For all the fun and enjoyment of a good ride on your bike, cycling pain is a potential problem. While cycling is known for of cycling its fractures from nasty high speed falls, it is repetitive cycling injuries that cause most cyclists pain unnecessarily.
As a cyclist myself, I am personally aware of knee pain, back pain, hip pain, sciatica and neck pain from a poor bike setup and too many kilometres in the wrong position.
In this article, I hope to keep your cycling fun by discovering how to prevent common injuries impacting on your ride. Whether you are interested in road cycling, triathlons, mountain biking, velodrome cycling or just the commute to work, the cycling injury prevention principles are similar, but do vary depending on the the performance you want out of yourself and your bike.
Cycling – Power Phases
As you can see from the infographic, cycling incorporates all of your major leg muscle groups at different phases. This can be wonderful for strengthening but overuse or compensation for a weak zone may cause an imbalance leading to cycling pain.
A cycling physiotherapist will be able to identify if you have any lack of motion, strength deficits and help you address these possible sources of injury.
Common Cycling Injuries
- AC Joint Injury
- Bursitis Shoulder
- Dislocated Shoulder
- Rotator Cuff Calcific Tendinitis
- Rotator Cuff Syndrome
- Rotator Cuff Tear
- Shoulder Impingement
- Shoulder Tendonitis
- Back Muscle Pain
- Bulging Disc
- Degenerative Disc Disease
- Facet Joint Pain
- Pinched Nerve
- Sacroiliac Joint Pain
Hip & Groin Injuries
- Adductor Tendinopathy
- Femoroacetabular Impingement (FAI)
- Gluteal Tendinopathy
- Greater Trochanteric Pain Syndrome
- Groin Strain
- Hip Arthritis (Osteoarthritis)
- Hip Labral Tear
- Osteitis Pubis
- Piriformis Syndrome
- Poor Hip Core
- Trochanteric Bursitis
- ACL Injury
- Bursitis Knee
- Chondromalacia Patella
- Fat Pad Syndrome
- ITB Syndrome
- Knee Arthritis
- Knee Ligament Injuries
- Lateral Collateral Ligament
- Medial Collateral Ligament Sprain
- Meniscus Tear
- Osgood Schlatter’s
- Patella Tendonitis (Tendinopathy)
- Patellofemoral Pain Syndrome
- Plica Syndrome
- Posterolateral Corner Injury
- Sinding Larsen Johansson Syndrome
Calf and Leg Injuries
- Achilles Tendon Rupture
- Achilles Tendonitis / Tendinitis
- Calf Muscle Tear
- Shin Splints
- Stress Fracture
Anke & Foot Injuries
- Anterior Ankle Impingement
- Heel Spur
- High Ankle Sprain
- Morton’s Neuroma
- Peroneal Tendonitis
- Pes Anserinus Bursitis & Tendinitis
- Pes Planus – Flat Feet
- Plantar Fasciitis
- Posterior Ankle Impingement
- Retrocalcaneal Bursitis
- Severs Disease
- Sprained Ankle
- Stress Fracture Feet
- Tibialis Posterior Tendinopathy
Sports Injury Management
You probably already know that a sports injury can not only affect your performance, but also your lifestyle. The latest research continues to change sports injury management considerably. Our challenge is to keep up to date with the latest research and put them to work for you.
How we treated you last year could vary greatly to how we treat you this year. The good news is that you can benefit significantly from our knowledge.
What Should You Do When You Suffer a Sports Injury?
Rest from painful exercise or a movement is essential in the early injury stage. "No pain. No gain." does not apply in most cases. The rule of thumb is - don't do anything that reproduces your pain for the initial two or three days. After that, you need to get it moving or other problems will develop.
Ice or Heat?
We normally recommend avoiding heat (and heat rubs) in the first 48 hours of injury. The heat encourages bleeding, which could be detrimental if used too early. In traumatic injuries, such as ligament sprains, muscle tears or bruising, ice should help reduce your pain and swelling.
Once the "heat" has come out of your injury, heat packs can be used. We recommend 20 minute applications a few times a day to increase the blood flow and hasten your healing rate. Heat will also help your muscles relax and ease your pain. If you're not sure what to do, please call us to specifically discuss your situation.
Should You Use a Compressive Bandage?
Yes. A compressive bandage will help to control swelling and bleeding in the first few days. In most cases, the bandage will also help to support the injury as the new scar tissue is laid down. This should help to reduce your pain. Some injuries will benefit from more rigid support such as a brace or strapping tape. Please ask us if you are uncertain what to do next.
Gravity will encourage swelling to settle at the lowest point. Elevation of an injury in the first few days is very helpful, especially for ankle or hand injuries. Think where your injury is and where your heart is. Try to rest your injury above your heart.
What Medication Should You Use?
