Cycling Injuries & Getting the Right BikeFit

Written by Gold Coast Physio & Sports Health Physio 

Cycling is easy on the body, right? It’s non-weight bearing and a great way to stay fit. Population statistics show those that ride between 1 & 3 times a week number 4 million in Australia. Great stats and great exercise in theory, yet people still get injured cycling.

Although there is very little research on cycling injuries this is what we do know:

  • Professional cyclists suffer most from lumbar (low back) and knee pain with knee pain resulting in the most time off the bike.
  • Recreational cyclists also suffer from lumbar spine and knee pain but also have high levels of neck and shoulder pain- possibly from being less conditioning and having poor bike positions.
  • Riders set-up in positions that go towards the end of most of their available lumbar flexion (low back bend range) are more likely to have back pain.
  • The knee is the most common site of overuse injuries in cyclists. Various biomechanical factors may play a role in knee pain including patellofemoral (knee-cap to thigh) joint compression, the knee moving inward excessively during the pedal stroke and cleat position.

There are 3 main causes to these injuries:

  1. Training load errors (ie. how much and the type of riding you do)
  2. Intrinsic factors- your anatomy, your cycling technique and reduced neuromuscular (brain-muscle) control.
  3. Extrinsic factors like your position on the bike (your Bike Fit)

Training Load Errors

As with any sport, an imbalance between acute loading (short term load over 1-7 days) and chronic loading (long term cumulative loading over 4-8 weeks) is linked to overuse injury. Cyclists are most likely to develop an injury following a rapid increase in load. When injuries are apparently caused by changes in equipment- like a shiny new bike!- it is normally because the change was made at an inappropriate time when the cyclist was already close to the limit of load tolerance.

An appointment with one of our physios or exercise physiologists can help you establish a plan to avoid these training mistakes, or get yourself a good cycle coach!

Intrinsic Factors- The Cycling Kinetic chain 

The body has a collection of interacting segments which is known as the kinetic chain, a problem in one area biomechanically affects another. As cycling is a closed kinetic chain (i.e. the arms and legs are relatively fixed in position) one must consider poor cycling technique or reduced neuromuscular (brain-muscle) control as a contributor to cycling injury.

Often this presents clinically as an inability to utilise the gluteal muscles under load while maintaining lumbar and pelvic position on the seat, and controlling the movement of the knee over the foot rather than dropping into a knock-kneed pedal stroke position. The foot and ankle position are also important in decreasing knee injury.

In regards to back pain, there is a moderate level of evidence that a loss of lumbar extension (backbend) control is associated with lumbar pain in cyclists but there are many other factors such as large leg length differences, hip range of motion restrictions and assymetrical muscle activation patterns, as well as issues with seat position that should be considered.

The kinetic chain is thoroughly assessed as a part of a physio bike fit.

Bike Fit

Bike fit is an important part of the performance/ comfort equation. However it aims to optimise a wide range of variables such as aerodynamics, comfort and control so it always involves a compromise. Despite surging technological advances in the cycling industry there is very little research into bicycle equipment and injury so bike fitting remains just as much an art as it is a science.

At Gold Coast Physio & Sports Health we understand the body, we are passionate about the bike and fitting it to your body and for your goals.  Comfort breeds performance and that is what we aim for in every bike fit.

If you have some long-term area’s of pain or symptoms when riding your bike, a Sports Physio with Cycling experience is a great place to start making you asymptomatic, comfortable and then performing better!

Combine our care & support with a Bikefit from GC Bikfit, & you will LOVE riding your Bike again pain-free & performing well.

Phone us on 07 5500-6470 & we can Book  your Bikefit or Book you a consult with our Resident Cycling Sports Physio, Rob Brown (previous Orica-Greenedge Pro Cycling Team Physio.