Cycling is low-impact, but not injury-proof. Here’s why pain happens and what actually contributes to the most common issues riders experience.
Bayley Forbes is an osteopath and strength & conditioning coach based in Ringwood, Victoria. He founded Summit Osteo & Performance to help people bridge the gap between treatment and performance — combining hands-on care with tailored movement and strength programs to support long-term recovery and better performance.
Cycling is unique. Unlike running or field sports, most cycling injuries aren’t caused by sudden impact or trauma. They develop gradually over time, usually because of load, position, or capacity issues.
Longer rides, repeated motion, and maintaining the same posture make cycling extremely repetitive. If your tissues aren’t prepared for this load, or if your bike position isn’t quite right, irritation can build in predictable areas.
Below are the most common cycling injuries and the reasons they tend to occur.
Knee pain is the most common complaint among cyclists. The knee takes a large portion of the workload during the pedal stroke, and when load exceeds tissue tolerance, discomfort develops.
Common contributors include:
• Seat height too low or too high
• Sudden increases in volume or climbing
• Reduced hip strength leading to altered tracking
• Cleat rotation or foot position issues
• Low tolerance to repeated knee flexion
Although the symptom is in the knee, the cause is often higher up (hip control) or lower down (ankle mobility).
Hip discomfort often develops when the hip flexors, glutes, and stabilisers are not conditioned for long periods in the flexed cycling position.
Typical reasons include:
• Weak hip rotators or glute med
• Aggressive riding positions
• Sudden increases in interval intensity
• Limited hip mobility causing compensation
Cyclists often feel “tight,” but tightness is usually secondary to load or strength deficits, not flexibility.
Lower back irritation commonly arises from prolonged flexion, low trunk endurance, or positioning issues.
Contributing factors:
• Excessive reach to handlebars
• Low core/trunk endurance
• Too much climbing in one block
• Limited hip mobility transferring stress to the lumbar spine
Most lower back pain in cyclists is a tolerance issue, not a sign of damage.
Holding your head up for long periods places sustained demand on the neck extensor muscles. This becomes more noticeable with aerodynamic positions or long rides.
Common causes include:
• Long reach increasing load on neck and shoulders
• Weak shoulder blade stabilisers
• Thoracic stiffness
• Prolonged static posture
This is almost always a load-management problem rather than a structural issue.
Hand numbness or tingling is often due to pressure through the palms and wrist over long durations. It reflects compression rather than injury.
Causes include:
• Excessive weight on handlebars
• Saddle too high (hips rocking forward)
• Fatigue in shoulder and wrist stabilisers
• Road vibration
• Grip position not varied
Simple strength work and minor position adjustments often reduce this quickly.
Saddle pain is common early in a training block or when ride duration increases. Most issues occur when pelvic stability is low or weight distribution is uneven.
Common contributors:
• Saddle height or tilt off by a few degrees
• Core endurance not matching ride volume
• Pelvic rotation causing uneven pressure
• Sudden increases in time seated
Saddle discomfort is often the easiest cycling issue to improve through setup, strength, and gradually increasing ride time.
Cycling pain usually results from a combination of:
• Load — doing too much too soon
• Position — saddle, bar reach, or cleat alignment
• Strength — tissues not ready for the demand
• Repetition — long rides with minimal movement variety
• Capacity — tissues not adaptively prepared for the volume
These issues are highly modifiable. With small adjustments and consistent strength work, most cyclists can reduce pain and improve comfort significantly.
