In the United States, participation in bicycling has steadily increased over the past decade. Whether they’re looking to implement healthier lifestyle behaviors or are searching for a cheaper, eco-friendly alternatives to car transportation, 47 million Americans ride bicycles at least monthly, with more than 5 million people riding at least 20 days every month.
Bicycling, when done properly, is a great low-impact sports activity, often recommended as a method of recovery after injuries and even surgeries; however, it isn’t without risk of pain and injury. Oftentimes, it is the very activity of cycling that brings about aches and pains, some of which are difficult to recognize and even harder to treat.
Most cyclists who visit our chiropractic clinic have sustained overuse injuries by pushing themselves beyond their limitations. Below we’ve listed some of the most common cycling injuries and the reason they happen.
Knee Pain. Although cited as the most common lower-extremity overuse injury in cyclists, knee pain caused by riding a bicycle is preventable, in most cases. Cartilage irritation or deterioration, usually occurring under the kneecap, is often the result of a biomechanical imbalance, incorrect saddle height, or improper foot positioning on the pedals. Using too high a gear, positioning the saddle too low, riding with longer cranks than you are used to, or standing on the pedals can all aggravate the stress on the knees and result in serious problems.
(Serious knee problems such as swelling, clicking, or popping may have different causes and should be immediately assessed by a sports medicine specialist).
Pelvic Pain (Cyclist’s Syndrome). Sitting for prolonged periods on hard surfaces such as a bicycle seat can cause compression or entrapment of a nerve that passes through the lower central pelvic area, leading to chronic pelvic pain over time. In fact, this problem occurs so frequently among cyclists, especially those who ride their bikes for prolonged periods on incorrectly positioned or improperly shaped saddles, that it is often referred to as Cyclist’s Syndrome.
Symptoms of Cyclist’s Syndrome arise from changes in nerve function that give rise to neuropathic pain in the perineum, genital, and anorectal areas. Common manifestations include: spontaneous and burning pain (with or without ‘electric shock-like’ sensations), urinary disorders, constipation/painful bowel movements, sexual dysfunction, recurrent numbness of the pelvic area, and impotence in men.
The condition is extremely painful and often made worse by sitting. Physical therapy and chiropractic care help to educate patients about stretching correctly and strengthening the pelvic floor, while alternative therapies such as acupuncture can help treat trigger points in the pelvic musculature to relieve pain. Selecting the proper type of bicycle seat and adjusting it correctly will prevent pressure on the pudendal nerve and preclude pain before it starts.
Neck and Back Pain. Neck and back pain while cycling are usually caused by poor cycling posture. Proper cycling posture differs from proper sitting posture and it’s meant to facilitate the pedaling action, as well as enable the rider to cope with terrain irregularities, which increase jarring and compression to the spine. When riding a bicycle in a relaxed posture (which is the foundation for all types of riding conditions), you should:
- Sit high in the saddle to prevent slouching or putting excessive strain on your knees and lower back
- Keep hands on the tops of the bars to open up your chest for easier breathing
- Keep wrists in neutral position to minimize the risk of developing carpal tunnel syndrome or handlebar palsy
- Keep the elbows slightly bent but not locked to absorb shocks and allow for more relaxed line changes
- Keep the back arched and not drooping forward between the shoulders and the hips to prevent bowing even further in the forward position and developing severe lumbar pain
What Should You Do If You Experience Cycling Pain?
Overuse injuries such as the ones described above can be stubborn problems. Unlike acute injuries, which are easier to identify as the result of a single, traumatic event, overuse injuries are the result of repetitive micro-trauma to bones, muscles, and joints. They are, therefore, subtler and usually occur over time, which makes them more difficult to identify and treat.
Aside from rest, the recommended treatment for overuse injuries is chiropractic care, which can:
- Provide instant relief from pain
- Increase flexibility and range of motion
- Improve muscle balance and tone
- Improve cycling biomechanics
- Ensure faster and safer healing for muscle, joint, and ligament injuries than conventional care
- Help prevent future pain and injury
Addressing cycling pain as soon as the first symptoms appear is essential to having a speedy and effective recovery. In chronic cases, continued activity will produce degenerative changes that will most likely result in weakness, loss of flexibility, decreased range of motion, and chronic pain. Working with an experienced chiropractor will help you manage your existing pain better and allow you to continue riding your bike in a safe manner.
About the Author
Dr. Marc Browner is the Founder of iChiropractic and Wellness in Naples, Florida. A graduate of the University of Florida in 1991, he earned his Doctor of Chiropractic degree from Life Chiropractic in 1995. In private practice since 1998, Dr. Browner is a member of the Florida Chiropractic Society, the Florida Chiropractic Association, and he attends continuing education seminars, classes, and workshops to remain abreast of the most current treatment methods and technological advances in the field.