I’m a Cyclist and a Physical Therapist, and Here is What I Do For the Four Most Common Recreational Cycling Injuries

Follow these tips to eliminate and treat the four most common recreational cycling injuries.

Most cyclists are recreational riders and amateur racers. While we lack the potential and the aspiration to go pro, we still push ourselves to the limit. With that comes the satisfaction of a ride well done. It also comes with some unsavory side effects not limited to the pros, namely recreational cycling injuries. 

Research Describes the Most Common Recreational Cycling Injuries

An October 2022 study published in The Physician and Sports Medicine asked almost 63,000 recreational riders over five years about their cycling-related pain history. The researchers were interested in one type of recreational cycling injury, in particular, gradual onset injury (GOI). 


The researchers characterized gradual onset recreational cycling injury as a progressive, non-acute (like a crash) onset that worsens over time. Gradual onset recreational cycling injuries are often the result of repetitive use or overuse.


A recreational cyclist pedals 5,400 times an hour during an average bike ride (at 90 rpm). If their bike fit isn’t perfect or they have an underlying muscle imbalance or postural abnormality, the cumulative irritation becomes inflammation. The result is gradual onset or repetitive use recreational cycling injuries.

Prevalence of Recreational Cycling Injury

Nearly 50 percent of cyclists reporting a GOI experienced pain for over 12 months. Over 40 percent complained of severe symptoms that reduced or prevented them from cycling. 


The researchers broke it down based on the location of the rider’s body, the type of recreational cycling injury, and its severity. Here are the top four recreational cycling injuries and what you can do to prevent them from happening, and how to treat them when they do.  


Below you will find the #1 bike fit, foam roll, stretching, and strengthening recommendations for each injury from a cycling physical therapist with over 25 years of experience and countless miles in the saddle.

Recreational Cycling Injury Number One—

Anterior Knee or Patellofemoral Pain Syndrome

The researchers found that 17.2 percent of the recreational cyclists studied with GOIs experienced anterior knee pain the previous year. Anterior knee pain, or Patellofemoral pain syndrome, describes pain related to how the kneecap (patella) interacts with the underlying bone (femur) at the patellofemoral joint. 

When imbalanced forces cause improper kneecap tracking during the pedal stroke, repetitive use causes inflammation. Simply put, if the structures on the inner side of your knee are weak and those on the outside are tight, it pulls your kneecap out to the side. 


The following are a few of the most important things you can do.

Bike Fit

Finding the proper saddle height is essential for recreational cycling injuries involving the anterior knee. A good rule of thumb is that your saddle height should be about 95-98% of your total leg length (from the bone outside your hip, the greater trochanter, to the base of your cleat). If you’re experiencing symptoms of PFPS, aim to have a 25-degree angle of your knee joint at the bottom of the pedal stroke.

Foam Roll

Here’s how to foam roll your quads.

Recreational cycling injury foam roll of thigh


Try this hip flexor stretching exercise.

hip flexor stretch for Recreational cycling injury


Add this Ball Squat with VMO Ball Squeeze strengthening exercise you do at home.

VMO ball squat exercise

Recreational Cycling Injury Number Two—

Shoulder Pain

It might be hard to believe, but shoulder pain is the second most common recreational cycling injury. The researchers found that 10.6 percent of the recreational cyclists studied with GOIs experienced shoulder pain the previous year.


Many cyclists take up riding after years of playing other sports, like baseball and tennis. The repetitive overhead motion of throwing and hitting a ball causes irritation and inflammation of the shoulder.

Recreational cyclists experience shoulder pain caused by prolonged pressure on the handlebars through a previously compromised shoulder joint. Here are a few things you can do.

Bike Fit

There are several upper body pain prevention tips you can follow.

  • Position your hands shoulder-width apart.
  • Hold your wrists in a neutral position.
  • Don’t lock your elbows.
  • Use padded gloves and cushioned bar tape to absorb vibration and lessen the impact.
  • Use a relaxed grip on the handlebars.
  • Set your handlebar height for a slight bend in the elbows.
  • Change your hand position every three to five minutes.

Foam Roll

Try this 90/90 foam roller chest stretch.

recreational cycling injuries 90/90 foam roll stretch

Lie down on a roll allowing your arms to drop to the floor with your elbows bent and 90 degrees away from your side. Shoulders should be in external rotation so that the back of your wrists move towards the floor. Hold for a gentle stretch across your chest and shoulders.


