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What cyclists must know about cold-related illnesses

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bicycle safety 20 Dec 2021 By Denis Voitenko

Winter riding can be every bit as enjoyable as warm-weather riding when you do it right. However, if you head out unprepared, it could turn out to be the worst riding experience of your life! That’s why it’s imperative that you familiarize yourself with the cold weather ailments that most commonly affect cyclists, and know how to prevent them.

How the cold affects the body

Exposure to chilly wintertime weather affects the body on multiple levels, all of which cause additional stress to it. Frigid temperatures cause the body to lose heat at a quicker rate and induces a defensive response within it. When your body goes into defensive mode, it must work harder and use more energy in order to continue functioning normally, which is why those winter rides feel so much harder.

In an effort to protect itself from the cold and to prioritize internal organs, your body will automatically reduce blood flow to the extremities and redirect it inward, towards your core, instead. All of this means your heart will have to put forth more effort in order to work efficiently, causing both your heart rate and blood pressure to rise.

cyclist in winter forest

Chilly temperatures also result in other involuntary responses, such as muscle contractions. Cold-induced contractions produce tighter joints and muscles, reduced mobility, and require that your muscles work harder to produce the same output. These factors cause a greater amount of damage to muscle tissue, an increased risk of injury, and more soreness than a warmer ride would.

Breathing in super cold air for a long time can take a toll on the respiratory system, too. While the airways and nasal passages are generally effective at warming any air you breathe so that it’s at a safe temperature by the time it reaches the lungs, there comes a point where breathing can become difficult or impaired. A drippy nose and more frequent urination are also common.

Common cold weather biking ailments

Riding in the cold can increase the chances of certain injuries, including muscle strains and tears. In some cases, prolonged exposure to the cold can result in even more severe injuries and ailments.

Muscle sprains, strains, and tears

Muscles are especially susceptible in lower temperatures, so the risk of muscle injury goes up as your body temperature goes down. Riding through a wintery wonderland actually puts you at greater risk of sustaining a sprain, strain, or tear. On top of making muscles more vulnerable to injury, the intense workload that’s required to overcome the physiological effects that frigid temperatures have on the body also increases injury risk.

While similar in some ways, muscle sprains, strains, and tears remain very different conditions. A sprain is damage to the ligaments, fibrous tissue that connects bones to bones at joints, in the form of a stretch or tear. Sprains often result from twisting or moving in a way that is outside of the body’s normal range of mobility. Signs of a sprain include the following:

  • Pain and inflammation
  • Bruising of affected area
  • Swelling of affected area
  • May feel a tear or pop in affected joint as it happens
  • May feel stiffness or instability in affected joint

A strain is a stretch or tear in a muscle or tendon, which connects muscles to bones. Doing a lot of heavy lifting or exercises that involve a repeated movement, such as rowing or tennis, can result in a strain. Some indications of a strain are:

  • Pain and inflammation
  • Bruising of affected area
  • Swelling of affected area
  • Limited range of mobility
  • Stiffness
  • Weakness
  • Spasms or cramps in affected muscle

Tears are injuries that include the ripping of tissue in muscles, ligaments, or tendons. The most common signs of a tear consist of:

  • Inflammation and pain
  • Bruising or redness of affected area
  • Swelling of affected area
  • Weakness or inability to use a muscle or joint
  • May hear popping sound as injury occurs
  • May see a gap, dent, or other defect in the normal outline of the affected muscle


Protect yourself: Help avoid muscle injuries by always warming up before heading out and not stopping unless necessary because every time you take a break from pedalling, your muscles have time to cool down, increasing your risk of injury. Make sure your bike fits you well and schedule a professional fitting if you have any reason to think it might be necessary. Wearing decent knee warmers or bib tights and sticking to lower gears is also recommended.

First aid: Resting the injured muscle as soon as possible is a critical element in preventing further damage. Some muscle-related injuries require medical attention and should not be left for home treatment alone. For milder cases, using ice, heat and anti-inflammatories are generally effective in addressing symptoms. If no improvement is seen within 24 to 72 hours, stop any home treatment and seek medical assistance as soon as possible.


Hypothermia happens when exposed to frigid temperatures for too long. Once your body has used up all its stored energy and it has nothing else to draw from, it can no longer perform the function of producing heat and results in an abnormally low body temperature, referred to as hypothermia. Symptoms vary, depending on duration of exposure, but initial indications include:

  • Shivering
  • Fatigue
  • Loss of coordination
  • Disorientation and confusion

If not addressed, hypothermia can become more severe in nature. Signs that suggest hypothermia has become severe include:

  • No shivering
  • Blue skin
  • Dilated pupils
  • Slowed pulse and breathing
  • Loss of consciousness

Protect yourself: Check the forecast to confirm that the weather conditions where you will be riding are within the safe range. If it’s too cold, don’t ride out. Also make sure the duration of the ride you have planned is appropriate for the temperature. When you do ride in the cold, always be sure that you’re equipped with the right winter riding clothes and accessories. If you don’t have the appropriate gear, don’t ride out.

