The Most Common Types of Cycling Pain and Injuries

Woman with bloody knee riding bike

Wesley Hitt / Getty Images

Cycling is a great, low-impact way to stay fit, but it isn’t without risk of pain and injury. Most cycling pain occurs due to poor bike fit or improper riding technique. It’s important to have your bike adjusted to your body because proper bike fit can prevent pain and injury.

Upper Body, Arm, and Hand Injuries

Your upper body is at risk of injuries in falls from your bike. But you also may have overuse injuries.

Concussion and Head Injury

A concussion is typically caused by a severe head trauma where the brain moves violently within the skull. It can happen in a fall. 

Wearing a bike helmet is recommended to reduce the risk of a serious head injury while biking. It is also important to recognize and treat the early warning signs of an injury.

Clavicle Fracture (Broken Collarbone)

A shoulder fracture typically refers to a total or partial break to either the clavicle (collarbone) or the neck of the humerus (arm bone). It generally is from an impact injury, such as a fall from your bike.

Hand Numbness (Ulnar Neuropathy) and Wrist pain

This pain and numbness of the small and ring finger are associated with pressure on the handlebars for long periods of time. Carpal tunnel syndrome can also occur.

Always ride with your elbows slightly bent to act as a shock absorber. Alternate the pressure on the inside and the outside of the palm while riding.

The age-adjusted incidence of bicycle injuries resulting in hospital admission increased by 28% from 1998 to 2013. Over half of these injuries are to an extremity, and 16% are head injuries.

Lower Body Pain

There are some specific problems with the lower body related to cycling.

Pudendal Neuropathy

This chronic pelvic pain happens from sitting in the saddle too long. Regular rest breaks and time off from cycling may be needed to reduce the risk. Changing the type of seat has not been found to be effective.

Piriformis Syndrome

If the piriformis muscle becomes tight or cramps it can put pressure on the sciatic nerve and cause gluteal (or buttock) pain or sciatica.​

Knee Pain

Knee pain is extremely common in cyclists. In order to treat the cause of the pain, it is important to have an evaluation and proper diagnosis. Shoe modifications and changing your cleat position may help. Common reasons for knee pain in athletes include the following.

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome usually refers to pain under and around the kneecap. It is also called runner's knee.


This term refers to softening and deterioration of the underside of the kneecap. In young athletes, this is typically an injury from trauma, overuse, poor alignment of the knee joint, or muscle imbalance.

This leads to friction and rubbing under the kneecap that results in damage to the surface of the cartilage. The sensation is a dull pain around or under the kneecap that worsens when walking downstairs or hills, climbing stairs, other weight-bearing activity.

Osteoarthritis of the Knee

Osteoarthritis is the most common type of arthritis in athletes. It is a degenerative disease that results in a gradual wearing away of joint cartilage.

Typical symptoms of osteoarthritis are pain, swelling, and a decrease in the range of motion of the knee. Morning stiffness that decreases with motion is also common.

Iliotibial Band Syndrome

IT band friction syndrome often results in knee pain that is generally felt on the outside (lateral) aspect of the knee or lower leg.

Leg and Foot Pain

These injuries are primarily due to overuse.

Achilles Tendonitis

Achilles tendonitis is a chronic overuse injury of the tendon in the back of the ankle. It tends to come on gradually over time until the pain is constant and exercise or activity too painful to continue. Left untreated, Achilles tendonitis can lead to an increased risk of Achilles tendon rupture.

Plantar Fasciitis

Plantar fasciitis is the most common cause of pain on the bottom of the heel and usually defined by pain during the first steps of the morning.

Arch Pain

Arch pain or strain can be due to inflammation, with a burning sensation under the arch of the foot. Treatment of arch pain often consists of adaptive footwear and inserts.


Blisters are fluid-filled sacs on the surface of the skin that commonly occurs on the hands or the feet due to friction. Your shoe may be rubbing your foot in the wrong place or your grip on the handlebars is causing this friction.