Add this posterior capsule shoulder stretch to your recreational cycling injury program.

anterior shoulder capsule stretch


Rotator cuff strength is essential for recreational cycling injuries involving the shoulder. Try this elastic band shoulder external rotation exercise.

theraband rotator cuff strengthening for recreational cycling injuries

Recreational Cycling Injury Number Three—

Iliotibial Band Friction Syndrome

Iliotibial band friction syndrome is better known as “Runner’s Knee,” but it’s also a common recreational cycling injury. The researchers found that 10.3 percent of the recreational cyclists studied with GOIs experienced pain in the previous year due to iliotibial band (ITB) friction syndrome.

The ITB is a long tract of strong connective tissue that runs along the outer thigh from the pelvis to slightly below the knee. When a recreational cyclist’s ITB is tight, it rubs against the outer knee bone, causing friction, inflammation, and pain.


These are the top things you should do to prevent and treat the third most common recreational cycling injury.

Bike Fit

A proper bike fit by a certified specialist is always a good idea, but you can give this a try until then.

  1. Lowering your saddle height (or decreasing crank length) will ease the friction of excessive flexion and give your knee time to heal, but it won’t solve the problem. A proper fit will. 
  2. Adjust your cleat inward to move your foot out on the pedal.
  3. Avoid toeing your foot on the pedal.
  4. Address any leg length differences with shims.
  5. Focus on pedaling technique and avoid low cadence and high torque. 

Foam Roll

Foam rolling your ITB is an effective way to improve flexibility and eliminate connective tissue adhesions. Foam roll your ITB like this.

itb foam roll exercise


The standing ITB stretch is an excellent way to lengthen the structures on your outer thigh and decrease the pain-causing friction on your knee.

standing itb stretch for recreational cycling injuries


The glutes are often weak in those suffering from recreational cycling injuries. You will lack hip stability when pushing on the pedals if your glutes aren’t strong. It causes your foot and knee to turn in and increase friction with each pedal stroke. 

forward lunge exercise with dumbbells

The alternating forward lunge exercise will improve glute strength and hip stability. You can use dumbbells for an added challenge.

Recreational Cycling Injury Number Four—

Lower Back Pain

The researchers found that 7.7 percent of the recreational cyclists studied with GOIs experienced lower back pain in the previous year. Lower back pain is common in our society and isn’t limited to recreational cyclists. 


However, long rides with our trunks bent forward cause tension in our low back muscles and pressure on our lower spine. Improper positioning and prolonged saddle time make our spinal muscles fatigued, and they can’t support our trunk. When our legs get tired, our posture deteriorates.

These are only a few factors contributing to recreational cycling injury of the lower back. Proper postural position while riding is essential, and here are a few tips to follow.

  • Relax your neck by ensuring you aren’t looking too far up or down.
  • Relax your shoulders by bringing them down and away from your ears.
  • Bend your elbows and keep them tucked to your sides to reduce strain on your shoulders and produce less pressure on your hands.
  • Avoid bending your wrist by maintaining a straight line from your elbow through your fingers.
  • Maintain a neutral spine by relaxing your lower back and keeping your shoulders and hips aligned.
  • Keep your knee over the ball of your foot while pedaling.


Here are a few more things you can do to eliminate and prevent lower back pain while riding.

Bike Fit

Check your bike fit and decrease the strain upon your back by ensuring you are not too stretched out. Adjust your stem height and length, move your saddle forward, and raise your handlebars to maintain a relaxed and flattened lower spine.

Foam Roll

Using a foam roller to self-massage and relax your lower back muscles is an excellent way to relieve tension.

low back foam roll exercise


The Cat and Camel stretch is an excellent way to improve lower back muscle flexibility and increase pelvic control.

cat camel stretch for recreational cycling injuries


Core strength is essential when maintaining proper cycling posture and positioning and eliminating recreational cycling injuries from the lower back.

In a 2013 study, researchers from Penn State named the forward plank the most effective and efficient core-strengthening exercise movement. Here’s how to do it properly.

front plank exercise

While lying face down, lift your body on your elbows and toes. Maintain a straight spine and a neutral pelvic position, and don’t allow your hips or pelvis on either side to drop.

Conclusion—Recreational Cycling Injury

Chronic overuse, repetitive, and gradual onset injuries are an unwelcome fact of life for recreational cyclists. Progressively worsening pain in a cyclist’s knees, shoulders, hip, and lower back is common, but it doesn’t have to be. By identifying the source of your pain and taking action, recreational cycling injuries can be prevented, treated, and eliminated. 

Your prescription?

What do you do to prevent and eliminate the four most common causes of cycling-related pain and injury? Comment below. Your fellow cyclists want to know.

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