Fix all kind of cycling injuries pain
We all know the feeling: biking along on a perfectly nice day, when, around the halfway point of the ride something starts to tweak in your leg or back.
You ignore it, but by the time you’re nearing home the pain is excruciating and you can’t wait to get off the bike.
Cycling is a ton of fun – until something starts to hurt.
But all is not lost when pain creeps into your ride. Although it may take a few days off and changing up your bike setup, pain when cycling can almost always be overcome.
In this article, we’ll cover everything you need to know to battle bike pain wherever it appears in your body.
Table of contents
The Basics of Bike Pain
Riding a bike should produce a steady burn in your legs and accelerate your breathing, but it shouldn’t produce pain anywhere in your body. Of course, pain can and does frequently crop up in cyclists both in the usual places – your back, legs, and butt – and in unexpected places.
The important thing to remember is that if you’re feeling pain, it’s a strong indicator that something is wrong and can often be a warning signal before a long-term injury develops.
When pain starts, it’s always best to taper your riding and address the problem before it gets worse.
Addressing the problem, however, is usually easier said than done. Everything from cycling form and bike fit to gear and pre-existing injuries can contribute to pain, and in many cases the culprit is a combination of all of these.
However, there are some general rules of thumb to help identify the sources of pain.
For new riders, or for experienced riders who have recently changed their bike setup, bike position is the most frequent cause of pain. Getting your seat, cleats, and handlebars exactly in the right spots relative to your body is difficult, and there can be a world of difference in terms of pain between getting it right and getting it wrong.
The solution here is to get a professional bike fit. Although a fit can be somewhat costly, for frequent cyclists the benefits to comfort and speed are well worth it.
Plus, a bike fit costs far less than seeing a physical therapist after getting injured on a poorly fitted bike!
In experienced cyclists, wear and tear is the more common source of pain. Riding or cross-training hard many days in a row can leave your body fatigued and more prone to injury.
Stretching and massaging – for example with a foam roller – are also commonly left out of many cyclists’ workout routines, but are key to keeping your joints loose and promoting healthy muscle fiber growth.
With those guidelines in mind, we’ll dive into specific areas of pain that occur frequently in cyclists and explain the common causes of pain and how to make it go away.
Achilles tendon pain is one of those injuries that is easily preventable, but difficult to recover from once the pain is triggered. The Achilles tendon is a long tendon that connects your calf to your heel, and as such most Achilles pain is felt along your upper heel and lowermost calf muscle. There are varying degrees of Achilles injuries.
The most common, and most benign, is Achilles tendonitis, which is simply inflammation of the tendon.
However, more serious pain can be indicative of a partial or full tear of the Achilles tendon, although that is relatively rare among cyclists.
The most common cause of Achilles tendonitis, and Achilles tendon injuries generally, is overuse of the calf muscles. Importantly, overuse in this case doesn’t only mean going out and riding too many miles at once – it can also mean riding hard after a period of not riding very much.
In particular, riding uphill places your Achilles tendons at greater risk for inflammation since climbing engages your calf muscles more than riding on flat road.
Bike fit can play an important role in Achilles tendon pain, too. In particular, pay attention to how your feet are attached to the pedals when wearing cleats.
Having your feet too far forward can contribute to strain in your calf muscles, as can pushing your heels out to the sides of the pedals when you push downward.
Having your seat too high can also contribute to your risk of Achilles tendon pain, since this forces your calf and heel to stretch upward when pedaling.
The best treatment for Achilles tendon pain is, of course, prevention. Make it a habit to stretch your calves before and after every ride, and the flexibility you build in your lower calves will go a long way towards keeping your Achilles tendon from becoming inflamed or tearing.
Foam rolling your lower calf muscles can also improve flexibility, although be sure to massage gently as you approach the tendon where it begins to wrap over the heel.
Once you develop Achilles tendon pain, continuing to cycle will likely only inflame the tendon more and contribute to the problem. Instead, rest and ice the heel area, stretch your calf gently but frequently, and try adding heel raises into your workout routine.
When you are ready to go back to cycling, check your foot placement on your pedals and consider using shoes with heel lifts to help prevent overextension of your calves.
