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Health & Exercise Forum

Cycling Tips: Part 2 of 2

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Apr 26, 2010

Dr. Mackarey's Health & Exercise ForumWhether you are a recreational bicyclist or competitive cyclist it is critical that you and your bike fit well together. A proper fit maximizes comfort and minimizes injury. Last week we discussed how to position handlebars, pedals, seat, at proper angles for the shoulders, trunk, hips and knees. This week, I would like to discuss the benefits of cardiovascular exercise and common problems that develop from biking on an improperly fitted bike.

Benefits of Biking

Biking, like all aerobic exercise, provides all of the following benefits without the added stress of joint compression, and wear and tear associated with many other full weight bearing exercises such as running:

  • Loss or Maintained Body Weight
  • Reduces LDL /Raises HDL Cholesterol
  • Improves Circulation and Blood Pressure
  • Reduces Risk of Heart Disease
  • Prevents Bone Loss
  • Reduces Stress/Muscle Tension
  • Lowers Risk of Depression
  • Improves Sleep Pattern
  • Improves Strength and Flexibility
  • Improves Balance/Reduces Risk of Falls
  • Improves Immune System
  • Improves Pain Threshold

Musculoskeletal Problems Associated with Biking

  • Knee Pain- in the front of the knee or knee cap is common with biking. This can happen if the seat is too low, speed is too slow or if there is weakness in the leg muscles.
  • Neck Pain- can occur if the handlebars too low or far to reach. Also, if the seat is tilted forward it can lead to neck pain.
  • Lower or Middle Back Pain- can be cause by tight hamstrings, slow speed or if the handlebars are too low or far to reach.
  • Shoulder Pain- can occur if you are reaching too far or pushing down too hard through the shoulders.
  • Hamstring Pain- can occur if the muscle is tight or weak, the seat too high or toe clips misaligned.
  • Ilio-Tibial Band Pain- can occur if the seat is too high, there is a difference in the length of the legs, or poorly aligned cleat on pedal.
  • Foot Numbness or Pain- can occur from slow pedaling, poorly fitted cleats or shoes, poorly aligned cleat on pedal. However, lower back pain can also be associated with and the cause these symptoms.
  • Hand Numbness or Pain- can be caused by short-reach type handlebars, poorly located brake levers or a downward tilted seat.


Prevention is the best management of musculoskeletal problems associated with biking. First, as previously discussed in Part I, prevent many of the above problems through proper fitting. Furthermore, it is important that your equipment is in good working order such as tires, chain, brakes and pedals. Next, be sure to maintain a fairly good fitness level in order to bike safely. If you are a beginner, start slowly. Warm up and slowly bike for 10 to 15 minutes and build up over time. Practice the coordination of stopping, starting, shifting and braking. Work on good strength and flexibility of the hamstrings, quadriceps, calfs and gluteal muscles. All of these muscles are necessary to generate pedal force. Balance is also important to safety and can be practiced on and off the bike. Be aware that adaptive equipment can modify your bike for added comfort and safety such as soft handlebar tape, seat post and front fork shock absorbers, cut-out and gel pad saddle seats, and wider tires. Remember, WEAR A HELMET!

Be careful not to progress too quickly because inactivity to over activity in a short period of time can create problems. Overuse injuries such as tendonitis, can be avoided by cross training. Bike every other day and walk, run or swim on off days. Consider sports such as tennis, golf, racquetball on off days. Make sure to take time off to recover after a long ride. Use ice and massage to sore muscles and joints after riding.

Remember, cycling should be fun! Pain from improper fitted and poorly maintained equipment is preventable. Excessive workouts and training rides should be kept to a minimum.

SOURCES: American Physical Therapy Association

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of  Scranton, PT Dept.