Most Common Bikepacking Injuries

How to avoid and treat them.

Welcome to The Project’s guide on the Most Common Bikepacking Injuries. Whether you’re tackling multi-day routes or weekend overnighters, long hours in the saddle can lead to knee pain, saddle sores, bikepacking hand numbness, and other overuse injuries. Knowing how to prevent and manage these issues will keep you riding longer and pain-free.

Of course, other injuries can occur while bikepacking, but these are the most common bikepacking injuries riders face. Take a page from the Boy Scouts and be prepared—proper planning and awareness will help you avoid unnecessary pain and keep your ride safe.

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Saddle Sores

Most Common Bikepacking Injuries

Saddle sores rank among the most common bikepacking injuries. Almost every bikepacker has dealt with them at some point, and the discomfort can quickly turn a great ride into misery. These seemingly minor sores have forced many riders to abandon their journeys. Fortunately, there are proven ways to prevent and manage saddle sores, keeping you comfortable in the saddle for longer.

Ways to Avoid Saddle Sores

Pre-Ride

Choose the Right Saddle:
- Find the Right Fit: Select a saddle that matches your sit bone width to reduce pressure points.
- Consider Cutouts: Saddles with cutouts or relief channels help minimize perineal pressure.
- Break It In: Allow time to adapt to a new saddle before taking on long rides.
Wear Proper Cycling Shorts:
- Use a Quality Chamois: Well-padded, seamless shorts reduce friction and provide cushioning.
- Avoid Underwear: Wear cycling shorts directly against your skin to prevent chafing.
- Keep Them Clean: Wash shorts after every ride to reduce bacteria buildup.
Apply Anti-Chafe Creams:
- Use a Chamois Cream: Apply a thin layer before long rides to reduce friction.
- Choose the Right Product: Some riders prefer petroleum-based creams, while others opt for natural ingredients.
Ensure a Proper Bike Fit:
- Adjust Saddle Height: A saddle that’s too high can cause excessive movement, increasing friction.
- Check Saddle Angle: A slight downward tilt may relieve pressure, but avoid excessive angles.
- Experiment with Positioning: Small adjustments can make a big difference in comfort.

On the Bike

Maintain Proper Hygiene:
- Clean the Perineal Area at the End of the Day: Use wet wipes or a damp cloth to thoroughly clean the perineal area and remove sweat, dirt, and bacteria.
- Change Out of Damp Clothing: Change into dry clothing as soon as possible to reduce the risk of irritation and infection.
- Allow Skin to Breathe: When resting, avoid tight or damp clothing to help the skin recover and reduce irritation.
Reapply Anti-Chafe Creams:
- Fresh Applications: On multi-day trips, reapply chamois cream as needed to maintain protection and minimize friction.

Treatment

One the Bike

Reduce Pressure on Affected Area:
- Shift Your Position: Change your riding position frequently to reduce constant pressure on the affected area and alleviate discomfort.
- Stand Occasionally: Stand up out of the saddle, even for short bursts, to relieve pressure and give the area a break.
Use Anti-Chafe Creams:
- Reapply Cream: Apply anti-chafe cream to prevent further irritation and reduce friction during long rides, especially if you’re dealing with soreness.
Take Breaks to Relieve Pressure:
- Shift Your Position: Change your riding position often to avoid putting too much pressure on the affected area.
- Stand and Pedal: Stand on the pedals every so often to reduce pressure and allow the area to rest.

At Home (Post-Ride or During Recovery)

Clean the Affected Area:
- Wash Gently: Use mild soap and warm water to clean the area, removing any sweat, dirt, or bacteria that could cause further irritation or infection.
- Dry Thoroughly: After cleaning, pat the area dry with a soft towel to prevent moisture buildup, which can worsen irritation.
Apply Healing Creams or Ointments:
- Use Soothing Creams: Apply creams like aloe vera, zinc oxide, or petroleum jelly to protect and soothe the area.
- Apply Antiseptic: For open or raw areas, using a mild antiseptic ointment can prevent infection and promote healing.
Rest and Recover:
- Allow Skin to Heal: Give the affected area time to heal by avoiding further friction. Wear loose clothing and avoid tight shorts until the soreness subsides.
- Air Out the Area: Whenever possible, let the area breathe by avoiding tight or damp clothing to speed up the recovery process.

