Road bike alterations after arm injury

[fetyjo]

My wife fell off her road bike going up a hill in the wrong gear on NYE just gone (PPPPP) and put her arm out to stop the fall and subsequently smashed her radial head. 11 months later, 2 surgeries and a new radial head the surgeons still have no clue what to do with her bent arm that cannot straighten - meanwhile my wife who was a happy triathlete and regular rider is now in a heavy state of depression as she really misses cycling (me heading out all the time does no help). I am thinking of a tandem (not having much finding anything but new) but, would like to know if there are any bike companies/people out there that specialise in bike setup/adjustment for this type of injury - she will never be able to fully straighten her arm again and the bounce of rough surfaces is likely to be an issue. Shes a tough nut and I want to get out, even if it may be on a Tandem but I would like to see her back on her own bike or, perhaps a new one with Di2 and maybe discs to try and foolproof her ride as much as possible and get her confidence back. Were in Adelaide but happy to look interstate for a solution - I want my happy wife back. Any advice would be welcome. Cheers.

[AUbicycles]

If you can move away from an aero or road bike and go ti a touring bike (flat bar style) then this would allow a lot of flexibility.

It changes the style of riding but means you can go with a relaxed geometry and the more flexible option for braking and gearing setup. The opportunity is to go with an adjustable stem and also creative handlebars that provide the height and position. Also can be adjusted and adapted easily of time.

Could make sense to involve a bike fitter who can bring you closer the the optimal bike style and setup.

[westab]

Another thing to consider may be a Trisled - I have no experience with them what so ever but I know others here who do.

In my opinion they look the best - both on this websitehttp://trisled.com.au/ and the couple that I have seen fly past me on the M7 shared path in Sydney.

[Duck!]

Is it purely a reach problem due to the inability to straighten the arm, or are there other hand strength & mobility issues to contend with as well?

If it's purely reach, the simplest, if not exactly elegant, solution is a "Heads Up" steerer extension, which slips over & bolts onto the steerer in place of the stem, then the stem is fitted in the normal manner to the extender. The rise is typically in the order of 50-60mm. A shorter stem, with or without a greater angle of rise can also be considered, in addition to the Heads Up if necessary. The raised position will also have the benefit of reducing the load borne by the arms, thus reducing the shock going into the injured arm. Double-wrapping the bar tape or adding gel pads ("Bar Fat") under the tape will also reduce shock loading. If hand strength & mobility is unaffected, normal controls can be retained.

Di2 or eTap and hydraulic brakes take a huge amount of the fine motor effort out of braking and shifting, but with varying degrees of adaptability; Di2 can be setup via the Synchro Shift mode so all shifting is done with one shifter, simply shift up or down and at set positions in the shift sequence the system will take care of front shifting. However hydralics are only available on disc brakes, which means specific frame & wheels. SRAM eTap lacks the shifting adaptability offered by Di2, but the ace up its sleeve is the availability of hydraulic rim brakes, which means no need for specific frame, fork or wheels.

[g-boaf]

Is it purely a reach problem due to the inability to straighten the arm, or are there other hand strength & mobility issues to contend with as well?

If it's purely reach, the simplest, if not exactly elegant, solution is a "Heads Up" steerer extension, which slips over & bolts onto the steerer in place of the stem, then the stem is fitted in the normal manner to the extender. The rise is typically in the order of 50-60mm. A shorter stem, with or without a greater angle of rise can also be considered, in addition to the Heads Up if necessary. The raised position will also have the benefit of reducing the load borne by the arms, thus reducing the shock going into the injured arm. Double-wrapping the bar tape or adding gel pads ("Bar Fat") under the tape will also reduce shock loading. If hand strength & mobility is unaffected, normal controls can be retained.

Di2 or eTap and hydraulic brakes take a huge amount of the fine motor effort out of braking and shifting, but with varying degrees of adaptability; Di2 can be setup via the Synchro Shift mode so all shifting is done with one shifter, simply shift up or down and at set positions in the shift sequence the system will take care of front shifting. However hydralics are only available on disc brakes, which means specific frame & wheels. SRAM eTap lacks the shifting adaptability offered by Di2, but the ace up its sleeve is the availability of hydraulic rim brakes, which means no need for specific frame, fork or wheels.

Hydraulics are also available for rim brakes with Shimano. The Magura RT8 /RT6 can be used with the adapter so they can run via normal brake levers. The adapter hangs below the stem. Not sure if it will work on Giant though with their larger steerer tubes.

