How to Prevent Cycling Injuries

Cycling is a fun, healthy and competitive sport, with around 6% of the UK population riding their bike at least once a week. The stats show that 50-60% of professional and recreational cyclists develop an overuse injury while cycling, which means that there is a strong possibility of you developing an issue. Due to this, it is no wonder that 67% of recreational cyclists continue to ride while in pain. With this in mind, you’re probably wondering how you can prevent cycling injuries.

As an expert in musculoskeletal injuries, I will simply be talking about how to prevent overuse injuries, rather than falls or accidents. I’m not trained in bike/body fitting, so although I will mention this significant aspect in this blog, I refer patients who require this service to an expert bike fitter.

This blog is written for the benefit of those who currently have an injury, or who want to reduce the likelihood of developing an injury. The best way to approach this topic is by explaining why cycling injuries occur, identifying the common injuries and explaining how to resolve and avoid them.

What are the most common cycling injuries?

As with all injuries, everyone is affected in a different way. In order to know how to prevent cycling injuries you will need to know which injuries are most common. Some people are able to tolerate more stress than others. Despite this, knee injuries are the most common injuries among cyclists, so this is where our focus will be.

ITB syndrome

ITB (Iliotibial band) syndrome is a problem that plagues a lot of cyclists, with it being the third most common injury seen in cyclists. The pain is located in the area that houses a pad of fat on the outside of the knee, and it is caused by a the dominance of the iliotibial band (a band of tough tissue that runs down the outside of the leg). For more information on this, please visit out blog

How can this be prevented and resolved? The ITB derives from the frontal hip muscles and becomes tight if the hip muscles are imbalanced. This imbalance occurs due to a weakness in the gluteus medius. This is significant because the gluteus medius is key to hip alignment and is commonly known as the hip stabiliser muscle. The answer is; by stabilising the hip by working on the gluteal muscles. The following rehab exercises will work for those who have ITB syndrome, and for those who want to prevent it:

Please complete 3 sets of exercises, twice a day for 4 weeks until you reach 80% fatigue in the side hip muscle:

Hoffa’s fat pad

Hoffa’s fat pad is a condition characterised by extreme pain, starting underneath the kneecap. It is usually very sore and is only alleviated by walking with a raised heel, due to the ease of compression around the kneecap when standing on tiptoes. It occurs as a result of kneecap instability and a repetitive extension (i.e. kicking your foot forwards) movement that compresses the fat pad. For more information on this, visit our blog; Hoffa’s Fat Pad Impingement.

The best way to avoid this condition is by focusing on technique, ensuring that your bike is adjusted to fit your body properly, which will help expose the knee t considerably reduce locking out as you cycle. In terms of resolving this issue, the focus should be on settling down the inflammation and elevating your heels; this is done in two ways:

  • Ice massage underneath the knee twice daily for 2 weeks for around 10-15 minutes each time
  • Avoid barefoot walking and walking in non-heel shoes until the pain eases
  • Exercise modification – if it hurts, don’t do it!

These exercises are designed to create dynamic knee stability, because an unstable kneecap is what causes the compression of the fat pad. Please complete 3 sets of exercises, twice a day for 4 weeks until you reach 80% fatigue in the muscles:

Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome (PFPS) is a condition which brings on frontal knee pain. It is very common in young sporty females (due to females having wider hips). It is a fairly common condition, which affects 22 in every 1,000 people, with twice as many female sufferers.

What causes PFPS is:

  • Decreased hip strength
  • Knock knees
  • ITB tightness
  • Excessive inward rotation of the upper leg bone

All factors that contribute lead to something called ‘’patella maltracking’’, which is where the kneecap creates friction behind the knee which causes the pain. Studies how that this could be due to the kneecap being too mobile. How can this be resolved? We know that two of the quadriceps muscles can become imbalanced, which causes a dominance on one side of the knee, which pulls the kneecap predominantly one way. To resolve this, we need to create balance and strengthen the quadriceps muscles. Please complete the following twice a day for 4 weeks until you reach 80% fatigue in the muscles. These exercises will help balance the leg muscles:

Correct bike fit

A good bike fit is essential for comfort, injury prevention and can improve performance. it is a key aspect on how to prevent cycling injuries.

There are three key things you can do to optimise your bike fit. The first adjustment you can do is adjust the bike saddle. When sitting on the bike, you should have a 5 degree bend in the knee when your leg is fully extended. If your hips are loose enough to move from side to side, your saddle is too high. For more information, please watch our recognised bike fit partner’s video:

If your handlebars are too low, you can develop numbness in the hands as well as soreness in the lower back.  You can avoid this by adjusting your bike in order to find the most comfortable position for you. Some people prefer higher positions, some people prefer lower positions, but you have to fit adjust it to find comfort. For more information, watch our bike fit partner’s video on how to do a full bike fit:

Finally, setting up your cleats is important to reduce the risk of muscle imbalances and again improve performance. Cleats are important biomechanically as they add a spring to your pedal, which not only helps you push forwards, but also helps reduce the load on your joints. For more information on this, please see Crimson performance’s video on how to set up your cleats by yourself:

For any further questions relating to how you can prevent cycling injuries, please don’t hesitate to ask:

0161 209 2980

Ed Madeley M.Ost