Disclaimer: This article is for general educational purposes only and does not constitute medical advice. Always consult a qualified health professional for advice specific to your condition. © 2026 Better Physiotherapy Bundoora.
Cycling is a low-impact, high-repetition sport — which means most cycling injuries are overuse in nature. The good news: overuse injuries are highly predictable, highly treatable, and often highly preventable with the right combination of physiotherapy and bike setup adjustment.
Why Cyclists Get Overuse Injuries
A cyclist completing a 3-hour ride at 80 rpm performs approximately 14,000 pedal revolutions per leg. Any small biomechanical inefficiency — a cleat slightly rotated in, a saddle 5mm too low — is multiplied across thousands of repetitions. This is why many cycling injuries appear gradually rather than from a single incident, and why subtle bike fit corrections often produce dramatic symptom relief.
Common Cycling Injury Locations and Causes
Anterior knee (front): Patellofemoral pain from saddle too low, excessive cleat float, or weak quadriceps and glutes.
Lateral knee (outer): IT band syndrome from saddle too high, cleat toe-in, or hip abductor weakness.
Posterior knee: Hamstring or popliteal tendon strain from saddle too high.
Low back: Sustained lumbar flexion from handlebar position too low, poor hamstring flexibility, or inadequate core stability.
Neck and shoulders: Sustained cervical extension from handlebars too low or too far forward.
Achilles/calf: Tendinopathy from excessive ankling, sudden training load increase.
The Physiotherapy Approach to Cycling Injuries
- Thorough injury assessment including cycling history, recent load changes, and bike setup
- Manual therapy for acutely painful joints and muscles
- Targeted strengthening — gluteal, hip abductor, and core exercises specific to cycling demands
- Bike fit assessment and recommendations for saddle height, cleat position, and handlebar setup
- Training load management to allow tissue recovery while maintaining fitness
Cycling Injury Treatment at Better Physiotherapy Bundoora
We treat cyclists from recreational riders to competitive road and mountain bike athletes. Our assessments include bike setup review integrated with biomechanical assessment. Call (03) 9467 6900 or book online.
Frequently Asked Questions
How does saddle height affect cycling injuries?
Saddle height is the single most important bike fit variable. Too low: causes anterior knee pain (patellofemoral), quadriceps overload, and reduced power output. Too high: causes posterior knee and Achilles pain, lateral rocking of the pelvis (IT band), and hip flexor strain. The commonly used heel method (slight knee bend at the bottom of the pedal stroke with heel on pedal) is a reasonable starting estimate, but a proper bike fit accounts for individual anatomy.
Why does my back hurt when cycling?
Cycling requires sustained lumbar flexion, which loads the posterior spinal structures. Contributing factors include: handlebar position too low or too far forward, inadequate hamstring and hip flexor flexibility, poor core stability, and a bike frame that doesn't match rider proportions. A combination of physiotherapy for spinal mobilisation and strengthening, combined with bike fit adjustment, resolves most cycling back pain.
Can I keep cycling with a cycling injury?
Usually yes, with modification. Cycling is generally a low-impact activity that can often continue during rehabilitation of overuse injuries. Load reduction (reducing distance, intensity, and climbing) combined with bike fit adjustments and targeted exercises usually allows continued riding. A physiotherapist will advise on specific modification for your injury.
Do cyclists need to strength train?
Yes. Cycling is a unilateral, repetitive, sagittal-plane dominant activity that creates significant muscle imbalances — particularly gluteal weakness and hip flexor tightness. Off-bike strength training (single-leg squats, deadlifts, hip abductor work) improves cycling performance, corrects these imbalances, and reduces injury risk. A physiotherapist can design a cycling-specific strength program.
Ashley Haleel
Physiotherapist & Owner — Better Physiotherapy Bundoora