Injury Prevention & Rehab for Cycling
Taking part in any sport or exercise brings the risk of injury, and cycling is no different.
It is common for cyclists to jump straight on the bike when going for a ride, whether it’s just a casual ride, a training ride, or even an amateur competition without ever thinking about preparing the body for exercise. The same can be said for afterward: getting off the bike after a ride and going about the day as if nothing ever happened.
This approach can work for some lucky individuals, mostly younger cyclists, but will begin to cause problems as the months and years add up, giving rise to mobility issues, overuse injuries, and imbalances. Cyclists need to take care of their bodies no matter their level, but the more cycling you do, the more time you should devote to taking care of your body.
Some people will ask “How can I prevent injury while cycling?” While most injuries can be avoided simply by having a professional bike fitting, as well as some careful pre-and post-ride care, if you cycle regularly, encountering an injury or painful area is inevitable, but a worthwhile trade-off for the wonderful hobby that is cycling. In this article, we will highlight some of the most common issues experienced by cyclists as well, some methods of prevention and rehab, and what to do before and after your ride.
How is cycling good for me?
As we’ve discussed, there is a risk of injury associated with cycling like any physical activity. However, let’s not forget the numerous physical and mental health benefits of riding your bike.
Cycling is an excellent way to develop the muscles in your legs, mostly your quadriceps muscles, calf muscles, and glute muscles. This helps to create a strong system whose benefits will be felt in all aspects of your day, whether participating in physical activity or not.
Cycling, especially moderate-intensity cycling, strengthens the heart, blood vessels, and lungs. Your body’s natural ability to adapt to stress (exercise) means that each time you get on your bike and raise your heart rate, you are making positive changes in your body, increasing the efficiency and strength of each system you use.
For anybody interested in losing weight with the help of exercise, riding a bicycle is a fun and effective way to do it. Cycling at any intensity will burn calories, and increasing your speed or tackling your local hills can really increase that amount. The most important consideration when using exercise to lose weight is choosing something you enjoy, and if a bike ride is that for you, it can be one of the most rewarding activities you can do both for your physical and mental health.
Mental & social benefits
Mental and social health are very closely intertwined, and physical exercise, especially with others, is a great way to achieve some of those benefits. Exercise reduces stress and anxiety, eases the symptoms of depression, and improves self-esteem. Improved social connection or a sense of community has also been linked to better mental and physical well being; joining a cycling group is a great way to make friends and bring added joy to the activity.
Common Cycling Injuries & Reasons
Seeking the help of a trained physiotherapist to diagnose any sports-related injury is always the best practice. Many symptoms stem from upstream or downstream of a pain site and the muscles, bones, and connective tissues of the body need to be considered as interconnected systems, where one impact or imbalance can cause ripple effects in other parts of the musculature or body.
The best way to avoid pain and injuries from cycling starts at the very beginning: ensuring you purchase and ride a bike for your height.
It is also important to have a fitting done with a professional to ensure your handlebars, saddle, seat height (among many other areas) are adjusted according to your specific body. You can check out our article on sizing to help you choose the perfect fit for your next bike.
Knee injury or pain
Knee pain is one of the most common problems encountered by cyclists. The pain is often due to a poor saddle or cleat position, leading to extra pressure on the joints or a repetitive motion in an unaligned position, resulting in pain. The pain can also be simply from overtraining or overuse. A good example of the connectedness of tissues is ‘IT Band Syndrome’ (ITBS). With ITBS, pain, and inflammation usually manifest on the outside of the knee at the insertion of the band into the knee, though the problem often stems from tightness at the hip insertion or a muscle imbalance in the glutes.
There are many sources online which help riders set up their bikes without the use of technology. See proper cleat setup and setting saddle height from Specialized in California (bike fitting heroes!) to help avoid these problems. The use of insoles is also a tactic for tackling recurring knee pain. At times, simply reducing the load (time spent cycling) is adequate to alleviate the problem.
When pain is not associated with fitting, fixing common mobility and strength issues in the hips and glutes can be effective in targeting the root of the pain. A physiotherapist will be able to offer a series of exercises with appropriate progressions for your body to help address these injuries.
Lower back pain
Spending hours in the saddle, especially in more aggressive positions (road bikes), is likely to cause some issues when added to common daily activities such as sitting at a desk for work, watching TV, or sitting down to eat throughout the day. Tight tissue systems, poor posture, and inactive or weakened core muscles are developed throughout our day-to-day lives, and the problems these weaknesses can cause are only exacerbated from hours of sitting on a bike.
To alleviate lower back pain, ensuring your bike is fit correctly will help a lot. Handlebar stem, position, and frame size can lead to overreaching and overextended lower back. Adding abdominal strengthening exercises to your routine is important for both daily life and exercise performance, and will not only help avoid back problems but improve the power of your entire trunk system.
