10 Most Common Cycling Injuries & How to Treat Them: The Ultimate Guide

Name: 10 Most Common Cycling Injuries & How to Treat Them | Bodytonic Clinic
Creator: James Gill

Written by: James Gill BOst GOsC 6039. Registered Osteopath, Founder & Clinic Director

Medically Reviewed: Lauren Egginton MChiro GCC 06282, Registered Chiropractor. Specialist in Pregnancy, Paediatric Chiropractic & Functional Rehabilitation | London.

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Our clinical team performed 8,000 specialised musculoskeletal treatments in 2025 alone. Across our Canada Water and Stratford clinics, we have extensive experience managing the specific back, neck, and joint pathologies commonly faced by London’s cycling community.

“Cyclists are everywhere these days,” right? Termed ‘the unstoppable rise of cycling,’ more of us than ever are taking our wheels for a spin to get from A to B.

While cycling is a fantastic low-impact sport, the repetitive nature of the pedal stroke – averaging 5,000 revolutions per hour – means that even a minor bike-fit misalignment can lead to chronic Overuse Injuries. Recent research in the British Medical Journal (BMJ) confirms that regular cycling significantly lowers the risk of many serious illnesses, such as heart disease. However, as with all endurance sports, you can occasionally end up with a ‘pain here’ or a ‘niggling ache’ there. If not managed properly by a medical professional, these cycling injuries can develop into longer-term problems that could slow you down and even stop you cycling.

Good for your brain, your heart and your bodily health in general, recent research conducted by the British Medical Journal has found that cycling regularly can significantly lower the risk of many serious illnesses, such as heart disease, source bmj.com. However, as with all endurance sports, occasionally you can sometimes end up with a ‘pain here’ or a ‘niggling ache’ there. If not managed properly by a medical professional, these cycling injuries can develop into longer term problems that could slow you down and even stop you cycling.

Expert Care for Cyclists in London

At bodytonic clinic, located in Canada Water and Stratford, our multi-disciplinary team of Osteopaths, Physiotherapists, and Chiropractors specialises in sports-specific rehabilitation. We don’t just treat the pain; we analyse your biomechanics to keep you pedalling.

Common Cycling Injuries and how to treat them

We Osteopaths, Physiotherapists and Chiropractors at bodytonic clinic want to keep you pedalling. Manual therapy can provide an easy solution to your issues, keeping you on the roads while shedding light on the reasons behind your injuries and giving you simple ways to prevent them from happening again.

As a starter for ten, here’s a round up of the most common cycling injuries, what causes them, and what you can do about it.

1. Neck Pain

Symptoms: Pain and ache in neck, can radiate to middle part of the back. Rotating and bending your head can be difficult, making it feel ‘blocked’.
Common Causes: One of the most common complaints for any cycling discipline, it is often the result of reduced flexibility in the upper back or neck with poor adaptation to sustained posture. Your spine is one of the strongest parts of your body, but it can be very sensitive when over-strained leading to a painful muscle spasm. Muscles like to be active and moving, so holding a static position you aren’t familiar with or for longer than you are used to can make them painful and stiff.
What you can do: Gentle neck stretches can help loosen your neck. An Osteopath, Physiotherapist, or Chiropractor can then help with hands-on treatment to mobilise your neck, adjust the cervical joints, and tailor exercises to get it back to normal.

Neck and Back Pain

Cycling Injuries Neck & Back Pain

2. Hand pain

Symptoms: Pain, which can be accompanied with weakness and pins and needles, in your ring finger and little finger (often termed ‘Handlebar Palsy’).
Common Causes: Irritation of a nerve which passes on the underside of your wrist (ulnar neuropathy). Commonly caused by holding handlebars in one position for too long.
What you can do: Try altering your grip position frequently. If things don’t improve, our Osteopaths, Physiotherapists, and Chiropractors can increase mobility in your wrist and elbow to reduce nerve tension.

3. Forearm pain – ‘Arm Pump’

Symptoms: Intense ache in the forearm that makes ‘un-gripping’ your hands difficult.
Common Cause: Tired, tight forearm muscles (often from ‘death-gripping’ the bars).
What you can do: Adjust your brake lever angle. A Sports Massage or an appointment with our Osteopathic, Physiotherapy, or Chiropractic team will help restore function to the elbow and wrist joints through soft tissue work and joint mobilisation.

Lower Back Pain

4. Low Back Pain

Symptoms: A sharp pain or ache in the lower part of the back, radiating to the buttock and thighs.
Common Causes: Affecting up to 60% of cyclists, this is often the result of sustained posture and decreased hip flexibility. Pain radiating into the legs can often be related to Sciatica and Nerve Pain.
What you can do: Check your saddle angle. Osteopathic and Physiotherapy hands-on treatment helps encourage better movement, while Chiropractic adjustments can ensure pelvic alignment. For long-term stability, we recommend 1-2-1 Clinical Pilates.

5. Hip Pain

Symptoms: Pain at the front and outer side of the hip, can travel down the thigh towards the knee cap.
Common Causes: Tightness in the hip flexors and irritation of the bursa (Bursitis). This is frequently diagnosed as Greater Trochanteric Pain Syndrome or Gluteal Tendinopathy.
What you can do: Check your saddle height. Seeking treatment from your Osteopath, Physiotherapist, or Chiropractor can relieve tension through manual therapy and get your hip moving normally again.

