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  1. #1
    Senior Member tony_merlino's Avatar
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    Riding position and chest pains

    I'm new to this forum, and I apologize if this first post is too negative.

    I used to ride a lot (150+ miles/week), but fell out of the habit about 14 years ago, after a fairly nasty accident. Then the kids came along, work got very demanding, yada-yada... and I pretty much lived in front of a computer all day.

    I used to be the stereotypical 150 lb rider back in the day, but since then, I've gained a lot of weight (60+ lbs, most of it in the last year or so). I started riding again this past summer, and it's been a lot more of an effort than it used to be - especially the hills. And I live in a pretty hilly area... I've had to learn to swallow my pride and walk the bike sometimes. That was hard - I used to pride myself on being a good climber.

    Rather than tax my old Bianchi road bike with my additional weight, I bought an used Specialized HardRock MTB, and put slicks and a rack on it to use for around town and for exercise rides. I ride it for errands, and also take longer rides - about 12 miles, for fun and exercise. I haven't ridden a whole lot, but have managed to log about 300 miles over the summer.

    The problem is that I'm no longer so tolerant of the bent-over riding position, and at times I feel that I just can't get enough air to breathe that way. Sometimes it's fine, and everything clicks, and I can ride almost the way I used to. Other times, it's a struggle to breathe. And this is basically on the same routes - it just varies from day to day.

    It came to a head the other day - I had ridden less than two miles, fairly flat terrain, when I started feeling intense pain in my chest, felt like I couldn't get enough air into my lungs, particularly if I actually gripped the handlebars (which requires me to scrunch over). The pain radiated down my left arm, and my left hand was tingling. It was a little better if I sat up and just touched the grips with my fingertips - but I was in traffic, and that wasn't a very safe way to ride at that point. I was pretty scared - nothing like that has happened to me before, and I certainly recognized the signs of cardiac distress.

    I had to pull over to the side and rest for 5 - 10 minutes, and then started feeling a little better. I probably should have gone to the ER, but I didn't, and decided to ride home. On the way, the same thing happened, again after just 1.5 miles or so. I had to get off the bike and walk the rest of the way home, panting all the way.

    Before anyone says anything, yes, I have an appointment with my cardiologist tomorrow (the earliest they could get me in...) But what I'm curious about is if the restriction of my lung capacity caused by having to scrunch over my belly could cause this sort of thing to happen. Is it possible that just putting riser bars on the bike, or comfort bars - something that would let me ride in a more upright position - , would alleviate this problem? Has anyone else ever experienced anything like this?

    I really hope I'm not finished as far as cycling is concerned. I guess one of the messages in here is never to put off doing what you want to do for a "better time".

  2. #2
    Travelling hopefully chasm54's Avatar
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    First of all, I'm glad you have an appointment with the cardiologist. Second,it is perfectly possible that comstricting your chest through your riding position has contributed to your becoming aware of the problem. In which case, in my opinion, it may have done you a favour by making you get yourself checked out.

    When the cardiologist says you're OK, that's the time to worry about your riding position.
    There have been many days when I haven't felt like riding, but there has never been a day when I was sorry I rode.

  3. #3
    Senior Member bud16415's Avatar
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    Hi Tony and welcome to the forum. I'm fairly new myself and have similar life experiences that got me back into riding a few years back. First and foremost keep that appointment with the doc just in case. I had a similar feeling at first and sometimes still do and I found out I had exercised induced asthma. The combination of pollen and exercise had me thinking it was the big one. I ride all the time now with my inhaler handy. On a similar note I always have my cell phone in my bar bag in case I need to call for a lift home, I haven't had to do that but it's nice to know it's there.

    That being said age, weight and inactivity all move us in one direction and our brain sees us as 18 and in top shape we once were in. My first bike coming back was a converted mtn bike also and don’t stop at just the slicks. The mtn bike is giving you the low gears that help but get rid of the straight bars and get a better posture that is slightly upright. Learn about cadence and use the gears to your advantage. I now look at a level of energy output I know I can sustain and then select gearing to suit. Speed is what suffers but we are not racing. I look at the end of a ride and say wow I rode 2 hours not that I rode 20 miles say. It takes longer to get back in shape than it once did but biking is a great way to go about it.

    Take water with you and have a place to store a few items. There is nothing wrong with walking a hill in fact it’s a great way to stretch out.

    I will post a picture of how much rise etc I changed my mtn bike into a more enjoyable rider to give you a few ideas. Bar ends with grips make for a nice second hand position also and allow you to play with different locations.

    Best of luck with everything.


    What's not in your legs needs to be in your gears.