Working on tissue mobility of the lower back muscles, as well as upstream in the mid to upper back and downstream in the glutes and hamstrings, will generally relieve some of the symptoms, however, a physiotherapist may need to develop a personalized strengthening routine to fix the cause of the problem if it is recurring.
Walking is an excellent active recovery strategy for back pain, and walking regularly throughout the day is something we should all be doing to balance our time spent sitting. If it is necessary to take a break from cycling to help with lower back recovery, it is important not to replace it with more sitting, which will delay your recovery and contribute to the problem.
Achilles Pain (Ankle)
The Achilles tendon connects the heel to the calf muscles, and it is another common injury or pain point experienced by cyclists. Tightness in the areas above and below the tendon can cause excess pulling on the tissue and result in pain. Poor foot positioning, too far forward or backward, may also contribute to tendonitis or tendon aggravation.
As always, it is key to have your bike fitted correctly to rule out its contributing to any injuries. Overtraining or increasing training load too quickly are also common causes of Achilles injuries, so taking more time to rest between rides, or doing shorter sessions to strengthen the area before progressing, could be sufficient to fix the problem. This problem should be treated quickly to avoid the possibility of chronic pain so if it persists, seek the help of a professional.
Hands & wrists
Extended time in the saddle can lead to pain in the hands and wrists, especially on flat handlebars since there are fewer positions available to grip the bars compared to drop bars.
Changing your hand position frequently during a ride is important for relieving the pressure on the joints.
Riding with a slight bend at the elbows acts as a shock absorber for any impacts or rough surfaces. If your bicycle is too small, you may be putting excess pressure on the handlebars, so having the right size frame and fitting it correctly will make sure that your weight is distributed correctly between the saddle and handlebars, giving your body the best chance of preventing this injury. If pain persists, decrease your time spent riding and seek the help of a medical professional.
Pain in the neck muscles or upper spine results from the tightening of neck muscles which create added pressure on the neck and spine. It is generally due to the positioning of your body on the bike. Raising your handlebars slightly and creating a less aggressive riding position overall can help with neck problems. Any persistent neck pain in the days following a ride should be treated quickly.
Rest, heat and some gentle neck mobility exercises can help alleviate some of the discomfort experienced after a long ride. It is important to note that an unusually long ride or coming back after some time without riding is likely to cause discomfort as the body has lost its conditioning.
Stretching vs Mobilizing
Stretching is just one component of any mobilizing routine. Mobilizing includes soft tissue work using the hands or tools such as a massage ball or foam roller to improve tissue stiffness and sliding capabilities. Active stretching focuses on movement through different positions with breath connection such as yoga, and passive stretching, which is generally done at the end range of a movement to increase the length of tissue.
‘Static stretching’ which is stretching in one position to lengthen muscles has been shown to be ineffective for warming up, producing no benefits to performance or injury risk reduction. A specific ‘dynamic’ warm-up is done through moving in and out of end-range positions by targeted contractions of the muscle at the end range or with fluid movement and focused control, both warming up the body and opening up the joints and muscles for exercise specific movements.
Priming your body for movement is important no matter what sport or exercise you are engaging in. Warming up increases blood flow and raises body temperature which in turn improves the range of motion in the joints and muscles. The effects of a targeted warm-up help to prevent injuries and will improve performance. There are many exercises for warming up, but for this article, we will identify the 4 muscles and joints which will provide the bulk of the value when mobilizing for a ride.
These exercises can be repeated 2-3 times in a circuit, with 10-15 repetitions for each exercise. As always, consult your doctor or physiotherapist before trying any new exercise routine to avoid issues with any current or underlying condition.
Much of the power generated for cycling comes from the glutes, mainly the gluteus maximus, one of the largest and strongest muscles in the body. Functions of the glutes include stabilization of the pelvis, supporting of the hips, and protecting the lower back. Warming up the glute muscles before a ride will help activate the area and allow them to effectively carry out these vital functions.
The glute bridge exercise with an isometric hold is an excellent way to activate the glutes for your ride. This exercise also helps with core activation and stabilization.
Because we spend a large percentage of our waking hours sitting (a closed position for the hips) we inevitably have tight anterior (front) hips, further accentuated by the time spent sitting on the bike. For this reason, it is important for cyclists to open up their hips both before and after a ride in order to avoid a hip impingement and to help generate maximum efficiency for the ride.
Check out this hip-opening exercise, which can be done in variations with or without the band, helping you to open the hip while also activating the glutes.
Thoracic (mid) spine
Mobilizing your thoracic spine has great secondary benefits for both your neck and lower back, creating more space in the chain and allowing for a more comfortable ride with less risk of strain. Making an effort to dynamically warm up this area will pay dividends for both your enjoyment and your performance while riding.
This lying thoracic opener is a great dynamic exercise to prime the t-spine for activity and teaches core activation throughout movement of the upper back.