6. Knee Pain

i) Patella-Femoral syndrome

Symptoms: Pain or a deep ache around the kneecap.
Common Causes: Muscle imbalances in the thigh or hip. Often caused by “mashing” big gears at a low cadence. For more detail, read our Deep Dive into Patellofemoral Syndrome Symptoms.
What you can do: Check your saddle height. Your Osteopath, Physiotherapist, or Chiropractor can determine the root cause, providing joint mobilisation and muscle re-education.

i) Patella-Femoral syndrome

Symptoms: Pain or a deep ache around the kneecap.
Common Causes: Muscle imbalances in the thigh or hip. Often caused by “mashing” big gears at a low cadence.
What you can do: Firstly, check the height of your saddle to make sure it is optimal for your height and not placing extra load on one group of muscles. Getting into a routine of hip and knee stretches can also help reduce tension over the knee cap and get things moving a better. Your local Chiropractor, Osteopath or Physiotherapist can help to determine the cause of your knee pain and tailor exercises and stretches to the root cause of the problem. Over-training can also be a cause for knee pain, so if you are putting in some hard miles to work up to a sportive, make sure you are sequencing your training appropriately and having enough rest days.

i) ITB Syndrome

Symptoms: Pain focused around the outside of the kneecap, often accompanied with a feeling of tightness in the hip on the same side.
Common Causes: The ‘IT’ (Ilio-Tibial) band is a length of fibrous tissue which runs from the hip to the outside of the knee. With repeated movement and decreased flexibility in the hip external rotators (particularly Gluteus Maximus), this can alter the muscle balance around the knee and create tension on the outside of the knee cap. Learn more in our guide: Everything You Need to Know About ITB Syndrome.
What you can do: Take a look at your saddle height. Adding mobility and flexibility exercises to your post-cycling routine can help. Our clinical team (Physio, Osteo, and Chiro) can provide targeted glute-strengthening programmes and myofascial release to reduce the build-up of tension. Additionally, a Chiropractor can check for pelvic “torsion” or functional leg-length discrepancies that may be over-tensioning the ITB during the pedal stroke.

iii) Patella Tendonitis

Symptoms: Tenderness and pain underneath the knee cap on the front of the lower leg.
Common Causes: The patella tendon can become irritated when placed under too much demand, such as with over-training or poor bike set-up.
What you can do: First thing is to continue riding but scale back on your training if possible, and make sure you take adequate rest days. A programme of stretching and exercises to help strengthen the tendon have shown to be most effective by research; these can be tailored to you by your Osteopath, Physiotherapist, ot Chiropractor. Shockwave Therapy is also highly recommended for persistent cases, as supported by NICE guidelines for tendon injuries.

Ankle Pain

7. Ankle Pain

Common Causes: ‘Achilles tendonitis’, an overuse injury of the tendon which runs from the calf muscle to the back of the foot. Often the result of training too much too quickly. If pedal cleats are set up too far forward and the saddle is too high, the ankle can be held in a pointed down (‘plantar flexed’) position which can place further tension on the Achilles tendon.
What you can do: Break up training to allow for adequate active rest. Physiotherapy, Osteopathy, and Chiropractic care can all help manage the tendon loading and check your ankle biomechanics. Applying ice can help with pain relief. If you experience clicking, see 10 Common Causes for Clicking Ankles.

8. Foot Numbness

Symptoms: Pins and needles and/or with a loss of sensation in the foot, often after cycling for a short period.
Common Causes: Ill-fitting shoes or cleats placed too close to the toes can create tension across the metatarsals (the bones in your feet).
What you can do: Check your shoe size. Additionally, ensure the pressure is directed to the ‘ball’ of your foot. If symptoms persist, a consultation with our Osteopaths, Physiotherapists, or Chiropractors can rule out nerve entrapment further up the leg.

Saddle Sore Pain

9. Saddle sore

Symptoms: A real pain the backside. Soreness between the contact area of your buttock and the saddle.
Common Causes: Skin irritation from friction, often from a poorly fitting saddle.
What you can do: Head to your local bike shop and try out some different saddles. Invest in a new pair of shorts and some chamois cream to reduce friction. If the pain is actually deep-seated in the sit-bones, an Osteopath or Chiropractor can check for pelvic rotation.

10. AC Joint sprain

Symptoms: Pain on the top of the shoulder around the tip. There can be a raised area above the joint where the capsule has been damaged.
Common causes: Falling onto an outstretched hand from your bike transmits the force up into your shoulder. For more information, see our Clinical Overview of Acromioclavicular Joint Dysfunction.
What you can do: First point of call after any major trauma or fall with prolonged pain should be to consult a healthcare professional. Depending on the grade of the sprain, our Physiotherapists, Chiropractors, and Osteopaths provide specialised Rehabilitation Programmes to restore stability. Please note: If you have a visible “step” deformity on top of the shoulder, significant swelling, or an inability to lift the arm, seek an immediate clinical assessment to rule out a high-grade ligament tear.

A fall onto the shoulder is the #1 cause of AC Joint sprains. Early diagnostic provocative testing is essential to rule out grade 3 tears.

Explore More Expert Guides for Cyclists

Setting your saddle up correctly

The popular ‘heel-to-pedal’ method will help you find the rough height you need:
Having a wall to lean on, take a seat on your saddle then place your heel on the pedal.
Rotate it backwards to reach the 6 o’clock position; your knee should be completely straight.

If your knee is bent slightly, increase the height of your saddle slowly. When you then place the ball of your foot on the pedal to ride, you will have the perfect slight bend in the knee (approx. 25–35°).