Chafing

Most Common Bikepacking Injuries

Chafing is one of the most common bikepacking injuries, caused by skin friction, moisture, and repetitive movements during long rides. It frequently affects areas like the inner thighs, groin, buttocks, and underarms, leading to irritation and discomfort. Left untreated, it can develop into painful sores or even infections, making proper prevention and treatment essential for every bikepacker.

Ways to Prevent Chafing

Pre Ride

Wear the Right Clothing:
- Wear Loose, Breathable Clothing: Avoid cotton and opt for synthetic or wool materials to keep skin dry.
- Go for Seamless Designs: Look for seamless shorts and shirts to reduce friction points.
- Ensure a Proper Fit: Loose clothing can cause rubbing, while overly tight gear may create pressure points.
Use Anti-Chafing Products:
- Apply Chamois Cream: Use a high-quality chamois cream to reduce friction in sensitive areas.
- Try Anti-Chafing Balms: Products like petroleum jelly or specialized anti-friction sticks can prevent skin irritation.
Ensure Proper Bike Fit:
- Adjust Saddle Position: A poorly positioned saddle can create unnecessary rubbing against your legs.
- Check Handlebar Reach: A stretched-out position can cause unwanted movement, increasing friction.
- Stand & Shift Positions: Avoid sitting in one position for too long to reduce prolonged skin contact.

One the Bike

Use Anti-Chafing Products:
- Reapply Chamois Cream: For long rides, refresh your chamois cream application mid-ride to maintain protection.
Maintain Proper Hygiene:
- Keep Skin Clean & Dry: Wipe sweat and dirt off when possible to reduce irritation.
- Change Out of Wet Clothing: Sitting in damp gear increases friction and the risk of chafing, so change as soon as you can.
- Air Out Your Skin: Whenever possible, let your skin breathe to reduce moisture buildup.

How to Treat Chafing

One the Bike

Reduce Friction:
- Shift Position: Change your riding position regularly to minimize friction in affected areas.
- Stand and Pedal: Stand up out of the saddle occasionally to relieve pressure and avoid prolonged rubbing.
Apply Anti-Chafing Products:
- Reapply Cream: If you experience ongoing irritation, reapply anti-chafing cream as needed during the ride.

At Home (Post-Ride or During Recovery)

Clean the Affected Area:
- Wash with Mild Soap: Gently cleanse with lukewarm water and mild soap to remove sweat and bacteria.
- Pat Dry: Avoid rubbing—gently pat the area dry to prevent further irritation.
Apply Healing Treatments:
- Use Anti-Chafing Creams: Apply soothing creams or balms to reduce inflammation and promote healing.
- Try Medicated Ointments: Use antibiotic creams if signs of infection appear.
- Consider Natural Remedies: Aloe vera or coconut oil can provide relief and aid healing.
Let the Skin Recover:
- Avoid Further Irritation: Rest and refrain from riding until the skin has healed to avoid worsening the chafing.
- Wear Loose, Breathable Clothing: Allow air circulation to speed up the healing process.
- Keep Skin Dry: Moisture prolongs irritation, so ensure the area stays dry during recovery.
Monitor for Infection:
- Look for Signs of Infection: Redness, swelling, or pus may indicate a bacterial issue.
- Seek Medical Help if Needed: If symptoms persist or worsen, consult a healthcare professional.
Prevent Future Issues:
- Once Healed: Once the area has healed, take preventive steps such as using anti-chafing balms and wearing the right gear.

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Numbness

Most Common Bikepacking Injuries

Bikepacking numbness is one of the most common bikepacking injuries, often caused by prolonged pressure on nerves due to extended time in the saddle or gripping handlebars. This issue can lead to a loss of sensation, tingling, or weakness, particularly in the hands, feet, or perineal area. If left unchecked, bikepacking numbness can develop into chronic nerve compression, impacting long-term comfort and performance.