Your Doctor or Pharmacist may recommend pain killers or an anti-inflammatory drug. It is best to seek their professional advice as certain drugs can interfere with other health conditions, especially asthmatics.
When Should You Commence Physio?
In most cases, "the early bird gets the worm". Researchers have found that intervention of physiotherapy treatment within a few days has many benefits. These include:
- Relieving your pain quicker via joint mobility techniques, massage and electrotherapy
- Improving your scar tissue using techniques to guide the direction it forms
- Getting you back to sport or work quicker through faster healing rates
- Loosening or strengthening of your injured region with individually prescribed exercises
- Improving your performance when you do return to sport - we'll detect and help you to correct any biomechanical faults that may be affecting your technique or predisposing you to injury
What If You Do Nothing?
Research tells us that injuries left untreated take longer to heal and have lingering pain. They are also more likely to recur and leave you with either joint stiffness or muscle weakness. It's important to remember that symptoms lasting longer than three months become habitual and are much harder to solve. The sooner you get on top of your symptoms the better your outcome.
What About Arthritis?
Previously injured joints can prematurely become arthritic through neglect. Generally there are four main reasons why you develop arthritis:
- Previous injury that was inappropriately treated (eg old joint or ligament sprains)
- Poor joint positioning (biomechanical faults)
- Stiff joints (lack of movement diminishes joint nutrition)
- Loose joints (excessive sloppiness causes joint damage through poor control)
What About Your Return to Sport?
Your physiotherapist will guide you safely back to the level of sport at which you wish to participate. If you need guidance, simply ask us.
What If You Need Surgery or X-rays?
Not only will your physio diagnose your sports injury and give you the "peace of mind" associated, they'll also refer you elsewhere if that's what's best for you. Think about it. you could be suffering needlessly from a sports injury. Please use our advice to guide you out of pain quicker . and for a lot longer.
If you have any questions regarding your sports injury (or any other condition), please contact your physiotherapist to discuss. You'll find our friendly staff happy to point you in the right direction.
Acute Sports Injury Clinic
The acute sports injury consultation fee is significantly lower than a routine assessment and treatment consultation. In most cases, your private health will cover the full cost of your full acute injury physio assessment fee.
How to Best Care for Your Sports Injury?
There is never an excellent time for an injury. But we do know that most sports injuries occur over the weekend! That's why at PhysioWorks, we have established an Acute Sports Injury Clinic at a selection of our clinics on a Monday and Tuesday.
Why Use an Acute Sports Injury Clinic?
Your Acute Sports Injury Assessment Consultation allows us to provide you with:
- A quick and accurate diagnosis. One of our Sports Physiotherapist's or an experienced sports injury-focused Physiotherapist will confidently guide your new injury management.
- Early acute sports injury care, professional advice and education. What to do this week?
- Fast referral for X-rays, ultrasound or MRI scans to confirm your diagnosis.
- Prompt referral to Sports Physicians, GPs or Surgeons with whom we work if required.
- Immediate supply of walking boots, braces and rental crutches if needed.
- Low-cost professional service.
Who is a Sports Physiotherapist?
Sports Physiotherapy is the specialised branch of physiotherapy which deals with injuries and issues related to spokespeople. Practitioners with additional formal training within Australia are Sports & Exercise Physiotherapists.
What is Sports Physiotherapy?
Sports injuries do differ from common everyday injuries. Athletes usually require high-level performance and demand placed upon their body, which stresses their muscles, joints and bones to the limit. Sports physiotherapists help athletes recover from sporting injuries, and provide education and resources to prevent problems.
Each sports physiotherapist usually has sport-specific knowledge that addresses acute, chronic and overuse injuries. Their services are generally available to sportsmen and women of all ages engaged in sports at any level of competition.
Members of Sports Physiotherapy Australia (SPA) have experience and knowledge of the latest evidence-based practice, skilled assessment and diagnosis of sports injuries, and use effective 'hands-on' management techniques and exercise protocols to assist recovery and prevent future damage. SPA members have access to the most recent advances in sports physiotherapy. You'll be pleased to know that most of PhysioWorks physiotherapists and massage therapists have a particular interest in sports injury management.
Professional Bike FitYour bike fit physio will explicitly tailor you and your bike. Cyclists are often surprised how a few subtle changes can make their ride more comfortable, efficient and effective. Now, who doesn't want that? A professional bike fit will address several components:
- Assess your riding style and level. Eg. Recreational, aggressive elite, road, track, MTB.
- Take into account your injury history. (e.g. back pain/surgery, knee pain)
- Measure your body's anthropometry. (e.g. body dimensions)
- Identify your ideal bike frame size.
- Analyse your current bike set up - then compare it to your ideal setup.
- Assess your current flexibility. (joint, muscle and neural)
- Analyse your current muscle control.
- Analyse your optimal riding position via slow-motion video analysis.
