Staying Healthy and Safe During Family-Fun Bike Rides

Hi, everyone, and welcome to today's webinar, Family Fun Bike Rides, Staying Healthy and Safe, brought to you by Sports Health at NYU Langone. We would like to first thank our partner, Bike New York, a non-profit organization that empowers New Yorkers to transform their lives and their communities through bicycling. In addition to organizing numerous annual events, including the TD Fiber Bike Tour, Bike New York provides free bike education programs to teach and empower children and adults on how to ride a bike safely and confidently. Before we begin, please take a moment to mute your computer mic or telephone. If you would like to submit a question to our speakers, please type it in the Q&A box on the bottom right corner of your screen, and we will try to answer as many questions later in the presentation. I'm now pleased to introduce you to our speakers, Julie Troutel, a program coordinator and athletic trainer at NYU Langone's Concussion Center, and Bethany Rittenhauer, a senior physical therapist at NYU Langone's Sports Performance Center. Bethany and Julia, welcome. Thank you. Hello. We can move to the next slide, Bethany. Perfect. First, I'll talk about how to stay safe on the road. So when we talk about safety equipment on a bike, most of our minds jump right to helmets. We commonly think of helmets as a way to prevent concussion. So it's important to understand that helmets do not prevent all brain injuries. What they do is help reduce the impact force and therefore decrease the injury severity. So a good way to think about it is the brain is floating around inside fluid inside your skull, just like a yolk in an egg. So a concussion is when the brain shakes around in the skull from a hit either to the body or to the head. And if it's hit in the body, the force kind of transmits to the head. And then you have some brief symptoms like headache, nausea, dizziness, or a bunch of other things. And if you think about kind of that brain shaking around, if you wrap the head in bubble wrap, let's say, or an egg in bubble wrap, it may keep the shell from breaking, but that yolk's still going to move around. So when you're buying a helmet or replacing your current one, there are three main considerations. First, does the helmet you own still fit, or does the new one you're thinking of buying fit properly? Does the helmet you own need replacement due to wear and tear? Or how well does the current or new helmet function to protect yourself from injury? Fit is really important so the helmet can do its job properly. It's worth noting that if you're shopping for someone else, like a child, you'll want to bring that person with you, again, to make sure that it fits before you bring them home. If you are unable to bring that person with you, just measure the person's head before you leave. And that will guide you to the small, medium, or large, at least, which can vary between brands. Most helmet types also have adjustment features beyond those three kind of size categories, either through a dial on the back or by, or maybe both, providing additional padding to fill any gaps. So we really don't want the helmet to look like this kid on the right, so let's explore how to fit a helmet properly. First, make sure that the helmet is snug around the head without gaps, but not uncomfortably tight. If there are gaps and the helmet comes with extra padding, you can try to fill those gaps. Otherwise, you may want to look at a different brand because each brand is shaped a little bit differently. The brim of the helmet should be parallel to the ground and two fingers above the eyebrows, as you can see in the upper left-hand corner. The back should also cover the bump on the lower back of the head where the neck meets the skull, which we call the occiput. So you can see that's where that gray dial is kind of sitting. Once the helmet fits the skull, you'll adjust the straps. The ear should line up with those Y straps that you'll see in picture four, and the chin strap should be tight while the mouth is open, maybe fitting one or two fingers between the chin and the strap, like in picture five. Once all of the components are adjusted, the way you test the fit to make sure that it's actually fitting properly is to wiggle it on the head to see if it shifts around. So what you can do is sit the child or seat yourself, and then you're going to have someone else hold the helmet and try to just shake it back and forth, front and back. And if it shifts, you know that it's not fitted properly, so you can try to go through it again, or you might have to explore, again, a different brand. Even a well-fitted helmet needs to be in good condition to do its job. The time to replace a helmet is not when it looks like it does on the left picture, but checking for small signs of wear and tear, like cracked padding, fraying straps, or if the shell has cracks or big dents. If there are broken straps, those might be able to be replaced without buying a new helmet, but again, that depends on the brand. So when you're looking at brands, that may be a feature you want