Injury Information provided by The Osteopathic Centre


Although it is a non-impact sport, cycling can lead to a number of common sporting injuries. Obviously there is the trauma of falling off the bike, but also due to the type of movement involved, overuse and repetitive injuries are common.

Below are some of the most common of these injuries with a description of the cause, the symptoms you may experience and what you can do to help yourself. Examples of stretchers numbered below can be found at

All of these conditions can be triggered or made worse by the following two factors: Incorrect bike set up, leads to poor biomechanics and increased positional strain on the body. Too rapid an increase in time/distance of cycling; the body needs time to adapt to new stresses.


Lower back pain
Cause - Sitting with your spine in a bent position for 1-6 hours at a time can cause muscle strain and lead to muscle imbalance (most commonly the hip flexors becoming overly tight) and in the worst instance, overloading of the lumbar spinal discs.

Symptoms - Usually causes an ache in the lower back that can turn to pain and often causes stiffness when not cycling.

Help - Stretching, specifically of the hip-flexors and the lower back muscles will often solve the problem (stretches 8,14 and 17). It is worth noting, that excessive tension in the hip-flexor muscles can lead to a pelvic muscle imbalance, which can effect performance)

Note - Excessive tightness in the hip-flexors or calf muscles may be responsible for numbness in the foot when cycling (it is much less common for the lower back to be responsible for this)

ITB syndrome/ Lateral knee pain
Cause -A repetitive overuse injury sometimes made worse by inaccurate pedalling technique.

Symptoms - Excessive tightening and inflammation of the connective tissue band that runs down the outside of the thigh, causing pain on the outside of the knee or pelvis.

Help - Stretching (stretches 9,19 and 20) help and ICE can be used over the painful area. If this does not fully relieve the symptoms then exercise must be reduced to allow the inflammation to subside.

Anterior knee pain/ Patella pain
Cause -A repetitive overuse, made worse by poor cycling biomechanics, poor technique and muscle imbalance. More common in women due to a different angle of pull on the kneecap compared to men.

Symptoms - Pain over the front of the knee/ kneecap during cycling and stiffness afterwards.

Help - Stretching of the ITB (ilio-tibial band) and strengthening of the medial quadriceps muscles helps by allowing the kneecap to track more naturally when moving (stretches 19 and 20), ICE can be useful if very painful.

Shoulder and neck pain
Cause -Generally pain occurs as a result of holding the head in a certain position for an extended period of time.

Symptoms - Pain may get progressively worse. Numbness in the hands may be experienced due to the tight muscles causing nerve irritation.

Help - Stretching of the neck, chest and trapezius muscles will help (stretches 1,2 and 3) and also allow the neck muscle to adapt by a slower increase in time on the bike.


Triathlon is a very balanced sport to participate in as it combines a mix of cardiovascular exercises, both impact and non-impact, which uses a wide variety of muscle groups. This is a positive point as it spreads the load on the athleteís body. However there is still the risk of acute and or overuse injuries.


Muscle, tendon and ligament strains and sprains.
Cause - Can be due to over training, trauma, and/or lack of flexibility or just bad luck.

Symptoms - Acute pain whilst exercising, often with localised swelling immediately or within 24 hours.

Help - Rest, Ice, Elevation, Compression (RICE), anti-inflammatory medication and seek professional advice.

Tendonitis (inflammation of a tendon)
Cause - Due to over training, or too much too soon, a previous injury or poor biomechanics.

Symptoms - Usually presents as pain at the start of exercise, then improves, only to return post exercise. This pattern continues with the symptoms getting progressively worse until normal function is altered. It can affect many different areas but most commonly the Achilles tendon, the patella tendon (front of knee) and the hamstring tendons.

Help - Rest and ICE and seek professional help. Unfortunately most of us train through these until it affects our ability to exercise, so by the time we seek help the condition is chronic.

Foot pain
Cause - Again overuse or too much too soon.

Symptoms - Often pain in the base of the heel or arch of the foot, which gets progressively worse during exercise. It may also be more painful with the first few steps in the morning after getting out of bed. The most common cause is inflammation of the plantar fascia.

Help - Rest, ICE and seek professional help; you may find a registered Podiatrist (foot specialist) can be the most helpful person to see for this injury.


Rotator cuff tendonitis (swimmers shoulder)
Cause - Overuse tendonitis of the rotator cuff in the shoulder. Can be made worse by a change in technique or poor technique.

Symptoms - Pain in the shoulder during swimming, often on raising the arm out sideways, to shoulder height. If very inflamed it may be painful to lying on that shoulder.

Help - Rest and ICE are important; stretches of the rotator cuff muscles may help (stretches 4,5 and 6). It may be useful to get a swimming coach to observe your technique, depending on your ability.


With all of the conditions discussed above there are simple things you can do to help prevent the problem in the first place. Do yourself a favour:

  • Get a good bike fitting
  • Invest in the right attire (running trainers, cycle shoes etc)
  • If you are new to the sport get some coaching or join a club and learn how to push your body at the correct tempo.
  • Make sure you progressively increase the time/ distance and intensity of your training sessions. (Whether you are a beginner, or a professional who has been on a rest period)
  • You donít need to be fanatical about stretching, just be specific and increase stretching proportionally to your increase in exercise.

If Rest, ICE, stretching etc are not working, seek professional advice for your condition. Generally the longer you leave an injury the longer it will take to heal once treatment commences.

For more information contact:

The Osteopathic Centre
44 Rochester Park
Singapore 139248
Tel: 6779 0660

The Osteopathic Centre
01-02 Bowmont Centre
20 Siglap Drive
Singapore 456192
Tel: 6446 7236

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