Carbon Fiber Bikes Failure

See the fork break

If you're a cyclist in Singapore, you would have probably seen the pictures of yesterday's crash from the failure of a carbon fiber fork. The fork snapped when the rider attempted to sprint. His teammate crashed as a result and broke his collar bone. Thankfully only one rider hurt.

Another look 

It looked like the epoxy bonding came off on one side of the fork and then the other side of the fork snapped. The cyclist is from the Integrated Riding Club and they were using Boardman bike frames previously. They just changed sponsors to this current 2019 Genesis frame.

Almost everyone who likes high performance bicycles uses a carbon fiber bike now. It's considered the norm and a wonder material since it's strong and extremely light to boot. Downside is damage to bikes with carbon fiber frames and/ or components can be hard to spot and potentially catastrophic as seen in the crash yesterday.

Of course these kinds of accidents are rare though they do happen. There was an article from Outside magazine last year highlighting other examples of carbon fiber bikes failing seemingly out of nowhere.

I spoke to Kenneth Tan from Cycleworx yesterday and he said that carbon fiber technology is "very advanced" now and not so prone to failure. In most cases, it's probably a legitimate design or manufacturing defect in the carbon fiber that leads to failure under normal conditions. Problem is it's difficult to see cracks with the naked eye before the cracks get worse and fail big time often without warning.

Kenneth says shoddy manufacturing and especially counterfeits, bikes that look like a "real" Pinarello (that Cycleworx is the agent) are the real problems. Counterfeit bikes pose a much greater risk than factory defects from a reputable brand. For those of you who don't know, Pinarello bikes are the Crème de la crème of bicycles. I've been going to Cycleworx since they opened in 1996 at the first Cycleworx location at Serangoon Gardens. And I used to ride a Fondriest and Pinarello before.

If you crashed your bike or plan to get a used carbon fiber one, get it checked by an expert. A foolproof test is to get an ultrasound scan done, but's it's pricey and not easily available here anyway. A simple test may be using a coin to tap the carbon fiber. When there's a defect in the carbon fiber it sounds a little flat compared to a "solid" sound.

Don't get me wrong, I'm not saying you need to abandon carbon fiber bikes. You just need to be aware that carbon fiber bikes need regular inspections and maintenance. Read the owner's manual and don't overtighten carbon fiber components (I'm sometimes guilty of that as I'm fearful of parts loosening and maybe causing a fall).

Me? I'm a fan of steel bikes although I do use a carbon fiber fork and seat post. Make sure you stay safe on the roads.

Steel is real for me

*From the Outside Magazine article.

"There's already a cottage industry of people who specialise in lawsuits resulting from bike accidents, including a growing cadre of attorneys and forensic experts who specialise in carbon fibre. Now that use of the material, once reserved for high-end bikes, has become widespread in the bike industry, reports of accidents and mysterious failures are on the rise. Kowal's case signals that bike manufacturers - even overseas brands - may be accountable. The result could be a dramatic spike in the number of lawsuits brought against makers of carbon fibre bike parts".  

Trade Offs In Triathlon Training

The fastest triathlon bike?

I did my first triathlon when I was 16 years young. Coming from a cross country/ track and field background, my strongest leg was naturally the run. Though I finished somewhere in the middle of that race (there was only the open category then), I ended up with a run time that was among the top ten fastest.

My swim and bike time was closer to the bottom half naturally. Yes, I learnt to swim when I was seven and definitely rode a bike from time to time, but my  swim/ bike timings in that race was not fast as I didn't have the specific training that I put in as a runner. Slow transitions and fumbling with my cycling cleats didn't help either.

It isn't surprising then that a particularly good performance in my run section will come at the cost of sub-par performances in the other two disciplines.

That's what I tried to explain to one of my triathlete patients (who swam competitively in school) who had an unusually fast swim but slower than normal bike and/or run splits in a recent race. Of course it may also be a simple question of pacing.

Other reasons may be genetic. His broad shoulders may work against him on the bike especially in the aerodynamics area and run for carrying the extra muscles in the upper body.