to see, like how does that company allow for refurbishing that helmet? CDC guidelines state that helmets should be replaced after one hard impact, and that may seem really frequent, but again, you never know what kind of internal structures that you can't see may be broken. Two other things about helmet conditions are realizing that you're sweating inside that helmet, so it can get stinky. And when it smells, that means bacteria is growing. So what you can do to maintain that is just spray it down with a disinfectant occasionally to keep it clean. I also learned that some manufacturer's warranties are void if any stickers, paint, or accessories are added. So especially for kids that kind of want to jazz their helmet up a little bit, you should check the manufacturer's website and read the warranty to make sure that you'll be covered if anything truly horrific happens. So the Consumer Product Safety Commission, or the CPSC, is the government agency, the federal government agency that evaluates children's helmets. So you should look for that sticker on the helmet to make sure that it meets federal standards. It's worth noting that the CPSC testing is pass-fail, and the price of the helmet doesn't necessarily reflect the helmet's performance in doing things like absorbing the force of an impact to decrease injury. So, for example, a helmet may have barely passed testing, or perhaps it performed incredibly well, and the price won't reflect that. The Virginia Tech Helmet Lab is one that I cite frequently, and they test many helmets on the market for various sports, including bicycle helmets. They grade each helmet on a scale of 0 to 5 based on performance, similar to a Yelp review, rather than pass-fail. They also list the market price, and the price where they bought the helmet off the shelf. If you check their website, you'll be surprised how much price truly doesn't reflect the performance. However, it's worth noting they don't currently evaluate children's bike helmets, but you would be able to check for adults. A newer technology you may see on the market is MIPS, and the Virginia Tech Lab has tested many helmets with this technology. So, there's essentially this gray interior shell that's kind of more padding, and then the lime green layer is another hard shell. And then the blue pieces that are on the outside kind of shift on that lime green, and the blue is similar to what, like, a traditional helmet would be. So, by allowing kind of the interior and exterior shells to move around each other, they can help absorb some rotational force to be even more effective than a normal helmet would be. And helmets that have this MIPS technology can be relatively inexpensive, which is nice. Helmets with this technology aren't necessarily better than regular helmets, so again, it's worth checking to see how the helmet has tested. And again, there are good helmets that cost less and perform just as well, if not better. As adults that commute by bicycle can attest, carrying your helmet around all day can be a pain. So, there are a few companies selling folding helmets so that they're more convenient to carry or put in a bag or a purse. There hasn't been much research to support that these work as well, but it's certainly better than not wearing one at all. And you can kind of keep tabs on this as they come out. There's many, many models on the market. This is just three. And if you go to websites like Kickstarter and things like that, you can see the different helmets that are available, kind of in these folding or collapsible models. But again, they haven't necessarily been tested to say that they work as well as a traditional helmet. There are some required safety accessories from a state law in 2009 that I'd also like to discuss. The first requirement is a bell or other device capable of being heard from 100 feet attached to the bike. It cannot be a siren or a whistle, though. So, think about like a loud honk or a ding like a bell. Next are lights on the bike are required to be on from one half hour after sunset to one half hour before sunrise. And they must be seen from 100 feet away. They require one white light in the front and a red light behind. They also require two reflectors on your bike, but the law doesn't specify where. And some nice options that are available is lights on your helmet. Again, they can be white and red. Adding more reflective tape. So, you can see in the photo they kind of ran reflective tape up the body of the bicycle. Or just wearing a reflective vest so that vehicles can see you. They also make these flags that kind of poke up behind the bike so that you can be seen if you're kind of navigating between other cars. There are some children-specific safety devices like training wheels to provide extra points of balance. But other safety accessories can be kind of sold or you can convince children to add them to their bike as personalization features. So, picking a horn or wheel lights that are their favorite color. And something that I loved as a kid, this picture on the right, is a plastic noisemaker that attaches to the frame. And it hits against the wheel