15 Common Cycling Injuries and How to Prevent Them
15 Common Cycling Injuries and How to Prevent Them
What is usually thought of as a happy-go-lucky ride can sometimes have unseen and often neglected consequences. Like any physical activity, cycling has an element of risk in regards to the injuries that you can develop. Whether you’re improperly riding your bike, skipping on stretching sessions, or aggravating old conditions such as a torn rotator cuff, there are common cycling injuries that you can easily prevent.
Let’s review the top 15 most common injuries related to cycling and simple steps to protect yourself from these conditions.
1. Piriformis Syndrome
Piriformis syndrome happens when trauma to the gluteal muscles (buttocks) occurs, mainly from prolonged sitting and cycling. Piriformis syndrome is usually characterized by pain and instability in the hip, coccyx, buttock, groin, or distal part of the leg. The piriformis muscle helps to externally rotate and abduct the thigh, which is why many people complain about a literal pain in their buttock.
Since piriformis syndrome is usually the result of overuse of the muscle, you can prevent this condition by taking breaks from what you’re doing. Stand and walk around for five minutes every hour. Perform piriformis-focused stretches that take the hip flexors through a series of static holds. You can also perform bodyweight exercises to improve the strength of the muscle. Hip extensions, hip abductions, and clam leg exercises are ideal.
2. Iliac Arteriopathy
Could high-intensity cycling damage the leg arteries? Elite cyclists, speed skaters, and even a few runners have experienced damage to the arteries of the pelvis, groin or lower leg. This damage, called arteriopathy, causes the athlete to have decreased blood flow of the artery in the affected leg which causes pain, burning, weakness, and powerlessness during exercise. Two of the leading causes? Repetitive hip flexion and an aerodynamic cycling position (which requires hip hyperflexion).
The best way to prevent iliac arteriopathy is to avoid an extended period of sitting combined with repetitive motion. If you’re cycling, be sure to stretch before a session, and take plenty of rest breaks off of the bike.
3. Iliotibial Band Syndrome
The iliotibial band is located on the outside of the thigh. It runs from your knee into the hip joint. The cause of ITB syndrome can be three-fold: weak musculature, overuse of a specific muscle group, and excessive cycling. ITB syndrome is characterized by tightness in the leg, and pain on the outside of the knee (sometimes pain in your hip which is more common for women). Flexing the knee only makes it worse. You may notice that your gluteal muscles are sensitive so sitting down becomes uncomfortable.
ITB syndrome can be prevented by ensuring your bicycle fits appropriately, changing your training program to include stretching and strengthening exercises, and by using a custom orthotic, if necessary. Deep tissue massage and chiropractic adjustments can also help to prevent ITB syndrome.
4. Iliopsoas Tendonitis
Iliopsoas tendonitis is an inflammation of your hip flexor tendon (Iliopsoas) and, or, the area surrounding it. Its notable characteristic is the harmless snapping sound when moving your legs. Two of the most common causes of iliopsoas tendonitis is damage to the tendon and overuse resulting from repetitive hip flexion. This is the exact movement during cycling.
Like many of the other injuries on this list, the best way to prevent iliopsoas tendonitis is to thoroughly stretch your hip flexors, glutes, hamstrings, and quadriceps. Clinical massage therapy works well even in chronic cases. You’ll also want to engage in hip strengthening exercises. Addressing any strength imbalances between the quadriceps and hamstrings will help avoid overuse injuries.
5. Patellofemoral Pain Syndrome
Patellofemoral pain syndrome (PFPS), often called runner’s knee, refers to pain under and around the kneecap. The pain of PFPS may occur in one or both knees, and it tends to worsen with activity, and after long periods of inactivity. When cycling, if your seat is set too low, you can increase the compression through the knee joint increasing the risk of runner’s knee.
Rest and recovery are the best ways to prevent PFPS. We would also recommend actively stretching your hip flexors and rectus femoris as well as to gently flex the leg during cycling rest breaks or while at work. Do this at least once an hour.
6. Patella Tendonitis (Jumper’s Knee)
Also known as patellar tendinopathy or Jumper’s Knee, this is when the knee is used in a repetitive motion for too long. Patients report anterior knee pain, often with an aching quality.
Prevention begins with stopping the activities that are causing the pain. All too often we keep walking or going about our day, ignoring the pain signals that later become real issues. After rest and recovery, the ideal way to prevent Jumper’s Knee is to strengthen the muscles in both a muscular and proprioceptive way. Strengthen muscles using a closed kinetic chain and eccentric exercise (i.e., single-leg squat descents). Be sure to try sport-specific proprioceptive training and plyometrics as well, but save these for when the knee feels better.
7. Chondromalacia Patellae
Chondromalacia patella is when abnormal softening of the cartilage under the kneecap begins to occur. It is the most common cause of knee pain, especially for cyclists. Chondromalacia patella results from the breakdown of cartilage due to poor alignment of the kneecap. As the misaligned kneecap slides over the lower end of the thigh bone (femur), it rubs and starts to break down.
Prevention begins with education. Visit your chiropractor to determine whether your kneecap is misaligned. If it is, you can begin a course of correction to ensure the cartilage stays strong. This may include ongoing soft tissue massage as well as trigger point therapy and stretching for iliopsoas, TFL, vastus lateralis, ITB and gluteus muscles. Activation and strengthening of VMO and glut max should be included where necessary.