Unless you are a professional athlete, there will be a finite amount of time and energy to train. If you spend too much time on one discipline, it will be at the expense of the other two.

Sometimes, we don't observe the trade offs due to the "big houses, big cars" effect (Van Noordwijk and de Jong, 1986). Just because someone who spends a lot of money on a fancy car does not mean he/ she will not have enough money left to buy a fancy house and vice versa. In reality, we do know people who can afford big houses and many fancy cars to boot.

This scenario is usually more obvious in slower triathletes compared to faster triathletes in Ironman distances. For the triathletes with slower finishing times, faster than average bikers are very likely to have slower than average run splits and vice versa.

This is less likely as the overall finishing times get faster. In male triathletes who are capable of finishing sub nine hours, those with a faster than average bike split are also likely to have a faster than average run split. These are your athletes who can afford the "big fancy houses and big fancy cars".

The above pattern emerges when comparing different triathletes, and this may reflect differences in innate talent and/ or training levels.

However, while comparing multiple races from a single triathlete, results suggest that pacing strategies are more important. What researchers found in slower triathletes was recording a faster than usual bike time was associated with a slower than faster run time and vice versa.

The faster triathletes were not subject to this pattern. A good time on the bike did not necessarily mean a good or bad run time.

Exceptions are when you have a very good bicycle (a form of resource allocation) which can provide aerodynamic and mechanical advantages that don't have a trade off elsewhere (except your wallet).

Here's the simple truth, for mere mortals with normal jobs, with children especially, it's pretty much impossible to reach the starting line of an Ironman with sufficient / optimal preparation for all three disciplines.


References

Calsbeek R and Careau V (2019). Survival Of The Fittest: The Multivariate Optimization Of Performance Phenotypes. Med Sci Sports Ex. 51(2): 330-337. DOI: 10.1249/ MSS. 0000000000001788.

Van Noordwijk AJ and de Jong G (1986). Acquisition And Allocation Of Resourses: Their Influence On Variathlon In Life History Tactics. The Am Naturalist. 128(1): 137-142.

Me (left) at the 2005 SEA Games triathlon event

When I was racing, during my peak training periods, I swam up to 20 km, rode 400 km and ran 70 km a week. All this for Olympic distance racing.

I'll wake up at 4.20 am, eat a little before leaving at 4.50 am. I'll ride to the pool where we plunge in at 5.30 am sharp. This was when I swam with Joseph Schooling, Quah Ting Wen etc under Centre of Excellence (COE) coach John Dempsey. We usually end at around 7 am after which I'll ride my bike to work at the old National Stadium. (Sometimes I have to treat some of my fellow swimmers before going to work).

If I'm up to it I would do a short run before showering and seeing my first patient at 8.30 am. This was when I was working full time as a physiotherapist at the Singapore Sports Council (Sport Singapore now).

No children then and a very understanding wife definitely helps. And we definitely didn't have a big house or a fancy car then and even now. We only bought a three year old car after my first boy turned one.

Here's a closer look at my bike then

Leg Length Discrepancy?

I've seen many patients come to our clinic being told by another health care practitioner they saw previously that they have an "obvious" leg length discrepancy. Meaning one leg is longer than the other. The patients are often worried about their difference in leg length and are usually prescribed orthotics by the doctor, physiotherapist, chiropractor, osteopath, podiatrist etc.

Remember my patient with collapsed arches? She was prescribed two pairs of orthotics and told that if they failed to help her, she will require surgery.

I usually just shrug my shoulders and explain it's not that big a deal usually. Almost everyone will have one leg longer or shorter than the other. It's perfectly normal. Don't believe anyone who tells you that it is abnormal. Nobody is perfectly symmetrical. My right leg is half a centimeter longer than my left. But my left foot is slightly longer than my right.

ASIS to medial malleolus

Some people measure a person's leg length from the umbilicus to the medial malleolus. Here's how I measure a patient's leg length in our clinic if I want to be absolutely sure. From the patient's anterior superior iliac spine (or ASIS) to the medial malleolus.