I think even SRAM E-tap without hydraulic has a lighter brake lever effort than Shimano Dura Ace. The hoods I think have a better shape too. That was one of the biggest improvements since moving over to E-tap, though I suspect a regular SRAM Red would also have the same nice brake lever feel.

[bychosis]

Maybe a decent MTB with suspension might help if vibration is an issue, cheap suspension doesn't do much but some quality air shocks could help. Sure it will be slower, but riding slower is better than not riding. You could potentially roadify it a bit with some slick tyres.

Which arm? a 1x drivetrain setup might also negate the need to shift with the injured arm, and perhaps switching the brake levers around to enable more efficient braking.

Edit: Apologies, left an f out of shift!

[g-boaf]

Maybe a decent MTB with suspension might help if vibration is an issue, cheap suspension doesn't do much but some quality air shocks could help. Sure it will be slower, but riding slower is better than not riding. You could potentially roadify it a bit with some slick tyres.

Which arm? a 1x drivetrain setup might also negate the need to !! BAN ME NOW FOR SWEARING !! with the injured arm, and perhaps switching the brake levers around to enable more efficient braking.

I think the Di2 setup that can be tuned to shift the front derailleur at the right time without your intervention is the better solution that a 1x drivetrain. You can tweak that to your preferences too. If it were me, I'd prefer that to a 1x drivetrain.

[NewStew]

I read this the other day on the Steve Hogg site - may be worth having a chat to them?

https://www.stevehoggbikefitting.com/po ... rm-injury/

[madmacca]

That fall sounds pretty Ouch!!

There are a few bike fit specialists (often with a physiotherapy background) who deal with adapting positions for injuries - dealing with lower body injuries may be more common, but they may be able to advise with more precision on the kind of positional changes Duck is talking about. Even if they are not based in Adelaide, you may find them there during TDU.

di2 satellite shifters may open up more positional possibilities, but you'd still be left with brake levers.

Edit: I see NewStew has posted a more specific link while I was drafting a reply.

[g-boaf]

Just a thought, SRAM E-tap allows the use of those blip shifters:

https://www.bikebug.com/sram-red-etap-b ... 57133.html
https://www.sram.com/sram/road/products ... ap-blipbox

That's another possibility if the standard SRAM E-tap shift levers are not good enough.

[AUbicycles]

Blips are a good idea for a road type setup for shifting though you also need reachable/usable braking.

[HenryCharlie]

Fetyjo, tell your wife not to give up hope. I smashed my radial head in a cycling injury in the late 90's and it was pinned back on. My arm has recovered well and I have full movement back....it did take a few years though.

[skyblot]

The Tri-Sled suggestion is a good one, but also for consideration think 2 wheel recumbents....

I know it's not a popular train of thought, but there are some seriously fast 2 wheel recumbents out there if your wife is not committed to the road bike lifetyle. Performer high racer, Bacchetta high racers, M5 mid and high racers....

700c wheels and tyres, standard road bike groupsets, plus the all day comfort recumbents can offer. No issues with weight on arms, shoulder or neck strain.

Just another option.

[trailgumby]

Another vote for Steve Hogg. You will need to travel to Canberra to see him, but well worth the trip for a medical bike fit.

[ausrandoman]

Some suggestions

1.
I once met a cyclist with one arm much shorter than the other. She used drop bars but on the short arm side, she had a mountain bike handle bar extender, facing up and forward with a brake lever mounted on it.

2.
Cut the head stem in half, put a sleeve inside it, rotate the bars off horizontal so she can reach with her bad arm then weld the sleeve in the head stem. This will make the good arm side too low, so raise the whole head stem on the steerer tube. A combination of stem height and handlebar tilt might put both hands in the right position. A light engineering machine shop could do this.

3.
Find an occupational therapist who is a cyclist. My wife is. What state are you in?

4.
http://www.solve.org.au

Good luck.

[Duck!]

One of my customers is basically a walking paraplegic, with very little functionality of the right side of his body. His setup is a flat-bar, with MTB-type bar-end extensions. The rear derailleur is controlled by a TT-style bar-end sifter fitted to the extension on trhe left side, while the front derailleur is controlled as normal by a trigger shifter, while the braking is covered by a dual-cable lever on the left so both brakes are worked off the one lever.