Cycling Injuries: Brace Yourself


Although the action of bike pedaling require feet, the foot is designed to walk on, not ride with. There are 3 phases of foot movement involved in walking; heel strike, mid-foot stance and toe-off. Bike riding most parallels the 2nd phase, mid-foot stance. Mid-foot stance is the point within the gait cycle in which the ligaments in the foot become unstable and are marginally off tension. This action assists absorbs shock while walking as the foot conforms to the shape of the ground. With bike riding this instability is exacerbated as the foot is non weight-bearing.

Injuries associated with cycling’s repetitive stress movements include foot, ankle as and knee disorders. Most injuries affect hard climbers who stand when pedaling or grinding for extended periods of time while at high gear. Clip-less pedals, can cause the foot to become locked at an angle that may twist the foot in a way that’s biomechanically unnatural. One’s feet should always be clipped onto the bike pedals at an angle that is natural for the rider.

Cyclists require their foot to be a rigid lever, working as one, with firm and stable footwear that can transfer power to the pedal. Any aberrant movement through the foot, ankle or knee is a waste of power and can cause injury. Footbeds for both cycling and walking must be different to accommodate different biomechanical needs; cyclists require rigid footbeds while those walking do not.

A rigid footbed is designed to allows the rider to use the inherent stability of their foot. These footbeds accomplish this by securing the foot from the rear with pressure under the sustentaculum tali.

Once the bones and ligaments in the foot are locked in it less muscle effort from the intrinsic muscles of the foot and lower leg will be required to stabilize the foot inside of the shoe. This means less aberrant movement in the foot and ankle and within the shoe itself. If unchecked unnecessary foot movement can create serious knee and back pain.

Tightly laced footwear can cause a rider numbness in the forefoot or paresthesia. If loosening the shoelaces doesn’t work to relieve the numbness seek a larger, more cushioned toe box. The toe box is the upper part of the shoe which encloses the forefoot. Most cycling shoes are have a tight toe box because it prevents wasteful movement during the pedal stroke.

Foot pain for cyclists falls into two general categories; friction injuries and compressive injuries. Also know as hot spots injuries, friction injuries and blisters are created by friction; sweating and swollen feet with consistent rhythmic force applied to them for hours on end is almost guaranteed to cause friction and pressure injuries to the soft tissues of the foot.

Well-fitting footwear, high quality socks, non-slip footbeds, appropriate cleat or foot positioning and bike setup will resolve most friction related injuries.

Compressive injuries such as numbness and sharp, stabbing pain occur because of poorly sized footwear. In particular, footwear that compresses and squeeze across the ball of the foot, the delicate neural structure within the foot.

Patellofemoral problems, pain experienced under the kneecap or just to the side of it, may be due to poorly positioned cleats on the bike pedal. By adjusting the direction of the toes in or out this pain may dissipate. Seat height also play a roll in injury and can stress the knee unnecessarily if poorly positioned. A higher seat height for some requires less flexion of the knee which can alleviate the pain.

Pain or clicking on the outer edge of the knee can be attributed to iliotibial band syndrome. Pedaling with the foot slightly toe-outward can alleviated this condition.

Cranking or riding long distances at a high gear, can increase the incidence of knee injuries and existing problems. A lower gear pedaled at a higher RPM can help reduce stress loads. Maintaining 90 revolutions per minute, RPM, is a good guideline to ensure safe stress loads and productive activity. RPM can be calculated like heart rate, count the number of revolutions pedaled in a 10 second time frame, then multiply that number by 6.

Even though the muscles most powerfully engaged during cycling are those of the lower extremity, it’s not uncommon for cyclists to experience pain in the arms, hands, shoulders and back. When riding, the muscles of the back, including the trapezius, erector spinae and latissimus dorsi, are isometrically contracted in order to stabilize the body position. However, the tension created can lead to pain, numbness or spasms. Shifting upper-body position by occasionally varying handlebar grip can provide enough movement to ease tension in these muscles. Handlebar drops, extensions, and forearm rest pads provide a variety of options for shifting position periodically to mitigate pain and injury when riding.

Lower-back pain is typically a result of sustained forward flexed posture during riding. A conditioning program that strengthens the trunk muscles may should alleviate this condition.

Repeated, jarring impact is transferred from the handle bars to the hand, wrists and forearms and leads to pain and discomfort. Shifting grips while riding and maintain a lighter hold will ease pain. Gel-padded cycling gloves and or foam padding on the handlebars can help offset upper extremity ailments and soreness.

Fall and collisions are among the most serious injuries incurred while cycling. Head injuries are considered the most severe cycling injuries so do not mount a bicycle, no matter how easy the terrain or short the distance, without appropriate head protection. Head injury deaths have been reported among cyclists who simply toppled over on their bikes from a standing stop position. In fact, 80% of fatal bicycle injuries are caused by trauma to the head. Other trauma-related injuries include broken collarbones and wrists, both of which can result from breaking a fall with an outstretched hand.