3 Benefits of Cycling with Ehlers-Danlos Syndromes

Author: Ozan Soyer, MD

Living with EDS and other hypermobility spectrum disorders (HSD) can make exercise difficult, and some exercises can be better than others. We previously discussed about swimming, and here we list how cycling also provides a low-impact alternative. Whether you have HSD, hypermobile EDS, classical EDS, or another form, the general rules of safe riding apply (with specific adaptations as needed). Some of the biggest benefits of cycling include:

1. Joint-Friendly Cardio: Cycling can improve heart health, circulation, and stamina without putting excessive strain on vulnerable joints. Many people with EDS/HSD have deconditioned muscles and poor cardiovascular fitness because of pain and exhaustion, therefore cycling is an effective way to gradually improve that fitness.
2. Stronger Muscles for Stability: One major benefit of cycling is building muscle strength in your legs, core, and glutes. Strong muscles act like shock absorbers and natural braces for hypermobile joints.
3. Mental Health and Enjoyment: Also we shouldn’t underestimate the psychological boost of cycling. Hopping on a bike (outdoors in nature or even indoors on a stationary bike) can be fun and freeing. Like any exercise, cycling can improve your mood, reduce stress, and increase confidence as you reach small goals (for example, biking an extra 5 minutes or exploring a new bike path).

Safety Tips for Cycling with EDS/HSD

1. Protect Your Joints: EDS/HSD patients' joints are more prone to overstretching, so take precautions when riding. Avoid locking out or hyperextending your knees and elbows while cycling; instead, maintain a modest bend in your joints, particularly during the pedal stroke or when bearing weight on the handlebars. In addition, utilize proper padding and equipment: cushioned cycling gloves can minimize stress on sensitive hand joints, and a well-padded seat (or padded shorts) can make rides more comfortable for the hips and spine.
2. Ensure Proper Bike Fit: If your bike is not fitted to your body, it might put your joints in unnatural positions. For example, an excessively high seat can cause your knee to overextend on each pedal stroke (when your leg straightens out), resulting in knee soreness or even dislocation. Aim to set your seat height such that your knees are slightly bent (not completely straight) near the bottom of the pedal revolution to avoid hyperextension. Similarly, the handlebar reach should be comfortable; you shouldn't have to lock your elbows or hunch too far to grab the bars.
3. Pace Yourself and Listen to Your Body: Enthusiasm is wonderful in the beginning, but going beyond might cause  tiredness or pain flare-ups. Adopt a "low and slow" strategy to increase your cycling endurance. Start with quick, easy rides and work your way up to longer or more intense sessions. It's acceptable to begin with just five to ten minutes on a stationary bike a few times per week. Consistency and gradual advancement are crucial.
4. Try a Recumbent Bike for More Support: For many people with EDS/HSD, recumbent bikes can be a game-changer. Because you sit supported against a backrest with your legs out in front, a recumbent bike takes pressure off the spine, hips, and wrists. It also minimizes the risk of falls since you’re lower to the ground and well-balanced.

Consider an E-Bike or Other Adaptive Options: If fatigue or limited strength is a major barrier, an e-bike might be the perfect solution to keep you cycling. For someone with EDS/HSD, this means you can get out and ride without pushing your body to exhaustion – the motor can take away the hardest effort when needed. You’re still pedaling and getting exercise, but you can dial in how much help you receive. Other adaptive cycling equipment includes adult tricycles which provide more stability if balancing on two wheels is difficult, and hand cycles for those who need to take pressure off the legs.

Lastly, stay in constant contact with your medical staff. To receive individualized guidance, talk about your cycling intentions with your physician or physical therapist. Cycling can be a fulfilling component of managing your EDS/HSD if you take the proper strategy, which will keep you strong, fit, and enjoy the ride.

Everybody's experience will be slightly different, but cycling is only one of several methods to stay active with EDS/HSD. We would be delighted to hear from you now! Are you thinking about cycling, or have you already tried it?