as it turns. I personally went kind of old school as a kid and just taped a playing card to the frame. But there are some fancier ones that even make a motorcycle sound. So, kids might really enjoy that. Plus, that also helps the child to be heard by others as they approach maybe from behind. And we just need to unmute Bethany real quick. Okay. Good. Okay, so you're getting your equipment together. And now we need to know about road safety. You want to go out there, you want to have fun, you want to stay as safe as possible. Luckily, Bike New York has a lot of free online education courses that both children and adults can be interested in. Quarantine, however, is making a lot of things difficult to access. But luckily, Bike New York has a class on Quarantine 22nd online for learning to ride with kids. So, this might be a great way that you can start getting some interest very soon after this lecture. But of note, your children should already have a bike in one of the kits that I'll talk about in the slides. You want to be able to already have that bike. The City of New York has also started closing about 40 miles of streets to allow social distancing. The link on the top and through the Department of Transportation will help you figure out what streets are in your neighborhood. The orange ones are on a map that I can take you to see. These are great ways to practice street skills with your children while creating safe pathways for cars and so you build up their skills enough that they can start going out into the community more. Above are a few quick and easy tips and rules for riding in New York City. Parents, I'm sure you're already aware of many of these, but it's important to remind your children as much as possible, especially because their attention spans can be a little short. Bike New York also has some great online resources, which we'll talk about at the end of this lecture, that can incorporate some of these rules into playtime. For the advanced riders, including teens and parents, Bike New York also offers the above in-person classes to have supervision during more technically challenging rides. However, we do need to address a bit of the elephant in the room. Hopefully you have the appropriate gear and you've got the rules of the road, but we need to account for this with normal. The first and easiest line of defense during COVID times is to maintain your proper social distancing of six feet. However, we live in New York City and the weather is getting nicer and it's going to be a lot of people outside, especially on the West Side Highway, as I'm starting to learn, so distancing around non-household family members is going to be challenging. So should you wear a mask when you're outside? In general, research has shown that aerosol spreading events are associated with a high risk. So mask wear is your best defense when participating in outdoor activities, but what type of mask should you be wearing? Do you want to wear a cloth or N95s or surgical masks? However, the CDC recommends that the cloth mask is better for all family members and their outdoor activities rather than the surgical masks. There's limited to no research out there about what's going on with the COVID aerosol molecules themselves, so they're really extrapolating a lot of this data based on the flu virus, but even that information in itself is important. For athletes, I would recommend using one of the buffs, which is on the picture on the upper right. That's the best way to keep it snug and tight on your face while you're still riding down the highway. It's very much recommended that the public does not use an N95 mask. Not only are you saving it for the medical providers out there, but also you need to require a very specific fit of the N95 itself, and if it's not fitting properly on your face and not assessed well, then it's really not doing the best job that it can. This might be a graphic that many of you who subscribe to Runner's World magazine or to Cycling magazine might have seen when COVID was first breaking. This graphic was from a paper published by Belgian and Dutch engineers, and we really want to start disregarding this. This was not a paper meant for general outdoor exercise. It was a few engineers that used a wind tunnel in order to do a decent amount of research and extrapolate some data, but the authors soon published an article after this article saying that they used a wind flow model. It's not appropriate for the general population. However, the biggest takeaway is that if you're with somebody that's a non-union member, you don't want to run or bike directly behind them for a long period of time. Now, does this say whether or not you should wear a mask? Well, New York City explicitly states that face coverings are not required when you're walking, running, or biking, if you can keep your distance. If you cannot keep your distance, you should be wearing a mask. For those of you who happen to travel, maybe to family members or drive up to Boston, you must wear a face mask at all times. Let's switch gears a little bit and talk about ways that you can be safe on the bike itself. The