First aid: Move into a heated building or shelter and request medical assistance. Immediately remove any wet clothes and focus on warming the core (chest, neck, head, and groin) with either an electric blanket or skin-to-skin contact under loose, dry layers of blankets, clothing, towels, or sheets. If it’s available, sip on a warm nonalcoholic beverage. If you are assisting someone suffering from hypothermia, only offer them a warm beverage if they are fully conscious. Once body temperature increases, refrain from getting wet again and just stay wrapped in a warm blanket. The most severe cases of hypothermia can be life-threatening and may cause you to lose consciousness or even slow your body’s functioning so much that you appear pulseless and lifeless. Should you discover someone who has no pulse, begin performing CPR immediately.

cyclist on ice


Frostbite is a condition where a part of the body—most commonly the ears, cheeks, chin, nose, fingers, and toes—begins to freeze, or in some cases, freezes entirely. Depending on the degree of severity, it can result in irreparable damage to muscle tissues. In some cases, it may even require the removal of a limb. Those with reduced blood circulation are at a greater risk of developing frostbite, as are those who aren’t dressed with appropriate cold weather clothing.

First degree frostbite is most common. While it’s nothing to ignore, it isn’t the worst thing ever and resolves itself as long as it isn’t given the opportunity to progress. It’s superficial in nature and can be recognized by the following:

  • Pale skin
  • Mild swelling
  • Numbness
  • Fingers and toes may look waxy

Symptoms of second degree frostbite can appear as late as a day after a cold ride and are noticeably worse. Signs include:

  • Swelling is more severe
  • Fluid-filled blisters surrounded by pinkish/reddish skin form in the affected area

The blisters should eventually slough off, leaving eschar, a black tissue. This is normal and not an indication of permanent damage.

Third degree frostbite affects deeper areas of the skin and is recognized by:

  • Blisters filled with blood instead of a fluid

Unfortunately, eschar left behind by blisters can last up to several months and results in irreparable damage.

The most serious form of frostbite, fourth degree frostbite, freezes muscle and bone and rots tissue, essentially mummifying it. This can occur in just a couple of days. In addition to the above manifestations of frostbite, the following are symptoms of fourth degree frostbite:

  • Reduced blood flow to hands and feet (fingers and toes freeze)
  • Numbness
  • Stinging or tingling
  • Aching
  • Bluish or pale, waxy skin


Protect yourself: Do not spend prolonged periods of time in extremely cold temperatures—especially if you’re not properly dressed. Always check the forecast to avoid finding yourself in a situation where you’re at risk.

First aid: Get into a warm space as soon as possible. If feet are frostbitten, then it’s imperative that walking be kept to a minimum because every step causes additional damage. Immerse the affected area in warm water only; water should never be hot. While warm water may feel painful to frostbitten tissue, the water should otherwise feel very comfortable to unaffected areas of the body. Hands can be gently tucked into armpits to comfort frostbitten fingers, but don’t ever rub or massage frostbitten tissue. Just like walking causes damage to the feet, massaging and rubbing will cause further damage. Since affiliated areas are numb and more susceptible to burning, refrain from using heating pads, heat lamps, or heat from a stove, fireplace, or radiator for warming.

Immersion Foot

Immersion foot is commonly called trench foot, a name it earned after first being described in 1914 during trench warfare of the first World War. It’s an injury that results from prolonged exposure to cold, wet conditions but differs from frostbite because it’s not a freezing-related injury. One way the body attempts to regulate heat is by constricting blood vessels in the feet, basically ceasing all blood flow to the feet. Without blood circulating oxygen and vital nutrients into and waste out of the feet, skin tissue begins to die. Because wet feet lose heat 25 times faster than dry feet, trench foot can occur at temperatures as high as 60F. Signs of immersion include:

  • Reddening of the skin
  • Numbness
  • Leg cramps
  • Swelling of skin on feet with reddening, swollen toes
  • Tingling pain
  • Blisters or ulcers
  • Bleeding under the skin
  • Gangrene (foot may turn dark purple, blue, or gray)

immersion foot

Protect yourself: Since trench foot can occur in temperatures as high as 60F, making sure that your feet will be warm, your shoes aren’t too tight, and that you’re sporting waterproof footgear is of the utmost importance before pedalling out into wet conditions. Tight-fitting shoes with poor insulation will increase both the likelihood of developing trench foot and the degree of severity to which it develops, as will shoes that don’t repel moisture from slush, so be sure that your shoes are appropriate.

First aid: Most people experience milder forms, called pernio and frostnip. Remove shoes and socks and dry feet and avoid walking because it will cause further damage. Medical attention may be required, depending on severity.