  4. #4
    Senior Member Mithrandir's Avatar
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    Quote Originally Posted by tony_merlino View Post
    But what I'm curious about is if the restriction of my lung capacity caused by having to scrunch over my belly could cause this sort of thing to happen. Is it possible that just putting riser bars on the bike, or comfort bars - something that would let me ride in a more upright position - , would alleviate this problem? Has anyone else ever experienced anything like this?
    A heart attack is caused when your heart cannot get enough oxygen to operate. When this happens, heart tissue dies or becomes scarred. Since what you reported has all the hallmarks of a potential heart attack, I am very glad you are seeing a cardiologist. I must say that yes, your lack of breathing capacity in a scrunched position could have induced a minor heart attack as your body may not have been able to get enough oxygen to your heart to prevent it from going into arrest.

    After speaking to your doctor, I would go find a bike shop and get a professional bike fitting performed. Make sure they know the situation and see what they recommend. They may decide a comfort bike is more in line with your current fitness level if you simply cannot get enough lung movement on your current bike.

    Good luck!

  5. #5
    Senior Member tony_merlino's Avatar
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    Thanks to all for the responses. I appreciate the idea of using the gears - I was a pretty dedicated roadie, so I'm familiar with the idea of saving my legs. I still try to keep my pedal cadence above 60 RPM, which may be part of the problem - doing a very aerobic exercise in a position that constricts my lungs might not be the greatest strategy...

    The explanations all sound plausible. I've rooting for the asthma (since it seems like the easiest thing to do something about :-) ).

    Assuming everything checks out with the cardiologist, and I'm still ok to ride, I'm first going to try to get my current bike to fit better, with riser bars and maybe an adjustable stem. I like the idea of the bar ends to give another hand position...

    Thanks again!

  6. #6
    Senior Member gyozadude's Avatar
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    Tony:

    I'm surprised you're seeing a cardiologist tomorrow and you didn't see one STAT. A dying heart is very serious. And somethings require an EEG/EKG hook up to see clearly WHILE it's happening. In the short amount of time between a day ago and the appointment, you could get scar tissue buildup and part of your heart could be dying/dead with no chance of revival. And that reduces your blood pumping capacity. The way you described it as "radiating pain" is a VERY HIGH PROBABILITY indicator of heart blockage.

    A bad fitting bike isn't going to cause chest pain. You'll get tired or sore in that position and naturally want to change it. But 2 miles into a ride, after riding 300 miles during the summer? Dude, get to an ER, have them wire you and do blood tests for a heart attack. If you're taking statins already, they have to small a dose. If you haven't seen a doctor in a while, you need a full physical, treadmill, blood work, BP, endocrine, liver panel, lipid panel, glucose, HB-A1C.

    My mother was a nurse for 30 years. I volunteered a lot. I fed a lot of vegetable-people that didn't take care of their hearts. I learned that with old folks in my family and myself being big, I need to have a portable AED in my car, in my house, and in my parent's house too, and they all need to trained and certified in CPR/AED. Even my two older kids, one 11 and the other almost 10, are Redcross Basic Aid/AED trained through scouts.

    No laughing matter. Best wishes for good health. Get checked out STAT!
    Yes, I can roll my own potsticker skins!

  7. #7
    Senior Member tony_merlino's Avatar
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    Quote Originally Posted by gyozadude View Post
    Tony:

    I'm surprised you're seeing a cardiologist tomorrow and you didn't see one STAT. A dying heart is very serious. And somethings require an EEG/EKG hook up to see clearly WHILE it's happening.
    I think I was in serious denial. As I said, a lot of my weight gain has been recent (60+ pounds in a little over a year), after some major changes in my life. Until even a year or so ago, my cardio health was really good - my last stress test was a couple of years ago, and at that time the doctor told me I had the heart of an athlete. Even now, my resting pulse is below 60, BP is normal ... Bottom line is that I couldn't (and on some level still don't) believe that I could have heart problems now. I know, ... really stupid.

    No laughing matter. Best wishes for good health. Get checked out STAT!
    Thanks, I will.

  8. #8
    Runaway Breadtruck
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    I'm glad you are getting in to see somebody, but I have to wonder at the quality of the cardiologist if they did not route you directly to the ER to get an EKG. You may want to find another one before this one kills you.

    Hopefully we are all wrong and its no big deal. But if it is a big deal, look at it this way.... you survived it. A lot of people dont. So you will have a chance to turn it all around, and get back to living your life, and once the docs give you the go ahead you can get back on the bike as well.

    Good luck.

