Cycling – common lower back and knee pain injuries

Cycling is a brilliant way to boost your health – not only is it a great cardiovascular workout, but it also supports joint mobility, coordination as well as overall physical and mental wellbeing. Our blog focuses on health benefits of cycling, bike set up, common injuries – with exercises to try.

Health benefits of cycling

Cycling is a low-impact form of exercise, making it ideal for people recovering from lower limb injuries or surgery.

Following the physical activity guidelines of 150 minutes of moderate-intensity exercise per week, this can help reduce the risk of Cardiovascular disease, Stroke, Type 2 diabetes and Mental health conditions like anxiety and depression.

Tips for a safe and comfortable ride

Your bike setup can make or break your cycling experience. A poor fit can lead to pain, inefficiency, and even long-term injury.

Here’s how to get it right: 

• Helmet first: Always wear a properly fitted helmet.
• Saddle height: Set the saddle at hip height. When seated, you should be able to touch the ground with your tiptoes.
• Foot positioning: Your forefoot (the ball of your foot) should rest on the pedals to distribute pressure evenly.
• Handlebar reach: You shouldn’t have to overextend to reach the handlebars. Check your bike’s frame size guide before buying and consider measuring your inseam for accuracy.
• Correct bike for the right terrain: Road bikes, mountain bikes, hybrids – make sure your bike suits the terrain and your fitness goals.

Common cycling injuries

Whether you’re a weekend cyclist or doing a charity ride like the London to Brighton injury prevention should be a priority. 

Why do cyclists get injured?

• Repetitive motion
• Prolonged poor posture
• Overtraining without recovery
• Incorrect bike setup

Up to 85% of cyclists experience some form of overuse injury in their lifetime – lower back and knee pain are the most common complaints

1. Lower back pain
   A common complaint among cyclists due to the sustained forward-flexed posture, which can cause the erector spinae muscles to deactivate. This can place stress on the discs in your lower back and contribute to muscle tightness.
   • Solutions:
     • Adjust seat height, angle and handlebar position
     • Strengthen trunk muscles
     • Improve lumbar mobility
   • Try these exercises: 
     • Glute bridges. Lie with your back on the floor and knees bent, feet on the floor and lift your bottom. Repeat.
     • Romanian Deadlifts. This is an advanced exercise that can be completed in the gym by holding dumbbells in each hand or a barbell. Keeping the bar close to you, feet shoulder width apart, hinge at the hips and push your bottom back. You should feel a stretch in the hamstrings. Push through the floor and return to start position. Repeat.
     • Crunches. Lie with your back on the floor, knees bent and feet on the floor. Reach forwards towards your knees. You should feel this working your core muscles. Repeat.
     • Dead bugs. Lie on your back, feet in the air knees bent. Arms straight up in the air, lower opposite arm to leg towards the floor and return to starting position. Repeat alternating arms and legs.
2. Knee Pain

         The knees generate most of the pedalling power. Incorrect saddle positioning can increase joint stress. 

• • Solutions:
    • Raise the saddle or shift it backward slightly
    • Ensure your kneecap is aligned with the pedal spindle at 90° flexion
  • Try these exercises:
    • Squats. Sink the hips down bending at the knees as if going to sit down and push through the floor to stand back up. Repeat.
    • Glute bridges. Lie with your back on the floor and knees bent, feet on the floor. Lift your bottom. Repeat.
    • Leg extensions. This can be done at the gym or using a band. Start with sitting, legs bent. Ensure the band or bar is against your ankles. Kick the legs out straightening them and hold for a few seconds to work your quadriceps. Control the movement back down and repeat.
    • Leg curls. This can be done at the gym or using a band. Start sitting with your knees straight. Ensure the band or bar is against your ankles. Bend your legs in towards the seat and slowly control the movement back to the start position. Repeat.

Cycling is one of the best forms of exercise for people of all ages and abilities. But like any sport, it is essential to train sensibly. With the right bike setup, a balanced strength training routine, and a focus on posture and recovery, you can avoid injury and pain. If you would like to speak to a physiotherapist then please get in touch. Book an appointment with a physio online.