easiest tip for injury prevention when you're on the bike is a bike tip. Let's start with the kids. The dimension that's most important for the kids is saddle height. Changing this position can make a beginner rider more confident in cycling a less scary endeavor and less of a chance of that bike ending up in your garage or in storage next year. So, how are we going to go about fitting a kid? Well, if they're a beginner and this is their first bike, you want to measure as if your child is sitting on the saddle and both of their feet are on the ground. As they start to feel comfortable pedaling that first bike and you can progress to a pedaling fit, they can sit on the saddle and have their tiptoes on the ground. That's the best. An advanced fit position is more similar to how an adult would be sitting, and the rider should be able to handle the brakes on their own and be comfortable when they're riding with both feet on the pedals and be able to not get scared or intimidated while they're balancing themselves. So, this means when they're in the advanced fit that they either need to move the bike over to put their foot on the ground or they need to come completely out of the saddle. Now, for adults, you need to make sure you have the correct frame for your height. You need to assess the standover height. Luckily, Bike New York on their video page has a great way that you can check your bike fit and see standover height, as you see right here. In a standing position with both heels on the ground, straddle the top two with your bike. When you lift your front handlebars and the front wheel off the ground, there should be a little bit of about two-inch space between the body and the top two. And if you have to order a bike online with the local bike shop's holes, even though they're opening at two feet, the distance should roughly be between the inseam of your pants minus two feet. The second measurement that you want to take a look at to make sure your seat height is appropriately adjusted is looking at your knee positioning. This measurement is correcting more for the advanced rider, so you can assume that the rider is comfortable with both feet on the ground, off the ground when they're pedaling, and dismounting the saddle and getting to a stop. So hopefully you can have someone who will hold the bike up for you, or if you put your bike on a trainer, that will work as well. Looking from the lateral view, you want to put your foot at the bottom of the pedal stroke so your crank arm is aligned with the back two. And at this position, there should be about 25 to 35 degrees. So the injuries we're preventing when we're paying attention to this bike fit is lower back pain and knee pain. While every injury is individualized, lower back pain is the most common culprit, so usually postural related. And with knee pain, there's usually an excessive amount of knee flexion throughout the whole process. Another great way to prevent injuries while cycling is to take a repair view. You're the engine, you're moving this whole bike as it's going. So we need to make sure we keep the engine, warming it up, and cooling it down to get our best rides. So prepping your family and yourself to remain healthy and active this summer will involve warming up or cooling down the muscles you can use the most. With cycling, your main muscle groups used are the gluteus maximus, the quadriceps, the calves, and hamstrings. Each of these muscles can also change your body dynamics on and off the bike, leading to injuries, so they're important to address in stretching ways as well. Exercise science research, no matter the activity or sport, recommends a dynamic warm-up with active, deep stretching of the working muscle groups. Static stretching should be safe for after the activity. Our goal with the warm-up is to rev up your cardiovascular system and prepare your muscles for the work. So above I placed a sample dynamic warm-up that's hopefully gift-friendly enough for people involved in participating. If not, I have more ideas on the slide. Jumping jacks are a great way to start to get that heart rate up, as well as engage the calf and gluteal muscles. Walking lunges engage and prepare the posterior chain, which are the hamstrings and gluteal muscles as well. Hingeworms, which are pictured on the top, stretch out the lumbar region and hamstrings, while encouraging stability with core and trunk activation. Toy soldiers are a great dynamic movement to get your kids actively stretching their hamstrings. And toe walks around the house can also allow the calf to stretch. Paddle and walks are a great way to involve your kids' body from the activity. All the warm-up and stretch muscles active on the bike will likely be more restricted. A gorilla walk is similar to the hingeworm, however you're moving your left and right legs separately. The bear walk is progressing past the gorilla walk and adding bent knees, great to warm up the gluteal muscles as well. And the duck walk engages the core and trunk, but perhaps not the best for those who aren't used to it. A pull-down stretch is where you're looking to lengthen muscles