  9. #9
    Humvee of bikes =Worksman Nightshade's Avatar
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    Quote Originally Posted by tony_merlino View Post
    Thanks to all for the responses. I appreciate the idea of using the gears - I was a pretty dedicated roadie, so I'm familiar with the idea of saving my legs. I still try to keep my pedal cadence above 60 RPM, which may be part of the problem - doing a very aerobic exercise in a position that constricts my lungs might not be the greatest strategy...

    The explanations all sound plausible. I've rooting for the asthma (since it seems like the easiest thing to do something about :-) ).

    Assuming everything checks out with the cardiologist, and I'm still ok to ride, I'm first going to try to get my current bike to fit better, with riser bars and maybe an adjustable stem. I like the idea of the bar ends to give another hand position...

    Thanks again!

    Depending on what the cardio doc tells you it is very likely that your "roadie" days are behind you. You must remember that as humans age they lose flexibility along with many other youthful abilities that slip away so very slowly for us all.

    So instead of being a "roadie" you will become a "cyclist" to join the larger community of people who love to ride bicycles. Welcome...........
    My preferred bicycle brand is.......WORKSMAN CYCLES
    I dislike clipless pedals on any city bike since I feel they are unsafe.

    Originally Posted by krazygluon
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  10. #10
    not as fat as I was Biggziff's Avatar
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    I've been told that if you have chest pain that is positional it is almost never heart related. Let's hope this is true.
    humans can be so....rude

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    Senior Member tony_merlino's Avatar
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    Quote Originally Posted by Biggziff View Post
    I've been told that if you have chest pain that is positional it is almost never heart related. Let's hope this is true.
    From your lips to God's ears, my friend. And yes, it was positional. I got blown off by the cardiologist once again today - I was originally supposed to go on Monday, and they called and rescheduled me for today. Called again today and rescheduled for tomorrow. In the meantime, I feel fine... I'm hoping for a massively annoying false alarm... and maybe an effective warning.

  12. #12
    2nd Amendment Cyclist RichardGlover's Avatar
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    Get your chest checked out. Assuming that's fine, get a bike fitting done by your LBS. Expect to pay 50-100 bucks for it, plus more cash for parts to fine-tune your fit if you need to (e.g. a shorter stem, different seatpost, etc).

    Cheaper than a trip to the ER (not to imply that you shouldn't go to the ER if you think you need to).
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  13. #13
    Senior Member tony_merlino's Avatar
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    Quote Originally Posted by Nightshade View Post
    Depending on what the cardio doc tells you it is very likely that your "roadie" days are behind you. You must remember that as humans age they lose flexibility along with many other youthful abilities that slip away so very slowly for us all.

    So instead of being a "roadie" you will become a "cyclist" to join the larger community of people who love to ride bicycles. Welcome...........
    I'm still hoping to pull the road bike out of mothballs ... maybe next year. I won't be doing what I used to do 14 years ago, before my accident, ... But I am hoping that I can experience the joy of riding a bicycle I can lift with my pinkie... The thing I loved about that bike was that it made going fast nearly effortless - it just seemed to want to go fast. The bike I ride now just seems to want to stand still. Or maybe it's the difference between being 45 and 59...

    The funny thing is that, less than 2 weeks ago, I felt I had really hit my groove with the bike I'm riding now, and averaged nearly 20 mph on the same 12 mile ride I started the other day when I had the problems. (It's a pretty flat ride - some gentle inclines, but no real hills.) Which I thought was not too bad for an old guy who's nearly 60 lbs overweight, on a not-built-for-speed bike.

    But you know what - it's not bad at all to be part of the larger community of people who love to ride bicycles. Thanks for the welcome!

  14. #14
    Neil_B
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    I don't mean to minimize the seriousness of the OP's problem, but heart attack is sometimes called "the big mimic." Indigestion, for instance, sometimes manifests itself with the same symptoms. What happens is that a guy eats the wrong thing, has chest pain, wonders if its a cardiac event, and as he panics his mind starts to generate the other symptoms. I wonder if that's what the OP experienced.

  15. #15
    Senior Member tony_merlino's Avatar
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    First of all, thanks to all who responded and expressed concern. I just got back from the cardiologist, where I had a stress test. Everything was fine. He said I have the cardiovascular system of someone 30 years younger than I am. He had no idea what happened on Friday - said it could have been weight related, could have been indigestion, could have been almost anything EXCEPT my heart. He said to keep exercising and riding, and stay on my diet.

    I'm still puzzled about what happened, but at least I know that it wasn't a heart attack, that my arteries are fine.

    NOW - to replace those straight bars with something that fits my body!

