If you are reading this, then I don’t have to tell you of the myriad benefits of cycling. But I will anyway! They include:
- improving cardiovascular fitness
- strengthening the immune system
- promoting weight loss
- decreasing heart disease and cancer risk
- improving sleep
- enhancing mental well-being
While the pedal stroke is low-impact and joint-friendly, over time the postural demands of cycling and its repetitive nature can lead to muscular imbalances which may limit the body’s ability to perform at peak level and dramatically increase the chance of overuse injury and chronic pain.
What Causes Virtual Cycling Injuries?
Most indoor cycling injuries are due to muscle imbalances and overuse. Hours of cycling in the bent-over position create tightness in the quadriceps and the psoas (hip flexors), which acts to pull the pelvis into a forward tilt, overloading the muscles of the lumbar spine while at the same time weakening the abdominals. This also causes the opposing hamstrings and glutes to be weakened and calves tightened.
Additionally, there’s the neck and upper back soreness we all feel as we hunch over the bars with rounded shoulders and head raised. The stationary nature of virtual cycling makes this soreness even worse.
What Can We Do To Actively Treat And Prevent Common Cycling Injuries?
As a Physical Therapist in Sports Medicine private practice for over 25 years, I have seen the deleterious effects of hours in the saddle. As a competitive amateur cyclist for the majority of that time, my experience provides a unique perspective. I have suffered from most injuries myself and am perhaps my own worst patient.
Despite this, I have always practiced by a simple edict: “As a Physical Therapist it is not my job to tell you to stop doing what you love to do, rather to treat and teach so that you don’t have to!” Because I know quite well that I wouldn’t stop riding either, despite injuries!
The Treatment
In this Zwift Insider series, I intend to utilize my experience to provide a basic understanding of common cycling injuries, including their treatment and prevention. Hopefully, this will keep you riding optimally or get you back on the bike quickly without pain.
We will address each injury through the following active approach:
- Identifying the Injury (Pain Symptoms and Location)
- Acute Treatment
- Flexibility and Mobility Exercise (Long-Term Treatment and Prevention)
- Strengthening Exercise (Long-Term Treatment and Prevention)
- Basic Bike Fit Recommendations
- Recovery
We’ll look at injuries related to problem areas common to cyclists: knees, hips, low back, and feet… amongst others.
The Follow-Up Appointment
Stay tuned, as in the next edition of this series I will address cycling pathology of the knee, including patellar and quadriceps tendinitis, iliotibial band friction syndrome, and other disorders. We will examine active intervention measures to keep you riding, training, and racing at your best!
What About You?
Comment below if you suffer from any of the cycling “aches and pains” mentioned, or if you have a few of your own. That way I can be sure to address them in upcoming installments.
Gluteal tedinopathy
Stay tuned Sheri for disorders of the hip coming soon!
My left knee recently started bothering me. It usually starts about an hour into riding. I can keep riding, but it’s uncomfortable and my power is limited. I can’t decide whether to take extended time off the bike, or take shorter rides. I’m also looking for the right balance between consistent training and over-training.
I am confident the decision will be more clear, Bernie, when equipped with the knowledge and tools to be found in upcoming installments. Disorders of the knee next week.
I didn’t know your avatar could get virtual cycling injuries. We don’t even have hit points in this game!
Oh, you meant injuries to *our* bodies, not our avatars! OK, then I’ll bite: low back pain.
Coming soon Weiwen
Thanks! Great to address this aspect of cycling! Looking forward to the rest of the series.
I’m looking forward to helping to keep as many of my fellow Zwifters on the bike Rob!
Intermittent sciatic nerve irritation – seems to be caused by higher watts/kg (90-100% FTP) low cadence power workouts.
Pay special attention to the lower back installment.
Pes anserinus tendinitis. Both knees.
Had cortisone injections, 20 + physio treatments, shockwaves, dry needles punctures, ultrasounds, naproxen, cycle thru the pain for 3 months, stopped completly 3 months, pain still there.
I’ve had bilateral total hip replacement 5 years ago that caused me to lose flexibility in my legs.
Can you help me ?
Im an “A” rider who does about 15 000 km/year. 41 years old.
Thank you in advance !
While I don’t claim to be able to replace your healthcare provider, I will do my best to provide some advice from a cyclist’s perspective which I am sure will help.