8. Neck & Upper Back Pain
Neck, shoulder, and upper back pain can be triggered in a few ways. First, a handlebar reach that is too long, and riding on the curved portion of the handlebars will hyperextend the neck. Second, neck pain usually relates to the prolonged time that cyclists spend in an extended position. Finally, constant compression of any joint over an extended period can lead to muscle fatigue and pain.
Efforts to raise the handlebars is the first step in prevention aimed at decreasing injuries. Also, make sure you are in an appropriate cycling position that isn’t putting you in a compromised form to exacerbate hyperextension or compression. Getting regular deep tissue massages and adjustments can also help alleviate strain and pain.
9. Handlebar Palsy
Handlebar palsy is when there is ulnar nerve compression at the tunnel of Guyon. It’s often a result of placing your hands on the hoods or the area where brake lever attaches to the handlebars. Not making the necessary bicycle adjustments to fit the size and anatomical characteristics of the rider may also make handlebar palsy more likely.
Handlebar palsy usually responds to rest, but you can prevent this injury by using padded gloves, changing hand positions on the handlebars frequently, and using aero bars to rest your forearms on pads.
10. Carpal Tunnel Syndrome
Carpal tunnel syndrome is less common in cyclists than handlebar palsy; however, it is yet another overuse injury that cyclists experience. Like handlebar palsy carpal tunnel syndrome affects the ulnar nerve however the location of nerve compression is different and in Carpal Tunnel Syndrome nerve compression occurs in the wrists however the symptoms are similar to handlebar palsy in that they include numbness and tingling in the thumb, index, middle, and ring fingers and weakness of the hand. As in Handlebar palsy, injury often occurs when a cyclist holds the handlebars on top and applies pressure directly to the median nerve.
You can prevent carpal tunnel syndrome by ensuring you have a proper fit for your bike. Use high-quality riding gloves, change your hand positioning every 15 minutes, and be sure to take stretch breaks.
11. Median Nerve Compression
Connected to Handlebar Palsy, the median nerve runs down your thumb and two adjacent fingers (to about the center of your hand) on both hands. When you compress this nerve, you might feel tingling, numbness, or pain in your wrist, thumb, and second and third fingers. If ignored, however, the tingling can rapidly progress to numbness and intense pain. This is caused by improperly resting and putting too much pressure on your hands/wrists on the handlebars.
Simply adjusting position will help, but you can also use padded gloves.
12. Genital Numbness and Erectile Dysfunction
Cycling for an extended period places direct pressure on the perineal area. This can begin with a seemingly harmless numb feeling and progress into several complications. You may increase your risk for prostate issues as well as erectile dysfunction.
You can alleviate the pressure on the perineal area with a wider saddle seat. Be sure also to take frequent breaks and stand during riding to relieve pressure. Make sure you keep the handlebar height lower than saddle height.
13. Plantar Fasciitis
In cyclists, Plantar fasciitis is generally caused by the constant pressure of the foot against the petal. Ill-fitting shoes or cleats are also blamed. The most significant characteristic of plantar fasciitis that you will hear is that the bottom of your foot and in particular your heel is painful upon rising, especially the first steps out of bed. The pain may be severe enough to prevent the athlete from walking barefooted in a normal heel-toe gait.
Getting in the habit of performing flexing and stretching exercises when you first wake up is an excellent preventative practice. Take breaks during physical activities such as jogging or cycling. Finally, make sure you are correctly fitted for a pair of quality running or cycling shoes.
14. Metatarsalgia (Hot Foot)
Metatarslgia, also known as Hot Foot, is caused by the compression and inflammation of nerves and joint tissue in the metatarsal heads, which is the area right above a well-placed pedal spindle. It is characterized by pain and a sensation of burning as well as numbness.
Prevention of metatarslgia starts with proper footwear. Depending on your biomechanics, you might even need to wear metatarsal pads or arch supports. Just like with plantar fasciitis, perform daily stretching and flexing exercises with both feet.
15. Achilles Tendonitis
The Achilles tendon’s purpose is to push and stabilize the gastrocnemius (calf) muscle. Most common injuries to the Achilles tendon occur when you overextend your heels for too long a period. This begins to tear down the tendon fibers, which in turn react by becoming inflamed.
You can prevent Achilles tendonitis by strengthening your calf muscles with resistance exercises such as calf raises. You’ll also want to take a few minutes before cycling to focus on stretching out the ankle and surrounding tendons.
Think You Might Have a Cycling Injury?
Did any of these symptoms hit home? Think you might be at risk for a cycling injury? Visit your chiropractor or schedule an appointment to see us. We’ll take you through a full consultation and determine if you’re at risk for any of the injuries mentioned above. Give us a call at 773-878-7330 today!
Dr. DeFabio is a highly regarded chiropractor in Chicago who focuses on helping his patients achieve optimal health and wellness. He takes a holistic approach to care, treating symptoms and addressing underlying issues to promote long-term healing. Dr. DeFabio is passionate about empowering his patients to take control of their health and live their best lives. You can find him surfing, skateboarding, and volunteering at the Lakeview Food Pantry when he’s not in the office.