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    not as fat as I was Biggziff's Avatar
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    Wonderful news!!
    humans can be so....rude

  17. #17
    Senior Member bud16415's Avatar
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    Tony

    That’s good news. The deceptive part of riding at least to me when I restarted and to even a greater extent when I started equipping a touring bike is the effect of weight and climbing. If you feel you are 50 pounds heavier than your weight you remember riding at as a young man then you are actually carrying the weight of a fully loaded touring bike with you at all times. I read so much about touring cyclists shaving a few pounds here and there and I found it hard to believe weight would play such a big role. On the flats it really isn't much of a difference once the rolling resistance is overcome. But throw in a 3% climb that looks like not that much but you are slowly lifting that weight up against gravity and it is a big deal. Getting the oxygen into the muscles can quickly reach a point of demanding more than you can provide. Feeling that coming on and adjusting to it can be big. I find things like you asked about in your first post play a big part in it such as allowing your lungs room to expand etc. I also find that as I get older the time between eating and exertion has to be greater. As a kid I could eat a lot and go jump on a bike and go full out no problem. now I do much better leaving a few hours in there or eating more lightly and often if I'm working hard. I don’t know why that is but in my case I have found it to be true.

    All the advice about a professional bike fitting is good. I am a person that like to see cause and effect. And it might be a slower process getting it right doing it yourself but when you do get it worked out you will know what to start changing again as you lose weight and want to make your posture more powerful again. Things like an adjustable stem are great places to start and as you improve can be changed easily. Keep us involved in what you do and thanks for being so open about your problems.
    What's not in your legs needs to be in your gears.

  18. #18
    Humvee of bikes =Worksman Nightshade's Avatar
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    Quote Originally Posted by tony_merlino View Post
    First of all, thanks to all who responded and expressed concern. I just got back from the cardiologist, where I had a stress test. Everything was fine. He said I have the cardiovascular system of someone 30 years younger than I am. He had no idea what happened on Friday - said it could have been weight related, could have been indigestion, could have been almost anything EXCEPT my heart. He said to keep exercising and riding, and stay on my diet.

    I'm still puzzled about what happened, but at least I know that it wasn't a heart attack, that my arteries are fine.

    NOW - to replace those straight bars with something that fits my body!
    Great news !! I wondered if your belly wasn't getting shoved up inside restricting your diaphragm and breathing due to the drop bars.

    http://en.wikipedia.org/wiki/Thoracic_diaphragm

    Since you need to be more upright , for now, suggest that you consider bars more along the Cruiser posture giving you lots of room to breathe. Not what an ex-roadie would choose on his own but will allow you ride to lose some of the extra 60lbs you carry now in real comfort. Once you loose weight you can always put the drops back on...........

    I really like this bar on my cruiser since it's really comfortable. http://www.amazon.com/Nirve-Cruiser-...7839071&sr=8-1
    My preferred bicycle brand is.......WORKSMAN CYCLES
    I dislike clipless pedals on any city bike since I feel they are unsafe.

    Originally Posted by krazygluon
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  19. #19
    Senior Member bud16415's Avatar
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    One thing I learned about drop bars is they don’t have to be set so low. When I started riding drops transitioning from the mtn bike modified to the touring bike I absolutely hated the drop bars. the drops were so low, the reach was too far, riding the tops I felt lack of control and the hood were awkward to shift and brake from. Plus I felt compressed to much in the low position very much what you described. I was reading some stuff Sheldon Brown wrote on hand positions and noticed he had bikes set up with higher drop bars. The conventional wisdom is the top of the bar should be about level with the seat or lower. I brought mine up and towards me to suit my arm length and proper seat position and split the difference making the seat half way between the drops and the tops and what a difference that was for me. I like all the hand positions but now my favorite position is the drops, so much so I lowered the brakes and hoods and shifters to suit riding the drops and added fake hoods for the other hand position. Keep trying things till you find what works for you. Here are my high drops.

    What's not in your legs needs to be in your gears.

  20. #20
    Senior Member goldfinch's Avatar
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    I suggest doing some core exercises to help strengthen your body. It will help with comfort on the bike, no matter what your set up. This was suggested to me here and it made a big difference in my biking comfort.

    You might also think about some breathing exercises.
    Last edited by goldfinch; 10-05-11 at 03:12 PM.

  21. #21
    Senior Member tony_merlino's Avatar
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    Quote Originally Posted by Nightshade View Post
    Great news !! I wondered if your belly wasn't getting shoved up inside restricting your diaphragm and breathing due to the drop bars.

    http://en.wikipedia.org/wiki/Thoracic_diaphragm
    I think that's exactly what was happening. That and going out to ride too soon after lunch.

