Cycling is a fantastic way to stay fit, it’s low impact so keeps the weight off your knees and doesn’t put pressure on your joints.  It can be done indoors, or outdoors in the fresh air, taking in the sites and scenery passing you by and is an enjoyable way to burn calories and improve your overall health.  However, it does not come without injuries. Injuries are fairly commonplace for cyclists and we will discuss the reasons why below.  

One of the top reasons cyclists become injured is because cycling involves a lot of repetitive movements, particularly in the knee from bending and straightening.  This can lead to injuries such as ITB Syndrome.  The Iliotibial Band runs from your gluteus and hip area along the outside of your quads to the outside of your knee and through friction caused by cycling and the repetitive movements up and down can become sore and aggravated.  If not treated it can cause swelling and lead to months of rest and no cycling.  

To recover from ITB Syndrome we recommend acupuncture which will help to release the myofascial system, combined with Tecar to soften up the Iliotibial band. Strengthening the gluteus medius with exercises like the crab walk with an exercise band around the thighs, or donkey kicks with weights on the ankle will also help to prevent injury and will naturally strengthen the gluteus and consequently stretch the fascia.  Furthermore, using a foam roller after exercise or having a soft tissue massage will release the tension within the ITB and the gluteus muscle.

Knee pain is extremely common amongst cyclists, caused by the repetitive motion of the knee and bad cycling technique.  If the technique is not good, pain in the front of the knee can cause Patella-Femoral Joint Problems which feels like an intense ache around the knee-cap and can feel stiff when getting up from sitting down.  Often it is caused by too much stress on the knee cap which is rubbing against the femur and grinding down the cartilage on both parts. This can also lead to tendinopathy which is pain and inflammation on the surrounding patella tendon tissue.

At ALO Clinic we would treat Patella-Femoral Syndrome by taping the knee to recorrect the alignment of the patella and give specific functional rehabilitation exercises.  We would also recommend exercises such as wall sits to increase the strength of the VMO (vastus medialis oblique muscle, which is part of the quadriceps), and mobilisation techniques to realign the patella and improve the tracking system which will help stop the knee from grinding. An assessment of the biomechanics of the feet would also be necessary to understand all the lower limb forces that may be affecting the knees.

If the problem is the patella tendon, then treatment to decrease tendinopathy would be to gently increase loading on the tendon by increasing eccentric strengthening exercises for the quads, but this would need to be evaluated on a case by case basis. 

Cycling can cause pressure on the prostate for men.  The pressure from the saddle can sometimes enlarge the prostate to the point where urination becomes difficult because it is restricting the urethra.  To reduce pressure on the perineum we would advise cyclists to wear padded shorts, regularly stand on the pedals and adjust the position of the saddle.  Male cyclists can avoid irritation of the prostate by having the correct saddle. There are many saddles that reduce pressure on the groin, they can have grooves and holes cut out at the back, or be split saddles with two sections and no middle, or noseless saddles etc, whatever style you prefer.  We would also suggest that cyclists buy a saddle pressure device and have a bike assessment before they take on the sport.

Lower back pain and sacroiliac pain is a prominent issue for cyclists and usually results in the seat not being at the correct height for the individual.  Setting up the bike properly is crucial to avoid back pain. The height of the saddle needs also to be taken into account and should be measured. As a rule of thumb if you stand beside your bicycle your pelvis should reach the height of your saddle.  Here a good bike assessment would be necessary to make sure you are all set to go!

To recover from back pain cyclists need to work on increasing their core strength to avoid impaired movement patterns.  Stretching out the hip flexors and the muscles that affect the sacroiliac joints will help to recover from lower back pain, along with a deep tissue massage to loosen up the muscles. 

If you’re preparing for a cycling event or you have injured yourself through cycling why not book a complimentary consultation with a physiotherapist to see how we can help you.  You can also book an appointment online or a call with a physiotherapist.  We look forward to hearing from you.