Are you a Tour de France fanatic? Or maybe a Giro addict? Perhaps your commute is now on two wheels instead of four. Maybe you just want to get out and see some scenery! Whatever your motivation, we’re here with some tips for avoiding the most common cycling injuries and how to treat them if they happen.
So, how do you get in a position to suffer from cycling injuries? You start riding, of course! And then something bad happens. Obviously, an accident is the biggest fear and can cause the worst injuries, but aches and pains can sneak up on you over weeks and months in the saddle.
You can counter this risk of injury even before you get on the bike - how you set it up is a central part of being healthy and avoiding injury while cycling.
And it goes without saying, be careful out there, especially if you’re cycling where there are cars.
Cycling is a great way to get out and see the countryside
Common cycling injury areas
Cycling is a great form of exercise. Like many, the main muscle groups at work are your legs, although your core is also doing its part to help you hold your position. That said, sometimes you may end up holding a stressed position for a long period of time, which can lead to problems.
The other issue is stress on your body, which can be influenced by how you sit on the bike - have a look at the injury prevention section for more about ways to avoid this. In fact, addressing any of these problems (aside from crashing) will likely require adjusting your bike setup.
Here are the main cycling injuries, possible causes and some treatment options for each.
Cycling is a fantastic family activity
Impact injuries
Whether you’ve slipped on a wet road or been hit by someone else, accidents are a risk of cycling, particularly in when on traffic-heavy roads.
The obvious risk from crashing is that you may suffer broken bones - especially the collarbone and wrists - but muscles can be torn or strained as a result as well. Unfortunately, there’s not much you can do to treat either of these except for seeing a doctor and taking plenty of rest.
Although it may not be the first thing that comes to mind, nasty grazes - also known as ‘road rash’ - are the main risk of falling off your bike. Although usually superficial, you should still clean these thoroughly when you get home with antiseptic and try to wash them out to avoid the risk of infection. Keep them clean and dry for the next few days and consult a doctor if things start to get worse.
Even if you feel that you came away from an accident without anything too serious, don’t push yourself too hard immediately, just in case there’s an unseen problem lurking. And of course, if you have hit your head, you should not cycle anywhere as you may have suffered a concussion. Similarly, if your helmet is damaged - and we really hope you are wearing one - then you need to replace it.
Back and hip pain
Make sure you always wear a helmet when cycling
Lower back pain and stiffness is a fairly common occurrence for cyclists, especially after long rides - more than 50% of cyclists report suffering from it. But you shouldn’t just be on the lookout for back pain, as issues in the muscles of your lower back can also give you pain in your hips and even sometimes your legs. This is because the muscles in your lower back can sometimes put pressure on the sciatic nerve, which runs down the legs.
There are several things that can cause back pain for cyclists, but it is often a result of leaning too far forward for extended periods of time or your legs either extending not far enough or too far when pedalling. Having tight hamstrings or hip flexors - the group of muscles towards the front of your hips - can be a problem as well.
Regularly stretching your back and legs is a good way to begin making a difference if you’re experiencing back pain from any cause. If you’re sitting down a lot anyway, perhaps due to a desk job, then we’d recommend taking regular breaks and stretching to minimise the risk of further pain.
You might also want to look at your posture both on the bike and when sitting generally. If you are leaning forwards on your bike then you may wish to sit a bit straighter. There’s also a risk that your core muscles are not strong enough to support your back so try and strengthen them if you want to maintain an aggressive riding position.
Adjusting your saddle and handlebar height is also a big factor here - see more in the prevention section.
Ultimately, it’s important to sort out what is causing you back pain, as this can lead to long-term issues with your spine if left unresolved for too long. A professional bike fit can help with this - glance at the prevention section for more details.
Knee pain
Clicky, knobbly, rickety, creaky. No, it’s not a staircase in your choice of 16th century manor, it’s (possibly) your knees!
Your core, thighs and glutes are the main sources of power when you’re cycling, and the knee is a key point in the transfer of that power to the bike. Pain here is usually centred around the patella, or kneecap, and is generally caused by saddle-height problems.
Pain at the front of the knee tends to come from the saddle being too low, while pain behind the knee is, perhaps unsurprisingly, from the saddle being too high.
Patellofemoral syndrome - also known as ‘cyclist’s knee’ - is characterised by a deep pain or ache around the kneecap. It’s not entirely clear why this develops, but is likely due to overuse and may stem from an imbalance in muscle groups around the hip and thigh. This can then lead to uneven tension on the kneecap and pull it to one side more than the other. The best treatment is to cut back on activities that cause the pain and rest enough. Use ice for any swelling and work hip and knee stretches into your routine.
Pain around the outside of the kneecap is a sign of iliotibial band (ITB) friction syndrome. The ITB is a long, fibrous tissue that goes from your hip to your knee. Problems here, usually muscle tightness, can pull on the kneecap and make it move in a way it shouldn’t. Massage is an effective treatment, as is stretching.
