Cycling: 12 ways to prevent common injuries

Incredibly, Geraint only suffered some cuts and abrasions in the crash, and is once again determined to win for the second year in a row.

For professional cyclists like Geraint Thomas or Chris Froome, who suffered very serious injuries after a crash in June, injuries like these can be considered an occupational hazard. However, cycling injuries don’t just affect the professionals. Anyone, from Tour de France winners to those who just enjoy a casual bike ride through the park at the weekend, is at risk if they don’t take the proper precautions.

Effective training and good preparation are key to reducing your risk of injury whilst cycling. The right preparation can also help to enhance your performance.

Everything from crafting the right training programme, to getting into the right mindset with mental preparation and learning to recover properly can help.

King Edward VII’s Hospital physiotherapists have come together to create tips to help readers understand some of the greatest risks that face cyclists and what precautions you can take to avoid them.

Common cycling injuries

Cycling injuries can vary from cuts and scrapes to broken bones (particularly the collarbone) and concussion, all caused by the impact of falling off your bike. Riding a bike of the wrong size for your height can also cause injuries to the knees, lower legs, feet and wrists.

Overtraining or competing in long races can result in pain and discomfort from being in one position for long periods of time.

But you can take steps to minimise your injury risk. Whether you cycle purely for fun, or you’re prepping for your next bike race, here are 12 important tips to help you on the road to injury-free cycling success.

Effective preparation and recovery

Getting the size and positioning of your bike right is crucial for helping to avoid overuse injuries and just as important as training, is recovery. Here are some mistakes to avoid during your preparation:

Incorrect saddle position – incorrect saddle height can cause altered biomechanics, which increases pressure at the knees and ankles, and can potentially cause tendinopathies of the patellar or Achilles tendons.

A general guide to setting saddle height would be to have a straight leg when resting your heel on the pedal at the bottom of the pedal stroke. It’s also worth considering the set back of the saddle – how far forward or backwards it is on the rails. If it’s too far forward, this may increase pressure on the knees. If it’s too far back, the hips remain quite flexed throughout the pedalling cycle and may reduce how much you can use your glute muscles.

Neglecting your core – when you’re in a cycling position for a long time, your lower back muscles can become sore. In some cases, this can lead to sciatica, which can be extremely painful.

To minimise your risk of back injury, it’s important to strengthen your core muscles so that you can stay balanced on your bike for long rides, without causing pain in your lower back. Just as getting your bike right is important, getting your body in shape to prepare for long rides or races is crucial for minimising injury risk.

Avoiding proper recovery – equally as important is recovery, especially after heavy training or a long race. Riding too soon afterwards, with fatigued muscles and bad form could mean you end up in an accident or make existing injuries worse.

Stretching and flexibility training such as yoga helps keep the muscles supple and relaxed. If you can stand it, having an ice bath helps overworked muscles to repair.

“Another good option is to use a foam roller, since many cyclists struggle with tightness in the hip flexors and hamstrings. The foam roller can help to reduce tightness and provide similar benefits to sports massage,” suggests King Edward VII’s Physios.

A healthy lifestyle will put you in good stead too. Eat a diet high in lean protein, carbohydrates and antioxidant fruits and vegetables and get plenty of sleep, especially before a big race.

On the road

Whether training or cycling simply to keep fit, there are some problems you can come up against. Here’s how to help prevent them.

Neck pain – if you’re experiencing pain in the sides of your neck that extends down to your shoulders, you could be tensing your shoulders whilst riding. This type of pain is often also a consequence of having to hold your head in an extended pose whilst cycling.

Riding in a more upright position, by lowering your saddle and bringing it forward slightly can help. A bike shop can help you adjust your seat for safe and comfortable riding.

The best way to reduce neck pain is to relax more whilst riding and holding your handlebars in a less tense way. Some cyclists find this difficult and quickly slip back into old ways but making a concerted effort to relax will help to form a new habit over time.

Cuts and grazes – falling off your bike can result in cuts and scrapes, especially if the road is particularly uneven and gravelly. Wearing appropriate clothing can help but as short sleeved tops and cycling shorts are best for speed and wind resistance, most cyclists have experienced grazes to the lower arms and legs.

“Cyclists are often seen wearing jerseys with sleeves, even in hot weather, as protection for the skin in case of a crash. The shoulders are one of the most common areas to graze and wearing a thin undervest under the jersey also largely reduces grazing,” says leading physiotherapists.

Road rash, from skidding along a tarmac road stings, and it’s important to clean your wounds as soon as possible and keep them clean.

Cycling to your ability and not cycling whilst tired or distracted will help to minimise falling and sustaining cuts and grazes.

Saddle sore – spending hours on your bike can result in saddle sore, an uncomfortable, irritating skin condition that affects the buttocks and undercarriage.

Ignoring saddle sore can make it worse, meaning that it becomes almost impossible to sit on your saddle. If you’re experiencing this, resting for a few days should help to calm things down.