- Work with you to improve your setup, riding technique and pedal efficiency.
Who Should have a Bike Fit?
- Elite cyclists.
- Serious recreational cyclists.
- Cyclists who are suffering pain or discomfort, eg.
- knee / back / hip / shoulder / neck / wrist pain
- crutch/perineum pain, numbness or pins and needles
- hand numbness or pins and needles
- fatigue cramps
- can't reach the drops comfortably
- Cyclists who have adapted their cycling motion from normal:
- wandering knees
- saddle sliding/tilting
- straight arm
- Cyclists who wish to increase their cycle efficiency (more power for the same energy).
Bike Size vs Bike FitMost bike shops are usually very good at quickly measuring a few of your body parts to determine the best bike frame size for you. They'll then adjust your pedals and seat height to where things should hopefully be. While this quick system will work for most people, it may not be so for the cyclist who spends a few hours on the saddle or want to become a faster or more efficient cyclist. However, sometimes they get things wrong for YOU! Your body isn't the same as someone else's. People have short legs, long trunks and dodgy knees and somehow that has to fit your bike as best we can make it. How often do you sit in someone else's car and have to adjust the seat and mirrors?
Right Bike Size - Wrong Body!Unfortunately, even though you may have the right bike size, your body may not always fit it comfortably! For example:
- Cyclists who are too stiff or inflexible can't attain that ideal cycling position.
- Cyclists who possess poor muscle control or endurance are vulnerable. They simply can't maintain a comfortable cycling posture for the length of their ride.
- Cyclists in pain.
- Cyclists with a physical limitation. They can't achieve a comfortable optimal cycling posture, e.g. previous surgery, leg length difference.
How Long Does a Bike Fit Take?Your professional bike fit is comprehensive and therefore, does take time. But, we'd rather be too thorough and get things right! We will need you and your bike, for between 1.5 and 2.5 hours - depending on the level of fitting you require. We'll also provide you with a detailed report that we'll send to you after we've further analysed your videos etc. That way, we can save you time, by just doing the assessing and measuring during your bike fit consultation.
At PhysioWorks we offer 4 Levels of Bike Fitting:
Full Professional Bike Fit
Standard Bike Fit & Cyclist Musculoskeletal Screening
Allow 2.5 hours
Combining your standard bike fit (Gold) with a cyclist musculoskeletal screening (Silver) and your bike frame sizing (Bronze) is the best and most efficient way to either optimise your cycling or eliminate any pain or cycling discomfort.
If you are suffering pain or discomfort with prolonged riding or you would like to simply prevent injury or optimise your cycling efficiency (lowest energy expenditure for cycling output), then we highly recommend the Full Bike Fit option.
We Recommend the Platinum Full Professional Bike Fit for:
- Elite cyclists
- Competitive cyclists
- Serious recreational
- Any cyclist who is suffering pain, discomfort, cramping or fatigue.
- You are optimising your bike fit for efficient power / minimal energy expenditure.
Your Full Bike Fit includes:
- Measuring YOU (Bronze).
- Measuring your BIKE.
- Full Cyclist Musculoskeletal Screen (Silver).
- Plus, all the components of a Standard Bike Fit (Gold).
- A thorough assessment report of your current status
- Your initial phase of corrective exercises.
- A recommended treatment plan.
Standard Professional Bike Fit
Our Most Popular Bike Fit Option!
Professionally Fitting You to Your Bike
Allow 1.5 hours.A professional bike fit takes time and accurate analysis. Bike fitting is all about ensuring that YOU fit YOUR BIKE optimally.
We Recommend a Gold Standard Professional Bike Fit for:
- a cyclist who does not experience any pain or discomfort when you initially ride your bike, but you do experience some soreness or ache with longer rides.
- You are optimising your bike fit for efficient power / minimal energy expenditure.
Your Standard Bike Fit includes:
- Measuring YOU.
- Measuring your BIKE.
- We are checking if your bike is the right size for YOU.
- We are analysing and modifying your bike to fit you best.
- We use slow-mo video analysis of your cycling setup and style.
- We provide an optional thorough report of your current status and any recommendations.
What to Bring:
- YOU - in cycling attire: shoes, knicks and tight-fitting top.
- YOUR BIKE - We'll pop you on a wind trainer so be ready to ride!
Cyclist Musculoskeletal Screening
Allow 1.0 hours
We focus your cyclist musculoskeletal screening upon your body and its ability to comfortably and optimally cycle. We'll inform you what is right, what could be improved, and how to improve any deficiencies.
We Recommend a Cyclist Musculoskeletal Screening for:
- Elite cyclists, high-end recreational, or competitive cyclists who wish to prevent a cycling injury or want to improve their cycling performance.
- You are a cyclist who is suffering pain, discomfort, cramping or fatigue.