The ankles are a less frequent, but important area of pain for many cyclists. In particular, riding uphill places a significant amount of stress on your ankles that can manifest as either a consistent, sharp pain, or a dull ache.
However, even if the pain is minimal, it’s safest to cut down your riding, let your joint heal, and work on addressing the problem rather than trying to ride through it.
Ankle pain is most often related to how your feet are pushing down on the pedals. Having your feet extended too far forward can stress your ankle joint. In addition, pronating your feet while pedaling puts your feet out of alignment with your lower leg, leaving a ton of stress piled on the ankle with each pedal stroke.
The best remedies for pain in the ankle joint are ice and anti-inflammatories. While this is a slow healing process, it is worth letting the joint heal fully so as not to reinjure it by trying to ride again too soon. In the meantime, work on increasing flexibility and strength in the ankle using this set of exercises.
Once you’re ready to get back on the bike, make sure that the ankle injury won’t reoccur by checking your foot placement on the pedals – you want the balls of your feet, not your midfoot, to be applying pressure to the pedals. If the issue appears to be related more to foot pronation than to foot position, look for orthotics designed to help correct your form.
Ask any athlete where they most often have pain, and you’re very likely to hear the knees. In fact, one study estimated that 65% of cyclists have experienced knee pain. While cycling does not have nearly the impact on your knee joints that running does, the knees are still a common source of injury.
Knee pain can also be one of the most difficult injuries to solve because there are a number of muscles and tendons running through and within your knees, any of which could contribute to pain.
Here, we’ll cover the most common knee injuries seen in cyclists – but if treating for these doesn’t make the pain go away, it may be wise to check in with an orthopedist.
We’ll start out with anterior knee pain, or pain right on the kneecap. This is most often related to the power being delivered from your quads through your knee – and delivered at an improper angle.
The culprit in this case is saddle height. If your saddle height is too low or too high, the knee joint will be cramped at the top of your pedal stroke and can cause stress in the cartilage under the kneecap.
However, your saddle isn’t always to blame. Mashing the pedals at high resistance can put a huge amount of stress on the knee joint, which can manifest in very similar pain just under the kneecap.
Pain behind the knee is less common, and usually easily fixable – it is almost always a product of overextending your knee as a result of a seat that is too high or too far back from the pedals.
However, if that doesn’t make the pain subside, the problem may be a more complex issue with your hamstrings.
Pain on the inside and outside of your knees is usually indicative of an issue with your foot placements. Feet that are too far apart or too close together on the pedals result in your feet being out of alignment with your knee, which places lateral stress on the joint every time you pedal.
In particular, placing your feet too narrowly together can overstretch your illotibial (IT) band, which then rubs against the outside of your knee to cause a sharp pain.
The treatment for knee pain depends on where your knee pain occurs. One of the nice things about knee pains is that since they usually stem from misalignment problems, fixing the misalignment should immediately relieve the source of the pain.
As long as you are able to manage any inflammation, it should be safe to carefully continue riding at a reduced training load.
For pain on the front or back of the knee, the best solution is moving your saddle position. To get a rough idea of where your saddle should be, sit on the saddle and adjust the height until your knee has a 25-degree bend when at the bottom of the pedal stroke.
The saddle should also be moved forward or backward enough so that the bony point below your kneecap is directly above the ball of your foot.
For pain on the sides of the knee, check your foot position. Your cleat should be set so that when pedaling your foot is directly under your knee, with no lateral splay to increase strain on the joint.
Foot pain can feel unavoidable, especially on long, hot rides when your feet begin to swell. It may materialize slowly, maybe as numbness or tingling, before progressing to a dull and finally a sharp pain.
Before long, you’ll be cursing at the inflexibility of your cycling shoes and wishing for the end of the ride.
But foot pain doesn’t have to be a normal part of your riding, especially since the problem typically stems from gear rather than wear and tear in your body.
Foot pain is almost always related to pinching of the nerves around your toes, even if the pain radiates to other areas of your feet. The nerve line in your foot travels from your ankle and through your midfoot before splitting off around the metatarsals to form endings on either side of each toe.
