How to Treat Common Cycling Injuries

At Sterosport, we’re committed to giving all sports participants access to the first aid tools and equipment they need in the event of an injury or an emergency, and cycling is no different. But what about injuries that aren’t as obvious as a broken bone or a spot of road rash?

Overuse injuries and damage that might only show up days later can be even more serious than the ones that take you off your bike immediately. Identifying injuries and caring for them correctly is what means you can recover quickly and get back on your bike.

Here, we’ll look at the most common bike injuries and what to do to take care of them. 
While properly treating cycling injuries is vital, prevention is better than cure. Find out how to prevent common cycling injuries in our blog.

How common are cycling accident injuries?

A report published by the UK Government covering cycling accidents provided some cycling injury statistics. The report found that between 2015 and 2020, “an average of 2 pedal cyclists died and 83 were seriously injured (adjusted) per week in reported road casualties.” The most common factor in serious or fatal bike accident injuries with another vehicle was “driver or rider failed to look properly.”

Even though minor bike accident injuries and even stationary bike injuries are generally the most common, there were still many severe accidents. In terms of severity, the report stated that in 2020 alone “141 pedal cyclists were killed in Great Britain, whilst 4,215 were reported to be seriously injured (adjusted) and 11,938 slightly injured (adjusted).”

But it’s not only commuting and road traffic that lead to bike injury. The report also found that “56% of pedal cycle fatalities occurred on rural roads compared to 29% of traffic.” So even when there’s no heavy stream of traffic, cyclists are still at risk of an accident. Wet roads, uneven terrain, and adverse weather conditions contribute to cycling dangers. 

A study published in the British Journal of Sports Medicine looked at downhill mountain biking injuries. Data was taken from 84 patients presenting with mountain bike-related injuries over the span of one year, and found that 23% required surgical operations. The most common mountain bike injuries include:

• Clavicle fractures (13%)
• Shoulder injuries (12%)
• Distal radial fractures (11%)

Cycling Knee Injury

The knee is the area that is most prone to injury during cycling. Patellofemoral syndrome, otherwise known as cyclist’s knee, medial plica syndrome, iliotibial band friction syndrome, and patella and quadriceps tendinitis, are some of the most common knee injuries that can happen to cyclists. You could also experience popliteus injury cycling, which affects the back of the knee, causing the area to feel swollen and painful. 

Generally, knee injuries result from putting too much strain on the joint, muscles, and tissues through intense use or riding long distances. 

MCL (medial collateral ligament) injury is another common knee injury that can affect cyclists. MCL injury can be painful, and your knee will require some time to rest and recover. You could have a cast applied, and you might need crutches to take the weight off your joints. Cycling with MCL Injury can help restore strength and flexion to the knee. 

Do not ride for longer than 20 or 30 minutes when cycling with a recovering MCL injury. Adjust your seat so that your leg is fully extended at the lowest point of the pedal, and ride with your forefoot on the pedal. Cycling knee injury recovery can be helped with gentle exercise as this will help to strengthen and stabilise the joint as the ligament and surrounding muscle repair themselves. 

Shoulder Injury

Injuries that result from falling off a bike are quite common and usually affect the shoulder, as this is the part of the body cyclists often land on. There are four main shoulder injuries from bike falls.

1. Posterior shoulder dislocation

Caused by: falling forward using your hand to break your fall.

Treatment: seek professional medical assistance as soon as possible. Use a shoulder brace to immobilise the joint while recovering. 

2. Acromio-Clavicular Joint Injury

Caused by: falling directly onto the shoulder or onto an outstretched arm. 

Treatment: seek professional medical assistance as soon as possible to determine whether surgery is needed. A grade 4 injury or more will almost certainly require surgery. Immediately following the injury apply the PRICE method and immobilise the shoulder by putting the arm in a sling. 

3. Anterior shoulder dislocation

Caused by: this type of dislocation can occur if you fall and land on an outstretched arm. The shoulder will essentially be ‘levered’ out of the socket. An anterior shoulder dislocation can also occur due to falling backwards, where the impact causes the shoulder to be pushed out of the socket.

Treatment: seek medical help immediately to treat the dislocation and realign the joint. You may need surgery, so it’s important to see your doctor. Following treatment, the shoulder joint should be rested. You can also apply ice (wrapped in a towel or using an instant ice pack) and take painkillers to manage pain and swelling.

It’s a good idea to wait until your shoulder is completely better before returning to sports, but some cyclists can return earlier by using a shoulder brace. Consult your physiotherapist or doctor to make sure it’s okay to wear a shoulder brace.

4. Rotator cuff tear

Caused by: any type of shoulder dislocation can cause a rotator cuff tear. This is where muscles and tendons tear from a sudden sharp force. Rotator cuff tears can also happen gradually over time as a result of other injuries too.

Treatment: depending on the severity of the tear, you may need surgery or simply rest to allow your body to heal on its own. It’s a good idea to see your doctor or physiotherapist if the injury is significantly painful or does not start to get better after a few days. If you see your doctor for a shoulder dislocation, they will likely tell you if you have a rotator cuff tear too. 

Sometimes surgery is required to repair the rotator cuff tendons or even to replace the shoulder in severe circumstances. Otherwise, your doctor might prescribe steroid injections or physical therapy.

Can I cycle with a rotator cuff injury?

More than 90% of people who suffer a rotator cuff tear recover completely and can return to sports without any problems. Surgery to treat a rotator cuff injury is fast and simple, but recovery time can be long, usually six months to one year. This means many cyclists are anxious to know whether they can ride on a healing rotator cuff.

While your muscles and tendons are healing, it can be painful and dangerous to cycle. Putting pressure on the injury will delay the healing process and could even cause more damage. You may also have lessened control over your shoulder joint, putting you at risk of further injury.