There are also "short cuts" we use without using measuring tapes if we're rushed for time. Getting the patient to bridge (or lift their buttocks) and straighten the legs. Just tricks of our trade ....

Get the patient to lift their bottom

Compare leg lengths

Many people will have a "temporary" leg length discrepancy due to overworked hamstrings, standing a lot on one leg or having hips that tilt forward.

See the difference?

Here's a more obvious picture, R hip higher

Problems that may arise from a temporary leg length difference are usually increased load to the muscles and joints working to counteract the imbalance.

Most of the pavements we run on are banked such that when it rains, water doesn't accumulate on the pavement. If you consistently run the same route during your daily training, (because of the sloping pavement) it creates a temporary difference in leg length. The "longer" leg is making more contact and taking slightly more load compared to the "shorter" leg.

If the muscles work too hard (when you increase your running distance or speed), they are not used to the new load, then an injury can happen.

In other cases, leg length discrepancies may be due to a structural problem like scoliosis in their spine. However, many patients that I have treated with scoliosis manage to adapt without any real issues. And that's probably a different post.

Now you know. So don't be too worried when your health care practitioner tells you that you have an "obvious" leg length difference.


Reference

Sabharwal S and Kumar A (2008). Methods For Assessing Leg Length Discrepancy. Clin Orthop Relat Res. 466(12): 2910-2922. DOI: 10.1007/s11999-008-0524-9.

Not Another Broken Arm!

Fractured L ulna and radius

No, not again .... My second boy fractured his right ulna and radius (both forearm bones) while on the third day of our farm stay holiday. He fell from a height of almost two meters while trying to wear his shoes onto a hard cement floor. Fortunately, nothing else was broken. Definitely an angel looking out for him though.

Older boy's fracture on 281117

This is after my older boy fractured exactly the same two bones (ulna and radius) but on the left arm  when we were on holiday in Brisbane in November 2017. We waited almost an hour for the ambulance to come, sat for another hour in the ambulance traveling to the hospital. And I'm not exaggerating, they had to repeat the x-ray five times on his arm and redo his plaster of paris cast twice.

Older boy in Brisbane

Talk about lightning striking twice. All credit to my boys. They didn't cry or complain at all. Not even my younger boy who turns four today. First we went to a rural hospital and they had to ask us to go to another hospital as the first hospital did not have an orthopaedic surgeon.

The second hospital we went to was much better than the Brisbane hospital my older boy went to. Much better splinting materials too! After the surgeon in the second hospital put his broken arm into a back slab, we went back to the farm and he was almost back to normal. Wanted to climb stairs, run around and feed the farm animals. Just like before he fell.

He never let that broken arm keep him down at all. He just shrugged it off as though it was all fine and dandy. Daddy has to learn from your indomitable spirit.

My two boys, tough as nails!

My wife? First, she had to deal with me having a broken head and spine, the older boy breaking his arm and now the younger one having the same broken bones in the right arm. Really thankful that she's holding us altogether all the time. Chapeau to her!!

Me? I'm just very grateful and absolutely thankful that nothing more serious happened to either of the boys. They still want to go back to the farm again (this was our second visit in in seven months). Thanks to farmer Ae for being such a great host.

See what I caught!

Silver lining is we now know much much more (than before) about broken ulnas and radiuses, green stick fractures and interosseous membranes in young children. And how to get them better, quicker. Hey, other than parents, we're still physiotherapists.

Let's see what the surgeon in Singapore says tomorrow.

2 Oakley Flight Jackets As Early Chinese New Year Hong Pows

2 pairs of Flight Jackets

My Chinese New Year hong pows came early today. Joey from Oakley sent them personally to Sports Solutions this morning.

Two pairs of Oakley Flight Jackets! A Flight Jacket in Matte Navy and a Flight Jacket Carbon for low light conditions.