The area of the split, around the metatarsals, is particularly narrow and can be pressurized from the repeated pushing down and up against the pedals – and consequently, the insides of your shoes.
This is also why the pain gets worse over longer rides: your feet swell with more riding, gradually increasing the pressure against the nerves.
The fundamental solution to treating foot pain is to relieve the pressure on the pinched nerves around your metatarsals. But there are many different ways to approach this depending on your preferences and ability to try out and pay for new footwear.
The simplest solutions are simply to loosen the straps on your shoes or to try wearing a thinner pair of socks, although the latter can lead to pain around the ball of your foot if there is not enough cushion.
If the simple solutions don’t work, the next step may be to try a pair of insoles that are specifically designed to spread your toes apart to relieve the nerves. When all else fails, consider buying a new pair of shoes – if you go this route, be sure to size up, find a wide-sized pair, or try on shoes at the end of the day when your feet are swollen like they would be after a day of cycling.
Pain in the rear when cycling shouldn’t come as a surprise – just one look at most saddle designs is enough to make you cringe at the thought of actually sitting on it for hours at a time. But while bottom pain is unavoidable to some extent, it shouldn’t prevent you from riding or force you to shorten your ride.
There are two primary ways that sitting in the saddle for hours at a time can cause pain in your bottom – pressure and chafing. Much of the weight of your upper body is pressing you into the saddle, and bumpy road can exacerbate the pressure of your butt on the often not-too-soft saddle.
This can become painful particularly quickly if you hit your sit-bone hard coming off a bump in the road, or when you spend multiple back-to-back days in the saddle. Chafing is equally insidious, and occurs due to the friction of rubbing your bottom and inner thighs across the saddle over the course of a ride.
Chafing can be especially bad on hot days, when salty sweat trapped inside your shorts can make already rubbed areas sting painfully.
There are a couple ways to fight back against saddle pain, but the most important thing you can do is find a saddle that works well for you. Everyone has a different preference when it comes to saddles, so simply reading reviews and asking friends won’t help you much – it’s important to actually try out different saddles at your local bike shop.
Another key piece of equipment that can help fight back against both pressure and chafing is a great pair of bike shorts. Different shorts designs have different chamois – the pad between your butt and seat. If you’re particularly prone to chafing, look for shorts designed for endurance cycling as they generally have the thickest pads. Applying lubricant to your rear and inner thighs can also go a long way towards reducing chafing.
Once you’re in the saddle, already committed to your saddle and shorts, the best thing you can do to avoid saddle pain is to move around during your ride. Stand up out of the saddle every few minutes, or move backwards and forwards slightly to alleviate pressure on a specific spot.
Hip pain is extremely common among cyclists, and can be surprisingly difficult to get rid of once you reach the point of pain. Like the knees, the hips are connected to many different muscles and joints involved in the motion of cycling – which can make it difficult to pinpoint the source of the problem.
Here, we’ll focus on the most common causes of hip pain and how to solve them.
One of the major causes of hip pain in cyclists is overuse combined with a muscle imbalance in the upper thighs. Even a small imbalance in the way you rock back and forth across the saddle when peddling can add up to noticeable pain over the course of days of riding.
The glutes are particularly prone to imbalance because they are critical to cycling stability, yet often weak thanks to a lifestyle of sitting at your desk all day during the workweek. Weak piriformis muscles and tight hip flexors function similarly to weak glutes by contributing to an imbalance around the hips during pedaling.
Your bike fit can also be a major contributor to hip pain, and exacerbate any pre-existing muscle imbalance. For example, if your seat is too high your body will rock back and forth excessively to help your feet reach the bottom of the pedal stroke. Bad posture resulting from a poor fit from the saddle to the handlebars can also contribute to hip pain over a long ride.
The best way to fight hip pain is to fight the muscle imbalances that underlie it. Working out your glutes and piriformis muscles will help erase any imbalances as well as strengthen your stability when pedaling.
In addition, foam rolling the hip flexors and upper illotibial band can help to relieve built-up tension around the hips that contributes to pain.
As we have mentioned throughout this article, a professional bike fit can make a huge difference in reducing pain on the bike.
