Common Cycling Injuries That Physiotherapists Treat
Cycling is not just a mode of transportation but also a beloved recreational activity and competitive sport enjoyed by millions worldwide. It is a fantastic way to stay active, it’s low impact, great for cardiovascular health, and easy to enjoy at any age. However, the repetitive motion and prolonged periods of time spent on the bike can lead to various injuries, affecting cyclists of all levels.
Cyclist Injuries
Cycling involves repetitive movements of the lower body, as well as prolonged periods of time spent in a fixed position, placing unique stresses on the body. Common cycling injuries can affect the lower limbs, such as the knees, hips, and ankles, as well as the upper body, particularly the neck, shoulders, and wrists.
Lower Limb Cycling Injuries
1. Cycling Knee Pain:
As physiotherapists, we regularly see cyclists , both new and experienced, struggling with knee discomfort that can take the fun out of the ride. The good news? Most cycling-related knee pain is manageable with the right approach. Knee pain, including conditions such as patellofemoral pain syndrome and iliotibial band syndrome, is one of the most common complaints among cyclists. Physiotherapy interventions focus on improving biomechanics, strengthening the muscles around the knee, and addressing any underlying factors contributing to pain and dysfunction.
Common Causes of Knee Pain in Cyclists
Knee pain in cyclists is usually related to overuse or poor biomechanics, rather than a specific injury. One of the most common culprits is patellofemoral pain syndrome, discomfort around or behind the kneecap, often caused by muscle imbalances or excessive load. Another common issue is iliotibial band (ITB) syndrome, which presents as pain on the outside of the knee. This can result from tightness in the ITB due improper alignment during pedalling. Other potential causes include issues related to cleat position, saddle height, and cadence.
Signs of Cycling Knee Pain You Shouldn’t Ignore
A dull ache at the front or side of your knee during or after riding
Pain when climbing hills or increasing intensity
Stiffness that lingers after a ride
If you’re experiencing these symptoms, it’s worth having a proper assessment before the pain progresses.
Prevention of Knee Pain from Cycling Starts with Bike Fit
One of the most effective ways to prevent knee pain after cycling is to ensure your bike fits you properly. An incorrect saddle position can increase stress on the knees. The same goes for cleats that are misaligned. Small adjustments can make a big difference. It’s also important to look at training load. A sudden increase in distance or intensity can overload the knees. Gradually building up mileage, and incorporating rest days can help prevent overuse injuries.
Strength and Mobility Matter
Muscle imbalance can put extra stress on the knees. Incorporating a mobility and well-rounded strength program off the bike is key. Exercises like bridges, step-downs, and single-leg work can help support better knee mechanics.
How Can Physio Help with Knee Pain in Cyclists
As physios, we look at the whole picture, your movement patterns, muscle control, and how you interact with your bike. A tailored program that includes hands-on treatment, targeted exercises, and possibly a bike fit assessment can get you back on the saddle pain-free.
2. Hip and Pelvic Pain:
Hip and pelvic pain can result from prolonged pressure on the saddle, improper bike fit, or muscle imbalances. Physiotherapy treatment involves stretching tight muscles, strengthening weak muscles, and implementing strategies to improve pelvic stability and alignment.
3. Ankle and Foot Pain:
Ankle and foot pain, including Achilles Pain from Cycling (e.g. Achilles paratendonitis/paratendinitis) and plantar fasciitis, can develop from repetitive pedaling motion, improper foot positioning and poor footwear. Physiotherapy interventions focus on reducing inflammation, improving ankle mobility, and addressing any biomechanical issues contributing to pain and dysfunction.
Upper Body Cyclist Injuries
1. Neck and Shoulder Pain:
Neck and shoulder pain can result from prolonged forward-leaning posture and repetitive stress on the upper body while cycling. Physiotherapy treatment involves strengthening the muscles of the upper back and neck, improving posture, and implementing strategies to reduce strain on the shoulder joints.
2. Wrist and Hand Pain:
Wrist and hand pain, including conditions such as carpal tunnel syndrome and handlebar palsy, can develop from prolonged pressure on the handlebars and repetitive gripping motion. Physiotherapy interventions focus on reducing inflammation, improving wrist mobility, and providing education on proper hand positioning and grip technique.
Cycling Lower Back Injuries
Lower back pain is a frustrating and common issue for many cyclists, and it’s not just confined to long-distance riders. Whether you’re tackling your daily commute, hitting the trails on the weekend, or working towards a racing goal, the repetitive nature of cycling can put significant strain on your lower back. But with the right knowledge and approach, you can manage and even prevent this discomfort, ensuring you stay on the bike without pain holding you back.
Why Do Cyclists Get Lower Back Pain?
Common contributors include:
Poor Bike Fit
Weak Core and Glutes
Limited Hip, Lumbar or Thoracic Mobility
Prolonged Riding
What Does It Feels Like?
Cyclists often report:
A dull ache or tightness in the lower back during or after riding
Stiffness when getting off the bike or the next morning
Pain that improves with movement but returns with long rides
What Can You Do?
Check Your Bike Fit: Small adjustments can make a big difference. A proper fit helps keep your spine in a more neutral, sustainable position.
Strengthen Core and Glutes: Exercises like bird-dogs, dead bugs, and glute bridges can build endurance and support your spine while riding.
Mobilise Hips and Spine: Mobility work for the hips, lumbar and thoracic spine can ease tension and restore alignment. Especially stretching into extension-based positions.
How Can a Physio Help with Lower Back Pain in Cyclists?
A physiotherapist can assess your posture, movement patterns, and bike setup to identify the root cause. Treatment may include hands-on therapy, a targeted exercise program, and advice on load management to keep you on the bike comfortably. Lower back pain doesn’t have to be part of your cycling experience. With the right approach, including proper setup, mobility work, and strengthening, you can ride longer, stronger, and pain-free. If your back’s been bothering you, book in for an assessment and let’s get you riding comfortably again.
Comprehensive Physiotherapy Approach
1. Bike Fit Assessment:
Physiotherapists conduct thorough assessments of bike fit, including saddle height, handlebar position, and cleat alignment, to ensure optimal biomechanics and reduce the risk of injury.
2. Biomechanical Analysis and Correction:
Evaluation of cycling technique helps identify faulty mechanics and implement corrective strategies to optimise performance, reduce the risk of injury, and enhance overall efficiency on the bike.
3. Strength and Flexibility Training:
Targeted exercises to strengthen the muscles of the lower body, core, and upper back, as well as improve flexibility and mobility, can help prevent muscle imbalances and reduce the risk of overuse injuries.
Injury Prevention Strategies:
1. Proper Bike Fit and Equipment:
Ensuring cyclists have a properly fitted bike and appropriate cycling gear, including padded shorts, gloves, and supportive footwear, can help reduce the risk of injury and improve comfort while riding.
2. Gradual Progression and Conditioning:
Gradually increasing cycling duration and intensity, as well as incorporating cross-training activities such as strength training and stretching, can help prepare the body for the demands of cycling and reduce the risk of overuse injuries.
3. Post-Ride Recovery:
Implementing post-ride recovery strategies such as stretching, foam rolling, and hydration can help reduce muscle soreness and fatigue, promoting faster recovery and reducing the risk of injury.
Conclusion:
Cycling injuries are a potential hazard for cyclists of all levels, but with proper preparation, awareness, and physiotherapy support, they can be effectively managed and prevented. Physiotherapists play a crucial role in diagnosing and treating cycling injuries, offering personalised rehabilitation programs to promote recovery and prevent recurrence. Come see our team at Brisbane Physiotherapy and Rehabilitation today to help keep you cycling.
