The Risk of Non-Traumatic Myelopathy in Time Trial (TT) or Downhill (DH) Bike Position

The time trial (TT) or downhill (DH) position (Figure 1) in cycling, which is different from general riding form, is used in time trial road races or triathlons to decrease air resistance and achieve faster speeds. In the TT or DH position, the rider’s neck is extended and his or her body is strained while racing, and some athletes develop neck pain or headache. Most cases of neck pain may be caused by fatigue due to sustained muscular stress, but there may be some risk of myelopathy in some cases.

Triathlons involve different distances, and there are also many different styles of bicycle; likewise, different athletes have different racing experiences and different body conditions. However, the TT position or DH position is common and many cyclists can use DH bars for faster speed.

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