while they're pliable, and prevent tightness, especially since cycling is such a difficult activity. So each stretch noted in the pictures will hold for at least 30 seconds, and for those kids that are younger and can't really sit still for that long, they can very easily help the parents stretch as well. You can have them apply gentle overpressure to your trunk and legs to assist in the stretch. Stretching with your bike is a great way to use a prop after cycling, and also keep the family involved instead of making a stationary on the floor. The shaded region in each picture is the muscle group ideally being stretched, however a lot of these stretches that are pictured here, you're getting a lot of other muscle groups as well, so this is an equally effective way instead of sitting down in front of the house, if you want to stay outside while the weather is still good. Now that you're all prepped and ready to go, time to get rolling. Let's see what Julia has to say. Fun. Thank you. Having fun requires that people feel confident on the bike, so I'll give a quick overview of progressive drills and a way to sneak some exercise into solo or family rides. Learning to ride can be a barrier, but fortunately there are non-profits in the New York City area, like Bike New York, that offer free bike lessons. For example, Bike New York offers Bike Skills 101, that Bethany already talked about for ages 5 and up, and the Bike Bonanza, which includes skill classes and helmet fitting as well. So below you'll see the Bike New York has a whole progression for bikers learning to bike and having the skills to safely commute and navigate the city streets. And a brief activity progression can look something like this. Before riding in areas with other bikers, riders should have lots of confidence with basic skills, like looking around as they bike and handling the bike with one hand to simulate that they're reaching for a water bottle or making a hand signal for turning. Riders should be confident with a few of these skills before riding on closed roads with other people. They should be confident with turning and riding in small groups. Riding side-by-side with someone is good practice for reaction time. And learning to kind of match the pace of someone else and not being distracted by a rider next to you. Finally, before going on the open road, they should learn and be confident with the rules of the road and navigating rougher terrain like potholes or if you're in the suburbs, dirt. As far as exercising on the bike, there are a few that a person could do alone or be done in a group simultaneously. The first is a single leg pushing drill. It's good practice for leg strength, but also core strength and balance. You can see maybe how fast you can go pushing only with one leg. But please note that for safety, both feet should remain on the pedals. You can also practice hill sprints or timed runs if you're able to set a straight track or if you can anticipate wider paths at turns. And finally, riding on unpaved terrain gives you a little more resistance, which can make a lot of these drills more difficult. Grass would be my first choice just for safety reasons if you fall off. But please don't take this as an endorsement of riding on the beautiful New York City parks grass. Next, you can practice not getting distracted by others. This is really important if you intend to ride on busy city streets. Children may have fun learning to draft behind the lead cyclist in a group and it's kind of working a science lesson in too. It reinforces following someone else's pace. And ultimately, take note of what the others, like the children, seem to enjoy most or what their default activity is on the bike and do those more often. There are a few exercise drills for groups that I'll attempt to demo here as well as I can. There's a drill called a train run, which some people may know as an Indian run. The group rides in a single file line and the front rider is setting the pace. In the first version, which is easier, the front rider eventually just drifts to the side and falls behind, as the graphic just demonstrated. So then that second person starts setting the pace and no longer has the advantage of drafting behind the first. A more difficult version of the train run looks like this, where the rear rider sprints to the front of the line and once they get there, they shout next and that person who's now in the back sprints to the front. This style of train run also helps practice communication and merging beyond incorporating a sprint into the activity. Okay, so now we have some time for questions and answers. If you have any, again, you can type that into the box on the lower right-hand corner with questions and answers. I believe we have some submitted in advance, so I'll read them out loud and then, Bethany, I can kind of discuss the answers together. So the first question is, my young child is a little scared to learn to ride a bicycle, but she sees her friends on them and feels left out. Do you have any ideas for how to make it more fun and less scary? Since, Bethany, since you talked about kind of the