Ways to Prevent Bikepacking Numbness

Pre Ride

Optimize Bike Fit:
- Adjust Saddle Height: Ensure your saddle is at the correct height to avoid excessive pressure on nerves.
- Check Handlebar Reach: Avoid overreaching, which can strain your wrists and lead to hand numbness.
- Ensure Proper Saddle Angle: A forward-tilted saddle can reduce perineal numbness, but excessive tilt can cause new pressure points.
Use Proper Gear:
- Wear Padded Gloves: Padded gloves help reduce pressure on the ulnar nerve in your hands.
- Install Ergonomic Grips: Wider grips or bar ends help distribute pressure more evenly on your hands.
- Install Aero Bars: Aero bars can help shift your body position, reducing hand pressure during long rides.
Proper Fitting Shoes:
- Choose the Right Size: properly fitting shoes prevent restriction of circulation and instability.
- Gel or Custom Insoles: Insoles improve support and circulation, significantly helping prevent foot numbness.
- Ensure Proper Cleat Positioning: Proper cleat placement can prevent pressure buildup on your nerves.

On the Bike

Vary Hand & Body Positions:
- Change Hand Positions Frequently: Shifting your grip can alleviate constant pressure on nerves in your hands.
- Stand Occasionally: Stand up out of the saddle, even for short bursts, to relieve pressure and give the area a break.
- Stretch & Stay Flexible: Regular stretching enhances circulation and prevents nerve compression.

How to Treat Bikepacking Numbness

One the Bike

Perform Nerve Gliding Exercises:
- Mobilize the Affected Nerves: Perform simple nerve flossing exercises while on the bike to improve mobility and reduce numbness.
- Focus on Wrists & Hands: Perform ulnar and median nerve stretches to alleviate hand numbness during stops.
- Incorporate Leg & Foot Stretches: Flexing your feet and legs helps prevent and reduce foot numbness.
Use Ice & Elevation (If Possible):
- Apply Ice Packs: If you’re stopping for breaks, apply ice to affected areas to reduce inflammation and irritation.
- Elevate Affected Limbs: Elevate your hands or feet to improve circulation and relieve pressure whenever you take a break.

At Home (Post-Ride or During Recovery)

Rest & Recover:
- Avoid Further Irritation: Refrain from riding until the affected areas have recovered to prevent worsening the numbness.
Use Ice & Elevation:
- Apply Ice Packs: Cooling the affected areas can help reduce inflammation and nerve irritation.
- Elevate Affected Limbs: Raising your hands or feet helps improve circulation and relieve pressure.
Seek Medical Advice if Needed:
- Monitor Persistent Numbness: If symptoms persist, consult a healthcare professional.
- Rule Out Underlying Issues: Chronic numbness may be linked to other conditions that require professional assessment.
Get a Professional Bike Fit:
- Identify Fit Issues: If numbness persists despite adjustments, a professional fitting can help identify issues causing the numbness.

Joint Pain

Most Common Bikepacking Injuries

Bikepacking joint pain is one of the most common bikepacking injuries, often caused by prolonged repetitive motion and sustained pressure on the knees, wrists, and ankles. Without proper preparation and adjustments, bikepacking joint pain can lead to stiffness, discomfort, or even long-term injuries that affect your ability to ride efficiently.

Ways to Prevent Bikepacking Joint Pain

Pre Ride

Ensure Proper Bike Fit:
- Adjust Saddle Height: Ensure the saddle height is correct to avoid excess strain on your knees.
- Check Saddle Position: Ensure the saddle is positioned correctly to prevent imbalances that may lead to joint pain.
- Optimize Cleat Placement: Misaligned cleats can strain your knees, leading to long-term joint pain.
Choose the Right Crank Length:
- Adjust for Comfort: Cranks that are too long or too short can create inefficient angles, increasing stress on the joints.
- Find Your Optimal Fit: Test various crank lengths to find the best fit for your riding style, or consult a professional for advice.
Strengthen Supporting Muscles:
- Build Leg Strength: Strong quadriceps and hamstrings help stabilize your knee joints.
- Improve Core Stability: A strong core reduces unnecessary movement, which minimizes joint strain.

