Sun’s Out, Bikes Out. Here’s How to Prevent Common Bike-related Injuries This Summer

A man in a red shirt standing next to a white bike.

Every Pacific Northwesterner knows: When the sun comes out, so do the bikes.

And while cycling is a great low impact way to improve cardiovascular fitness, strengthen your lower body, and reduce your carbon footprint, there are some cons to trading four wheels for two—namely, risk of pain and injury.

So, to kick off the PNW’s prime biking season, we’re talking bicycling safety tips. Read on to discover the most common bike-related pains and injuries, and what you can do to prevent them.


“Take up cycling,” they said. “It won’t hurt your knees,” they said. While it’s true that biking is a low-impact form of exercise, it doesn’t always alleviate knee pain—in fact, roughly a quarter of professional cyclists suffer from knee injuries. One of the most common complaints among bikers is anterior knee pain, or pain in and around the kneecap. Cyclists can get it from muscle tightness, overuse, or a poorly-adjusted bike.

An x-ray of a knee.
x-ray OA knee x-ray


First, check your bike fit against an online calculator. You want to make sure your bike is adjusted to your measurements, but also to the type of riding that you do. Areas to pay extra-close attention to are seat height, seat position, and the rotation and position of your cleats.  

Next, make sure you’re stretching—something cyclists often overlook. Try getting on a foam roller and gently rolling the quads, the inside of the thigh, hamstrings, and calves. Pro tip: When rolling, use long, continuous motions to add some length to your muscles—don’t go quickly up and down like a rolling pin.


During June and July, our Zoom providers see twice as many bike accidents as other months. As we previously reported, the most common injury isn’t a broken wrist or a broken collarbone, either—believe it or not, it’s the elbow. (More specifically, the radial head and radial neck.)

Why the elbow and not the wrist, you ask? When you fall and catch yourself with your hands, the impact of hitting the ground travels up your forearm, where it hits a fixed point at the elbow—which can cause the head or neck of the radius bone to fracture, or sometimes fragment.  

An x-ray showing a radial head fracture, a common bike-related injury


This is a tricky one. Outside of, well…not crashing your bike, there isn’t much you can do in the way of prevention. “Extending one or both arms to break a fall is something we do instinctively to protect our heads, which is good,” says ZOOM+Care’s Orthopedic Surgeon Carolyn Yang. “If you can think to do one thing as you go down, bend your elbows, which will reduce the impact on the joint.”

If you do suffer a break, be sure to visit ZOOM+Super—our Emergency Care Clinic in Portland. Super can treat 80% of the reasons adults and kids go to the ER, including breaks and bone fractures.


Hours spent sitting on an uncomfortable seat + sweating in tight clothing = chafing. And while saddle sores aren’t the sexiest summertime biking injury, they’re certainly a common one.

If chafing does pop up this summer, be sure to wash daily with a fragrance-free soap, then gently pat—never rub—dry. After cleaning the area, apply an ointment like petroleum jelly to reduce friction.

One note: If the area becomes swollen, beefy red, hot, painful, crusted, or starts bleeding, be sure to schedule an appointment with a healthcare provider, who can recommend a medicated ointment.


If you start to develop chafing and saddle sores, take time off the bike. Seriously—constantly re-exposing the area isn’t going to help you heal.

Other preventive measures include wearing loose, breathable clothing, making sure your seat is adjusted to the proper height and angle, wearing padded shorts, and switching to a seat with better cushioning.


Ask any urban cyclist—biking downtown is akin navigating to a war zone. There are the usual dangers (read: cars, buses, streetcars), but there’s another, less-obvious foe lurking: train tracks. The gaps between the rails and pavement can easily swallow a bicycle wheel, and slick tracks can make your tires slip out from under you.

“This time of year, people are out riding their bikes all the time—and railroad tracks can be super dangerous, even for experienced riders. Every summer, we see a trend of people breaking bones because they get caught in those grooves,” says hardcore cyclist Dr. Mark Zeitzer. (He also happens to be our Medical Director of Acute Care Services.)

A person on a bike riding next to the train tracks.


First things first: When you come a railroad crossing, slow down and make sure there is no train coming. Once it’s safe to cross, attack them from a perpendicular angle—cross at 90 degrees to the way they run, or as close as you can to that. Be sure to look out for perpendicular gaps, as well.


Is it any wonder that biking—an activity which requires you to maintain an unnatural, hunched over, position—causes back pain? While nagging back pain should be addressed by chiropractor or and or medical massage specialist, there are a few changes you can make to prevent it during the heavy riding months.


