Pain with cycling

Cycling is a popular form of exercise, as a recreational activity or as a competitive sport. It can be a great option for exercise for someone looking for activity with less impact. But like all sports, there is a risk of injury, either due to a traumatic event or from overuse.

In a review of injuries in cyclists, researchers found that the odds of overuse injuries increased when a cyclist performed other activities such as running and swimming (i.e., triathletes), and acute injuries were more common with people who rode their bikes to work or rode on trail terrain, or those who used a low-end bicycle compared to high- or mid-end cycles. 

The likelihood of acute injuries is decreased with safety measures: follow the rules of the road and be aware of your surroundings. Wear appropriate protective gear.

63.2% of cyclists reported pain while riding, most commonly in the neck, low back, knee, hand, genital area, and shoulder.

Much of this discomfort can be affected by changing the set-up of your bike. For neck pain, try changing the seat to handle drop so that you don’t have to extend the neck as much. For low back pain, the seat height or handle height can be changed. And genital pain can be decreased by changing the type of saddle or changing the seat position.

Pain over the front of the knee is common, so check the seat height – at the bottom of the cycling motion your knee should still be bent about 30 degrees. You can also check the position of your feet on the pedals to be sure they are in a neutral position so that your knee drives straight up and back and doesn’t drop inwards.

For more specific assessments, a local bike shop can provide some excellent tips, and will do a bike fit (see @finishlinebikes)

Training technique is important, especially if you are putting in a lot of hours or are training for a run and swim as well. Ramping up slowly, and periodizing your training or manipulating training variables (intensity, duration, days of training) can help to avoid overuse injuries.

If you continue to have pain with cycling, see a good PT! An overall assessment of your strength, flexibility, and mechanics can pinpoint deficits, target weaknesses, and allow you to cycle on!

Priego Quesada, Jose Ignacio, et al. "A retrospective international study on factors associated with injury, discomfort and pain perception among cyclists." PloS one 14.1 (2019): e0211197.