To help prevent saddle sore, always wear well fitting cycling shorts. Shorts with a padded bottom help, as does applying chamois cream. Making sure your saddle fits your body shape will help too.

You should measure the width at the ischial tuberosity, also known as the sit bones, to determine the saddle width and locate the pressure effectively. This can be done on a gel cushion and there are many brands that offer such services. Lots of brands also offer trial periods for saddles, so it is worth trying a few different ones, as they can make a huge difference in terms of comfort. There are also many that are specifically tailored to women.

Upper limb pain – holding your handlebars at an unnatural angle for long periods of time will cause your wrists to ache and your thumb and fingers tingle which can lead to carpal tunnel syndrome.

Make sure your handlebars are rotated slightly upwards to reduce the pressure on your wrists and hands and to prevent your forearms from overreaching. Look for cycling gloves with padding that helps reduce pressure on the fingers and helps riders avoid conditions like Cyclist’s Palsy, also known as Handlebar Syndrome.

During a cycle race

Race day comes with its own hazards, from long rides, spectators and the sheer number of bikes sharing one space. Here are some top tips to help prevent injuries and accidents on the big day.

Stay alert – road hazards, bends in the road, patches of oil or gravel, puddles, parked cars and pedestrians are all part and parcel of competing in a road race. So staying alert is important, even on familiar roads, especially as fatigue sets in.

Falling off your bike because you momentarily lacked concentration is at best frustrating and could mean that you can’t continue.

Riding with your weight further back in the saddle helps to keep you more stable and looking as far ahead as possible will better prepare you for unexpected hazards.

Have well-fitted cleats – making sure your cycling shoes are compatible with your pedal cleats is an obvious aspect to get right for comfortable riding. But getting the angle of your cleats right is just as important.

Consider allowing some float in the cleat set-up, so the lateral movement can take place and increase comfort and prevent injury to both the lower limbs and back.

Optimal cleat positioning is different for everyone, but generally it’s best to position them so that the middle of the pedal sits at the ball of your foot.

Having your cleats too far forward can result in knee pain and a numb feeling in the foot, which can impact on your performance.

“It’s very important that you have your cleats checked regularly, especially if you walk in them a lot. Cleats can move if not tightened adequately and this often goes unnoticed until something becomes sore,” explains King Edward VII’s Physiotherapy team. “Also, if they are too worn, the foot can pop out of the pedal, particularly when pushing hard on the pedals while sprinting.”

Be aware of other riders – it’s almost inevitable that you’re going to find yourself amongst a group of other riders. So before you enter any cycling race, make sure you’re experienced in riding in close proximity to other cyclists.

It can’t be overstated how important it is to look over your shoulder for other riders, since you don’t have wing mirrors, Bumping into other cyclists can be very dangerous and might lead to serious injuries.

Practicing with friends is a good idea, in a park or on a quiet road. Ride close together to become more used to the vulnerability you could be in if another rider falls or accidentally bumps into you.

Learn to fall properly – should the worst happen and you do fall off your bike, learning how to fall to minimise injury could mean the difference between competing in your next race or not.

When we fall, our first instinct is to put our arms out to break our fall. This means that all the impact from the fall is in the felt in the collarbone. A broken collarbone is a common cycling impact injury and can take months to fully heal.

It might feel counterintuitive but holding onto the handlebars whilst falling helps avoid broken bones as your whole body absorbs the impact of the fall, spreading it out over a larger area.

The benefits of cycling

Cycling is a fun and rewarding sport and following these tips to remain injury free will help you reap the benefits of cycling.

Cardiovascular exercise such as cycling makes you fitter, allows you to sleep better and improves your state of mind and mental clarity. It also allows you to burn fat and gain lean muscle mass.

Cycling also helps to improve cardiovascular health. Studies show that cycling to work can help significantly reduce your risk of developing heart disease and certain cancers. Riding to work also saves valuable time, leaving you free to enjoy more of the things you love, rather than having to find extra time in your day to exercise.

Plus, since riding a bike isn’t a weight bearing exercise, it puts less strain on your joints than running does. When comparing long distance runners and cyclists, one group of researchers found that the cyclists experienced significantly less muscle damage and inflammation.

Finally, cycling can be enjoyed as a social sport, either with friends or family for a leisurely ride at the weekend, or by expanding your social circle by joining a local cycling club.

More information

• If you’re suffering with a cycling injury, it’s important to get a diagnosis and treatment plan from an expert medical professional. Speaking to your GP is a good first step. (Don’t have a GP?)
• At King Edward VII’s Hospital, we have a dedicated Sports and Exercise Medicine department that can help you recover from your cycling injury so that you can get back in the saddle as soon as possible.
• If you require physiotherapy, our specialist and fully equipped Physiotherapy Centre is on hand to help. If your injury means that you need surgery, you can be referred to our Orthopaedic Surgery department.