One the Bike

Pedal Efficiently:
- Maintain a Smooth Cadence: Avoid mashing gears, as this places excessive strain on your knees.
- Use a Higher Cadence: Spinning in an easier gear reduces stress on your joints compared to grinding through a harder gear.
Increase Mileage Gradually:
- Avoid Sudden Jumps in Distance: Gradually increase riding time to allow joints to adapt without overloading them.
- Incorporate Rest Breaks: Taking breaks during your ride allows joints to recover and reduces the risk of overuse injuries.

How to Treat Bikepacking Joint Pain

On the Bike

Rest & Recovery:
- Take a Break: Reduce mileage or take rest days to allow joints to recover.
- Avoid Overuse: Continuing to ride through pain can lead to long-term joint damage.
Apply Ice or Heat:
- Use Ice for Inflammation: Applying ice to inflamed areas helps reduce swelling and alleviate pain.
- Apply Heat for Stiffness: Use a warm compress or heating pad to relax tight muscles and promote better circulation during stops.
Take Anti-Inflammatory Measures:
- Use NSAIDs if Needed: Over-the-counter anti-inflammatory medications like ibuprofen can help reduce pain and swelling during the ride.
- Consider Natural Remedies: If preferred, supplements like turmeric or omega-3s may help reduce joint discomfort naturally on the bike.

At Home (Post-Ride or During Recovery)

Apply Ice or Heat:
- Ice for Inflammation: Apply ice packs to the affected areas to alleviate swelling and reduce joint discomfort.
- Heat for Stiffness: Use a heating pad or warm compress to loosen tight muscles and enhance circulation to the affected joints.
Take Anti-Inflammatory Measures:
- NSAIDs for Pain Relief: Over-the-counter anti-inflammatory medications like ibuprofen can help manage pain and inflammation post-ride.
- Natural Alternatives: Consider supplements like turmeric or omega-3 fatty acids to support joint health and reduce discomfort.
Perform Gentle Mobility Exercises:
- Stretch Regularly: Gentle stretching can help increase flexibility and alleviate stiffness in the affected joints.
- Incorporate Low-Impact Movements: Activities like yoga or swimming are excellent for maintaining joint mobility without putting additional strain on your body.
Seek Professional Help if Needed:
- Consult a Physical Therapist: A physical therapist can design specific exercises to help with joint pain recovery.
- Rule Out Underlying Conditions: If joint pain persists, consult a healthcare professional to diagnose any underlying health issues.
Get a Professional Bike Fit:
- Address Fit Issues: If joint pain continues, consider a professional bike fit to ensure that your setup isn’t contributing to the discomfort.

Exposure

Most Common Bikepacking Injuries

Among the most common bikepacking injuries, exposure-related issues can be some of the hardest to avoid. Whether it’s relentless sun, unpredictable storms, or irritating plants and wildlife, the elements can challenge even the most experienced riders. With the right preparation, you can minimize the risks and stay focused on the ride.

How to Prevent Exposure-Related Injuries

Pre Ride

Know Yourself & Your Limits:
- Recognize Your Vulnerabilities: Understanding your personal limits is key to handling exposure.
- Identify Allergies: Determine if you’re allergic to certain plants or animals before heading out.
- Assess Your Sun Sensitivity: If you burn easily, take extra precautions with sun protection.
- Evaluate Your Decision-Making Under Stress: Know how well you function when wet, cold, or both.
- Prepare for Challenges: If you struggle with staying warm or dry, check out How to Stay Warm and How to Stay Dry When Bikepacking for strategies to manage extreme conditions.
Shield Yourself from Sunburn:
- Wear Protective Clothing: Choose lightweight, SPF-rated clothing to protect exposed skin.
- Apply Sunscreen Regularly: Use a broad-spectrum sunscreen and reapply frequently.
- Protect Your Face & Eyes: Use sunglasses and a cap or helmet visor to shield yourself from direct sunlight.
Prepare for Harsh Weather:
- Check Weather Forecasts: Monitor conditions before and during your ride.
- Wear Proper Gear: Carry a rain jacket and extra layers to stay warm.
- Watch for Warning Signs: Be mindful of heat exhaustion and hypothermia, and take action immediately.
Avoid Harmful Plants:
- Learn to Identify Threats: Recognize plants like poison ivy and poison oak before heading out.
- Dress to Minimize Exposure: Wear long sleeves and pants when riding through overgrown areas.
- Wash Off Quickly: Rinse exposed skin immediately if you come into contact with an irritant.
Minimize Wildlife Risks:
- Store Food Securely: Keep food and scented items away from your sleeping area.
- Stay Aware of Your Surroundings: Make noise in areas with large wildlife to avoid surprise encounters.
- Respect Wild Animals: Never approach or feed wildlife, as this can lead to dangerous interactions.

