Unless you fall off, cycling is a sport blessed by its body friendliness! In fact, riding big miles is more likely to get you ﬁt than fractured. But, like any endurance sport, cycling can produce a catalogue of niggling aches and pains, which if left untreated can become more serious. To give your pain a name and point you down the right road to recovery, we’ve listed the 8 most common cycling ailments, their most likely causes, and how to go about ﬁxing them.
One of the most common cyclist knee complaints is pain in the kneecap. This is most likely to be patellofemoral pain syndrome (PFPS). PFPS is often worse when walking up and down hills/stairs or sitting for long periods of time. It may include wasting of the quadriceps (thigh) muscles if the injury is an old one, and tight muscles around the knee joint.
PFPS occurs when the patella (kneecap) rubs on the femur (thigh) bone underneath. It is believed that incorrect tracking (gliding) of the patella over the femur is a signifi cant factor and results in damage to the cartilage underneath the patella. The cause may be from external factors like an increase in training, the seat being too low or riding too long in big gears. Internal factors such as poor patella tracking may result from excessive pronation (fl at foot), rotation of the lower leg and tight or weak muscles around the thigh and pelvis.
After knees, the back is probably one of the biggest causes of pain for cyclists, with lack of flexibility and bad posture generally the cause. Hunching forward on your bike, and probably also at work, places strain on your spine, loading structures for prolonged periods of time.
Cyclists’ back pain is often due to mechanical factors. Have your bike properly fitted to your body, then look at your body. Lack of flexibility, such as excessive hamstring and hip flexor tightness can contribute to low back pain. Differences in leg length are common mechanical problems leading to imbalances in the spine. Core strength is very important to avoid low back pain. Core strength comes from a collection of deep muscles both big and small that work together to give you core lumbar and pelvic stability.
Neck pain from cycling usually stems from poor posture and weak muscles. Pain caused by neck hyper extension is made worse by positional issues on the bike, combined with lack of flexibility. Just as you have core stabilisers around your lower back, you have stabiliser muscles called deep neck flexors around your neck to hold your head up.
When your neck stabilisers are weak or fatigue quickly it is left to the trapezius muscle (that goes from the base of your skull to the tip of the shoulder) to support your head as you lean forward. And when these ‘stand-in’ muscles fatigue you can aren’t pushed all the way forward towards the toe will help to even out what muscles you’re using to pedal
Iliotibial Band (ITB) Pain
While it is more commonly known as “runner’s knee”, ITB syndrome is another common cycling injury. ITB pain is typically associated with prolonged, repetitive activity. Symptoms include pain on the outside of the knee, tenderness and sometimes swelling. In some cases, pain is felt simply walking or going up and down stairs. You may feel stiff or tight after periods of inactivity.
The ITB is a tendinous fascial band that originates on the iliac crest (hipbone) and attaches to the outside of the knee. As your knee bends and straightens repeatedly, the band can become inflamed by rubbing over bony condyles. Other contributing factors may include tightness of thigh, hip and buttock muscles as well as weak pelvic stabilising muscles.
Achilles Tendon Pain
The Achilles tendon is the tendon at the back of the ankle, connecting the gastrocnemius (calf) muscle to the heel. If your Achilles is sore during or after riding you may have Achilles tendinopathy.
Inflammation, micro-tears or compromised blood flow, often caused by overuse, could put a stop to your riding season. There is a whole host of stretching and strengthening options available from your therapist.
Possible causes of hip pain in cyclists include bursitis, snapping hip syndrome, impingement syndrome, labral tears or piriformis syndrome. Although the diagnoses may vary, the causes of cycling hip injuries are usually similar and involve over-training, pushing excessively high gears and muscle imbalances. For example, piriformis syndrome is caused by overuse of the gluteal (buttock) muscles, which results in a weak, tight piriformis muscle that can cause sciatica.
‘Handlebar Palsy’ is a name given to a condition suffered by cyclists caused by compression of the ulnar nerve at the wrist against the handlebar. It often comes on after long rides, and is not just due to the pressure from your weight but also the transmission of road ‘buzz’ and vibration through the bars.
Symptoms include numbness, tingling and weakness over the outside of the hand, little finger and outer half of the ring finger. A feeling of clumsiness in the hand is often reported and pain may be present when moving the wrist.
Painful burning of the ball of the foot (a.k.a. “hot foot” or metatarsalgia) is usually a result of hot weather and/or poorly fitting shoes on long, hilly rides. Pressure can pinch nerves in one or both feet.
If you would like to find out more information about cycling injuries, signs & symptoms, common causes and tips then please feel free to download our cheat sheet.