Similarly to knee pain, many cyclists experience back pain due to a poor bike fit. Make sure your seat is the right height and position—one that’s too low or too high can aggravate your lower back. Likewise, adjust your bike to fit your exact height and build. That way, your spine rests in a neutral—not a rounded—position.

Finally, try some core strengthening exercises like planks, leg lifts, and lunges. By strengthening your core, you’ll rely less on your lower back for power, making it easier to handle the forward position on your bike.

If you’re still experiencing chronic muscle pain in your knees or back, it might be time see an Orthopedist. The best part? You don’t need a referral—simply schedule a visit at one of our three Portland clinics. 

Allergy Season Is Getting Worse. It’s Not Your Imagination

White flower surrounded by a cloud of pollen.

You’re walking around with a wad of tissues stuffed up your nose, you’re sneezing so much people have stopped saying ‘bless you,’ and every morning, you wake up to a layer of yellow pollen coating your car. If you’re feeling like allergy season sucks more and more each year, you’re not alone—and you’re not mistaken.

According to an article published by Lancet Planetary Health, climate change is, in fact, making allergy season worse. The study looked at data from 17 locations across three continents, dating back an average of 26 years. The conclusion is bad news for America’s 20 million allergy sufferers: thanks to rising temperatures, pollen loads and durations have been increasing over the past two decades. The higher carbon dioxide levels stimulate plants’ growth rates, which increases pollen production and creates a longer growing season.  In other words, we’re living in the perfect pollen storm—there’s more of it, and it’s going to stick around for even longer.

And unless carbon dioxide emissions start dropping dramatically, experts predict things will get worse—and not just for current allergy sufferers. The pollen uptick means people who don’t normally have pollen allergies may start to develop symptoms, too.

What can you do about spring allergies?

As pollen-plagued springs become the new norm, you may be wondering what you can do to avoid seasonal allergy symptoms. Before you move into a bubble full-time, try out a few  preventative allergy hacks, or schedule a same-day, no-wait visit at your neighborhood ZOOM clinic.

Manic One Day, Meh the Next? It’s Not Just You.

Letters spelling mood on swings

Zoomers in Portland and Seattle report rapidly cycling moods that have nothing to do with their love of bikes.

Consider what went through your head the last time someone casually asked how you’re doing.

Did time slow down as you debated five answers that ranged from “Great!” to a philosophical reflection on suffering and the human condition? Take heart — you’re not the only one stuck in a mental spincycle.

At ZOOM+Care, our mental health team is seeing more people struggling with mood swings. “The first thing I’m hearing is that people feel irritable and annoyed at everyone and everything,”  says Erik Vanderlip, MD MPH, Psychiatrist and Primary Care Lead at ZOOM+Care. “When we dig further, there’s a pattern of feeling highly productive and energetic or restless — almost manic — for a few days or weeks, followed by a period of draining doubt and frustration.”

It sounds a little like bipolar disorder, but it’s not that severe. “What we’re learning in the mental health field is that every condition exists on a spectrum,” says Dr. Vanderlip. “Changing moods can become disruptive to your well-being, relationships, and/or job without reaching the level of the most severe forms of bipolar disorder.”

Think of mental health issues the same way you would a cough: If it’s just a tickle in your throat that has minimal impact on your day, it’s no big deal. If it persists for two weeks and it’s bugging you at home and work, consider seeing a doc.


  • Are the ups and downs getting disruptive? If your mood is putting stress on your relationships or making it harder to get things done at work, it’s time for a mental health check-up.
  • Are you still as resilient as you were before? When problems come up on down days, do you feel as capable of handling them as in the past? Or are you so checked out, you’ve lost your resolve to fix things?
  • Are you worried about how much you worry? There are a lot of rational things to be worried about, but if anxiety is becoming its own issue, talk to a doc.


  • Keep a journal to track mood changes and their triggers.
  • Stay active — take short walks a few times a day.
  • Avoid skipping meals.
  • Keep a regular sleep schedule.
  • Breathe deeply in stressful moments.
  • Lean on friends you trust.


At your neighborhood ZOOM+Care clinic – Schedule a same-day, no-wait visit for mental health.  “At Zoom, we make it super easy to get treatment for any health issue, whether it’s for your ankle, lungs, or frontal lobe,” says Dr. Vanderlip.  

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This Tide Pod Thing Is Going Too Far

No kid you know would purposely eat laundry detergent… would they? ZOOM+Care’s Lead Pediatrician Dr. Mark Banks prepares you for the worst-case scenario.

Maybe you’ve seen posts comparing travel-sized Tide packages to juice boxes, tips on making Tide Pod pizza, or a snapshot of the ravioli-like detergent packets garnished with herbs. It would be funny if kids all over the country — including Portland and Seattle — weren’t ending up hospitalized (or dead) after consuming detergent.