On the Ride

Monitor Your Environment:
- Stay Aware of Weather Conditions: Be aware of sudden weather changes to avoid hypothermia or heat exhaustion.
- Adjust Clothing and Layers as Needed: Add or remove layers based on changing conditions throughout your ride.
Minimize Exposure to Sun and Wind:
- Use Sunscreen & Reapply as Needed: Keep sunscreen on exposed areas, especially during long breaks or in strong sunlight.
- Wear a Hat or Helmet Visor: Shield your face and neck from the sun to prevent sunburn.

How to Treat Exposure-Related Injuries

One the Bike

Sunburn:
- Cool the Skin: Apply aloe vera or soy-based lotions to soothe the burn.
- Pain Management: Use over-the-counter pain relievers like ibuprofen to reduce swelling and discomfort.
- Hydration: Increase water intake to prevent dehydration and aid in recovery.
Hypothermia:
- Gradual Rewarming: Move to a warmer environment and replace wet clothing with dry layers as soon as possible.
- Warm Beverages: Consume warm, non-alcoholic drinks to help raise core temperature.

At Home (Post-Ride or During Recovery)

Sunburn:
- Hydrate & Rest: Ensure proper hydration and rest to speed up the healing process for sunburn.
- Use Topical Treatments: Apply aloe vera or other soothing ointments to ease pain and moisturize the skin.
Hypothermia & Frostbite:
- Gentle Rewarming: Warm the affected area gradually, using lukewarm water or blankets to restore blood flow.
- Seek Immediate Medical Help: In severe cases of hypothermia or frostbite, consult a healthcare professional as soon as possible.
Allergic Reactions (e.g., Poison Ivy):
- Topical Treatments: Apply corticosteroid creams or calamine lotion to alleviate itching and reduce inflammation.
- Oral Antihistamines: Use oral antihistamines, such as diphenhydramine, to alleviate allergic reactions and help with sleep.
- Avoid Scratching: Keep the area clean and refrain from scratching to prevent infection and further irritation.

Racer Cough

Most Common Bikepacking Injuries

Race cough is an unpleasant side effect that many endurance athletes experience after long or intense efforts, making it one of the most common bikepacking injuries. The combination of rapid breathing, cold air, dry conditions, and high exertion can leave riders with a persistent cough, chest tightness, or an irritated throat. This condition, also known as exercise-induced bronchoconstriction (EIB), occurs when the airways temporarily narrow, leading to discomfort during or after a ride. While usually harmless, severe cases can make breathing difficult and impact recovery.

Although race cough can’t always be avoided, understanding what triggers it and how to mitigate its effects can help you manage symptoms and minimize its impact on your riding.

Preventing Race Cough

Pre Ride

Wear a Buff or Face Mask:
- Warm and Humidify Air: Use a buff, scarf, or mask to warm and humidify the air before it enters your lungs, especially in cold or dry conditions.
Breathe Through Your Nose:
- Filter and Warm the Air: Nasal breathing helps filter and warm the air, reducing irritation in your airways.
Use Electrolyte Solutions:
- Maintain Hydration: Hydration tablets or drinks with electrolytes help maintain moisture and prevent dryness in your airways.

On the Bike

Hydrate Regularly:
- Maintain Moisture: Drink fluids throughout the ride to keep your throat and airways moist and reduce irritation.
Adjust Your Effort:
- Ease Off Intensity: If you feel a cough coming on, reduce your effort to ease strain on your lungs and allow them to recover.
Avoid Exposing Yourself to Pollutants or Allergens:
- Stay Clear of Irritants: Avoid areas with heavy traffic or high pollen counts, which can irritate your airways.
Take Breaks for Deep Breathing:
- Open Airways: Periodically focus on taking deep, controlled breaths to open your airways and avoid shallow, rapid breathing.