Abdominal muscles (core)
Your core muscles provide stabilization throughout the body for almost every movement you do. This means that an active and effective core musculature translates to improved efficiency of each of the connected systems. This results in improved balance increased power through improved energy transfer, and less chance of injury due to better organization and control of the body’s systems.
The ‘dead bug’ exercise is an excellently targeted core activation exercise, with the added benefit of keeping the lower back in a supported position.
Post-ride & rest days
Spending some time mobilizing your body after a ride will keep injuries at bay while also improving the day-to-day function of your muscles and joints. To get the maximum benefits for injury resilience and performance, include some mobility work into your daily routine or at the end of each workday before you sit down to relax.
Work on the same main muscle groups targeted pre-ride when mobilizing post-ride, adding other areas to your daily routine to help maintain good all-round mobility. There are dozens of exercises with different variations of each, but here are three mobilizations with really high return-on-investment.
The couch stretch
The couch stretch opens up your hips flexors and quads, which tighten and shorten during cycling. This stretch may help prevent injuries and improve performance for your next ride while also counteracting some of the negative effects of sitting. The variation in the link above, which includes isometric contractions, also strengthens the brain’s connection to the glutes with glute activation through movement and conscious breathing.
A take on yoga’s pigeon pose, the elevated pigeon allows less flexible individuals the opportunity to get the benefits of the position. The stretch not only targets the back of the hip and glutes, but also the front of the hip on the non-elevated leg, a great comprehensive addition to the mobility routine for any cyclist. This is an excellent position to spend some time in passively, freeing up the hands to hold a book and read, catch up on some emails or just watch your favorite TV show.
Lower back & hamstring opener
Lying on your back with your legs flat against the wall is a popular way to achieve a well-supported position to open your hamstrings and lower back while keeping your lower back supported from the stress of gravity. It also helps to prevent blood pooling in the legs following a long ride, making the joints and muscles of the legs more mobile. An excellent way to improve the effectiveness of this position is to introduce a lacrosse or tennis ball by lying on the ball and slowly moving it around the lower back muscles and upper glute muscles. This creates extra pressure which helps to release tight or ‘knotted’ tissue, similar to a deep tissue massage.
Sleep & Nutrition for recovery
To find out more about the importance of good nutrition for performance and recovery, you can check out our guide on cycling nutrition.
Sleep is absolutely fundamental to injury prevention, rehabilitation, and general performance both on and off the bike. Getting enough rest in the form of 8 hours of sleep a night improves athletic performance and reduces the risk of injury. Sleep deprivation, or lack of sleep, reduces cognitive ability and reaction times, meaning a greater possibility of an accident on the bike. To give your body the best chance at recovery, make sleep your number one priority when injured or training for competition. To learn more about the power and importance of sleep, check out UC Berkeley’s Dr. Matthew Walker’s TED Talk, or his book ‘Why We Sleep’.
Massage, massage balls, and foam rolling
Massage is widely used in professional sports as it has been shown to aid recovery by improving muscle soreness induced from exercise (DOMS) and increasing mobility. Massage does this by increasing blood flow and hydration to the worked area, as well as freeing up tight muscle tissue and myofascial networks that can restrict movement if not addressed properly following exercise.
For most cyclists, getting a massage regularly after a ride is not practical, however, using a foam roller or lacrosse ball can help us make some of the positive changes that a trained sports massage therapist aims to make from deep tissue massage therapy. Once you know what you are doing, it is easy to take a lacrosse ball or roller and incorporate some soft tissue work into your daily routine.
There are many free resources available online that will teach you how to use these tools in different and creative ways. The quality of these resources varies greatly, so learning how to do it correctly will make a big difference in how much benefit you see from the time you spend. The Ready State channel by Kelly Starrett on Youtube has many great videos on improving mobility in different areas of your body with or without these tools, and also offers a ‘Virtual Mobility Coach’ app service to those who want to go deeper on these techniques.
Yoga for Cycling
Yoga is an excellent way for cyclists to supplement their exercise routine, while also counteracting some of the imbalances that can result from the hours spent in one position, whether it be in the saddle or at a desk. Another aspect of yoga is that it is centered around connecting breath to movement, which along with having more supple joints and muscles, is a big reason yoga is practiced regularly in the sporting community. Improving breath control and depth during exercise is a fundamental benefit of yoga that translates directly to all other exercise modalities.
Yoga International has a short routine that is tailored for cyclists on their website, but you can also practice by following along to any of the hundreds of free videos online, or by joining a local class. With the popularity in recent years, there are thousands of studios and teachers all across the US.
Whatever you decide to do to help improve your chances of staying injury-free and improving performance, it is important to consult with a licensed professional.
Finding the time to ride can be difficult for many people, so to incorporate injury prevention and mobilization into your routine may seem impossible, but if you are creative with your time and use time spent relaxing to do 1 or 2 minutes of mobilization, the benefits add up quickly and can go a long way to preventing injuries and improving your performance on the bike and in your everyday life.