Most people have experienced some form of frostnip. Frostnip is localized numbness that results from exposure to cold temperatures. While it’s a mild form of frostbite, there is no permanent tissue damage. Common indicators of frostnip are:

  • Cold skin
  • Numbness
  • Prickling sensation
  • Discolored skin


Protect yourself: Always check the forecast and dress with winter appropriate gear and accessories.

First aid: Frostnip can be treated by simply rewarming yourself.

Pernio or Chilblains

Pernio, also called chilblains, most commonly the cheeks, ears, fingers, and toes and is a product of repeated exposure of skin to cold, damp conditions that range between just above freezing to temperatures as high as 60F. It results in permanent damage to the networks of small blood vessels under the skin called capillary beds. Signs of pernio include:

  • Pain and inflammation
  • Red or purplish/bluish skin
  • Itchiness or “pins-and-needles” feeling
  • Possible blistering
  • Inflammation
  • Possible ulceration in severe cases


Protect yourself: Make sure you wear accessories that are effective in keeping your cheeks, ears, hands and feet warm and dry. Refrain from riding in wet, slushy conditions if your riding gear isn’t up to that challenge. Certain autoimmune disorders and health conditions can increase the chance of developing pernio.

First aid: Slowly warm the skin. Refrain from scratching and use corticosteroid creams to relieve itching and swelling instead. Any blisters or ulcers should be cleaned and covered. It may be necessary to seek medical attention.


Bronchoconstriction is a condition where muscle contractions of the smooth muscles of the airways cause a narrowing in the airways and a decrease in airflow. The result is difficulty breathing. Certain respiratory conditions, including asthma, increase the likelihood of developing bronchoconstriction, but there are also environmental triggers that can affect your susceptibility. Some signs that suggest bronchoconstriction are:

  • Coughing
  • Shortness of breath
  • Wheezing
  • Tightness or pain in chest
  • Extreme tiredness during exercise (generally exercise induced bronch)
  • Physical performance that is poorer than expected (Exercise-induced bronchoconstriction)


Protect yourself: Check the forecast to ensure that weather conditions are safe enough for a ride. Dress in warm, waterproof gear and keep rides on the shorter side to avoid overdoing it and always avoid intense exercise if you already have a respiratory infection. Before rolling out, make sure to get in a good warm up so your body is ready for whatever comes its way. If you live with a respiratory condition that increases your risk, consider sticking to warmer winter days or indoor training. It may be worth consulting with your doctor to determine if there are other ways to help manage symptoms.

First aid: Stop engaging in physical activity and go inside where it’s warmer. If bronchoconstriction continues to arise when you ride in chilly temperatures, schedule an appointment with your doctor to discuss your concerns and options.

Be proactive

Being proactive is the best way to set yourself up for an enjoyable winter ride. By dressing appropriately, taking measures to stay warm, and thinking and planning ahead, the likelihood of a successful ride is increased.

three cyclists in snow

Dress the part

If you plan on enjoying your chilly ride, then it’s imperative that you wear the right clothing and accessories and that you know how to layer them. Be aware that quality really does matter, so make sure the materials your winter gear is made from are able to stand up to the weather conditions. Also be sure everything is cut and fits in a way so there is no exposed skin.

Your head and neck lose a lot more heat at a much quicker rate than most people realize, so it’s important that you keep them warm. On days that warrant it, a beanie or skull cap under your helmet and balaclavas or turtlenecks to protect your neck and throat are recommended. Always wear protective eyewear, preferably extra large sunglasses or snowboarding goggles to better break winds.

Keep your hands and feet toasty with accessories that provide the warmth and dryness required to stay safe. Insulated gloves that trap in heat are the go-to for many, but make sure they don’t impair shifting or braking. If standard gloves aren’t doing it, lobster mitts or doubling up on gloves might do the trick. Decent socks—merino wool whenever possible—and overshoes are recommended as the absolute minimum. On extra cold days, wrapping plastic or foil around your toes might even be necessary. Keep in mind that wearing thicker socks could affect how your riding shoes fit. If you’re not able to wiggle your toes inside your shoes, then it’s recommended that you purchase larger ones to avoid numbness and injury that can result from shoes that are too snug.

dressing for winter cycling

Keep your body warm

Wearing winter gear keeps you warm by providing an external barrier to break chilly winds and trap heat. Keeping your body warm is of the utmost importance. To set your body up for success, always warm up before pedalling out. It’s best to not stop riding unless it’s absolutely necessary. If you think you’re going to need to take a break, plan your route so that you can go somewhere warm during your break.

Think ahead

Always think ahead before going for a ride to help protect yourself from the most common ride-killing culprits. Check the forecast to avoid getting stuck in a surprise winter storm. Always pack the essentials, including extra layers, basic bike tools, water, and some snacks

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