Common Cycling Injuries and How Physical Therapy Can Help

Wesley Miller, PT, FAAOMPT
Oct 21
3 min read

Updated: Oct 22

Brought to you by AntiFragile Physical Therapy – Asheville, NC

Cycling is one of the best ways to stay active, improve endurance, and explore the outdoors. But like any sport, cyclists are prone to specific injuries that can affect performance and long-term health. Understanding common cycling injuries and knowing how physical therapy for cyclists can help is essential for staying on the bike safely.

1. Knee Pain in Cyclists (Patellofemoral Pain Syndrome)

Knee pain is one of the most frequent complaints among cyclists. Often caused by overuse, improper bike fit, or poor pedaling mechanics, it can present as discomfort around the kneecap during or after rides.

How Physical Therapy Helps:

Strengthening the quadriceps and hip stabilizers to reduce knee stress.
Adjusting bike setup for proper alignment.
Stretching and flexibility routines for the lower body.

Tip: Consistent monitoring of knee discomfort can prevent chronic injuries and keep you cycling longer.

2. Iliotibial Band Syndrome (ITBS)

Pain on the outer side of the knee is usually related to ITBS, a common overuse injury in cyclists. Improper bike fit, saddle height, or repetitive motion can aggravate the iliotibial band.

Physical Therapy Strategies:

Targeted stretching and strengthening exercises for the IT band.
Adjusting pedal alignment and saddle position.
Foam rolling for relief and injury prevention.

3. Achilles Tendinitis

Cyclists may experience Achilles pain due to repetitive pedaling or poor ankle mechanics. This manifests as soreness at the back of the heel or stiffness in the lower leg.

PT Solutions:

Eccentric calf exercises to strengthen the Achilles tendon.
Gradual return-to-ride plans after rest or injury.
Incorporating proper warm-up and cooldown routines.

4. Hip Pain from Cycling

Hip discomfort can result from prolonged riding positions, muscle imbalances, or weak stabilizers. Symptoms may include pain in the hip flexors or outer hip during or after rides.

Physical Therapy Recommendations:

Strengthen hip flexors, extensors, and glutes.
Optimize saddle and handlebar positions.
Include core stability exercises for overall balance.

5. Numbness or Pain in Hands and Feet

Cyclists often experience nerve compression or circulation problems in their hands and feet, leading to tingling, numbness, or pain during rides. These issues are commonly linked to factors such as handlebar and neck position, saddle design or placement, shoe choice, or pedal setup.

Preventative and Recovery Tips:

Professional bike fitting to reduce pressure points.
Stretching and mobility exercises for hands, wrists, and feet.
Padded gloves, ergonomic handlebars, and proper footwear.

How Physical Therapy Supports Cyclists

At Antifragile Physical Therapy, we specialize in cycling injury prevention and rehabilitation.

Our physical therapists provide:

Biomechanical assessments to optimize movement.
Manual therapy for muscle and joint recovery.
Guidance on posture, bike fit, and cycling mechanics.
Customized rehab programs for safe return to cycling.

Prevention Tips for Cyclists

Bike Maintenance: Regular checks prevent mechanical-related injuries.
Strength Training: Focus on cycling-specific muscles for endurance and injury prevention.
Nutrition & Hydration: Supports muscle recovery and overall performance.
Rest & Recovery: Adequate recovery time reduces overuse injuries.

Why Riders Choose AntiFragile PT

At AntiFragile PT, every cycling injury assessment is guided by a clinician with advanced training in biomechanics and physical therapy. Wes and Jeff combine medical expertise with real-world cycling experience, so you’re getting care that understands both the science and the sport.

Our approach looks beyond symptoms — we identify the underlying movement patterns, muscle imbalances, and bike setup factors that contribute to pain or recurring injuries. We also collaborate with local bike shops and coaches to ensure your recovery and performance plan fits seamlessly with your riding goals and training demands.

Getting Started

You don’t have to wait until pain sidelines you completely to take action. Start today by:

Paying attention to early warning signs — numbness, tightness, or pain that creeps in during rides
Making one small change at a time and noting how your body responds
Checking your position and posture on and off the bike
Reaching out for a professional assessment when discomfort persists or limits your performance

Cycling injuries often develop gradually — but with the right guidance, recovery and prevention can, too.