Foot pain and numbness
The most common cycling-related problems for your feet are a lack of feeling or tingling due to issues with your shoes and cleats - the clips between your shoes and pedals.
If your cleats are too close to the toes, there’s a risk of compressing the nerves and causing numbness as well as potentially straining your Achilles tendon.
Continuing the theme of shoe fit, make sure yours aren’t too tight or loose. Cycling shoes can be a bit restrictive, so during the summer, when our feet may swell, they can become too tight and cause discomfort. Equally, they may be too loose in the winter and lead to blisters. Consider having multiple pairs of shoes - including ones made specifically for winter if you’re a committed cyclist - or find ones that can be more easily adjusted. But don’t use two pairs of socks! This can restrict blood flow and your feet will get even colder. We’d recommend thermal socks or ones made of Merino wool for winter.
Plantar fasciitis is an issue that is more common in runners but sometimes cyclists can suffer from it too. There’s a thick band of tissue that runs along the bottom of the foot, which is called the plantar fascia, and it can become damaged by excessive stress. Pain is the most common symptom that can become quite severe and cause trouble walking. Various exercises are usually the treatment but there are other options.
Wrist and arm pain
Make sure not to lock your elbows when cycling
Swapping from feet and legs to hands and arms, one cause of problems here is how your handlebars are set up and how you grip them. For setup tips, check the prevention section, but one of the main things to remember is to try and vary your grip occasionally and to not have your wrists below your hands.
Holding the same position for a long time, especially if you’re squeezing the brakes, can lead to nerve problems like carpal tunnel syndrome or ulnar neuropathy. These tend to come with tingling, weakness or pain in the fingers and hand. It is possible to fully recover from these with prompt treatment, which often centres around limiting mobility of the wrist, such as wearing a splint. Being nervous can make you grip too tightly so try and relax!
You should also avoid locking out your elbows - a lot of vibration is transmitted through your bike’s frame and you need loose elbows so that your arms can function as shock absorbers. If they stay locked in place, you’ll probably be feeling sore and stiff afterwards and for several days to come. Consider soft handlebar grips or good quality bar tape if you’re on a road bike.
A useful investment may be cycling gloves with extra padding to make things more comfortable - and will keep your hands warm in winter! No one wants freezing fingers.
Neck pain
Not quite as ubiquitous as knee pain, cyclists are nevertheless prone to neck pain, particularly if they’re riding in a more aggressive, forwards position. This leads to having to lift your head and hyperextend your neck to see what’s ahead.
If this is the case, you’ll probably feel a stiff and sore neck, but stretching - as is so often the case - can help alleviate this. The discomfort can extend into your shoulders as well, so efforts to strengthen them along with your neck wouldn’t go amiss.
Saddle sores
The scene of so many cycling injuries
Saddle sores, the bane of so many riders and the cause of discomfort in rather sensitive areas. It goes without saying that anything which makes sitting down unpleasant should be avoided!
In reality, the term covers a range of issues that arise in the areas of your body that touch the saddle. There are three main categories:
- Folliculitis - inflammation and possible infection of hair follicles. It looks a bit like a white or red pimple and is (sometimes) painless.
- Boils - if a hair follicle becomes more seriously infected, particularly with staphylococcus, then it can form boils.
- Swelling - usually caused by direct damage to the area, perhaps cycling on a particularly bumpy road. This can become permanent if the damage is bad enough so make sure to rest and consult a doctor if it doesn’t go away.
The causes mostly boil (we’re sorry) down to unwanted friction and chafing and how you sit and distribute your weight on the saddle.
In the friction department, common culprits include bike shorts that don’t fit quite right - make sure you wear them without underwear - or a poorly fitted chamois (the pad that goes inside the shorts to give you some extra cushioning).
The chamois, despite its intended purpose of protecting you, can still cause problems on longer rides. To counter this, there’s a whole world of chamois creams - a bit like moisturisers - that you can apply to your skin as a form of lubrication to reduce friction. But it doesn’t just free things up, it usually has an antibacterial effect as well to reduce the risk of infection. Cycling Weekly have a great list of the best chamois creams to use so check it out!
You don’t have to always use chamois cream but it really makes a difference for longer rides above an hour, multi-day events or hot weather.
Removing body hair that would be under the shorts can be problematic as well, as it can damage the skin, while regrowing hair can cause irritation and infection.
Additionally, you want as much of your weight to be supported by your saddle as possible, but try not to have it focused on more sensitive areas like your genitals as this can cause numbness and, in serious cases, long-term issues.
The angle of your saddle is also a very common cause of saddle sores. If it’s tilted backwards then you’ll probably be forcing yourself to the front of the saddle to compensate, which is going to make your genital area sore. And no one wants that.