safety, do you want to take this one and then I'll add what I have to say? Sure. The first thing you can do in terms of a fit is to just make sure that if your child already feels very heavy about it, maybe that's a time to step back on the scale and adjust the saddle height, make it a little bit lower, because then they can easily pop off the saddle and put their feet on the ground or stay in the saddle. Wow. Julia, maybe any ideas about games or anything to make them feel a little bit more comfortable that way? Yeah, so I would, again, like Bethany said, recommend having them use their feet rather than pedals to get moving so that they can practice balance and get that settled before they're kind of cognitively trying to think about moving the pedals while they're trying to balance so they can kind of master one aspect before kind of incorporating two. And I would also make sure that when you're teaching them to ride, try to do it kind of in an inconspicuous area, maybe, because they might also have some, like, crowd anxiety of falling in front of other people. So being able to just kind of do it as isolated as possible might help as well just to help with the scariness factor. Yeah, so if they don't have a bike nearby, maybe that's where you can check out the Department of Transportation website and see if you have any street coaches nearby they can use. Exactly. So why don't we take one quickly from the chat? Which bike is better for learning for a child, a mountain bike or a road bike? And I did a little research on this before the, before this presentation. And what can really help with the balance for children, besides the fit, is the thickness of the tire. It just gives them a little bit more area to balance on. A lot of these road bikes can have very, very thin tires. And additionally, making sure that there's enough, well, the word's escaping me, but, like, the ridges on the bottom, like, make sure it's not a flat bike that has worn tires. And it gives them a little bit more grip to the road. The other thing is that you can, the way the handlebars sit is you're much more upright, as opposed to a road bike you have to bend over. So they can sit upright and look around much more, requiring a little less balance than when you're down, which might already be uncomfortable in itself. So a mountain bike might be a little bit better to keep them upright. Okay. Bethany, you want to go to the next slide? Okay, I'll read it. The next question is, is it okay to let a rider raise his seat so his feet are off the ground? Is it okay to let him ride with a shorter seat, or does this lead to more injuries? I think, Bethany, this one's all for you. Yes, I'll grab this one. I definitely would recommend that he continues to ride with a shorter seat until he gets comfortable. The injuries tend to be more, with the shorter saddle heights, and going more than 12 to 15 miles at a time. And also he has nice, young, supple knees, which many of us parents probably don't. So I don't think he has to worry about it yet. I would rather him be safe and feel confident in riding and have a lower seat. And then when he builds those skills back up, then you can raise his seat up. I don't think we necessarily have to worry about moving him just yet. Now, if he plans on, I don't know, going to college next year, and you're doing a very high mileage, you might want to work on a lot of the skills that Julian talked about today before you start raising that seat in anticipation of that event. Thank you. We have one or two more questions that were submitted in advance, so let's get through those first. Okay, how often do I really need to get new helmets or new bikes for my kids as they grow? So I'll talk first about helmets, and then maybe Bethany can take the bikes. From a helmet perspective, to answer the second question first, I would not personally recommend getting a used helmet because you don't know if someone has had a hard hit previously, and maybe there's some internal structural damage that would compromise the effectiveness of the helmet. And for getting new helmets, there are some federal recommendations, like once every 10 years replacing your helmet, but really that's more for football and baseball. They don't really have those recommendations specifically for bicycling. I would say if the helmet fits and you haven't had a hard hit, that helmet's fine. There's no specific timeline that any federal or national organization has set for replacing the helmet. Okay. In terms of using a used bike, there's not necessarily any set recommendations for that. I would highly recommend that you look at all the parts, making sure the brakes are working, the wheels are turning well. But if you're really considering this, this might be a chance where you can ask whoever's selling it if you can get it assessed at a bike shop and make sure all the parts are working. But in terms of being able to keep them safe for kids, if your bike is moving well and your engine is working well and the child can confidently ride that bike, then it should be pretty safe. Next question. I have a son who suffered a severe puncture