This is especially true for hip pain, since having your seat height and tilt properly dialed in for your hip’s natural side-to-side rotation can make a huge difference in whether small muscle balances remain benign or turn painful.
You probably know the feeling – getting off the bike, only to groan as you try to straighten your back as you stand up. It happens even to the pros: back pain accounts for 45% of reported aches and pains among pro cyclists.
But just because back pain is exceedingly common among cyclists doesn’t mean you need to grin and bear it.
Teasing out the causes of your back pain on the bike and finding incremental solutions can diminish your pain greatly, even if it never fully goes away.
The most common cause of back pain on the bike is a poor bike fit. A proper bike fit is everything when it comes to keeping your back happy. In particular, being stretched out too far on the bike, due to low handlebars, your seat being too far back, or too few stem spacers, will strain your back.
Poor core strength and flexibility can also contribute to making any problems with your bike fit much worse. If your core is weak, your body will have trouble supporting your back as you lean forward. The same goes for inflexible hips, which will force you to flex your back more than is healthy from its base.
The first step in treating back pain on the bike is to get a professional bike fit. For many cyclists, this alone will address the problem enough to the point that back pain only becomes an issue during especially long rides or after multiple days of riding.
If back pain persists, work on your strength and flexibility. A variety of core exercises are designed to strengthen your lower back muscles, abdominal muscles, and glutes, all of which are involved in supporting your back. Also be sure to stretch your hip flexors to keep your pelvis flexible.
Small changes can also go a long way for frequent back pain sufferers. Watch your posture off the bike, as back pain starting at your desk will almost always get worse when riding. Move around, stand up and down, and stretch out your back frequently when riding to prevent stress from building up in your back while cycling.
Finger pain isn’t common among cyclists, but riders who do experience it will tell you that the pain, numbness, or tingling can be crippling to your ride. Trying to avoid using your fingers can make a ride difficult if you’re avoiding changing gears, or dangerous if you wince at using the brake levers.
But thankfully, finger pain is almost always fixable with a few tweaks.
Finger pain is almost always the result of a pinched nerve, similar to how foot pain develops for some cyclists. But there are different nerve connections for the thumb and first two fingers versus the ring and pinkie fingers.
Pain in the thumb, index, and middle fingers is usually the result of the median nerve, which runs through its tightest point around your wrist, being pinched. Pain in the ring and pinky fingers is caused by pinching of the ulnar nerve, which runs through the pad on the palm of your hand.
Pinching of the nerves in your wrist or palm pad typically can be traced back to a poor bike fit. The median nerve can be pinched when your handlebars are too low or your seat too high, since this position forces your wrist to bend drastically to reach the bars.
The ulnar nerve can be pinched when you are resting your hands too heavily on the handlebars, which can result from a combination of low handlebar and high seat positions as well as keeping the handlebars angled too far down.
If simply changing up your bike position doesn’t solve the hand pain, there are a few other treatments you can try.
One is simply letting some air out of your tires – riding at high tire pressure increases the impact of every bump in the road on your palms and wrists. Adding thicker bar tape or wearing padded cycling gloves can also go a long way towards reducing pinching of the ulnar nerve.
Neck pain is right up there with knee pain as one of the most pervasive areas of trouble for cyclists – around 44% of male and 55% of female cyclists say they’ve had neck pain at some point.
The reason is that your head is effectively a giant weight which, if not aligned in a stable position relative to your neck when riding, can quickly cause strain.
And that’s a big problem for many cyclists, since neck pain can be debilitating to the point where it’s hard to get on the bike. But thankfully, with some tweaks to your bike fit and form, neck pain can be easily avoided.
The fundamental cause of neck pain is your head coming out of alignment with your neck and spine for extended periods during a ride. That places strain on your neck to hold up your heavy head, which in turn leads to pain.
Part of the reason for this misalignment can be a poor bike fit – having handlebars that are too low, a seat that is too far back, or a stem that is too long can all contribute to forcing your body to compensate and overextend your neck. This is particularly problematic for cyclists who spend long periods in the drop bars or triathletes who typically spend hours in their aero bars.
