Injury Prevention in Cycling

Injury Prevention in Cycling by Jeanne Boisseau, M.Ed., LMT

Spring has arrived, your bike is tuned and you are ready to get outside! But, a word of caution - the most critical time for overuse injuries is at the beginning of the season when you are all revved up and tempted to do too much too fast!

It’s important to take it easy for the first few weeks on the road, building your performance level up gradually. Pedal at a low resistance and easy going cadence so your body can adjust to being on the road again. Minimize hills at first and remember that patience now will pay off later. To avoid injury, stretch and massage your muscles both before and after riding to maintain and improve flexibility and tone. Massage will also help your muscles to recover and heal more quickly from any minor damage that is normally caused by exertion. Pay particular attention to how your body feels and note any pain in your neck, shoulders, low back, hips, quads, knees and hands. Much of this pain may be alleviated by adjusting your bike fit and cycling posture. Body awareness can greatly improve the pleasure and performance of your ride.

Because your neck may become tight when locked in the road-cycling position with head tilted back, try to alleviate some of the tension by occasionally looking around or moving your head from side to side and up and down. You can also angle your head to either side of center for a few minutes every now and then. Check the handlebar height and adjust to a comfortable position. If it is too low, you will be craning your neck. If it is too high, you will be hunching up your shoulders and causing pain to the trapezius muscles at the base of your neck.

To avoid shoulder pain, keep your elbows flexed, putting less weight on your arms. Check the seat adjustment. You might try a more upright posture on the bike or tilt the seat back a little. If you choose to tilt the seat, be sure to avoid putting too much pressure on the perineum.

Paying attention to cycling posture all the time will help you to avoid low back pain. Your back should be flat and muscles lined up when you are riding. Stretching your hamstrings will help to keep the pelvic muscles in line and reduce stress to the back. It may be a good idea to check to see if your leg length matches as any inequality can cause both low back and knee pain.

On the outside of your leg, the iliotibial band runs from your hip to your knee. When it is tightened, it rubs over the hip bone or the outside of the knee, causing pain. If your saddle is too far back, you will be overstretching the IT band as you reach. If the saddle is too low, you may also feel pain in the quad muscles in your thighs.

Saddle position is important to your knees as well. When it is too high, you may feel pain behind your knee; too low may cause pain in the patella, or kneecap area. A condition called chondromalacia, an irritation of the cartilage behind the knee, may occur. It is more commonly seen in women cyclists due to the angle of the knee in relation to the pelvis. Strengthening the quads and shortening the crank may help you to avoid this.

If inner knee pain is present, cleat position may need adjusting. Check to see if your foot is rotated out. An inwardly rotated foot causes pain on the outside of the knee.

Finally, hand pain can become a problem, especially for mountain bikers because of surface vibration and grip. The grip should be firm but relaxed, with straight wrists. Hand position should be changed frequently. Massage of palm, wrist and forearm during a stop or after riding alleviates the discomfort.

Sometimes muscle cramping occurs during hard exercise. They are caused by overdoing it, overuse, poor hydration and sodium imbalance. When a cramp is in progress, massage and stretching might relax the affected muscle. Prevention of the cramp is preferable. There are no guarantees that all cramps can be avoided, but the old saying “an ounce of prevention is worth a pound of cure” is true if you have ever suffered from sudden muscle cramps. Train to an appropriate level - don’t go over the top. Stay well-hydrated and maintain appropriate salt intake, especially on hot days when you will sweat a lot. Be sure to eat enough on high activity days. Always stretch and massage before and after riding.

Spending a few extra minutes on these preventative steps will have you pedaling with pleasure all through the season. Have a great ride - and don’t forget to enjoy the scenery!!

Copyright 2007 Jeanne Boisseau, M.Ed., LMT is a nationally certified and NH licensed Massage Therapist She owns and operates a therapeutic massage practice in Bethlehem, NH. A former public school teacher, Jeanne has been a massage therapist since 1999 in resort, corporate and private practice settings and provides chair massage at large national events coast to coast. She presents workshops regularly on health topics related to massage and aromatherapy and has authored numerous articles on the same. Jeanne can be reached at 603-869-5594 or

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