Maybe you take part in cycling competitions such as the London to Cambridge bike ride on Sunday 2nd July 2017, or you cycle just for recreational enjoyment. Either way, cycling can cause range of painful injuries, many of which are due to an improper body position, resulting in overuse of certain joints. Here we cover the most common cycling injuries and how to better protect yourself to avoid them.
Is your bike set up properly?
Generally, the most common cause of cycling injuries is linked to an improper body position, which puts added strain on certain joints, because they have to work harder than required to compensate for misalignment.
Overuse is made worse the more frequently you cycle and the longer the duration of each bike ride, so it is important to understand what you can do to help avoid painful conditions arising.
Common factors include:
- Incorrect saddle height
- Incorrect saddle tilt
- Saddle design and trunk angle
- Pedal systems
- Issues at the shoe to pedal interface
- Unsuitable handlebar position
- Improper biomechanics
- Poorly fitting clothes and shoes
One or more of these, particularly over longer cycle rides can cause misalignment, which can have painful effects, particularly to the knee, lower back, perineum, coccyx, hands and feet.
Cycling injuries to the knee
It is estimated that half of cycling injuries relate to the knee and many can be avoided if you ensure you have a good bike fit.
Patellofemoral pain syndrome – “Cyclist’s Knee”
Patellofemoral pain syndrome is known as “Cyclist’s knee” and is the most common of cycling injuries.
The patella is the formal name for the kneecap and “Cyclist’s Knee” results in discomfort or pain behind or around the patella, caused from abnormal movement that can result in wear and tear on the posterior (back) surface.
A saddle that is too low or a saddle position that is too far forward, can be the cause of abnormal movement to the kneecap, which makes the foot roll inward, meaning the foot and leg are misaligned.
Subtle adjustments to your bike set up and cycling position can make all the difference, ensuring that you move symmetrically when pedalling.
Ilitibial band (ITB) syndrome
Another common condition affecting cyclists is ITB syndrome.
The ITB is a band of connective tissue, which runs down the outside thigh from the hip to the lower knee.
Pedalling requires continual flexion and extension of the knee joint and this overuse can result in inflammation, where there is a constant rubbing over the lateral condyle, located on the outside of the knee.
A saddle that is too high, or a saddle position that is too far back, can cause the leg and foot to be misaligned resulting in pronation.
Again, subtle adjustments to your bike set up and cycling position can make all the difference to ensuing your retain alignment when cycling.
Cycling injuries to the hip
Groin pain is fairly common for cyclists, often with the pain originating in your perineum, which is the area between your sit bones. Because this area contains many major nerves and arteries, too much pressure can cause discomfort, pain and wider issues.
Abnormal hip flexion when cycling can cause wear and tear to the soft tissues and hip joint.
The piriformis is a muscle that connects the upper surface of each thighbone, starting at the lower spine. It’s function is to assist hip rotation and to turn the leg and foot outwards.
Piriformis syndrome occurs when this muscle spasms and causes posterior buttock pain, which can be the result of cycling activities.
It can also aggravate the sciatic nerve, which can result in numbness or pain along the back of the leg.
The cycling stroke can cause abutment of the hip bones, which may result in pain, dysfunction and a limited performance.
Persistent groin pain is typical from flexion and internal rotation of the hip.
It may be necessary to modify your activity, perform different stretches or adjust your bike to ensure you have the right fit. If pain continues, arthroscopy (keyhole surgery) to remove the impinging part of the bone, can be performed.
Snapping hip syndrome
Snapping hip syndrome is caused when the iliopsoas tendon slides over the front of the femur. It can occur in cyclists, however some snapping hips are not painful and therefore don’t require treatment.
The symptoms of “internal” snapping hip syndrome are a deep, painful groin and a snapping sensation when the hip moves in a frog-kick type motion. With “external” snapping hip syndrome, it may feel like the hip has dislocated and the pain is on the external of the hip.
There are several treatment options for snapping hip syndrome including physical therapy and surgery.
Cycling injuries to the feet – “Hot Foot”
Metatarsalgia, also known as “hot foot” is a common condition for cyclists.
Metatarsal bones are located in the foot. When cycling these metatarsal bones can squeeze and aggravate the nerves and tissues near the ball of your foot, causing a burning type pain.
It also causes throbbing and tenderness to the sole of the foot with pain specifically located on the third and fourth toe joints.
Sometimes orthotics, which are specially designed shoe supports, may help to create a better fit and a more efficient movement.
If pain persists, consult with an Orthopaedic doctor about your options.
Cycling injuries to the hands – “Cyclist’s Palsy”
“Cyclist’s Palsy” is linked to chronic ulnar nerve compression and it can affect any type of cyclist, from experienced to novices, on long-distance competition rides to recreational outings or mountain biking.
This condition causes a numbness in the fourth and fifth finger due to pressure on the hypothernar eminence, which is the fleshy part of your hand near the little finger.
Subtle adjustments to your position when cycling can help, as can using padded gloves.
Cycling injuries to the lower back
Many cyclists suffer with lower back pain, particularly when training for a competition, where intensity and duration of ride increases.
Low handlebars and incorrect saddle height and tilt are considered two of the typical causes of lower back pain.
How the saddle is tilted varies for women and men, with women often choosing to angle their saddle slightly downwards to avoid pressure on the perineum. It also depends on the type of cycling you do, whether that is mountain biking or road cycling.
If you are experiencing any pain from your cycling activities, speak to specialists about your bike set up and your cycling position as well as to better understand the therapy and treatment that is available for your condition.