Physiotherapy for cyclists
Physiotherapy for Cyclists — Comfort, Power and Fewer Niggles
Cycling is low impact but high repetition — around five thousand pedal revolutions an hour, all in a fixed position. That combination means small inefficiencies do not stay small. Most cycling complaints are the product of position, volume and capacity interacting rather than a single injury event.
What we see most in cyclists
Anterior knee pain
Commonly linked to saddle height or fore-aft position combined with a quadriceps capacity gap; worse on climbs and big gears.
Low back pain and stiffness
Sustained flexion with limited hip mobility, particularly on longer rides or an aggressive position.
Neck and shoulder pain
Extended neck position and weight through the hands, often worse on the drops or in a new position.
Hand numbness
Pressure through the ulnar or median nerve at the handlebar; usually a position and hand-position variation issue.
Position, load and capacity together
A bike fit adjusts the position. Physiotherapy assesses whether your body can hold that position for the duration you ride, and whether the muscles being asked to produce power have the capacity to do it. The two work best together — and a fit alone often fails when the limitation is capacity.
Off-the-bike strength for cyclists
Cycling loads the legs in one plane, at low force, with no impact. Adding strength work off the bike addresses the gaps.
- Single-leg strength for lateral control and knee tracking
- Hip hinge and posterior chain loading
- Trunk endurance for holding position on longer rides
- Impact and bone-loading work, which cycling does not provide
Volume changes are the usual trigger
Most cycling niggles appear in the weeks after a jump in weekly hours, a first sportive block, or a switch to a new bike or position. Mapping the last month of riding usually identifies the cause faster than any physical test.
Commuters count too
A daily commute is a training load whether you call it one or not — five days a week, often in work clothing on a poorly set-up bike. The same principles apply.
Common questions
Do I need a bike fit or physiotherapy?
If the pain is new after a position change, start with the fit. If it persists across positions or bikes, it is a capacity problem and needs assessment.
Is knee pain from saddle height?
Often a contributing factor, but rarely the whole story. We look at position, gearing, volume and strength together.
Should I stop riding?
Usually just reduce volume and intensity while we treat it. Complete rest is rarely required for cycling overuse problems.
Can sports massage help between events?
Yes, particularly during a heavy block. It manages accumulated tightness — but a specific recurring pain still needs assessing.