wound injury in the groin area that required surgery. Are there any products he can wear to better protect the area once he is able to ride again? Bethany, as a cyclist, what kind of dressing should he be wearing? That's a very interesting question. I'm not sure. It would really depend on exactly where the wound is itself and what kind of dressings and what stage of healing it's currently in. Luckily, a lot of the products that cyclists wear are spandex and really very tight shorts. So the good thing about that is that if your bike is moving well, you can make sure that the dressing is tight and well-secured. You might want to pay attention. A lot of bike shorts have chamois or the very padded parts that go underneath your bottom to make it a lot more comfortable. You might want to check where the wound is and how that might be rubbing in the area. Also, if you're wearing any undergarments, you can check how that's rubbing. It's hard to say where the wound is. I think the padded bike shorts and the padded seat covers like they offer for spin classes that may just make it more comfortable once the wound is completely healed. I would not recommend wearing both the padded shorts and the padded bike shorts. One or the other. Definitely. Should I have my kids so they can follow my lead, especially on busy paths, or should I ride at the back to keep an eye on them? That is a fantastic question. Although I try not to say one question is better than the others. But this is a difficult thing to think about. I personally feel like it depends on how well you think your kids will be compliant in following your lead. And also how comfortable you feel when you ride at the back to keep an eye on them. I think also them being able to focus on one person and one path ahead of them will help keep them from kind of or it will keep them focusing on that one person rather than getting distracted by another person. Kind of thinking about a drunk driver. They'll look at something and be like, oh, don't go there, but their mind just kind of takes them there. So if they're looking at other people, but if you don't think the kid will be compliant in staying behind you, you may want to go in back. And I would also think of the parents as well. They might, if they don't have the best bike skills, they might do the same thing where they're looking over the shoulder and the front wheel follows. So it really depends on the parent and their comfort level in navigating their bike. They used to make an accessory. I imagine they still do. But when I had one as a kid, there was a clip to my helmet that was like a side view mirror. You could also do that to make it easier for you to just like peek backwards and keep an eye on them without having to turn all the way around. Okay. So let's get to some of these questions in the Q&A. So there was a question about the foldable helmets. What should we be looking for to tell whether or not a helmet is safe? This question is pretty cut and dry. There is no body that, or no like federal and national body that will determine whether or not a helmet is safe, even on a pass or fail. So until groups like the University of Virginia Helmet Lab starts testing these products, or maybe, you know, those products will probably, in today's business environment, they'll get purchased by a larger company who would then test it. And you could, really, I would go to scholar.google.com, which is dedicated to research articles, rather than like whatever Joe Schmoe's blog happens to say about a helmet. And those peer-reviewed articles on scholar.google.com, if you type in the bike helmet, they may be able to populate some independent research that was performed on those bike helmets. But when you're looking at research, make sure, again, that it's independent research, because the company, even if they're, you know, they have the best intentions, there may be some unconscious bias in interpreting the data, if the company that developed the helmet is interpreting the data. So then we had a question on if it's possible to get a copy of this presentation sent to her email. And very quickly, we'll be posting the full video of this webinar to our NYU Langone Sports Health YouTube channel. So it should be up in the next two or three days, and you can just look out for it there. And we are recording the full session now, and you'll be able to see both the slides and hear everything that we're saying. The next question is, do you suggest taking off the pedals to teach my 10-year-old son how to balance on the bike before forcing him to ride? So my first response is don't force him to ride. You're encouraging him to ride, but I'm sure that was just the word that popped into your head. And that's actually a good point. So like we were saying earlier, if you're just like seated on the bike saddle, and they're just kind of pushing on their feet rather than focusing on the pedals and balancing, you might end up just like kicking the pedals if they're attached there. So an option is removing them. And I've actually seen, I don't have children of my own, but a bunch of my friends that are teaching their