Treatment

On the Bike

Cool Down Gradually:
- Reduce Effort Gradually: If you feel the onset of race cough, ease off your pace to allow your respiratory system to recover.
- Controlled Breathing: Focus on slow, deep breathing while riding to help prevent further irritation of the airways.
Stay Hydrated on the Trail:
- Carry Fluids Regularly: Drink water or electrolyte beverages to keep your airways moist. Use a hydration pack or water bottles.
- Use Hydration Tabs: In dry or cold conditions, hydration tablets with electrolytes can help maintain hydration while reducing throat dryness.
Protect Your Airways:
- Wear a Buff or Face Mask: In cold conditions, covering your mouth with a scarf or buff can help warm the air you breathe, reducing irritation.
- Nasal Breathing: Breathe through your nose when possible to filter and humidify the air, protecting your lungs.

At Home (Post-Ride or During Recovery)

Hydrate & Soothe Your Throat:
- Warm Fluids: Drink warm herbal teas, broths, or warm water to soothe irritation and promote healing.
- Throat Lozenges: Consider using throat lozenges or soothing syrups to calm your throat after a long ride.
Steam Therapy:
- Use a Humidifier: At home, use a humidifier in your sleeping area to keep your airways moist and help reduce coughing at night.
- Steam Inhalation: Inhale steam from a hot shower or over a bowl of hot water to relieve dryness and irritation.
Rest & Recovery:
- Take It Easy: Avoid exerting yourself if race cough persists. Rest and give your airways time to recover.
- Post-ride Stretching: Gentle stretches, especially for your upper body, can help relax your respiratory muscles.
Over-the-Counter Remedies:
- Cough Suppressants: Use lozenges or syrups to reduce the urge to cough if necessary.
- Anti-Inflammatories: If inflammation persists, use anti-inflammatory medications like ibuprofen to reduce throat irritation.

Achilles Pain

Most Common Bikepacking Injuries

Achilles pain is one of the most common bikepacking injuries that riders face, especially during long tours or bikepacking routes. This issue is prevalent on events like the Tour Divide, where the constant strain from pedaling and poor bike fit can exacerbate the condition. Achilles pain can range from mild discomfort to severe pain, and if left unaddressed, it can lead to more serious injuries like Achilles tendon rupture. Preventing and treating this injury is crucial for maintaining long-term bikepacking performance, and with the right precautions, you can minimize its impact on your adventure.

Ways to Avoid

Pre Ride

Ensure Proper Bike Fit:
- Adjust Saddle Height: A saddle that is too high can cause you to point your toes, putting excessive strain on the Achilles tendon.
- Optimize Cleat Position: Cleats positioned too far forward can force your foot into a downward point, increasing tension on the Achilles. Make sure cleats are set to allow natural foot movement.
Gradually Increase Mileage:
- Avoid Sudden Increases in Distance: Allow your Achilles tendon time to adapt by gradually increasing mileage during training.
Strengthen Calf Muscles:
- Build Strength with Eccentric Calf Raises: Perform calf strengthening exercises, focusing on the eccentric phase to build tendon resilience.

On the Bike

Pedal Technique:
- Maintain a Smooth Pedal Stroke: Avoid overextending or pointing your toes while pedaling, as this can exacerbate strain on the Achilles tendon.
Vary Your Cadence:
- Avoid Mashing Gears: Shift to a higher cadence and use lower gears to reduce stress on your Achilles tendon.

Treatment

On the Bike

Rest & Recovery:
- Take Breaks: If you feel discomfort or pain in the Achilles, stop periodically to give it a rest and reduce strain.
Adjust Saddle and Cleat Position:
- Lower the Saddle: Lowering your saddle can help reduce excessive strain on your Achilles tendon by allowing for a more natural pedaling motion.
- Reposition Cleats: Ensure cleats are correctly positioned to avoid forcing your foot into a toe-pointed position during pedal strokes.