Common Injuries

Cyclists are also at risk for these common aches, pains, and injuries:

  • Abrasions and road rash: Falling from your bike onto a hard surface can scrape away layers of skin.
  • Muscle cramps: A cramp is a sudden, tight and intense pain caused by a muscle locked in spasm. Factors that may contribute are dehydration, electrolyte depletion, muscle fatigue, and doing a new activity.
  • Sprains and strainsThese are acute injuries that vary in severity but usually result in pain, swelling, bruising, and loss of the ability to move and use the joint.
  • Delayed-onset muscle soreness: This is muscle pain, stiffness or soreness that occurs 24 to 48 hours after unaccustomed or particularly intense exercise.
  • Overtraining syndromeOvertraining syndrome frequently occurs in athletes who are training for competition or a specific event and train beyond the body's ability to recover.
Was this page helpful?
Article Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Leavitt TG, Vincent HK. Simple seat height adjustment in bike fitting can reduce injury riskCurr Sports Med Rep. 2016;15(3):130. doi:10.1249/JSR.0000000000000254

  2. Høye A. Bicycle helmets - To wear or not to wear? A meta-analyses of the effects of bicycle helmets on injuriesAccid Anal Prev. 2018;117:85–97. doi:10.1016/j.aap.2018.03.026

  3. Lea MA, Makaram N, Srinivasan MS. Complex shoulder girdle injuries following mountain bike accidents and a review of the literatureBMJ Open Sport Exerc Med. 2016;2(1):e000042. doi:10.1136/bmjsem-2015-000042

  4. Brubacher JW, Leversedge FJ. Ulnar neuropathy in cyclistsHand Clin. 2017;33(1):199–205. doi:10.1016/j.hcl.2016.08.015

  5. Sanford T, McCulloch CE, Callcut RA, Carroll PR, Breyer BN. Bicycle trauma injuries and hospital admissions in the United States,1998-2013JAMA. 2015;314(9):947-949. doi:10.1001/jama.2015.8295

  6. Guess MK, Partin SN, Schrader S, et al. Women's bike seats: a pressing matter for competitive female cyclistsJ Sex Med. 2011;8(11):3144–3153. doi:10.1111/j.1743-6109.2011.02437.x

  7. Cass SP. Piriformis syndrome: a cause of nondiscogenic sciaticaCurr Sports Med Rep. 2015;14(1):41–44. doi:10.1249/JSR.0000000000000110

  8. Althunyan AK, Darwish MA, Abdel Wahab MM. Knee problems and its associated factors among active cyclists in Eastern Province, Saudi ArabiaJ Family Community Med. 2017;24(1):23-29. doi:10.4103/2230-8229.197178

  9. Halabchi F, Abolhasani M, Mirshahi M, Alizadeh Z. Patellofemoral pain in athletes: clinical perspectivesOpen Access J Sports Med. 2017;8:189-203. doi:10.2147/OAJSM.S127359

  10. Callaghan M. Lower body problems and injury in cycling. J Bodyw Mov Ther. 2005;9:226-236. doi:10.1016/j.jbmt.2005.01.007

  11. Amoako AO, Pujalte GG. Osteoarthritis in young, active, and athletic individualsClin Med Insights Arthritis Musculoskelet Disord. 2014;7:27–32. doi:10.4137/CMAMD.S14386

  12. Egger AC, Berkowitz MJ. Achilles tendon injuriesCurr Rev Musculoskelet Med. 2017;10(1):72–80. doi:10.1007/s12178-017-9386-7

  13. Chinn L, Hertel J. Rehabilitation of ankle and foot injuries in athletesClin Sports Med. 2010;29(1):157-167. doi:10.1016/j.csm.2009.09.006

  14. Miller KC, Stone MS, Huxel KC, Edwards JE. Exercise-associated muscle cramps: causes, treatment, and preventionSports Health. 2010;2(4):279-283. doi:10.1177/1941738109357299

  15. Vickers AJ. Time course of muscle soreness following different types of exerciseBMC Musculoskelet Disord. 2001;2:5. doi:10.1186/1471-2474-2-5

  16. Kreher JB, Schwartz JB. Overtraining syndrome: A practical guideSports Health. 2012;4(2):128-138. doi:10.1177/1941738111434406

Additional Reading
  • American Orthopaedic Society for Sports Medicine. Bicycle safety. Updated February 2016.