Preventing Common Orthopedic Issues While Cycling

Preventing Common Orthopedic Issues While Cycling

With COVID-19 vaccine rates climbing, the world is slowly getting back to normal (or at least a version of normal) and that normal includes more opportunities to cycle. Cycling is a great way to improve cardiovascular fitness, increase muscle strength and reduce stress.

Whether you are a competitive triathlete, spend your weekends at local cycling races, or are simply an avid cyclist, there is nothing more frustrating than an injury that forces you off the bike. Like all sports, it’s important to take precautions to avoid pain or injury. Here are the top 4 most common cycling injuries and tips on how to prevent them.

IT Band Syndrome

The iliotibial band (IT band for short) is that tough, connective tissue that runs from the outside of your hip across the top of the knee and down to the top of the foot. You can feel it when you run your hand down the outside of your leg. The IT band helps stabilize the knee while walking or running.

IT band syndrome is an overuse injury that is common among runners and cyclists that results in tightness in your IT band and inflammation. It can cause pain on the side of your knee and, in some cases, pain in your hip. The repetitive motion of bending and straightening your knee joint as you cycle can lead to this IT band inflammation.>

Common symptoms of IT band syndrome can include:
  • Pain or burning sensations that radiate from the knee up through the thigh
  • Pain during motion such as pedaling
  • Knee pain that increases instantly upon impact while running

To prevent IT band syndrome, consider getting your bike professionally aligned to your specific height. The knee joint should not be overextended when the pedal reaches the bottom of its revolution.

Common treatments for IT band syndrome can include:
  • RICE: Rest, ice, compression, and elevation
  • Over-the-Counter anti-inflammatory medications
  • Physical therapy
  • Steroid injections
  • Arthroscopy

Carpal Tunnel Syndrome

When you hear “Carpal Tunnel Syndrome” you may think of the keyboard as the culprit. But it is also a common injury among cyclists. The carpal tunnel is a narrow, rigid passageway in the wrist that protects the nerves that supply your hand and fingers.

Carpal tunnel syndrome is an overuse injury; it occurs when you repeat the same movement over and over again. It can also result from too much pressure on the median nerve, which is the nerve that runs through the carpal tunnel. If the passageway becomes narrow, it can cause pain, tingling, or weakness in the thumb, fingers, and hand. Repetitive movement and especially pressure, can occur in cycling.

Common symptoms for carpal tunnel syndrome can include:
  • Pain, burning, or tingling sensation in the hand and wrist
  • Numbness in the hand, wrist, or fingers
  • Reduced ability in hand dexterity
  • Weakness in the hand and fingers

To prevent carpal tunnel syndrome, cyclists should avoid riding with locked elbows or straight arms. Bending the elbows can offer shock absorption in the event of hitting bumps or uneven terrain that would otherwise jar the wrists. Cyclists can alleviate wrist pain by changing hand positions often during a long ride and consider padded gloves. If your handle bars are not aligned correctly, you could be putting too much pressure on your wrists, leading to carpal tunnel syndrome. Consider adjusting or rotating your handle bars for the best wrist position.

Common treatments for carpal tunnel syndrome can include:
  • Over-the-counter medications or topical ointments/creams
  • Wrist brace or wrapping
  • Ice therapy
  • Wrist stretches and exercises
  • Hand therapy
  • Steroid injections
  • Endoscopic surgery

Achilles Tendonitis

The Achilles tendon connects your calf muscles to your heel bone. Every time you take a step, your calf muscles contract to push your foot forward. The Achilles tendon helps your foot move more efficiently. Achilles tendinitis is a painful condition that is caused by repeated stress to your Achilles tendon, either through overuse or physical activity such as cycling. Another common cause of Achilles tendonitis in cyclists is improper or misaligned seat height and positioning.

When the Achilles tendon gets inflamed, it can cause severe pain and swelling, which can make it difficult to walk and exercise. If left untreated, this inflammation can lead to degenerative issues and even Achilles tendon rupture.

Common symptoms of Achilles Tendonitis can include:
  • Pain, swelling, and stiffness in the calf
  • Reduced strength in the calf
  • Reduced range of motion in the ankle
  • Tenderness and redness in the tendon area

To help prevent Achilles Tendonitis make sure your bike is the right fit for you. This can involve making sure the saddle is not too high as to force your toes to point down, resulting in an extended time period in which your calf is hyperextended. Also assess the placement of your feet while peddling. If your cleats are too forward, you could be aggravating your Achilles tendon.

Common treatments for Achilles Tendonitis can include:
    • Physical therapy
    • Over-the-Counter anti-inflammatory medications
    • Ice therapy
    • Foot elevation
    • Heel inserts

Clavicle Injury

For some cyclists, a clavicle or collarbone injury is seen as a right passage. When we are on a bike and fall, it is instinct to try to break our call by reaching our arm toward the ground or any solid source of stability that could stop the fall.  But when the hand makes contact with the ground of anything solid, the force will travel up the arm and into the shoulder.

In many cases, the clavicle is the “weak link” in this chain. This means, due to the way cyclists tend to fall, clavicle injuries are one of the most common results of crashes. This bone is slightly “S” shaped and when it bears the weight of the body during a crash, it can fracture or even break.

Common symptoms of a clavicle injury include:
  • Pain during arm or shoulder movement
  • Swelling bruising, and tenderness in the area
  • Reducing range of motion

To prevent a clavicle injury can be difficult as there could be elements outside of your control such as other cyclists, vehicles, and even road debris. If you are on your bike and think you are going to fall, try to remember to keep your hands on the handlebars or close to your body. Roll with the impact rather than attempting to brace with your arms. This can spread the impact across a larger mass, like your trunk, and reduce the likelihood of a clavicle injury.

Common treatments for a clavicle injury can include:
  • Arm support such as a sling
  • Over-the-counter medications
  • Physical therapy
  • Minimally invasive surgery

Sport Medicine Expert in NJ and NY

You don’t need to be an Ironman athlete to suffer from any of these common orthopedic issues. Cyclists of all levels can benefit from being aware of IT Band Syndrome, Carpal Tunnel Syndrome, Achilles Tendonitis, and clavicle injury, plus how to prevent them. These tips can help you get a good quality ride without getting hurt.

If you think you are experiencing the symptoms of an injury from cycling, don’t wait until the pain worsens to seek medical help. Oasis sports medicine expert Dr. Keith Johnson can diagnose your pain and create a treatment plan that gets you back on the bike quickly and safely.

Dr. Johnson

Meet Dr. Keith Johnson 

Dr. Keith Johnson is a board certified orthopedic surgeon and sports medicine specialist. Dr. Johnson specializes in sports medicine and post-traumatic joint and soft tissue injuries with a focus on arthroscopic, minimally invasive surgical treatments of injuries. As an avid cyclist, he understands exactly what you are going through and can help you get back to the active lifestyle you love.



Oasis Orthopedic & Spine offers telehealth appointments in addition to in-person appointments.

We are dedicated to your safety during COVID-19 and are actively practicing the COVID-19 Safe Care Protocols at all of our locations so you can find the pain relief you deserve.