Common Cycling Aches and Pains

Do you remember the day the training wheels came off of your bike? Can you still feel the excitement and exhilaration? Now is a great time to pull the bike out of the garage, tune it up and take it for a ride. And now that we live in an era where a gallon of gasoline costs more than a grande nonfat latte, you can think about cycling your way to work a few times a week to help save a few dollars as you get your daily exercise. As with any other activity, I see more than my fair share of cycling injuries in my clinic. Below are a few precautions you can take to hopefully avoid any aches and pains.

Raise your seat! Most people ride with their bike seats too low and too far back. Low seats are generally responsible for achy knees, usually in the form of Patellofemoral pain syndrome.

If the seat is at the correct height, your knee should be almost straight when the pedal is at the bottom of the pedal stroke. A quick way to get your seat to the correct height is to raise the seat until your heel can barely touch the pedal at the bottom of the pedal stroke. While riding, the ball of your foot should be directly over the axle of the pedal. Any further back and your foot may slip off. Any further forward and you lose a lot of power production.

Slide your seat forward on the rails! Most of those low seats are also forward seats. By having your seat so far back it forces you to rotate your pelvis forward, placing more pressure on your perineum and lower back. The increased pressure on the perineum is the cause of numbness and discomfort that so many men experience with cycling. Part of the answer to this problem is a good seat, and the other part is proper positioning of that seat. The forward rotation of the pelvis also can place too much pressure on the lumbar facets. Known as facet syndrome, any prolonged extension can aggravate this condition.

With your cranks horizontal, a plumb line dropped from the bottom of the forward kneecap should run directly through the axle of the pedal. Time trial and triathlon bikes may be a little further forward than this and cruisers may be a little further back that this. You can adjust this measurement up to 2 centimeters based on your riding style.


Raise your handlebars! Well, maybe. If you ride a hybrid, city bike or a cruiser, then your bars can be several inches higher than your seat. With mountain bikes, the bars may be higher or lower depending on your flexibility and riding style. On road bikes and time trial bikes, the bar is very low, up to 5 inches lower than the top of the seat. Do not attempt this position unless you are physically ready for it. Handlebars that are too low force you to extend your neck, placing far too much pressure on the muscles that move and support your neck and head. One study of cyclists showed that the most common overuse injury report was to the neck, with almost half of the subjects reporting neck pain.


Get a good pair of gloves! Not only will they save you a lot of skin if you happen to crash, but they’ll protect a very delicate nerve that passes through your palm. Cyclist’s palsy, a condition where the ulnar nerve is impinged as it passes through the tunnel of Guyon, is often avoided by simply wearing well-padded gloves.