Cheers.
Patella-Femoral Pain Syndrome in my case. PT eventually resolved the issues with my left knee but now my right knee is affected. Hoping the same set of exercises will fix the problem
Likely true. The exercises I recommend will also help KimS.
Hit a carelessly opened car door. Skull and 3 vertebrae fractured 15 years ago. I got back on the bike as soon as I could and made a good recovery thereafter. Took to indoor cycling to avoid Covid and finding it a great way to keep fit. No problems so far but keen to learn how to keep it that way from an expert.
The exercises will be great for maintenance and prevention Robert!
Mortons Neuroma and Capsulitis of the second toe. It hurts to pedal!
I can imagine! Foot information should help Jeff.
I had this last year. The podiatrist told me to use a Powerstep Protech insert, which I did in my walking shoes, and I got a Specialized insert with extra arch support for my bike shoes. The pain went away in weeks.
Left knee / it band. I’ve done it all, foam rolling, glute strengthening, mris, all but given up hope. Simply tough it out and know at 20+Miles I’m gonna hit w snag. And damn if the knock isn’t tight as a knot after rides, we all squinch those shoulders
Keep at it Evan. You are the example for Active Treatment.
My left knee has become very weak, possibly from jogging but I felt like it was improving with cycling. A few months ago my left knee started clicking while cycling and although it doesn’t hurt yet, I’m afraid to continue cycling and doing more damage. My rides now are only about 30 minutes once or twice a week. I’ve also started taking osteobi-flex, fingers crossed it helps.
Some focused exercises should help also Amanda!
How about ankle pain? Happened this week to me, piercing pain, very annoying. A modification of the foot position helped, but why did it happen in the first place?
Great idea! Noted…Ales.
Tight calves
Some stretches will help!
Super painful sit bone, specifically on my left side. Tried different saddles, becomes an issue after 75 mins and/or riding every day. Feels like the point where my hamstring attaches to arse. Struggled to walk after a 2hr Zwift session. Super sharp nerve feeling kind of pain.
Sounds like a real pain in the arse! My recommendations for active treatment of the hip may help. In addition to finding a comfortable saddle…Mr. Diggler.
You are the man!
No…you da’ man!
I did the Wringer workout on Zwift after having recently updated my FTP. Very high cadence (130ish) at high power for 30 second intervals. Murdered the outside of my left thigh. It hurts least if I stand. Driving (stick!) is sooo painful. Trying to cool it down, cycling very easy rides and stretching. But the pain has been there for 3 days now.
I intend to discuss acute treatment techniques as well. I hope they help Hennig! You are on the right track.
My most common issue is numbness and pain into my hands, especially my thumb. To a lesser extent and on longer rides some numbness into my feet or aching into my outer toes on the foot
(Bike fit planned for once COVID allows!!)
Of all the investments we could make in optomizing our cycling enjoyment and performance, a proper bike fit is perhaps of the greatest value! Plan it soon Andrew.
Golfer’s elbow on my dominant arm.
Probably caused by/related to computer work. Possibly aggravated by cycling (on a road bike).
Will be prioritizing lower extremity issues, Alessio. Will consider upper body if there is a need. In the meantime, quit playing golf…lol!
Love this concept Chris. Thank you for taking it on! For this 30,000km/300,000m elev Zwifter it is lite is medius syndrome and iliopsoas pathology. Cant wait to read more from you.
Hope my tips help you ride comfortable and fast Jeffrey!
Have a muscle pain in my left thigh. Came after a couple of hard rides, it’s a pain that sometimes makes me feel like my knee might giveaway too. Knee never given way bu t still acwirry. Forbidden for a few weeks hoping it’s get better but it’s slightly better not to his it was before. Had hip replacement 6 years ago and I’m only 54, any help welcome
Timely question…MIchael. Active treatment suggestions for the knee coming soon. Stay tuned to ZwiftInsider!
Looks like my kindle is playing up too! Not ridden for a while hoping the rest will help. It’s a little better but not to previous levels. Hip replacement on leg that’s playing up 6 years ago. It’s been so bad have contacted my doctor and am going to hospital for an xray. If you can give some exercises to alleviate the thigh pain it’s a real godsend Chris.
Absolutely…you will have them soon! Stay tuned. I hope they help.