Dealing with dizzy riders

by Angela Reed-Fox RN

Managing dizziness in the indoor cycling studio

It's not just new riders that might feel a bit faint or dizzy when doing new indoor cycling workouts - if riders are increasing the intensity of their classes, they may experience the same symptoms. Here I'll explain why - and how to avoid the drama!

Feeling faint during or after a class is not hugely rare. If riders are new to vigorous workouts, or they've recently upped the intensity of their workouts they're more at risk of feeling dizzy or faint during or after your class.

There are two main reasons why you might feel dizzy. One is low blood sugar, and the other is low blood pressure.

Low blood sugar

Your facility should receive agreement that riders with diabetes will let you know before starting their class with you. Such riders are generally well aware of how to deal with 'hypos', and will come prepared. Generally it's the medication that causes the hypo, not the condition. If you're unsure, check with your venue that they're gathering this information from new riders.

For riders who are not diabetic, low blood sugar is less likely to cause a problem. However, with sudden intense exercise, particularly at high resistance, this can see blood sugar levels dropping lower than normal. This can cause dizziness or faintness.

Low blood pressure

It’s often the case that people (mostly women) with low blood pressure can feel dizzy during or after exercise. This is because one of the way the body maintains an even temperature is by dilating the blood vessels to cool down - this is why your skin goes red when you're hot. Also when you're working hard at a high intensity, your muscles are also demanding a greater blood supply. This is perfectly natural, and usually OK - only if you usually have low blood pressure, in this condition, less of your blood is supplying your brain with oxygen, which makes you feel dizzy or faint.

How to help and advise riders

The gold standard is to provide written guidance from your venue. The following advice is useful:
How venues can prepare:

• Check and restock first aid kits in workout areas. Each area should have its own. Make sure there are small packs of jelly or sugar sweets in the case of riders with low blood sugar.
• We strongly recommend that all instructors should be first aid-trained, and know what to do in the case of fainting.
• Have a well-ventilated area where a rider can easily get to in the case of dizziness. (Not down a corridor.)
• Have fresh drinking water available in each workout area.
• Make sure your PARQ is comprehensive enough to gather the information you need - and make sure this is passed on to instructors if it's something they need to know. (Obviously, it is your repsonsibility to ensure that such information remains secure and confidential.)
• Include in the PARQ the agreement that if the rider is unwell, or has a change in their health that may be relevant to their workout, that thye let the instructor know at the outset of the session.
• Include with rider induction a checklist of what to bring - medication if required, water, towel etc.
• Have a robust reporting system. Advise riders to seek medical advice if you are concerned in any way, or think the dizziness is out of the ordinary.
• In the case of a rider feeling dizzy or unwell in class, make sure there's a good follow-up system - this is not only professional, but it enables you to make any changes, as well as making sure they're OK and are supported to come back.
• If a rider is known to get dizzy - consider having a member of staff riding with them for reassurance.
• Consider having fans in workout areas rather than just relying on air conditioning. Fans are more instant, and will provide relief and can be quickly turned off to prevent chilling at the end of the session.
  
• Have a reliable contact person for riders to go to who can provide help and support.
  

As a precaution, before the class:

• Advise riders not to ride hungry. Just a light snack riding should be sufficient – a couple of light crackers or a biscuit.
• Offer and encourage riders to choose a lower intensity session until they get comfortable and used to the higher intensity of indoor cycling. Make sure there are plenty to choose from on the timetable.

In preparation and during the class:

• Encourage good hydration – and that means drinking plenty of fluids in the 24-48 hours before the class (and to avoid a headache, drink sufficient afterwards too).
• Suggest riders get a BP check. If BP is usually above 120/80mmHg, this is less likely to be an issue for.
• Focus on breathing more deeply from your diaphragm (the large muscle that separates your chest from your abdomen). This enables you to take in more oxygen and get rid of carbon dioxide more quickly. Using the 'accessory muscles' in our shoulders can make us tire more quickly, as it's not so efficient.
• If a rider feels faint, encourage them to get off the bike immediately. Have them sitting on the floor (or lying with their feet elevated if they're really dizzy). Have a member of staff check on them, or a friendly rider to look after them if appropriate.

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