At Home (Post-Ride or During Recovery)

Apply Ice:
- Ice the Affected Area: Apply ice to reduce inflammation and swelling in the Achilles tendon after riding.
Take Anti-Inflammatory Measures:
- Use NSAIDs: Over-the-counter anti-inflammatory medications like ibuprofen can help manage pain and inflammation.
Gentle Stretching & Mobility Exercises:
- Stretch Calves: Regularly stretch your calves to maintain flexibility and reduce tension on your Achilles tendon.
- Strengthen with Eccentric Exercises: Focus on eccentric calf raises to help build tendon strength and improve mobility.
Seek Professional Help if Needed:
- Consult a Physical Therapist: A physical therapist can create a customized rehabilitation program to treat Achilles pain and prevent future injuries.

Altitude Sickness

Most Common Bikepacking Injuries

Altitude sickness is one of the most common bikepacking injuries experienced at higher elevations, affecting riders differently depending on their acclimatization. Symptoms can range from mild to severe and may include headaches, nausea, and dizziness. For some, altitude sickness can be debilitating, leading to more serious conditions like high-altitude pulmonary edema (HAPE). For bikepackers tackling high-elevation routes like the Colorado Trail Race (CTR), which features long stretches at very high altitudes, being prepared for altitude sickness is essential. Knowing how your body reacts to elevation changes, understanding the symptoms of altitude sickness, and being prepared to manage its effects can help you stay on track and avoid serious setbacks.

Mild symptoms:

Shortness of breath
Faster than normal heart rate
Headache
Tiredness
Nausea
Dizziness
Throwing up
Loss of appetite
Not feeling well overall
Trouble sleeping

Severe symptoms:

Same as mild symptoms but more intense versions
Feeling out of breath, even when you’re resting
Tightness in the chest
Trouble walking/riding
Congestion in the ches
Coughing that won’t stop
Seeing double
Confusion
Skin color that changes from normal to gray, blue, or paler

Ways to Avoid

Pre Ride

Gradual Ascent:
- Ascend Slowly: Increase elevation gradually to allow your body to acclimate. Avoid ascending more than 300 meters (1,000 feet) per day above 3,000 meters (10,000 feet). :contentReference[oaicite:0]{index=0}
- Include Rest Days: Incorporate rest days every 3–4 days to aid acclimatization. :contentReference[oaicite:1]{index=1}
Hydration and Nutrition:
- Stay Hydrated: Drink plenty of water to prevent dehydration, which can worsen symptoms. :contentReference[oaicite:2]{index=2}
- Eat Carbohydrates: Consume carbohydrate-rich meals to provide energy and aid acclimatization. :contentReference[oaicite:3]{index=3}
Avoid Alcohol and Sedatives:
- Avoid Alcohol: Refrain from consuming alcohol, as it can exacerbate symptoms. :contentReference[oaicite:4]{index=4}
- Avoid Sedatives: Avoid sleeping pills and narcotic pain medications, as they can slow your breathing, which is dangerous at high altitudes. :contentReference[oaicite:5]{index=5}

On the Bike

Gradual Ascent:
- Ascend Slowly: Gradually increase elevation to allow your body to acclimate. Avoid ascending more than 300 meters (1,000 feet) per day above 3,000 meters (10,000 feet).
Hydrate:
- Drink Plenty of Water: Continue drinking water throughout your ride to stay hydrated and avoid dehydration, which can worsen altitude sickness symptoms.
Monitor Symptoms:
- Stay Alert: Be aware of any signs of altitude sickness and take immediate action if symptoms develop.
Sleep at Lower Elevation:
- Rest at Lower Elevation: If possible, sleep at a lower elevation to help your body recover and continue acclimatizing.
Cover Up to Avoid Exposure:
- Protect Yourself: Wear appropriate clothing and gear to avoid exposure to the elements, which can exacerbate symptoms of altitude sickness.
Medication:
- Consider Medication: If symptoms develop, consider taking over-the-counter medications for altitude sickness, such as ibuprofen or acetazolamide, as recommended by a healthcare professional.

Treatment

On the Bike

Descend to Lower Altitude:
- Immediate Descent: If symptoms are severe, descend to a lower elevation immediately to alleviate symptoms. This is the most effective treatment for altitude sickness.
Rest & Hydration:
- Take a Break: Stop riding, rest, and drink plenty of water to help reduce symptoms and allow your body time to recover.

