Common Cycling Injuries And How To Prevent Them

Warwickshire osteopaths treat common sports and cycling injuries

The recent Spring weather is great news for cyclists. Whether you’re in the saddle to commute, compete or just for fun, cycling is a fantastic way to get around and also excellent exercise.

Being an osteopath (as well as a cyclist), I know that cycling injuries do occur and often re-occur. In my experience, they are usually caused by overuse or poor riding position. The resulting pain and physical limitations can be particularly debilitating for cyclists, impeding performance or preventing cycling altogether. Luckily, most injuries can be fairly quickly resolved with some simple bike set-up tweaks and some manual therapy such as osteopathy for persistent pain.

Below, I will discuss the most common cycling injuries and simple things you can do to help prevent them.

Common Cycling Injuries

Lower Back Pain

This is largely caused by the sustained flexed forward position in cycling which can put excessive pressure through the joints and discs of your low back.

How to avoid it:

  • Raise your handlebars to reduce the amount of flexion going through your lower back
  • Do some daily exercises and stretches to improve hip and lumbar flexibility. An osteopath or other manual therapist can advise on the best stretches for you.

Lower back pain treatment in Warwick for cycling sports injury

Neck Pain and Headaches

Neck pain and headaches can also be due to a flexed forward cycling posture. This in turn causes your neck to over-extend, especially when you are looking up and around. Long periods of neck extension lead to muscle tightness,  joint pain and associated headaches.

How to avoid them:

  • Try raising your handle bars to decrease the extension curve in your neck.
  • If possible, alter your cycling position, so you are sitting more upright for short periods.
  • Do regular neck flexion and side-bending stretches to ease neck and shoulder tension. An osteopath or other manual therapist can advise on the best stretches for you.

Knee Pain

Common causes of knee pain are saddle too low and cleats not optimally positioned. A saddle that is too low means that your knee and leg never straighten out fully. This leads to shortened hamstrings, sustained tension on the knee cap and weakening of the muscle controlling the last 10 degrees of knee extension (vastus medialis). All of these can lead to knee problems including patella mal-tracking, patellar tendonitis and overuse injuries.

Many road cyclists use cleats to connect their shoes to the pedals. Whilst cleats improve performance, they can also result in persistent knee pain if not optimally positioned. Watch this useful video on setting cleat position.

How to avoid it:

  • Raise your saddle
  • Optimise cleat position
  • Cycle in a lower gear to decrease the amount of stress through your knee on each pedal stroke.
  • Consider getting a professional bike-fit done. If you live in Warwickshire, try Bike Dynamics in Leamington Spa.

Hand and Wrist Pain

Leaning forwards during cycling puts a lot of tension through forearms and hands, which can be exacerbated by gripping too hard and not varying hand position. This can lead to repetitive Strain (RSI) type symptoms with pain and tightness in the wrist, forearm and elbow.

Some cyclists also experience tingling and numbness into their hands and fingers. This most commonly affects the little and ring fingers, but can affect the others too. It is caused by compression of the ulnar or median nerves due to the sustained wrist and hand position on the handlebars. This can be made worse from vibration due to cycling on rough terrain.

How to avoid it:

  • Change your hand position on the handlebars regularly.
  • Try to keep wrists straight rather than over-extended.

Muscle Strains and Tears

Hamstrings and calf muscles are most commonly injured amongst cyclists. This is because these muscle groups get particularly tight, making them more vulnerable to tears and tendon injuries.

How to avoid them:

  • Warm up before a ride and stretch afterwards to keep your muscles healthy and flexible. Using a foam roller after a ride can help with this too.
  • Check saddle height. A saddle that is too high can put strain through hamstring tendons.
  • Check cleat position as cleats too far forward may put strain through the achilles tendon.
  • Build up gradually to longer-distance cycling.

Getting Professional Help

If you only experience pain when on your bicycle, then hopefully the tips above will help. If your pain persists once you are off your bicycle you may need to get professional help. An osteopath will be able to provide relief by releasing restrictions, improving flexibility and releasing muscle tension.

Osteopathy can also give you the best chance of staying pain-free by maintaining joint health, mobility, muscle flexibility and giving individualised exercise advice.

You may also want to consider getting a professional bike fit done. This will ensure that no particular part of your body is under excessive strain and should also help maximise performance.

Emma Lipson is Principal Osteopath at Feel Better Osteopathy in Warwick, Warwickshire.

Over to you…

Are you a cyclist? What did you think of this article? If you enjoyed it please like, share or comment below.

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6 thoughts on “Common Cycling Injuries And How To Prevent Them

  1. Thanks for this article. It is very informative and useful info for either just leisure riders or pro cyclists. Finding a technically right position while riding is very important and this article helps a lot!

  2. Emma, a couple of questions on your thought processes. firstly, all your recommendations will decrease the performance of a cyclist, not ideal if you’re a professional or take part in regular cycling events; let’s face it, we all want to improve, not get slower. Secondly, most people do have comprehensive bike fits but are still in pain, does it not occur to you that the problem is intrinsic and not the bike or cleats? Thirdly, any cyclist who tears a muscle riding a bike has to be in pretty bad shape, lending further support to ‘off-bike’ assessments prior to a bike fit – after all, if you’ve got dysfunctions off the bike, you’ll have dysfunctions on the bike. Finally, as a professional GB cyclist the initial emphasis must always be placed on the person, not the bike or cleats – this paradigm of injury prevention will cause polarized opinion but one I firmly believe is the missing link in many chronic cycling injuries.

  3. Thanks for your thoughts Nathan, and good to hear views from the perspective of professional cyclist. I totally agree that if a cyclist or any person for that matter has dysfunctions physically, that needs to be addressed. However, adapting set up of bicycles or other equipment can also help prevent undue stress on the area(s) of the body that are healing or compromised for whatever reason, helping to prevent injuries reoccurring. I believe the two can work hand in hand. As an osteopath I would obviously encourage anyone suffering pain or injury to come and see in part to alleviate their pain, but equally to work with them to try to work out how to optimise their body/flexibility/lifestyle/cycling posture etc to prevent reoccurrence. In an ideal world, people should come to me before being pain for a preventative assessment. However, it rarely works like that, as people don’t want to make the time/money commitment.

    I take on board that some of my advice re cycle set-up may affect speed, but if the set up is making pain worse or even causing it, then performance will be compromised further anyway.

  4. I’ve been working with the osteopath for Team Movistar, the Spanish professional road racing team, and certainly they’ve changed their bike set-up in recent years to a more upright, less aerodynamic posture that sacrifices some speed for extra comfort and fewer aches and pains. I guess the balance of pros and cons would be different for sprints or other forms of competition.

    They get assessed off the bike, and clearly individual structure and history of injuries are important, but there are also clear patterns of muscular imbalance and common postural issues due to the position on the bike and the other demands of racing. The whole picture can be “tweaked” with changes to the bike set-up, alongside other interventions. These guys have spent so long on their bikes, apparently they notice the difference a change of a couple of millimetres makes straight away!

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