What started as a stupid internet joke is now serious enough to prompt the American Association of Poison Control Centers to issue an official High Alert for intentional exposures to detergent packets among 13 to 19 year olds. And YouTube is scrambling to delete any videos related to the Tide Pod Challenge.

The worst part is that if teens are messing with them, Tide Pods are more likely to end up in toddler’s hands. Last year, there were 10,570 reports of kids under the age of 5 coming in contact with the packets. Risks of ingestion include seizure, pulmonary edema, respiratory arrest, coma, and death.

“Substances in laundry detergent can cause excruciating burns that penetrate and perforate the tissue of the throat and esophagus,” says Dr. Mark Banks, Lead Pediatrician at ZOOM+Care. “These pods have caused fatalities in small children, so it’s a big deal.”


  • Keep detergents on a high shelf in their original packaging. If you live with kids, pets, or a cognitively-impaired adult, store them in a locked cabinet.
  • Warn your eye-rolling teenager. “Ask your kids what they think of these memes,” says Dr. Banks. “If they don’t acknowledge the danger themselves, be clear — it has killed people.”
  • Talk to other parents. It takes a village to keep kids from doing moronic things. Ask fellow parents what steps they take to keep children from jumping onto dangerous bandwagons.


  • Call 911 immediately if… you know or suspect that someone has ingested laundry detergent and can see that they’re in distress. They may be holding their throat, choking, bleeding from the mouth, drooling, and/or having trouble breathing.



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Portrait of Lead Pediatrician, Mark Banks, MD
Lead Pediatrician, Mark Banks, MD

Seen at Zoom: Growing Concern About Low Sex Drive

Zoom’s Lead Gynecologist Cynthia McNally, MD, is seeing more women in their 20s and 30s worried about low sex drive. Maybe a little too worried. Turns out, there’s a lot of confusion about what constitutes “normal” female libido.

Here are a few fascinating truths about female arousal that will put things in perspective — and help you decide if you need to see a doc.

Continue reading “Seen at Zoom: Growing Concern About Low Sex Drive”

Seen at Zoom: Handling Anti-Vaccine Conversations with Care

The number of parents choosing not to follow the CDC’s recommended vaccine schedule is growing, especially here in Oregon. We’re one of nine states with the largest percentage of unvaccinated infants and toddlers.

The anti-vaccine trend is putting pediatricians in a difficult spot. Should they keep unvaccinated kids in their practice or turn them away?

Continue reading “Seen at Zoom: Handling Anti-Vaccine Conversations with Care”

Seen at Zoom: Our Derm’s 5 Fave Sunscreens For Sensitive Skin

Crappy sunscreen makes you feel like you’re coated in Elmer’s glue. It can also irritate sensitive and acne-prone skin. Which is why many of us with skin issues often skip SPF altogether.

Of course we know we shouldn’t: Wearing sunscreen on the regular can lower risk of melanoma by 50-73%. We just need to find one we can tolerate.

To that end, we asked Zoom’s Lead Dermatologist Omar Qutub, MD, for his reigning favorites. If your current bottle, tube, stick, or aerosol SPF isn’t cutting it, check out this list.

Continue reading “Seen at Zoom: Our Derm’s 5 Fave Sunscreens For Sensitive Skin”

Seen at Zoom: When an IUD Causes Pain During Sex

The IUD fan club gets bigger every day. Its most impressive members? Female GYNs. When it comes to their own birth control, gynecologists pick intrauterine devices more often than the Pill or implants.

They know that IUDs deliver maintenance-free contraception for 3 to 10 years (depending on the type and model). And that serious complications are reassuringly rare. But as a recent Zoom patient demonstrated, an IUD can cause pain during sex. Which completely defeats its purpose.

Continue reading “Seen at Zoom: When an IUD Causes Pain During Sex”

Seen at Zoom: This Body Treatment Destroys a Tattoo in Seconds

We love a great tattoo. And if you’re over shaving and waxing, laser hair removal is a great option. But a recent case at Zoom made it clear that these two great things do NOT go great together. Spread the word, before someone else gets hurt.
Continue reading “Seen at Zoom: This Body Treatment Destroys a Tattoo in Seconds”

Seen at Zoom: The #1 Bike Injury (It’s Not a Broken Wrist)

In June and July, bike crashes send people to Zoom twice as often as any other month. Which isn’t that surprising. Here’s what is: The most common injury isn’t a broken wrist.  Nor is it a broken collarbone. Continue reading “Seen at Zoom: The #1 Bike Injury (It’s Not a Broken Wrist)”