From roughly two weeks into healing, you can maintain light training on a stationary reclining bike, allowing you to cycle without putting your weight on your arms. After roughly two months, you may be able to move to an upright stationary bike. Be sure to consult your physio or doctor to make sure your injury can tolerate this exercise.

Urogenital Injury

Cyclists are at risk of a few different urogenital injuries, the most common of which are nerve entrapment syndromes (50–91%) and erectile dysfunction (13–24%). These are often overuse injuries that result from repetitive strain on the muscles, tendons, and joints that affect the genitourinary system.

Bike Saddle Injury

Cycling saddle injuries like perineal injury are the result of a few sometimes unavoidable factors:

• The small surface area of a bike seat which absorbs the impact against the perineum.
• The fact a bike seat usually doesn’t offer much padding.
• The narrow seat which is required to allow for the pedalling motion of cycling.
• The vibrating ‘road buzz’ which is caused by the rough surface area of the terrain.

These all contribute to the repeated impact that affects and damages blood vessels, nerves, and muscle tissue in the sensitive perineal area. This can also lead to prostate injury cycling complications like inflammation of the prostate, which, while not directly dangerous, can increase the risk of such things as prostate cancer.

A perineal injury is treated differently depending on the severity. If you have a perineal tear, you will need to be examined by a doctor. If you are experiencing less severe perineum discomfort, consider changing your bike seat to help absorb or dissipate the impact when riding. Look for:

• Centre-slit bike saddles which have a hollow middle to prevent direct impact.
• Gel-cushioned saddles to provide added impact absorption.
• Additional padding attachments to increase the level of padding on your current seat.

Musculoskeletal Injuries

There are myriad ways to sustain musculoskeletal injuries when cycling. Here, we cover some of the more common areas of injury.

Hamstring Injury

Hamstring injury affects the muscles at the back of the thigh. The severity of a hamstring injury is measured in grades: 

• Grade 1: a mild muscle pull or strain
• Grade 2: a partial muscle tear
• Grade 3: a complete muscle tear

Grade 1 injuries can easily heal on their own and may only take a few days to get better. Grades 2 and 3 can take much longer and may need treatment by a professional. If the pain in your hamstring doesn’t start to get better or if it’s affecting your mobility, see your GP.

Minor hamstring injuries can be treated at home. Take time to rest the area and apply ice wrapped in a cloth or an instant ice pack to relieve the swelling. Compression with a cohesive bandage can help to reduce swelling and support the area to aid healing. Finally, keep the area elevated by laying down with your leg under a pillow or propped up using furniture.

Can you cycle with a hamstring injury?

Wondering ‘can I cycle with a hamstring injury?’ The answer is yes, but don’t jump straight back into cycling at the rate you were before. Start with gentle regular stretches and work up to cycling over a few days or weeks. It might also be a good idea to start on a stationary bike and help your muscle build strength again before graduating onto a road bike or similar.

Calf Injury Cycling

The calf muscles can rupture during cycling due to sudden contraction during intense exercise. If your calf muscle ruptures or pulls, stop using it immediately and apply the PRICE technique. Depending on how bad your injury is you may only need to rest the area for a few days. On the other hand, you may need to use crutches to ease mobility without putting too much pressure on the area.
Gentle stretches and exercises are a good way to rebuild strength in the muscle if your doctor approves. Swimming is an excellent form of activity that will not put undue pressure on the calf. Cycling with ankle injuries or calf injuries should be avoided until the area is adequately healed or very nearly healed completely.

Head Injury

When you’re at risk of falling from your bike, a head injury resulting from impact or collision is always a hazard. Protecting yourself from a bike accident head injury can be the difference between life and death or help you avoid a life-altering injury.

Bike accident brain injury is complex, and treatment isn’t always straightforward. The best way to treat a brain or head injury is to minimise the risk of getting one in the first place with a good quality, well-fitting helmet.
The brain injury association Headway reviewed studies to demonstrate how much of an impact wearing a helmet can have at the point of injury. In a study of over 11,000 pedal cyclists who experienced an accident, 47.6% of casualties who were not wearing a helmet sustained a traumatic brain injury compared with 19.1% of those who were wearing a helmet.

Cycling Foot Injuries

The feet are a focal point during cycling due to pressure and movement in these localised points. The feet are the closest point to the ground, too, so there’s also a risk of collision or impact. Here are some common foot injuries in cycling and their recommended treatments. 

• Numbness and paraesthesia, sometimes called ‘pins and needles’ because of the sensation it causes. This is caused by compression of the nerves and usually doesn’t require any special treatment. It can be prevented by ensuring footwear, and pedal straps aren’t too tight.
• Metatarsalgia, a pain associated with stress and pressure on the balls of the feet. This can be treated by resting and icing the area. You can minimise the chance of metatarsalgia from returning by using padded insoles and arch supports or switching to shoes with more padding for the soles of the feet.
• Plantar fasciitis, inflammation or pain in the arch of the foot. This can be treated by resting and elevating the area. You can also use over-the-counter pain killers. Regular stretches can also help you reduce the symptoms of plantar fasciitis over time.
• Achilles tendinitis, a result of incorrect use or overuse of the Achilles tendon. This can be treated by resting and icing the area. Use over-the-counter pain killers. A compression bandage can also help to support the area. 

Speak to your physician about using kinesiology tape to alleviate the symptoms of any of these foot ailments. K tape can help to encourage movement in the right direction and provide relief to swollen or strained areas.

When it comes to emergency first aid, seconds count. Be prepared if you suffer an injury or help another cyclist with essential cycling first aid skills for common bike injuries.

Find out which cycling first aid kit you should carry depending on the type of cycling you do and what to think about including in a cycling first aid kit if you’re making your own.

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