- You are optimising your bike fit for efficient power / minimal energy expenditure.
Your Cyclist Musculoskeletal Screening includes:
- Joint flexibility and hypermobility testing: spine and limbs.
- Muscle power testing.
- Muscle control testing.
- Muscle endurance testing.
- Muscle timing and activation order assessment
- Muscle flexibility and tone.
- Neural tissue extensibility.
- The impact of previous injury or surgery on your cycling ability.
- Corrective exercises.
- Your subsequent treatment plan.
Professional Bike Sizing
Allow 0.75 hoursWhat bike size should you purchase? Your physiotherapist will accurately measure your anthropometrics. Then, they will advise you of your best bike size and recommended crank length etc. For more information, please contact our reception team or bike fit physio for their recommendations.
How Should You Setup Your Bike?While we are happy to provide you with general guidelines on how to set up your bike, we have observed that these guidelines will help some cyclists but not all. We highly recommend a professional bike fit if you are suffering pain or discomfort while cycling, or if you'd like to optimise your cycling efficiency. More information: Bike Fit Brisbane
General Bike Setup Guidelines
Riding Position Set UpA comfortable and efficient riding position is vital. Your bike must be correctly set up and adjusted. A tailored bike will suit your particular body size and shape; you will then feel more relaxed and will be able to ride longer distances with less effort. The notes below are the most common settings that work.
- Centre the ball of your foot over the pedal axle.
- Small feet and high cadence pedlars place the ball of your foot slightly behind centre.
- If you have clip-less pedals, you can make this adjustment by clipping your shoes into the pedal and adjusting the cleat fixing bolts.
Saddle PositionSet the saddle height the following way. With the crank arm perpendicular to the ground and heel (shoes on) on the top of the pedal:
- Your leg should be in the straight "locked" position.
- Allow for oversized shoe heels or extra-thick soles.
- Your saddle top surface should be parallel with the road surface.
Saddle Front/Back Adjustment
- Sit on your bike in your normal riding position with the cranks in the 3 and 9 o'clock position.
- Position your saddle correctly. The correct position is where your tibial tuberosity (the bump at the top of the shin bone) is 1cm behind the pedal axle.
- You may need a plumb line and a helper to make this adjustment, and you may have to readjust saddle height if you move the saddle significantly.
Stem and Handlebars
- Correct stem height can be somewhere between level with the saddle height or as much as 6 cm below. The preferred range is 2.5 to 4.5 lower.
- Check to ensure that your knee just clears your elbow when seated on your bike with the cranks in the 3/9 o'clock position.
- To ensure good chest expansion and breathing your handlebars should be shoulder-width.
- On a mountain or hybrid bike, some riders may prefer a more upright riding position with a higher stem position.
- Extra-wide flat-type mountain bike handlebars may give more stable control on unsealed roads, but you may find them uncomfortable on long rides over sealed roads.
- Bar extensions and narrower handlebars will give you a greater variety of comfortable hand positions and also place your upper body in a slightly lower position to reduce your overall resistance to the wind.
- If the handlebars are too far away, you will be very uncomfortable.
- Sit on your bike in your normal riding position, and your arms should be at 90 degrees to your torso.
Adjusting to Your New PositionIt takes time to settle into the new position, and you may still have to do some fine-tuning. Overall you should feel much better when you ride and less strained when you arrive back home.
What if None of this Works?If you can't get comfortable after making these adjustments and riding for a while, then your bike may not be the right size for you. You should consider visiting a physiotherapist with a particular interest in bike setup or a cycling store professional. More information: Bike Fit Brisbane
Private Health Insurance Rebates
PhysioWorks Physiotherapy and Remedial Massage are more affordable than you think. Your Private Health Insurance (PHI) usually pays for the majority of your treatment fees, leaving you with only a small gap payment.
However, Private Health Funds do vary their rebates payable depending upon the level of cover that you have taken. Some funds have kept up with the costs of modern medicine whereas, sadly others haven't, with rebates similar to what they were a decade ago.
HICAPS - Instant Health Fund Claims
Most health funds are members of the HICAPS instant claims system. Swipe your health insurance card at our reception counter, and you can instantly claim your physiotherapy treatment via our online Hicaps System. Remedial Massage is claimable via Hicaps for some but not all funds. For more information, please visit Hicaps for the latest funds which can use their instant claiming system.
Private health insurance rebates are available for all of our physiotherapists. Instant claims are possible via our in-practice Hicaps system.
- All Private Health Insurance Funds including BUPA, Medibank Private, HCF
- For a full list of Hicaps instant claim funds see here: Hicaps Funds
- HCF More for Muscles Program
PhysioWorks practitioners are registered providers for government, Workcover and insurance companies including:
- Australia Post; Coles Myer; Woolworths
- Department of Veterans' Affairs
- CTP & Sports Insurers