So ensuring that your saddle fits properly is essential to preventing saddle sores. Finding the proper fit is a process that can have many aspects to it. The main ones to look at are width, amount of padding, curve of the shell and whether or not you should have one with a cutout section. The experts over at BikeRadar have an excellent in-detail guide to this but if you’re still having trouble then consult a professional who will be able to give you a more personalised assessment.
Equally, finding the right shorts is key to a comfortable ride. There are many options available, so have a look around, and a lot of companies should also offer free returns. Speaking of returns, our devices have a 30-day free returns policy as well just in case you find that they don’t work as you hoped - this will make more sense when you reach the next section!
Also, wash! You need to keep bacteria and other grime away from your skin as much as possible to avoid infection (that’s one of the things hair does) so make sure you wash as soon as you can after riding. Sitting all day in sweaty bike shorts is not good for your skin.
Saddle sore treatment
If you’re reading this, then it may be too late for prevention - at least until the sores go away - so let’s move on to treatment!
Aside from making sure everything fits, moisturisation is probably the best option. Your skin is a barrier against infection and all the problems that contribute to saddle-sore formation, and moisturising will help it stay healthy.
Unfortunately, there’s not much else that can be done once saddle sores appear other than resting and giving your body time to heal - we’re sorry to say.
For all these issues, you should see a specialist such as an osteopath or physiotherapist if the problem persists. They may do some tests and give you some exercises that you can do, which will be targeted to the areas that are problematic.
Electrotherapy for cycling injuries
The mitouch is ideal for helping recover from cycling injuries
We’ve covered common cycling injuries and some of the ways they can be treated. We mentioned stretching a lot there - enough for a small yoga class - along with allowing your body time to rest and recover.
But what if there were something you could do to help your body recover?
Electrotherapy is a non-invasive form of treatment that uses gentle electrical stimulation to support the body’s processes and offers a whole range of benefits including pain management and optimising recovery. It’s also great for addressing inflammation, another issue that often crops up with stress and overuse of muscles and joints.
We’ve developed revolutionary technology that is used by dozens of elite athletes to help them stay in shape and get back out there after injury.
'I use my NuroKor device both before and after training on my knee. On rest days I will sometimes sit with it for hours. I believe it has had a huge positive impact on my recovery.' - Ellie Dickinson
To learn more about how our technology works and the recovery benefits it offers, check out our website.
One of the fantastic things about our technology is that we’ve made it ultra-wearable so you can even get the benefits while you’re on the road. Some of our team members are passionate cyclists. While on a recent cycling holiday, Matt James used his device as he rode to help deal with upper back pain, caused by a hire bike being the wrong size, to release muscle tension that was building up. He even said he wouldn’t have been able to complete all the week’s rides without it!
If you’re feeling sore and stiff, hopefully this has given you some idea of what the problem is and how you can address it. But what if you’re looking to avoid the problem in the first place?
Just as an aside though, stretching really is great for helping you to avoid injuries, pain and stiffness, and not enough of us do it on a regular basis. Here are some examples of daily stretches to get you started.
Injury prevention - making yourself comfortable
First, make sure your bike is the right size for you! This is sort of simple thanks to adjustable components, although the specifics are a bit more fiddly. Fundamentally, you’re just trying to ensure that you can comfortably reach the pedals and handlebars and that there’s enough room for you to dismount without any risk to more sensitive areas. See what the experts at Cycling UK have to say for a more detailed guide on finding the right bike size.
Once you’ve got the right size of bike, it’s time to adjust it. Great Britain Road and Track Cycling champion and NuroKor ambassador Ellie Dickinson reminded us of this when we spoke to her.
‘Spend time on your position on the bike. Make sure you are as comfy as possible. The more time you spend on working this out, the less chance you have to get injured and it will really pay off in the long run.’
We should note that while there are some general principles for setting up your bike, the specifics will vary depending on what kind of cycling you’re doing, your age and, of course, your proportions. Below are some starting points to consider but for the best results and the best chance of avoiding cycling injuries, it’s sensible to consult a professional bike fitter.
These experts use specialist equipment to accurately measure all aspects of your bike set up and your position on the bike, as well as addressing your cycling technique. Sometimes this is offered for free when buying a bike, but otherwise you will have to pay. However, if you’re looking to take part in a specific endurance event or heavy training where you need to be as comfortable as possible, then it can be well worth it.
With all that out of the way, let’s meet the holy triumvirate: saddle, (handle)bars, and pedals.
Saddle
How you set your saddle is a central part of how much power you can put into your cycling. Getting it right is also vital for protecting your back, knees, hips and ankles and for avoiding the dreaded saddle sores.
Make sure you’re not riding with your saddle too low or too high. Too high and you might be rocking side to side to reach the pedals, which can give you lower back pain and bring on saddle sores. Too low and your knees will probably start giving you grief - though too high can do this as well.