The other primary cause of misalignment is poor form. Tensing up so that your shoulders creep up towards your ear puts tons of tension on your shoulder blades and surrounding muscles, all of which contribute to supporting your neck. As the tension builds up in these muscles, it may be expressed as neck pain.
In addition, many cyclists have a tendency to look forward with their head rather than their eyes only. Lifting your head in this way places a significant stress on your neck, which can develop into pain rather quickly.
The first step in addressing neck pain is to get a professional bike fit. Simply adjusting saddle height based on general guidelines won’t help here – you need someone who knows what they’re doing to look at the combination of saddle setback, bar spacers, and handlebar drops to fully address any fit problems that are causing neck pain.
Once you’ve got a good fit, the next step is addressing issues with your form. It’s important to remind yourself not to lift your head out of alignment during the ride, and you can address shoulder tensing by practicing rolling back your shoulders. Use a foam roller to massage out any knots that may have already formed in your shoulders and upper back to start fresh.
Along with your neck, your shoulders are primarily responsible for holding up your head when cycling – no small task considering that your head is effectively a heavy object extended away from your body.
Shoulders do much of the work of supporting the neck itself, and can take a ton of stress and strain before showing any signs of pain. As a result, it’s important to recognize shoulder pain as symptomatic of broader and likely long-term issues that need to be corrected before continuing to ride.
As for neck pain, the primary causes of shoulder pain are a poor bike fit and poor form. A bike fit that leaves your neck overextended or cramps your body tightly together can pull on or push against your shoulders, slowly adding to muscle knotting in the upper back.
Meanwhile, many cyclists tend to hunch their shoulders up towards their ears without realizing it. This position puts a significant amount of stress onto the shoulders. All of this stress can be handled by the shoulders to some extent, but eventually they will begin to hurt if proper care is not taken to alleviate the stress.
The first step in tackling shoulder pain should be to seek a professional bike fit. While this may be costly, the benefits to your body are well worth it. It is difficult even for experienced cyclists to accurately position their seat, handlebars, and stem in a way that keeps your neck from being overextended.
Once a proper fit is achieved, the next step is remediating any damage that has already been done to your shoulders.
In most cases, simply massaging out knotted muscle tissue in the shoulders - which builds up as a result of cumulative stress loads – using a foam roller can keep your shoulders functioning pain-free as they should. If that’s not enough, train your shoulders to handle greater stress by trying out these strength-building exercises.
Thigh pain can sound like a joke at first among cyclists – after all, burning quads and chafing are part of the sport – but true thigh pain unrelated to burning muscles should be addressed as the problem that it is.
Thigh pain can range greatly in severity, but if it keeps you from completing your rides then it’s time to get serious about treating what ails you.
Your thighs have more than just your quads running through them. There’s also the illotibial band, a fibrous band of connective tissue that runs from your hip to your knee.
When this band gets inflamed, it will often rub either against the knee or against the lower part of the hip – causing pain in your thigh.
Because the illotibial band is so fibrous, thankfully it is difficult to inflame it. However, severe overuse or a sudden increase in training can start the inflammation process, and it can be difficult to tame once it gets started.
The best treatment for thigh pain, especially if it’s related to inflammation of your illotibial band, is to ice and massage the inflamed area. Ice will keep the inflammation down, while foam rolling will smooth out damaged muscle tissue to address the root cause of the inflammation.
Stretching is also important, as providing more leeway for the band to run between your hip and knee can help prevent the likelihood of inflaming it again. Before riding again, check your bike fit to make sure that your seat is not too high – this forces your leg to overextend, stretching the illotibial band past its comfort zone.
Wrist pain is one of the most common pains that occur among cyclists, and it’s not always a sign of serious issues – on especially long rides, wrist pain is almost certain to occur.
However, if you experience wrist pain during every ride, or during short rides, there is likely a problem.
This type of wrist pain can be more serious than just a discomfort, since it can affect your ability to change gears or access the brakes.
The most frequent culprits for wrist pain on the bike are bike fit and bad form in holding the handlebars. Both of these can affect how much body weight you rest on your hands, which will place strain on your wrists and ultimately lead to pain.
In particular, the height difference between the saddle and handlebars will affect the angle at which you rest on the handlebars and the amount of weight that you have to rest through your hands.
