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How To Help Prevent The Most Common Cycling Injuries

Make sure your bike and body are cycle fit.
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Inspired by the achievements of homegrown heroes like Bradley Wiggins, Chris Hoy and Victoria Pendleton, Britain has become a cycling nation.

The number of daily average trips made by cycle in London in 2015 went up to 0.67 million, a leap of 61% from 2005, according to Transport for London. Meanwhile British Cycling, the sport’s governing body in the UK, surpassed 125,000 members for the first time in the organisation’s history in August 2016 – with 75,000 signing up since London 2012.

With improved cycling routes, the Cycle to Work scheme, and bike rental opportunities cropping up all over the country, it’s never been easier to get around by two wheels. And with benefits including increased fitness levels, reduced carbon footprints and financial savings, why wouldn’t you?

But with an increase in the number of amateur cyclists comes an increase in the number of cycling injuries.

“An obvious cause of cycling injuries is falling off the bike, but most cycling injuries we see in our physio clinic are actually overuse injuries that come on gradually over time,” says Jenny Heron, a senior physiotherapist at Physiofit.

“Many overuse problems on the bike are caused by incorrect bike set up, poor cycling posture and imbalances in muscle strength and flexibility. It is worth investing in a session with a suitable qualified professional to help avoid injury. As well as assessing static bike fit, a good assessment should look at your pedalling technique and at strength and flexibility off the bike.”

We asked Heron to outline five of the most common cycling injuries and offer her advice on how to prevent them.

Knee pain
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“This is the most common cycling problem, with many structures that can be affected, including the patella (kneecap), patella tendon and various bursae. Bursae are fluid filled sacs, usually under tendons and muscles, designed to prevent friction. Excessive strain can be placed on these structures by poor position on the bike and imbalance of the muscles in the leg.

“The saddle position and position of the feet on the pedals can affect the knee, particularly if cleats are being used. The saddle may be the wrong height or positioned too far forwards or back. The cleats may also be placed badly on the shoes causing the feet to rotate unnaturally placing strains on the knee. A professional bike fit would highlight and correct any issues.

“Imbalances of muscle strength and length anywhere in the leg can affect the knee. Common issues are overuse of the quadriceps muscles, tightness in the iliotibial (IT) band down the outside of the thigh and weakness in the hip muscles. A specific strength and flexibility programme could help correct these imbalances.”
Back pain
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“Back pain on the bike is often related to the forward flexed position that is required for long periods. Lack of flexibility in the lower spine, hips and muscles at the back of the legs can limit the ability to maintain this position.

“Altering the bike set up to lessen the reach, with a shorter stem, higher handlebars, or even a smaller frame may help. A programme of mobility and stretching exercises for the stiff areas may help the rider eventually achieve the aerodynamic position that many cyclists are trying to achieve.

“Back pain that comes on with effort may be muscular strain, with the back muscles overworking on long or hilly rides. Excessive pelvic movement also places strain on the back. Both of these issues can be helped by a programme of strengthening of the back and abdominal (core) exercises.”
Neck pain
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“This is often related to the position on the bike that requires the neck to be extended for long periods. The longer the reach the more strain on the neck. Altering the bike set up to lessen the reach will help, as well as limiting the time spent using the drop handlebars.

“Neck pain may also be caused by poor shoulder posture that tenses the muscles from the shoulders to the neck. Lessening the weight going through the hands by using the core muscles, drawing the elbows closer in and pulling the shoulders away from the ears whilst riding can help. A programme of strengthening for the neck, shoulder blade and core muscles can make this easier to achieve.”
Hand and wrist pain
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“These are usually caused by excessive pressure being placed on the nerves at the wrists, causing tingling or numbness in the hands. The most common, known as 'cyclists palsy', is caused by pressure on the ulna nerve and affects the little finger and that side of the hand, while pressure on the median nerve causes symptoms in the thumb side of the hand.

“Specially designed padded gloves can help to limit the pressure on these nerves as well as regularly changing the position of the hands to use the top, hoods and drops on the handlebars. The pressure is worsened if the wrists are extended (bent backwards) so try to use positions that keep the wrists straighter.

“Altering the bike set up and strengthening the core to lighten the pressure going through the hands also helps. It may be something as simple as correcting a forward tilted saddle that forces the rider to put more pressure on the bars.”
Achilles pain
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“Pain in this tendon often occurs after a sudden increase in training, mileage or intensity. Having the saddle too low or too high and having the cleats placed too far forward can all place more pressure on the tendon. Getting the correct bike set up, following a structured training programme and doing off the bike specific calf muscle strengthening and stretching exercises can help protect the tendon.”

Suffering the pain of a cycling injury and itching to get back in the saddle? Pain relief products can help you along the road to recovery. Voltarol Pain-Eze Emulgel provides up to three times more effective pain relief than non-medicated gel, offering a triple effect, which helps relieve pain at the source, reduces inflammation and helps speed up recovery.

Voltarol Pain-Eze Emulgel contains diclofenac diethylammonium for relief of pain and inflammation. Always read the label. Jenny Heron does not endorse Voltarol.

©2017 GlaxoSmithKline Consumer Healthcare.


i) Transport for London Report - see pages 143-144
ii) British Cycling