kids to ride, they actually make wooden bikes that don't have any pedal feature, nothing. It's just the frame and a saddle and the two wheels. The entire intention of these bikes is to be a mechanism for the children to learn to balance, and they're meant to be in lieu of a tricycle or training wheels. It's just they get to master that skill, and then you can incorporate the pedals. So if you're buying one of those, especially a tank, just remove the pedals. Agreement, Bethany? Okay. Okay, should I get a free wheel bike and teach the kids to use hand brakes? I've been talking a lot, so Bethany, why don't you take this one? You cut out for a second. Oh, I'm sorry. Should I get a free wheel bike and teach the child to use a hand brake? Hmm. I'm sorry. Go ahead. I think the importance of using hand brakes is going to be what progresses your child to start using more advanced bikes. It's probably a great skill that they should start incorporating as early on as possible instead of the one where you pedal backwards in order to brake. But earlier on, you can incorporate it. I would recommend that if your child is learning, it's going to go along with that confidence factor in terms of handling the bike and give them a better sense of control for themselves. If they are able to brake when they need it, that might help with their confidence as well instead of doing what I used to do when I was a kid, which was just veer off into the grass and fall. Yeah. The next question is, is there a chart for kids' height and the corresponding bike size? I'm not sure about that. I know there are ones if you go to very specific bike companies that will give you an idea of frames that will fit certain heights for children. I would recommend considering going to an actual bike shop in order to make those fit adjustments because then you can see if the child is comfortable with the bike itself. And then, of course, they can make their very specific recommendations on color and style. There are specifications out there for height and bike frame size. I try to make it as freeform as possible and try and stay away from those recommendations for certain brands the most. It also depends on what style frame you want to buy. If you want a straighter frame like a road bike or if you want it to be angled like more of a hybrid bike, that might be with the hybrid bikes where you will look at a chart for child's height and the frame of the bike itself for the company that you buy. Yeah. I think an additional consideration with going with the child's height is their leg length. I have extraordinarily long legs and my sister has a very long torso. So even if we were the same height, we would need different size bikes. That's where looking at the inseam and subtracting two inches might go well, but then that's with the top part, the top tube of the bike instead of a hybrid, but that might be a good 30-inch torso. Yeah. I think ultimately going to the professionals and getting measured in person is the way to go. Okay. So we have hit the end of the list of questions. So I'll quickly talk about Bike New York's new virtual education resource hub. Since they, as Bethany mentioned, have had to offer less in-person classes, they have a great list of materials designed to keep kids of all ages engaged with the history, community, fitness, and then ultimately the fun of cycling. So you can see the link here on the slide. They have their curriculum from those different courses, books, videos, movies and documentaries, recommendations for activities, and also STEM resources. So don't hesitate to check out that website. I've taken a look at it too. It has some really great resources. Especially I know that school is technically over, but if you can still make a little classroom setting, there are some teacher resources on there where it almost gives you a curriculum for the day to work on with your kids where you can circle does the car have to yield first or does the bike have to yield first or matching different signs with different activities. It's a good way to continue to structure going into the summer if you really need that in school. Yeah. So those bike New York curriculum options really walk you through the course that would have been in person. And as Bethany mentioned, it's basically like a driver's test to make sure that they understand the rules of the road before you allow them to bike in areas where there might be other bicyclists or vehicular traffic. That's the last slide. So we can go to the... Go ahead. So here at NYU, we're still taking appointments both in person and with video visits. And we can make appointments with our hotel experts at NYULangone.org slash hotel or you can call our main line at 888-8701. If you're all Bike New York members, make sure you visit NYULangone.org slash Bike New York. It's a better portal in order to get access that's maybe a little bit more exclusive to New Yorkers when you want to be able to make an appointment with us. It takes you right to a concierge for the Bike New York members. Thank you so much for your time and attention and the great questions. Thank you so much.