Whether you’re new to cycling or ride regularly, there is a lot to learn about how physiotherapy can benefit cyclists. This low impact sport is not only great for cardiovascular help, but it’s also a great way to balance training for anyone who participates in multi-sport activities.

That said, the more you ride, the more you might feel little niggles – from knee pain and tightness in the lower back to overuse injuries and muscular imbalances. But sometimes all you need are small adjustments or some focused exercises to help enhance your ride and keep you going the distance pain free. And physical therapy can help with that – even before the pain starts, or gets worse.

Why physical therapy is important for cyclists

Cycling is a repetitive, fixed-position activity. You perform the same pedaling motion thousands of times per ride, in a posture that shortens certain muscle groups while underworking others. Over time, this creates predictable patterns of tightness, weakness, and injury.

Physical therapists who work with cyclists focus on two key areas: injury rehabilitation (treating problems that have already developed) and injury prevention (identifying and correcting imbalances before they become problems).

What are some of the most common cycling injuries?

Knee Pain is incredibly common with cycling. Two of the most common complaints are:

• Patellofemoral pain (runner’s knee): This is pain around or behind the kneecap, which is often caused by weak hip abductors and glutes forcing the knee to track inward during the pedal stroke.

• IT band syndrome: Also very common in runners, IT band syndrome is the result of tightness along the outer thigh causing sharp pain on the outside of the knee, typically aggravated by high mileage.

For many of our patients, strengthening the hips and glutes is essential to minimizing some of these pain points. The more we sit, the weaker these areas become, even if we exercise on a regular basis – it’s about both quality, and quantity! Our physical therapists can create a focused exercise plan that is specific to you to help build strength in those weaker areas, while at the same time providing targeted stretches that can help lengthen the compacted muscle groups.

Lower Back Pain is another common issue for cyclists, and one that probably comes as no surprise! Spending hours hunched over the handlebars places sustained load on the lumbar spine. Tight hip flexors (from prolonged hip flexion on the bike) tilts the pelvis forward, while increasing lower back strain.

If this is something you have dealt with before, talk to one of our physical therapists. They can help work with you on hip flexor flexibility, core stability and postural endurance to help take the pressure off of the spine.

Neck and Shoulder Pain is another common complaint from cyclists – and one that might be felt in tandem with low back pain. Keeping the head lifted to see the road while in an aerodynamic position strains the cervical spine and upper trapezius muscles. To alleviate this, physical therapy would focus on thoracic mobility and deep neck flexor strengthening.

Achilles Tendinopathy can be caused by repetitive ankle motion while pedaling paired with poorly positioned cleats. Achilles tendinopathy can be incredibly painful and to alleviate some of the initial pain, a physical therapist can help with manual therapy. For longterm training however, your physical therapist can also help to program a training plan that includes gradual increases to help with loading.

The importance of getting a proper bike fit

While physical therapy can be essential for longterm success when it comes to cycling pain-free, it’s also essential your tools are working with you – and not against you. If you’ve never done a bike fitting, all of the pain points mentioned above, might just keeping coming back due to the bike not being the right fit for your body. A few things that are adjusted during a proper bike fit include:

• Saddle height and position – If the bike is too low you can overload the patella; too high and you can strain your hamstrings.
• Cleat alignment – Misaligned cleats directly affect knee tracking.
• Handlebar reach – Excessive reach strains the neck, shoulders, and lower back.
• Crank length – This can affect hip and knee mechanics, particularly for riders with hip mobility limitations.

Several of our physical therapists at UP have bike fitting expertise – or can refer to a specialist who can help. If this is something you’re interested in getting done, be sure to let our team know when you make an appointment!

Strength Training

While you might prefer just getting out and going for a ride, the importance of strength training – especially as we age or are fighting against niggles – becomes increasingly more important. Targeting weak muscle groups, such as the glutes and hip abductors, core and hamstrings, can keep those pain points at bay. For a suggested list of exercises and how to do them, check out ‘8 Efficient Exercises for Endurance Athletes’ article.

Flexibility and Mobility

Along with strength training, adding in some flexibility and mobility to your training routine can be equally important. Being in a cycling position shortens the hip flexors, hamstrings, and pectoral muscles over time. A regular mobility routine targeting these areas can improve comfort on the bike and reduce compensatory strain elsewhere. In addition to creating a strength training program, your physiotherapist can also create a simple routine designed with flexibility and/or mobility in mind for your needs.

Whether you’re getting back into your cycling routine, training for a sport like triathlon or just getting started, it’s never a bad idea to talk to your physiotherapist about injury prevention, progressive mileage, a proper bike fit or simply how to prevent pain. Schedule your next appointment at UP and enjoy the ride.