Many cyclists also have the bad habit of overextending their wrists in holding the handlebars, which can lead to pain over longer rides.
The placement of your shifters, which is assessed as part of a bike fit, can also make a difference – having your shifters out of alignment with your hands can force you to twist your wrists with each gear change.
There are a number of incremental fixes that can help to reduce the likelihood and severity of wrist pain when riding. A bike fit will do the most to prevent wrist pain, as properly adjusting the height of your seat and handlebars can drastically reduce the amount of weight that you are transferring onto your hands.
A good pair of cycling gloves can also help transfer weight through your wrists, and in dire cases a splint-like setup can help to reduce over extension of your wrists. Dampening vibrations, either through a new layer of bar tape or by upgrading to a carbon fork, can reduce the rate at which wrist pain sets in, although it won’t address the underlying issues.
Muscle pain is a complex and much-discussed issue among cyclists, but there are some common threads among all the different types of muscle pains out there.
Here, we’ll focus on severe muscle soreness during and after workouts, since this is one of the most common types of muscle pain that almost every cyclist has experienced at some point.
Severe muscle soreness during and after workouts depends on a huge variety of factors, including the intensity and duration of your workout, your overall training load, and your overall fitness. But one of the fundamental things that triggers it, regardless of how hard you were riding, is poor nutrition.
If you don’t fuel your body properly during a hard ride, even if you get through the ride without muscle pain you’re putting yourself at risk for delayed onset muscle soreness.
If your muscles lacked the fuel they needed while they were being worked hard, they’ll suffer more damage during the workout and take longer to rebuild. Of course, since this is a recovery-related issue, training load also plays a role – ignoring muscle soreness and continuing to train hard will only deplete your muscles further, worsening the pain and extending the recovery time.
The best medicine for muscle soreness is prevention. Aim for 30 to 60 grams of carbohydrate per hour, plus one liter of water per hour, during rides to prevent muscle depletion on the bike.
If you still suffer from muscle soreness after dialing in your nutrition during the ride, try eating proteins before your workout – the amino acids will continue to break down during the ride and help your muscles rebuild fibers.
Also be sure to eat a mix carbohydrates, healthy fats, and proteins in the first hour after a ride to fuel your recovery. And if you are suffering from muscle soreness, allow your body to fully recover before taking on another hard workout.
Your hands are one of the main contact points between your body and the bike, and keeping them pain-free throughout your ride is extremely important.
Hand pain, like finger and wrist pain, can quickly turn a pleasant ride into a struggle and make it nerve-wracking to even reach for the shifters or brake levers. But thankfully, hand pain can be easily solved with a few tweaks to your bike setup.
The most common cause of hand pain is pinching of the medial and ulnar nerves in your wrist and hands. For many cyclists, this occurs because they rest too much of their upper body weight on the handlebars rather than resting lightly on the handlebars – a problem that can, in turn, be traced back to poor bike fit. In some cyclists, however, the problem is not weight but over-gripping the handlebars. This can result from an uncomfortable handlebar grip, poor form, or from not moving your hands around while riding. In any case, excess road vibrations from riding on rough roads can exacerbate hand pain.
The best way to fight hand pain is by tweaking your handlebar setup. Raising or lowering your handlebars can help to redistribute your weight so that you rest more lightly on the handlebars. One of the best things frequent hand pain sufferers can do is to swap out their current handlebars for a new set that fits their grip better – this will both allow you to rest lighter on the bars and will reduce the severity of over-gripping. To combat vibration, add a pair of cycling gloves, new bar tape, or best of all invest in a carbon fork or carbon handlebars.
Pain has a tendency to pop up in some unusual places during cycling. But pain generally appears for similar reasons and requires similar treatments wherever it appears. The first step in addressing pain should be to take a rest from cycling for a few days to allow the pain to subside.
Then, before getting back on the bike, get a professional bike fit to prevent the pain from coming back. If rest and a bike fit don’t do the trick, or the pain persists off the bike, try stretching and foam rolling to work out damaged muscle tissue. If that doesn’t make the pain go away either, it’s probably a good idea to see an orthopedist.