How to prevent cycling aches and injuries

Paul Sanderson from PS Physiotherapy gives us his tips on how to prevent aches and injuries whilst cycling.

Cyclists sometimes ask me, “as a cyclist what are the common and most frequent injuries I may experience” Here’s my list of the main ones that I encounter with cyclists in my job as a physio.

  • Anterior knee pain – pain at the front of your knee
  • ITB syndrome – pain on the outside of your knee
  • Wrist injuries – ‘handlebar palsy’
  • Low back pain
  • Neck pain
  • Hip pain

What can lead to these problem areas? What can you do to help prevent them?

Here are my Top Tips…

06

Arm position

Poor arm position, by reaching too far, means that the trapezius muscle needs to work and this can lead to neck pain. Over-reaching also results in excessive flexion of the lumbar spine resulting in low back pain

If the neck is sustained in a poor position this can lead to nerve compression (cervical radiculopathy) which can cause pain, pins and needles and/or numbness in the arms.

Excessive handlebar drop is the most common cause of neck pain. Try not to reach too far (not letting the arms extend beyond 90 degrees). You need to aim for ‘soft arms’ whilst your hands are on the hoods.

Importance of warm up and cool down

A good warm up is key to increasing the heart rate, helping to increase the blood flow to the muscles and ensure a more effective training session.

A good cool down is important to help reduce the stiffness and soreness in the muscles the next day.

Encouraging efficient cadence

This is essentially pedalling efficiently. You need to develop an efficient pedalling technique. If your cadence is more efficient it helps you to reduce stress on the knee joints. Most people’s cadence is around 90rpm. You are aiming to achieve around 80rpm, or what feels comfortable for you.

The ability to develop and be conscious of your cadence helps improve your body’s neuromuscular control.

You should not try to pedal in circles. Don’t consciously pull up on the pedal. Evidence demonstrates that pedalling like this does not improve cycling efficiency. Attempting to pedal like this can create problems at your hip. It is the overwhelming power of the thigh and glute on the other pedal (downstroke) that negates any contribution the biomechanically-inhibited hip flexors can make.

The hip flexors should only work to control the movement and to get the leg over the top part of the pedal stroke revolution.

08

Cleat set up

You need to get your cleats in the right position on your shoes. The position you lock your foot into the pedal is a big deal. This interface needs to be correct as it allows you to apply as much energy to the pedal rather than wasting energy trying to stabilise the foot/pedal interface.

If you are locked in incorrectly this can predispose you to ‘overuse injuries’ such as anterior knee pain (pain at the front of your knee), ITB band friction, hip pain and low back pain.

As a general rule you want to align the ball of the foot with the centre of the pedal. However, it needs to be highlighted that the cleat position can be very individual.

Correct saddle height

This is important to prevent back pain and knee problems.

Cycling involves being in a position of prolonged flexion at the lumber spine. An excessively flexed posture can cause pain through muscle fatigue, chronic tension of the ligaments or compression of discs in the spine.

The optimal knee angle for riding is 30-40 degrees (of maximum knee flexion). The optimum height of your saddle can be influenced by hamstring flexibility and this can manifest itself as pain at the back of the knee where the hamstring muscles insert and also pain at the outside of the knee.

Core strength and muscles

Strong abdominals and glutes create a more stable pelvic position.

Fatigue in the glutes and hamstring muscles can cause back-sloping of the pelvis, straining the back muscles and causing pain.

A combination of strength training of the core muscle group and lower limb stretching will aid in pelvic stability and produce a more efficient cycling ability.

Wrist position

Poor wrist position on the bike can lead to carpal tunnel syndrome and also ‘Handlebar palsy’ (AKA ulnar nerve palsy). Both of these conditions lead to pain and/or pins and needles and numbness in the hands. These symptoms can be caused by excessive weight bearing through the hands and your hand positioning (excessive wrist extension).

Anyone who plans to ride the bike for any period of time should consider having their position assessed by a trained professional to ensure optimal efficiency, comfort and injury prevention.

A bit about the author

paul4Paul Sanderson has been cycling time trials, road racing and competing in triathlons for 20 years from ‘sprint distance’ up to ‘ironman’ events and has represented GB in both world and european age group competition.

Paul is the Founder Member of Preston Triathlon club in 1997 and is currently the club President.

Paul has specialised in the musculoskeletal field of physiotherapy for over 10years and using his experience in sport has developed a particular focus on sports and athletic assessment and rehabilitation

Paul is also a qualified Bike Fitter and has gained ‘Cyclefit Education Programme Diploma’ and applies these skills uses skills working with a range of cyclists from amateur up to elite cyclists.

paulsandersonphysiotherapy.com

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3 Comments
  1. Hi, have you ever heard of acute pain in the area between the spine and shoulder blade, usually happens between an hour to two hours into a ride, been bothering me for a long time and has caused me to stop riding ?
    Jason

    • According to Paul…

      “It’s always difficult to make a diagnosis without carrying out a full assessment. However, this may be related to the riders Thoracic spine being aggravated by their sustained posture. I’d start with some upper trunk mobility/stretching – rotations, extensions…yoga/Pilates may help. Posture correction / posture at work…? Could be worth trying some adjustments on the bike for reach/bar height.”

  2. According to Paul…

    “It’s always difficult to make a diagnosis without carrying out a full assessment. However, this may be related to the riders Thoracic spine being aggravated by their sustained posture. I’d start with some upper trunk mobility/stretching – rotations, extensions…yoga/Pilates may help. Posture correction / posture at work…? Could be worth trying some adjustments on the bike for reach/bar height.”

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