The Hidden Dangers of Cycling: Is it Healthy? (Clue: yes it is)

“A Warning to Enthusiasts”, Punch, July 6, 1889, 5.

The illustrators who worked on Punch are responsible for many a humorous cartoon that captured the concerns and interests of the day. The growing popularity of cycling in the late nineteenth century was a topic that raised frequent comment in the pages of the satirical magazine and this example from 1889 by Edward Tennyson Reed is one of my favourites.

As more people took up cycling in the 1880’s a growing literature emerged that discussed the benefits, or otherwise, of the latest craze. Reed’s cartoon depiction of the skeleton of a cyclist preserved in the British Museum of the future with its elongated and disproportionately heavy lower limbs, its exaggeratedly curved spine, and spindly arms reflected one branch of contemporary opinion that viewed cycling as a health risk.

A leading proponent of this view was Doctor Benjamin Ward Richardson, an eminent British physician, who in his multi-volume series, The Asclepiad, addressed the issue in a paper titled, “Cycling and Physique”. Cycling, Richardson reminded his readers:

is an exercise so different to any other exercise, that it moulds the bodily framework, as it were, to its own mode of motion [1].

Cyclists who spent too much time in the saddle inevitably developed “the cyclist’s figure” which was a “perversion of the physical build”. Richardson was writing in 1890, a year after the Punch cartoon was published, and referred to it in his paper, commenting that

The backbone of the cyclist was a little too much curved anteriorly; the scapulae were rather too much raised ; the hands were more talon-shaped than is ever seen; the leg bones were too curved, and the feet were more sharply transformed into the clutch-like hand of the baboon, than is to be found in the world of cycledom [2].

The exaggerations of caricature aside, Richardson felt that the illustration captured the effects of prolonged and habitual cycling on the body, particularly of those who had not yet reached physical maturity. Deformity of the limbs, round shoulders, an exaggeration of any tendency to be knock-kneed, and reduced flexibility were the inevitable result. Muscular development meanwhile led to “derangement” in the muscles of the lower limbs and a reduction in “pedestrian powers” [3].

Richardson was not the only doctor or medical expert to question whether cycling was a healthy activity. In “The Hidden Dangers of Cycling”, Doctor A. Shadwell reported the case of a girl who “developed exophthalmic goitre as the result of a rather long ride”, another whose appendicitis was blamed on cycling, numerous cases of tiredness and headaches, and the delusions of six-day race riders suffering from what was certainly sleep deprivation and probably the effect of taking stimulants [4]. Elsewhere cycling was claimed to be the cause of digestive problems, haemorrhoids, fatigue fever, sprains, hernia, irritation of the bladder, urethral stricture, cardiac and nervous disease, and, not least, sexual and moral depravity.

Ranged against these critics of cycling were those who argued in favour of its health benefits. In 1889 Frank Bowden, the founder of the Raleigh Cycle Company, wrote an article for The Graphic in which he argued that:

To those who are troubled by constipation, indigestion, piles, varicose veins, chronic or rheumatic gout, sluggishness of the blood, want of action in the skin, lassitude, loss of appetite, or lack of muscular power, cycling is curative or decidedly beneficial, when, like medicine, it is taken with regularity, and in doses suitable to the complaint [5].

And in a brief article of the same year The British Medical Journal concurred with the findings of Doctor Oscar Jennings that no evidence had been advanced to prove the theoretical assertions made by the critics in regard to medical disorders, but did agree that extreme over exertion, in distance and endurance attempts for example, could lead to symptoms of physical distress and in some cases permanent injury [6]. Elsewhere in “Cycling for the Insane” Doctor C. Theodore Ewart advocated cycling as a “therapeutic agent” with the caveat that the excitement provided by cycling was suitable for the melancholic, but not for the suicidal or those prone to attacks of acute mania [7].