    Since you need to be more upright , for now, suggest that you consider bars more along the Cruiser posture giving you lots of room to breathe. Not what an ex-roadie would choose on his own but will allow you ride to lose some of the extra 60lbs you carry now in real comfort. Once you loose weight you can always put the drops back on...........

    I really like this bar on my cruiser since it's really comfortable. http://www.amazon.com/Nirve-Cruiser-...7839071&sr=8-1
    I have a straight bar, not drops - but your point is well taken.

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    I went through a similar experience with the chest pain except picked up a $2,300 ER bill. The ER docs did an EKG, chest xray, and CAT scan and found nothing. Finally saw a cardiologist and he diagnosed chondrochondritis, an inflammation of the tissue between the ribs and brestbone. He couldn't explain what cause it but gave me some anti-inflammatory meds and sent me on my way.

  23. #23
    Senior Member TacomaSailor's Avatar
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    Very similar experience - lost 30 pounds - rode 2000 miles - no more problems

    Several years ago I experienced almost identical symptoms for almost identical lifestyle reasons ( I went from a rock solid 185 pounds to a very pudgy 240 pounds over a 5 year period). I visited my cardiologist several times and had several stress tests. Problem persisted for months of intermittent riding with intermittent scares.

    Eventually ended up in the ER at 3 AM with tachycardia (HR>215), BP 200/120 and horrendous chest pains radiating down my arm. ER doc was sure it was a heart attack.

    Cardiologist (I've had the same one for 35 years) said "NO heart attack - NO heart problems - you have the heart of a person 25 years younger"

    Eventually I saw a gastroenterologist who did a complete exam of my food intake system from mouth to small intestine (not pleasant but useful) and verified that I had a hiatal herinia (as suggested by another person here).

    Certain riding positions, combined with certain foods, and my excess weight, caused stomach contents to be forced back up my esophagus. The stomach doc says the esophageal irritation, particularly if left untreated for months, can cause terrible pain and your systems reacts with heart rate increase and blood pressure increase. He said it is very commonly mistaken, even by ER docs, for heart problems.

    I learned what not to eat and lost 30 pounds and EASED back into long distance riding on the drops on a Specialized Roubaix. I can now easily ride 60+ miles with no discomfort and can ride over two hours non-stop (feet not touching the ground). It has taken me over a year of increasing my distance and level of effort but I am now able to ride as comfortably (not as fast!) as I did 40 years ago.

    The stomach doc put me on Omeprezol (Prilosec ) twice a day but I am now down to taking it as needed - for example - haven't ridden for two days and am having spaghetti for dinner. I just use generic pills that are very cheap.

    Lost weight and learned to eat correctly- haven't had a riding "episode in 18 months"

    That also solved most of my night time gastric reflux problems and dropped my blood pressure to an OK level.

  24. #24
    Senior Member Mithrandir's Avatar
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    Quote Originally Posted by Neil_B View Post
    I don't mean to minimize the seriousness of the OP's problem, but heart attack is sometimes called "the big mimic." Indigestion, for instance, sometimes manifests itself with the same symptoms. What happens is that a guy eats the wrong thing, has chest pain, wonders if its a cardiac event, and as he panics his mind starts to generate the other symptoms. I wonder if that's what the OP experienced.
    On the other hand, the opposite can happen. My old boss's wife died of a heart attack at 39. She was fit and thin, one day she left work an hour early because she felt like she was having some terrible indigestion. Went home, died in her sleep of a heart attack.

    Really scared the **** out of me because if someone like that can have a heart attack, what are my chances? Life is weird.

  25. #25
    Humvee of bikes =Worksman Nightshade's Avatar
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    Quote Originally Posted by tony_merlino View Post
    That and going out to ride too soon after lunch.I have a straight bar, not drops - but your point is well taken.
    Not to press but.........
    In this case it will be in your best interest to get as upright as you can to breathe with ease. VERY important! Straight bars will not allow the correct upright posture nor will they allow good posture for your hands & arms. Human arms hang parallel to your side not twisted 90 deg out in front!!

    All kidding aside, comfort is so important to either a beginning ,or a returning, rider than you can ever imagine.

    Oh yes, it is safe to ride after a meal be it big or small IF you just take it easy and toodle along..............
    My preferred bicycle brand is.......WORKSMAN CYCLES
    I dislike clipless pedals on any city bike since I feel they are unsafe.

    Originally Posted by krazygluon
    Steel: nearly a thousand years of metallurgical development
    Aluminum: barely a hundred, which one would you rather have under your butt at 30mph?

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