How to prevent and treat common cycling injuries

Bike riding is a great way to lose weight and stay in shape. Regular cycling strengthens your heart muscles and improves circulation, reducing your risk of cardiovascular and other diseases. That’s not all, some studies show that cycling can have a positive impact on your mental health and well-being and may decrease symptoms of depression. 

So, it’s pretty clear that cycling can be a fun and highly beneficial form of exercise for anyone, but it doesn’t come without its drawbacks. Besides the potential for head injury and broken bones in the event of a bicycle crash, frequent cycling for long periods of time presents its own set of problems. 

According to Dr. Vonda Wright, a double board, fellowship-trained HCA Florida Healthcare orthopedic surgeon with subspecialty certification in sports medicine, “One of the most common reasons that cyclists get injured in the first place, other than trauma, is because their bike does not fit them properly. Seat height, pedal position and handlebars must fit a person’s specific body and should be set at a knowledgeable bike shop to prevent overuse injuries.”

Common overuse injuries associated with cycling:

• Knee pain
• Neck and back pain
• Wrist and hand pain
• Numbness and tingling in feet 
• Prostate and urinary problems (for men)

Knee pain: This is one of the most common cycling injuries, the knee after all takes the brunt of the impact when riding. The most common types of cycling-related knee pain are anterior knee pain (front of the knee), posterior knee pain (back of the knee) and lateral/medial knee pain (sides of the knee). 

You may be surprised to learn that most cycling knee pain is actually caused by improper positioning. If the seat on your bike is too low, it can put added pressure on your patella (knee cap). Likewise, if your seat is too high or too far back, it can cause your knee to overextend, straining the back of your knee, up into your hamstrings.  

Neck/back pain: Leaning over and staying in one position for long periods of time can put a lot of strain on your neck and lower back, causing discomfort. This can happen when the handlebars on the bike are too low, causing you to lean over or hunch. The neck muscles also become fatigued from holding the head in the same position for too long.

Wrist/hand pain: Cyclists often complain of wrist pain when cycling. This may be accompanied by numbness and tingling in the ring and pinky fingers. This compression of the ulnar nerve (sometimes referred to as handlebar palsy) is caused by the pressure on the wrists from gripping the handlebars too tight. Carpal tunnel syndrome is also a common overuse concern among bikers for this reason. “An overuse injury usually presents as aching, inflammation, a feeling of soreness and increases in intensity with the duration or intensity of the activity,” says Dr. Wright.

Numbness and tingling in feet: This is caused by the compression of nerves running into the balls of your feet. It’s very common for bikers to experience numbness in their toes while riding. The culprit here is usually shoes that are too tight or the placement of your cleats if you have clip-in pedals.

Prostate/urinary concerns: Prolonged pressure from the seat and the jarring impact from the ride can irritate the prostate in male riders. A hard seat can also cause numbness and pain in the genital or rectal area.

Preventing cycling overuse injuries

You don’t have to endure pain and discomfort to enjoy cycling and vice versa, you shouldn’t have to give up cycling if you’re experiencing pain. You can avoid many common overuse with simple adjustments to your routine and equipment.

1. Have your bike properly fitted by a professional for your size. Adjust your handlebar length and seat height to a comfortable position that doesn’t restrict your movements or make you hunch over. You may want to opt for a wider seat with extra cushioning to reduce pressure on your pelvic area and upper thighs.
2. Wear shoes that are comfortable and not too tight. If you are using clip-in pedals, make sure they are positioned correctly so that you are not putting additional strain on your ankles and feet.
3. If you are new to cycling, start slow. Build up to longer rides in small increments to avoid straining muscles and minimize hill training.
4. Consider adding strength training to your exercise routine. You may be able to avoid cycling knee pain by slowly strengthening the muscles around the patella for support.
5. At the first signs of pain, take a break. Pain is your body’s way of telling you that you are doing too much. Pain and inflammation reducers, such as ibuprofen, can help alleviate discomfort. Alternating ice and heat will also help to reduce swelling and inflammation.
6. Stretch before and after your ride. Focus on lengthening the large muscles in the legs, hamstrings and iliotibial (IT) band (the thick bank of fibrous tissue that runs along the outside of your leg from your hip to your knee). Stretching your lower back, arms, wrists and hands is also important. 
7. For safety, always wear a helmet and protective gear when cycling and brightly colored clothes when riding on streets where there are cars.

When to see a doctor 

“Cyclists should seek medical care when their home remedies don’t work, or the pain is intensifying to a point that they cannot do their activity,” says Dr. Wright. A trusted orthopedic specialist can help diagnose and treat common cycling injuries. Call (844) 671-4206 to get connected with an orthopedic doctor and find the care you need.