Three Common Cycling Injuries and How to Prevent Them

Posted On October 15, 2018 / Training Intel

Holowesko Citadel cyclist

Written by David Jolson, Greenville chiropractor and clinic director at Upstate Spine & Sport. Dr. Jolson is team chiropractor for the Hincapie Racing Team, Greenville Drive, and local PGA Tour Pros.

No one wants to be forced off the bike due to an injury, but unfortunately cyclists face risks aside from high-velocity crashes, including several musculoskeletal injuries such as pain in the lower back, knees and neck.

So what can you do to prevent these injuries?

Posture control, core strengthening and breathing techniques: How to beat lower back pain

Many cyclists experience back pain after spending hours flexed over handlebars. On top of that, most of us have jobs that require sitting at a desk in front of a computer, making lower back pain one of the most common injuries cyclists suffer.

Back pain can lead to a whole other set of issues due to altered biomechanics, which can lead to strained muscles, piriformis syndrome, and sciatica symptoms.

How to prevent it: It’s important to problem-solve your condition to decrease pain quickly and prevent reoccurrence. Key things to analyze are:

Position on the bike: Is your saddle the right height? One that’s too low or high can aggravate low back pain. Be sure the rest of the bike’s anatomy fits you so your spine is as neutral as possible and not excessively rounded.

Position off the bike: If you work at a desk, think about your posture. It’s worth investing in a Mckenzie roll (a cylindrical pillow that supports your lower back and helps maintain good posture). Be careful of other flexed positions throughout your day: driving, picking up children (or any weight) with a rounded back, or sitting slumped on a comfortable couch.

Core strength & breathing: If your core muscles are not strong enough and working together, your lower back musculature and spinal anatomy will not be happy. Working on your core strength and breathing not only will protect your lower back, but also will make you a more powerful rider, as your legs will push the pedals from a more stable base.

Assessing root causes, treating the symptoms and strengthening the surrounding muscles: Overcoming cycle-related knee pain

Many take up cycling to ease pain in their knees since the sport is considered “low impact.” Cycling doesn’t always entirely relieve this pain, however, and faulty mechanics or bike fit can make knee pain worse. Common knee problems include: patellofemoral joint syndrome, IT band syndrome, bursitis, or meniscus issues.

How to prevent it:

Treating the knee first involves addressing the “what” (i.e. what’s causing the knee pain itself). This includes stretching, kinesio taping, foam rolling, and the use of ice or anti-inflammatories to help calm it down. Once it’s calmed down, it is imperative to figure out the “why” and get to the bottom of the problem.

Knee pain often stems from a bike fit issue. If this is the case­, there are easy things to look out for. Pain at the front of the knee, called anterior knee pain, often comes from a saddle that is too low, which places excessive pressure on the kneecap. Pain behind the knee (called “posterior knee pain”) commonly occurs when a saddle is too high, which stretches the distal hamstring attachments. Pain on the outside or inside of the knee can be caused by incorrect cleat set up and faulty knee tracking.

Knee pain is often considered a functional issue and often times is due to weakness around the hips or faulty ankle mechanics. Without strong glutes, the body will do what’s easiest, not what’s best. Other muscles like the piriformis or the tensor fascia latae and IT band take over which ends up getting tight and painful due to taking on more of the work.

Align your neck and spine to beat neck pain

The average human head weighs about 10 pounds. Add in a helmet and some eyewear and that’s a lot of weight your body must absorb. For every half inch the head juts out in front of our body, the effective (or felt) weight of our head doubles. All of the sudden we’re trying to absorb 50-60 pounds of head weight on the bike. This can lead to neck pain and upper back tightness and strain.

How to prevent it:

Assuming your bike size is correct, your neck and spine should be comfortably aligned on the bike. You should look up the road with your eyes, not by cranking your neck to lift your entire head, which stresses your neck.

Address the ergonomics of your workstation. Improper set-up can lead to tight muscles and trigger points. Once in the saddle, these will worsen as those tight muscles absorb the impact of the bumps in the road. Prevent the tightness by massaging out those knots using a lacrosse ball on a wall. Mobilize your thoracic spine with a foam roller to release your upper back, a common tight area for cyclists. Another great exercise to perform to combat that forward head position is a cervical retraction.


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