seen in this image. In addition, Nikki Sorensen was struck by a photographer on his motorbike.

For a useful review of injuries associated with cycling, see this 2001 article by Thompson and Rivara published in American Family Physician.

Those of us who are perhaps more used to keeping safe whilst cycling in the streets might be more interested in this article published earlier this year in Injury Prevention by Lusk and colleagues, based on regional data from Montreal, which highlights the differences in injury rates between cycling on cycle tracks compared with comparable reference streets. The study found that the relative risk of injury on cycle tracks was 0.72 (95% CI 0.60 to 0.85) compared with cycling in reference streets, suggesting that the risk of injury from cycling on tracks is less than cycling in the streets.

A key element of road cycle safety surely has to be legislation for the mandatory use of helmets which still hasn’t found it’s way here in the UK. This is perhaps regretful – especially following the introduction of the London Cycle Hire Scheme which merely advises riders to consider wearing a cycle helmet . The British Medical Association currently supports the introduction of legislation, but this is opposed by the Transport and Health Study Group. Whether or not the position on mandatory laws for cycle helmets in the UK will change in the future may well depend on reaction following  the recent publication of the ‘Health on the Move 2’ report .

Historically, Australia has taken the lead Internationally on compulsory cycle helmet laws which have been enforced there since 1990, with New Zealand following suit in 1994. Read more about issues related to cycle helmets in Australia and Internationally on this interesting Australian website.

A recent bmj.com poll on the compulsory wearing of helmets by adult cyclists resulted in 68% of respondents (n=1439) voting no to the idea of mandatory wearing of helmets. The BMJ blog led to a lively debate on the topic. Despite the controversy, I for one will continue to wear my cycle helmet whilst cycling on the roads.

Do you think that there should be world-wide mandatory legislation for cycle helmet wear for road cyclists? CJSM would like to hear your thoughts on this – feel free to post your comments on the blog.

Vote on our quick poll on the issue on our website front page here.

(Pictures from mIKL194FV and AFP) 

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