If you have ankylosing spondylitis (AS), your physical condition can be another layer of uncertainty in this task. You may wonder whether pain, stiffness, or other AS symptoms will allow you to use a particular bike as much as you’d like, or you may even worry that using a bike the wrong way could make your symptoms worse. It’s valid to have concerns about bicycling with AS, and normal to be baffled about how to choose a bike and get started. But simply knowing what basic options exist, and how they relate to your needs and preferences, can make this process much easier. Here’s an overview of the options and personal factors you may want to consider when selecting a bicycle if you have ankylosing spondylitis.
What Kind of Cyclist Are You?
The most important factor to consider when choosing a bicycle — regardless of your diagnosis or level of ability — is what you intend to use it for, according to Kimberly Perring Lenington, a doctor of occupational therapy and an assistant professor of occupational therapy at the University of Southern California in Los Angeles. For people who want a bike for occasional excursions or leisurely errands, “it’s really just got to be comfortable to sit on for long periods of time and not exacerbate your symptoms,” Lenington says. But if you’re a skilled rider and want to have a road bike or mountain bike, Lenington advises paying closer attention to how different options affect your posture, and the amount of stress riding puts on your joints. For example, if you’re a mountain or trail bike rider, you may want a bicycle with a full suspension to absorb the shock from riding on rough terrain. But a mountain bike — with or without suspension — is unlikely to be the best fit for casual city riding because they tend to be slow on pavement. Similarly, a road bike with thin tires won’t be an ideal fit if you need to cover a variety of surfaces, such as both city streets and crushed-rock bike trails.
AS Factors to Consider
No matter what type of bike you’re looking for, it’s important to consider the specifics of your ankylosing spondylitis when deciding if it’s a good fit. The longer you’ve had AS, the greater the chance that your joint mobility is significantly limited, Lenington notes. This can lead to poor posture while riding your bike, which can put extra pressure on your joints and contribute to worsening symptoms. Especially if your AS is more advanced, Lenington advises using any bicycle for short periods at first to make sure your symptoms don’t get worse. For anyone considering biking, it’s important to do stretches that improve your ability to ride your bike properly, according to Lenington. These may include stretches for your neck and shoulders, upper back, lower back, and hips, she says. Someone with significant AS hip involvement, says Lenington, should look for a bike that doesn’t require overextending the hip joint. “You want to maintain a neutral pelvis when riding, which depends on your hip flexibility and the distance between the pedals and the seat,” she says. “Shoulder involvement is another issue that can affect bike riding,” Lenington says. If this applies to you, “choose a bike with handlebars that don’t put added strain on your shoulders. Not too high or low is important.” Reduced joint mobility may also make it wise to consider less-conventional bicycle options, such as a recumbent bike, which supports your back and reduces strain on your upper body. You may also want to consider how your mobility affects your ability to mount and dismount from your bike. Bicycles can have a high- or low-step frame, which refers to how high you need to lift one of your legs to get into a seated position.
Bicycle Types and Options
There are a few basic types of bicycles, with seemingly infinite variation inside (and blurring the lines between) these groups. Beyond deciding which type is right for you, there are a few options to consider within each category. Road bikes This broad category includes bikes that tend to have a lighter frame and thinner wheels, to achieve maximum speed on smooth surfaces. They usually have “drop” handlebars, which are low and keep the rider in a chest-down position. The exact angle at which you bend forward on a road bike will depend on the construction of the frame and the height of the handlebars, so it’s important to find a bike that puts you in a comfortable riding position. This type of bicycle can be challenging for people with AS and should probably be reserved for serious cyclists, Lenington says. If you use one, it’s important to have a stretching program and exercise good posture, “not hunching over too much, but maintaining your shoulder blades in a neutral, retracted position.” Mountain bikes These rugged bikes are designed for off-road use, with a heavier frame and wide, heavily treaded tires. Like road bikes, they’re probably a good choice only for people who are serious about using them for their intended purpose. Getting a mountain bike with a front or dual suspension can significantly reduce the impact of riding on your joints, as well as significantly increase the cost of the bike. Hybrid bikes This cross between a road bike and mountain bike is often the best choice for errands, shorter commutes, and riding around for fun or exercise. These bikes tend to have larger padded seats and higher straight handlebars, which keep the rider in a more upright position. Depending on the terrain you cover, you may opt for a wider or narrower tire size with less or more of a tread, as well as more or fewer gears for speed or hill-climbing. Cruiser bikes These bikes are built for casual riding, with a very wide padded seat, wide tires, and high handlebars that bend toward the rider on each side, allowing a very comfortable upright sitting position. Cruisers often have low-step frames that make it easy to get on and off, and some have an elongated frame in which the pedals are far forward of the seat. This lets you put your feet flat on the ground while stopped, without compromising full extension of your legs while pedaling. Recumbent bikes You sit in a reclined position near the ground with your legs in front of you on this type of bike, which supports your back and upper body.
Gears, Brakes, and Electric Assist
Having more gears on your bike lets you shift down to make pedaling easier when going up a hill, or shift up to achieve better speed on flat or downhill surfaces. This can be useful for anyone, but particularly people with AS. “If someone has thoracic involvement — if they have issues breathing — I would want to make sure they don’t overexert themselves going up hills, that they have the option of pedaling with less resistance if they need to,” says Lenington. Some bikes have gear controls right on the grips of handlebars, which may be easier to operate than separate levers beside the handlebar grips. There are also automatic shifters that adjust based on your pedaling resistance, although these cost more and are still somewhat uncommon. Most bikes have traditional brake controls, which are levers under the handlebars (or, on road bikes, in front of them). But some bikes, especially cruisers, let you brake by back-pedaling, which may be easier for some people. If you need more power than your own pedaling can provide — such as for commuting or biking with others — you may want to consider a bike with an electric assist mode, which uses a battery and motor to supplement your pedaling. Electric bikes are, of course, significantly more expensive than their nonpowered counterparts.
The Right Fit Is a Must
All the considerations listed above are important for people with AS when selecting a bike — but they’re just a starting point. You need to try out a bike to make sure it feels right. A bike has to be the right size for you, which may not be obvious if you’re not sure what to look for. Someone at a bicycle shop can help you pick a bike that fits your body. Ultimately, a bike that feels great is important so that you’re excited to use it and will use it whenever you can. “We want you to get out there and ride,” says Lenington. “It’s a great way to exercise, be outside, and maintain your overall health.”
