Cycling with a disease like multiple sclerosis often requires some modification, be it with the style of your riding or with the equipment you need to get out on the bike safely. Now I’ve ridden bikes regularly for years—I’ve got the road-rash scars to prove it—and I’ve also got a mean streak of stubborn. When I was diagnosed with MS in 2006 I had to make some tweaks, and then some more tweaks as my disability has progressed. Along the way I’ve learned some valuable lessons, lessons I don’t want you to repeat. So, from both personal experience and from veteran riders with MS, here’s what you need to know to get out—and stay out—on the bike trail with a disability.
Get the right cycle for your level of disability. Today. Don’t “wait” for your balance to improve or your leg strength to get better. I didn’t ride for several years, hoping to get back on two wheels. When I finally capitulated, I waited so long to transition to a leg-powered trike that I only rode it for one season before gifting it to my wife in exchange for an arm trike.
Pay attention to the ease of mounting/dismounting. A disease like MS often affects the legs. When I was riding a two-wheeler, the first issue I had while riding was not balance, but getting on and off the bike. Boy was it challenging to swing my legs over the center tube after a hot ride. Certain trikes can be especially tricky to get off of because they tend to be low to the ground.
Consider how you will transport your ride. If you plan to ride from your garage, this isn’t a big deal (although finding space to park your bike in there may be). But if you need to drive to your fave bike trail, transporting said bike is going to be rather important. Because of their size, trikes can be challenging to transport without a large SUV or pickup. And tandems can be harder still. Trike tandems? You best be a professional mover.
Clipless pedals: use them. Paresthesia and cycling don’t go great together. Like two-year-olds at Toys R Us, feet tend to wander off pedals when you can’t feel them that well. Clipless pedals prevent that, and also permit you to use both your upstroke and downstroke to provide power, conserving energy. If you ride a low-slung trike, these pedals are mandatory—you don’t want to drag a foot under your ride. Youch.
Always wear a helmet. This is a no-duh, but MS affect cognition. And it is easy to rationalize with your MS brain that helmets are hot and that you don’t need a helmet because you are riding a trike and you can’t possibly wreck. Um, I proved that false and ended up in the ER. Thankfully I had a helmet on at the time, which I then cracked getting into the car to drive to the ER. Sigh.
Weigh your budget. You can find used bikes on Craigslist for a song or drop five figures on a tricked out roadie. Know that you usually get what you pay for. My advice: buy what you can afford, and don’t go nutzo unless you are confident that cycling is your sport and your disability level is mostly stable. Alas, even entry level trikes tend to be expensive (over a grand usually) and used ones are hard to come by, but arm trikes pop up with frequency on resale websites. I found mine for $900 and it had only been ridden a few times (originally over $2K).
Ride with friends. Cycling is fun. But cycling with a pal or two is even more fun. There’s also a practical side to riding with others. “Riding with a buddy adds to the fun, is safer, provides motivation and keeps one honest,” says veteran Active MSer and longtime cyclist Larry Danahey. “If I tell my buddy I'll meet him at 0-dark thirty for a ride, I'll do it.” Best of all, if you have a mechanical or medical issue, someone is there to help (or can ride off to get help).
Choosing Your Ride
When you learned to ride a bike as kid, it was probably on two wheels or perhaps four if you had training wheels. And your parents probably told you to watch out for that fire hydrant, which you then eyed so intently that you barreled smack into it (true story, poor Laura). Today, there are gobs of options to ride, so let’s get rolling.
Unicycle. Seriously? Good-on-ya, my friend.
2-Wheel Bike. Unsurprisingly, you can find a vast range of two wheelers, from road to mountain to snow to recumbent. But what’s best when you have MS? There isn’t a best, because it all depends on the issues your disability presents. In general, the bigger the tires, the more stable the bike. In general, road bikes tend to be lighter. In general, cruisers with no top tube are easier to mount and dismount. Like I said, it all depends. Choose what works best for you and your goals. If you plan to compete in an Ironman, a cruiser is a poor choice (but great for a quick ride to your local bakery).
3-Wheel Trike (Leg). When balance gets iffy, a trike makes a load of sense. Another bonus: when you tire, you can park in the shade and chill while seated. When I finish riding, I’ll relax and cool down before I climb out of my trike, giving my body extra time to recover. There are two main designs in trikes: delta and tadpole. Delta trikes have one wheel in front and two in back (one of the rear wheels typically provides the power). Tadpoles have two wheels in front and one in back, with the rear wheel typically providing the power. Generally, tadpoles are more stable and agile, but entry and egress tends to be harder. There are upright deltas that are chair height that, while not terribly sporting or quick or light, will get one from point A to point B. As a rule, trikes with larger wheels are faster, but they will never be as fast as a two-wheeler.
