Like running, cycling is a repetitive sport which can expose weakness and stiffness in the body’s movement systems (muscles, joints and nerves) placing extra stress on tissues which can then lead to pain and injury – this is obviously separate from actually falling off your bike! 

One area that cyclists appear to be particularly susceptible to is where the Iliotibial band crosses the outside of the knee.  As the leg moves through repeated revolutions on the bike this large tendon running down the outside of the thigh can develop an inflammatory reaction called “iliotibial band friction syndrome” as it moves back and forth over the bony bit on the outside of the knee.

The lower back can also suffer as it spends long periods of time in a fully flexed position.  Optimising the bike set up is very important in terms of seat to bars position as well as the pedal and cleat set up to make sure that for a given person the joints are moving optimally.  Consideration is also given to subtle variations in the shapes of the skeleton between each side including leg length and foot posture.  We look at this routinely by getting patients to bring their bikes into the clinic. We video the cyclist on a turbo trainer and a physiotherapy/podiatry team analyses the skeletal factors as well as the bike set up and the way the muscles work to drive the leg movement and relate these factors to any injuries.

As with most injuries there is a variable amount of manual therapy needed in order to loosen tissues that may have become tight as well as corrective exercise to improve quality of movement and muscle performance.  Better movement efficiency brings about improvements in performance as well as reduced risk of injury and reoccurrence rates.

Those cyclists involved in triathlon appear to be particularly susceptible to these kinds of injuries as the transition from flexed postures and movements involved in cycling to extended ones involved in running can prove particularly hard to cope with unless specific conditioning is applied.