What you’re aiming for is that when the pedal is at the lowest point of its rotation, your leg should be almost completely straight. Quite how straight doesn’t necessarily have a fixed definition (unhelpfully) but if you follow the next steps, you should be in a position where you’re mostly there.
Get your cycling gear on - including shoes - but instead of placing the ball of your foot on the pedal as you would normally, put your heel on. When the pedal is at its lowest point, your leg should be locked out and the crank (the little arm that your pedal attaches to) should be in line with your leg. If you then have the ball of your foot on the pedal, the extra length will prevent your leg locking all the way out. Global Cycling Network have a great video that illustrates this if you’re feeling a bit stuck!
You’ll also want to have your saddle either level or slightly tilted forwards - but not too far forwards because that’ll put too much pressure on your wrists and arms.
As for the saddle itself, try not to have one that’s too soft as the extra movement it gives can lead to unnecessary friction. We’ll level with you, it will probably require some trial and error to get a properly comfortable saddle. A saddle that is good in the long run may well hurt at first so try and keep going even if it’s painful. But if the pain doesn’t go away after a few rides, you probably need to look for something else.
If you get saddle sores, you definitely need to change something.
Handlebars
It's important to have your handlebars in the right position
Straight grips or sweeping curves - both up and down - there’s several options to choose from when it comes to handlebars. Whatever your preference, which will likely come from the type of cycling you’re planning to do, your handlebars will play a big role in how far forward you lean.
It should come as no surprise that leaning far forwards for a long time can lead to problems. If you’re having to lift your head up consistently then your neck can easily get stiff or painful. Equally, your lower back may become particularly problematic. Having a more upright position can lessen the chance of this happening but if you’re planning to be a triathlete then it might be a bit of an issue!
How you hold the handlebars is also important and the wrong angle can lead to wrist problems. These days, many bikes give you the option of shifting the positions of various elements of the handlebars, including fine tuning positioning of the brakes and gear levers. You can even alter the shape of your handlebars, so if you find that you’re having to reach too far down to hold your curved bars, you can probably find an alternative.
Pedals
This one is a bit of a trick as it’s not so much the pedals themselves as your shoes and how you place your feet on the pedals. You should be connecting with the ball of your foot so if you’re using cleats, make sure they’re not too close to the toes or too far towards the heel.
Cleat placement is something that a professional bike fitter can help you with and is one of the more fiddly parts of setup, but it’s well worth getting it right as it will both give you more power and comfort.
Phew! That’s quite a lot of information that you might not have been expecting, but prevention really is the best solution when it comes to cycling injuries - and injuries in general. If you’re looking for some more detailed ideas for adjustments, have a look at the Global Cycling Network again.
Take your time
Ellie Dickinson (right) knows the importance of not rushing yourself
Ok, so your bike is prepped, you’ve got the snazziest gear - which team’s lycra did you choose? - and even the weather is working for you. Time to zoom away over the hills and never stop, right?
Sadly, we’re going to recommend that you slow down a bit.
Although one of cycling’s great advantages is that it is comparatively easier on the joints and the body than other forms of exercise like running, it’s still wise to take some time to get into your rhythm.
‘Build up your cycling gradually. If you are anything like me, when I have time away from something, I am eager to get back quickly and go full gas straight away. I then usually end up having to take time off because I have pushed too much.’ - Ellie Dickinson
As Ellie says, trying to do too much will increase your risk of some form of cycling injury. This is true whether you’re just getting started or you’re coming back after injury (cycling related or otherwise).
The other thing to remember is properly resting, as without rest days, your body will be unable to work properly for long and riding when tired and (saddle) sore is usually no fun at all.
The same applies when coming back to cycling after an injury - don’t set your expectations too high. To turn to Ellie again,
'When coming back to cycling after injury or taking some time out, you will be a little rusty when you come back. But don’t be disheartened, it will come back like everything you have learnt does. Like everything in life, progression and consistency is key. You have to keep in mind that you won’t be where you were fitness wise when you come back from time away. You need to build things up gradually.' - Ellie Dickinson
It might be frustrating at first, but it’ll get better and you’ll be able to progress more consistently.
Final thoughts
Cycling is a fantastic sport and a great way to stay active or even just get to work. With such a wide range of styles - road cycling, mountain biking, even cycle polo - there’s something for everyone.
But it’s no fun getting injured, and saddle sores make sitting down a pain, so be careful out there. Make sure your bike fits properly, wear a helmet, wear comfortable but appropriate gear, and try to incorporate stretching into your pre- and post-ride routine.
If you’re looking for something extra to help your recovery, perhaps even something to wear on the go to help manage pain, then consider one of our devices - you can even return it for free if you find it doesn’t work as you want it to.
See you on the road!