Since I just ended work earlier, I haven't worn it for to ride or run of course but what I like from first impressions will be the option to change the ear pieces as they give an extra pair of interchangeable temples.  Great as too long ear pieces sometimes get in the way of helmet fastening/ adjustment straps while riding.

Extra ear pieces to get your preferred length

Other impressions are the lack of a frame at the top of the lens. If you're in a breakaway or doing a time trial on your bike in an aero tuck position, this gives you a better field of vision. Another benefit would be improved air flow to decrease chances of fogging when you're huffing and puffing.

It also means you can't change lenses though. I guess that's why I got two pairs then. Good for me!

My personal observations are after the release of the Radars in 2006, the lenses have started to go downhill. They usually flake or peel off after a while. Hopefully they have improved on that aspect.

My first Oakley Razor Blades and  Blades lenses from 1989 are still in good condition. Yes, this is how long I've used Oakley sunnies.

Perhaps this has to do with Luxottica Group SpA (an Italian company) hostile takeover of the company in late 2007. Yes, Oakley founder Jim Jannard doesn't own the company anymore.

Here's a closer look at the two pairs of Flight Jackets.

Matte Navy

Flight Jacket Carbon

*Rode with the Matte Navy this morning (2/2/19). The lack of a top piece for the frame has made the vision field in front much better. It's unobstructed all the way to your helmet. Peripheral vision is great as always.

Increase Of Strokes In Young Adults

Last December, one of my colleagues needed to take urgent leave to go to Taiwan. He found out that his 36 year old brother had a suspected stroke and their whole family went to Taiwan to be with him.

I was shocked as his brother seemed relatively young to suffer a stroke (although I remember while still working in the hospital my youngest stroke patient was just 29 years young). The same colleague mentioned that at least four other friends younger than his brother also had a stroke!

Though it may seem shocking to you for such a young person to experience a stroke, evidence shows that this is becoming more common in young adults.

An article published in JAMA Neurology found that the number of men aged between 35 to 44 hospitalized for stroke increased by a staggering 42 percent when they compared 2003-2004 to 2011-2012.

It seems to be more common among males (41 percent versus 30 percent for females). The authors found significant increased risk of getting a stroke if you are diabetic, have hypertension, heart disease, smoking cigarettes currently and long term alcohol consumption.

The majority of the above listed factors are definitely easily modified, correctable or can be stopped. So prevention strategies definitely have the potential to reduce the impact of stroke in this young age group.

I'd add that exercising will definitely reduce your risk too.


Reference

George MG, Tong X and Bowman BA (2017). Prevalence Of Cardiovascular Risk Factors And Risk Factors And Strokes in Younger Adults. Jama Neurol. 74(6): 695-703. DOI: 10.1001/jamaneurol.2017.0020.

Drug Companies Admit That Curing Patients Is Bad For Business

Some of you may may have read this article written by Goldman Sachs analyst Salveen Richter earlier last year, but not me. I only read the article recently while looking for interesting articles so I can post on this blog.

My nephew had a anaphylactic shock (after being given the wrong food at their resort) while on holiday in Bali recently. Fortunately they used both the Epipens they had on him and he was discharged from hospital shortly after observation.

Because they couldn't find any Epipens anywhere in the whole of Bali, my wife ordered two for them in Singapore and then my mother-in-law flew there to make sure they had spare Epipens for the rest of their holiday.

Other than pricing their Epipens ridiculously expensive to make money, big drug companies have admitted that developing one-off treatments don't make them much money. They prefer to make pills/ drugs that just manages but do not totally cure diseases so that they are able to make more money.

Reliance on the medication (to keep the condition at bay) will ensure continuous streams of income.

Back in 2014, Bayer's CEO openly admitted that they developed medication for rich Westerners and not for the poor. Rather than wanting to save lives, they are more interested in maximising profits.

As we wrote before, we don't aim to be the biggest private physiotherapy chain of clinics in Singapore. We at Physio Solutions and Sports Solutions just want to be the best at treating the cause of your pain quickly. If we can get you better in 2-3 sessions, we won't want you to come back for further for more sessions unnecessarily. That's our promise to you.