3-Wheel Trike (Arm). Handcycles for the road tend to be deltas with the front wheel providing power, but tadpole arm bikes, where the rider kneels instead of sits, are the cycle of choice for off roading on rocky mountain trails due to their superior stability and ability to generate climbing torque (alas, I have not tried one yet). The deltas can vary widely from perched high (slowest) to near prone (fastest). If you have trouble with entry/egress, lying down to cycle could prove seriously problematic. Keep in mind, though, that the higher the seating position, the slower and less stable the handcycle. Cycling using your arms requires more effort and is slower than a comparable three-wheel leg cycle or traditional bicycle.
3-Wheel Trike (Arm & Leg). It’s called the Berkel Bike (there are other types). Have I tried one? No. Does it hold promise? Yes. Will you go fast? No. Does it look awkward? Yes. Does that matter? No.
4-Wheel Cycle. These are called surreys and they are mainly for rent to ride on a boardwalk with three other friends who can pedal while you pretend to pedal.
Proper Bike Attire. If you are a cyclist, you likely already own gear—shorts, top, shoes, socks. While certainly not mandatory, cycling gear helps keep you drier and cooler and more comfortable. Plus it looks rad.
Cooling Vest. Staying cool is essential if you have any heat sensitivity. A cooling vest can help (I always ride with one). Here’s how to choose the right cooling vest for you, and my review of the best cooling vests on the market today.
Insulated Water Bottle. The Polar insulated but squeezable water bottle crammed with ice is my go to when I ride on hot days. Ice will last hours and it fits into any water bottle cage.
Walking Aids. Walking after cycling can be an issue with MS, especially if you are overheated. I strap on a pair of foldable forearm crutches to my trike. They’ve saved my bacon for restroom emergencies (and, ahem, ER visits). A foldable cane or trekking poles work well for that extra assist when you need it.
Other Aids. Even if you don't use them normally, you might find an AFO, knee, wrist or elbow brace or even just a little appropriately placed athletic tape can add a significant level of strength, comfort and endurance to your rides, says Larry.
Protection. Sometimes nature calls and there aren’t trees. I always ride (but rarely need) protection. Plus, it provides a touch more padding if you have a hard bike seat. Score!
Q: I wanna still ride my 2-wheeler, but my balance is meh. Right now it just sits in the garage, basically a brick made of expensive carbon fiber. Would training wheels be a good compromise?
A: No. This has been tried by many MSers and the answer is always, “well that didn’t work out as planned.” You can’t turn properly, ride at speed properly, dismount properly, or even feel confident staying upright properly. Training wheels are not a solution, sorry.
Q: My partner is a hardcore cyclist. What are your thoughts on tandems?
A: A tandem is potentially a great solution. You’ve got a backup engine when you run out of gas, an extra layer of stability, and full assurances that your partner won’t speed away from you. If eyesight or cognition is an issue, riding with someone is practically mandatory, and this is ideal. That said, there are some potential drawbacks other than being forced to listen to said partner discuss the direction of endless plot lines in Game of Thrones over a 3-hour spin. For starters, these larger bikes are easy to ride out of the garage, but not so easy to load into a car. Also, they may be challenging to mount/dismount with a high center bar. Tandem trikes might be the Holy Grail, but they turn like a semi-truck and basically require a semi-truck to transport.
Q: Speaking of transport, I only own a small car. How about a foldable trike that fits in the trunk?
Hmm. Beware of “foldable” bikes and trikes, as they tend to offer lower performance and cost more. The kicker: I’ve heard from bike retailers that owners rarely bother folding them anyway because it’s a hassle. I’m not saying there aren’t good options out there, but definitely try before you buy.
Q: I love to cycle, but with my disease I worry about bonking mid ride without enough energy to get home. What about electric assist?
A: I have not tested these devices, but they could do the trick. You can either go full electric bike or purchase a kit that you can retrofit onto your existing ride. This kit from Gruber offers a bit of help, but still makes you work a bit (yay exercise!). The Copenhagen Wheel holds promise, the E-BikeKit makes a deal for trikes, and the Hill Topper offers a range of assistance. There are more options that could scoot you along at sprint speeds, but they weigh a lot more and then, well, you are riding a moped more than a bicycle. I hope to review these in the future. Note: they are not cheap. Expect to spend at least $500.
Q: You mention riding with a buddy, but I don’t know anyone who cycles. Where do I find these folks? And what if they are too fast—or too slow—for me?
A: You can mine all sorts of areas for potential riding partners. You can post a meet-up on the forums at ActiveMSers. Your local MS Society or even MS clinic may have connections. There are also a number of adaptive sports organizations like Adaptive Adventures. If you have a life partner, perhaps he or she might take up cycling with you. My wife Laura has been my seeing-eye-wife on the bike trail when my eyesight got wonky, my Sherpa when it comes to carrying my forearm crutches and loading my bike, my water babe when I need a refill, my extra eyes when crossing a street, and more. She is much faster than I am, so she’ll often ride ahead, and then loop back around so we can cruise together. We make a good team. In fact, I think I hear her calling. It’s time for another ride!
This hand fat bike will not fit in a Ford Fiesta.
Electric assist is not needed for downhill plummets.
Ride enough and you, too, can get an official bike tan.