At Home (Post-Ride or During Recovery)

Apply Ice or Heat:
- Use Ice for Inflammation: Apply ice packs to reduce swelling if you’re feeling bloated or experiencing headaches.
- Use Heat for Stiffness: Apply a warm compress to your muscles to help relax tightness and improve circulation.
Anti-Inflammatory Medications:
- Take NSAIDs: Over-the-counter medications like ibuprofen can help alleviate pain and reduce inflammation related to altitude sickness.
- Acetazolamide (Diamox): This prescription medication can speed up acclimatization and reduce symptoms of altitude sickness, but consult with a healthcare provider first.
Oxygen Therapy:
- Supplemental Oxygen: If symptoms are severe, using supplemental oxygen can help alleviate the symptoms of altitude sickness.
Rest and Recovery:
- Rest at Lower Elevation: Ensure you sleep and rest at a lower altitude until the symptoms subside. Allow your body to adjust to the changes before attempting to go higher.

Conclusion

Most Common Bikepacking Injuries

Bikepacking injuries, while common, can often be prevented with the right preparation. Many injuries stem from improper bike fit or insufficient pre-ride conditioning, both of which can be managed with careful planning. By understanding the most common bikepacking injuries, knowing how to avoid them, and familiarizing yourself with treatment options, you can drastically reduce your risk.

Before heading out, take the time to assess your gear, your body, and your limits. Make sure your bike is properly fitted, focus on strengthening key muscle groups, and hydrate well. A Shakedown Ride is an excellent way to test your setup and make any necessary adjustments before hitting the trail. Also, familiarize yourself with the Most Common Bikepacking Mistakes so you can avoid rookie errors that lead to injuries.

With the right knowledge and preparation, your adventure will not only be safer but also far more enjoyable.

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PLANNING / GEAR RESOURCES

PLANNING AIDS

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TRIPLE CROWN GEAR

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Dive into all three gear lists from the Bikepacking Triple Crown, and find pros & cons; things I’d do differently; and tips.

“IF I RODE…” SERIES

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In depth look at what I would bring for gear and why, if I rode the Tour Divide, CTR, AZTR, Kokopelli Trail, and Bay Circuit Trail again.

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Curios to know what gear other riders used to get to the finish line? Checkout our Rider Surveys to find out what works or to take the survey yourself.

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Options for SPOT tracker & Trackleaders setup - SPOT tracker, Zoleo, and Garmin InReach.

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Bikepacking Resources

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guide, planning aid, coconino 250, bikepacking, resource - Planning Aids for Bikepacking and Hiking

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Most Common Bikepacking Injuries

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Saddle Sores

Ways to Avoid Saddle Sores

Pre-Ride

On the Bike

Treatment

One the Bike

At Home (Post-Ride or During Recovery)

Chafing

Ways to Prevent Chafing

Pre Ride

One the Bike

How to Treat Chafing

One the Bike

At Home (Post-Ride or During Recovery)

PLANNING AIDS

Numbness

Ways to Prevent Bikepacking Numbness

Pre Ride

On the Bike

How to Treat Bikepacking Numbness

One the Bike

At Home (Post-Ride or During Recovery)

Joint Pain

Ways to Prevent Bikepacking Joint Pain

Pre Ride

One the Bike

How to Treat Bikepacking Joint Pain

On the Bike

At Home (Post-Ride or During Recovery)

Exposure

How to Prevent Exposure-Related Injuries

Pre Ride

On the Ride

How to Treat Exposure-Related Injuries

One the Bike

At Home (Post-Ride or During Recovery)

Racer Cough

Preventing Race Cough

Pre Ride

On the Bike

Treatment

On the Bike

At Home (Post-Ride or During Recovery)

Achilles Pain

Ways to Avoid

Pre Ride

On the Bike

Treatment

On the Bike

At Home (Post-Ride or During Recovery)

Altitude Sickness

Ways to Avoid

Pre Ride

On the Bike

Treatment

On the Bike

At Home (Post-Ride or During Recovery)

Conclusion

MORE RESOURCES

PLANNING / GEAR RESOURCES

PLANNING AIDS

TRIPLE CROWN GEAR

“IF I RODE…” SERIES

RIDER SURVEYS

MOST POPULAR RESOURCES

Checkout our bikepacking resource page for more planning help.

CHECKOUT ALL OUR GUIDES

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