Thank you for your interest in partcipating in our research survey for cycling injuries.
Respondent Gender:
Male
Female
1.
How many miles a week do you ride?
10-20 miles
20-30 miles
30-40 miles
50 miles or greater
100 miles or greater
2.
Do you wear riding gloves?
Yes
No
3.
What kind of bike seat do you use?
Gel
Race
Special contour
Other:
4.
Do you experience loss of sensation or cramping to your lower legs during or after long rides?
Yes
No
5.
Have you had circulation to your lower legs checked for vascular compression syndrome of the external iliac artery?
Yes
No
6.
Have you ever had surgey for vascular disease to your lower extremeties as a result of bicycling?
Yes
No
7.
Do you experience numbness to the ring and small fingers of the hand after long rides?
Yes
No
8.
Have you been diagnosed with ulnar nerve compression syndrome?
Yes
No
9.
Have you been surgically treated for carpal tunnel syndrome?
Yes
No
10.
Have you been diagnosed with carpal tunnel syndrome?
Yes
No
11.
Have you been surgically treated for carpal tunnel syndrome?
Yes
No
12.
Has the carpal tunnel syndrome been directly related to cycling?
Yes
No
13.
(Men only) Do you experience scrotal numbness after cycling?
Yes
No
14.
(Men only) Do you experience impotence as a direct result of cycling?
Yes
No
15.
(Men only) Have you stopped cycling because of scrotal numbess or impotence?
Yes
No