From our current perspective its clear that the perceived health risks of cycling were unfounded and that the physical activity involved did not uniquely lead to illness as some contemporaries proposed. Goitre’s for example are a result of an iodine deficiency in over 90% of cases and the condition is in no way related to any physical activity, let alone specifically cycling. It is easy today to scoff at the arguments made by Richardson, Shadwell and many others. We should, however, remember that they were writing in the context of contemporary ideas on health, physiology and medicine.

The question of whether cycling is healthy continues to attract debate. Evidence from numerous studies indicate that cycling as an activity has significant benefits for the prevention of non-communicable disease, notably coronary heart disease, stroke, type 2 diabetes, and some cancers[8]. Research from Holland has found that increased activity through cycling resulted in about 9 times more gains in life years than the losses in life years that accrued from greater exposure to air pollutants as a result of increased cycling activity [9]. The average of 74 minutes per week spent cycling by Dutch adults aged 20 to 90 years old has been estimated to prevent 6,500 deaths per year with an economic health benefit of €19 billion a year [10]. And analysis of American data has demonstrated statistically significant relationships between cycling and lower rates of obesity and diabetes [11].

The health benefits of cycling are clear, yet there are other factors that have a significant impact on efforts to promote cycling as an activity that has both personal and wider societal benefits. A study into the effects on well-being of physical activity found that while cycling led to improved health, environmental factors could count against perceptions of well being [12]. Compared to walking cycling was seen to be less convenient and having an inherently higher risk as a result of sharing space with motor traffic. A study of views about cycling in Liverpool, England, found that fear of the dangers of cycling in traffic, of the risk of theft, anti-social behaviour, and of the perceived higher risk for women created barriers to participation in cycling as a leisure and transport activity [13].

The implication of these, and other, studies, is that if we are to realise the tangible benefits of cycling we need to look carefully at the environment in which cycling takes place. Improved infrastructure is needed to provide safe, convenient, and attractive spaces in which people may cycle. Urban development should be designed to make short-distance journeys easier by bicycle, and restrictions on motor vehicle speed, traffic calming measures, and car-free zones should also be implemented. By investing in such measures, and shifting our patterns of travel activity, we will benefit both as individuals and as a society.

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[1] Benjamin Ward Richardson, The Asclepiad: A Book of Original Research and Observation in the Science, Art, and Literature of Medicine, Preventative and Curative, Volume VII (London: Longman, Greens & Co., 1890), 21.
[2] Ibid., 24.
[3] Ibid., 31-32.
[4] Dr. A. Shadwell, “The Hidden Dangers of Cycling,” National Review 28, no. 168 (February 1897): 787-796.
[5] Frank Bowden, “Cycling for health,” The Graphic, January 26, 1889, 23.
[6] “Cycling as a Therapeutic Agent,” British Medical Journal 1 (1889): 252-253.
[7] C. Theodore Ewart, “Cycling for the Insane,” The British Journal of Psychiatry 36, no. 154 (July 1890), 317-325.
[8] United Kingdom, Department of Health, At Least Five a Week. Report of the Chief Medical Officer, 2004, iii.
[9] Jeroen Johan de Hartog, Hanna Boogard, Hans Nijland, and Gerard Hoek, “Do the Health Benefits of Cycling Outweigh the Risks?,” Environmental Health Perspectives 118, no. 8 (August 2010): 1113.
[10] Elliot Fisshman, Paul Schepers, and Carlijn Barbara Maria Kamphuis, “Dutch Cycling: Quantifying the Heath and Economic Benefits,” American Journal of Public Health 105, no. 8 (August 2015): e13-e14.
[11] John Pucher, Ralph Buehler, David R. Bassett, and Andrew L. Dannenberg, “Walking and Cycling to Health: A Comparative Analysis of City, State, and International Data,” American Journal of Public Health 100, no. 10 (October 2010): 1990.
[12] Simona Rasciute and Paul Downward, “Health or Happiness? What is the Impact of Physical Activity on the Individual?” Kyklos 63, no. 2 (May 2010): 256-270.
[13] Nick Cavill and Francine Watkins, “Cycling and Health: An Exploratory Study of Views About Cycling in an Area of North Liverpool, UK,” Health Education 107, no. 5 (2007): 404-420.