Road Cycling FAQs

Neck pain

The experience of neck pain is often related to the sustained posture one must maintain whilst cycling. The neck needs to maintain an extended position whilst cycling. This is because your body is leant forward on the bike, yet you still need to keep your eyes on the road! This extended position loads the muscles and joints of your neck. As above, adopting a more upright posture can reduce the load on these structures and you can progressively revert to your previous position as your body adapts.

Knee pain

This is one of the most common painful areas for cyclists and is most commonly experienced at the front of the knee. The most common cause is PFPS (Patellofemoral pain syndrome). This is where the loads placed on the joint between your kneecap and thigh bone (patellofemoral joint) aren’t well tolerated leading to pain. Some strategies to help reduce pain are changing the saddle height. A saddle height too low increases loads placed upon the patellofemoral joint. Other factors which may contribute are selecting a gear too high for the speed you are riding, meaning you need to produce high amounts of force relative to selecting a lower gear requiring lower amounts of force with more repetition to maintain the same speed.

Foot pain/numbness

Cyclists can experience foot pain/numbness (commonly referred to as ‘hot foot) especially on longer rides. It usually manifests as a burning pain sensation at the balls of your feet or numbing feeling of toes.This is usually caused by irritation of the nerves that run between the metatarsal bones of your foot (the long bones just before your toes start). There are a few potential things to consider that may cause this irritation of these nerves.

Shoe size, especially the toe box width should be considered. Wearing a shoe too narrow can put pressure on the metatarsal bones, bringing them slightly closer together and not allowing them to fully spread apart, thus increasing the pressure on the nerves between them. Trialling wearing thinner socks and wearing the shoes slightly looser can be a good starting option to see if that makes a difference. Many cycling shoe manufacturers make shoes that are quite narrow and are unaccommodating for wider feet, though more wider shoe options are seeming to be hitting the market.

Using a more rearward cleat position (moving cleats further back towards the heel) can be helpful as well. This will move the point where pressure is most concentrated further behind the ball of the foot, of the painful area.

Wrist/hand pain

This is often due to increased pressure on the hypothenar area of the hand and the ulnar nerve as it passes into the hand where the hand rests on the handlebar. 

Road bike handlebars have three different hand positions : the hoods, the tops and the drops. Placing your hands in each of the different parts of the handlebar stresses your hand in different areas. There is evidence to show the hypothenar region is stressed most in the drops position and may increase the chance of ulnar pain due to the course of the nerve through this region. It may be helpful to regularly change positions on the handlebars between the hoods, the drops and the tops to share the load on different parts of your hand. Wearing gloves has also been shown to reduce pressure on this area with thinner gloves performing better than thicker gloves.

Other potential contributing factors to this issue are the bike set up - A saddle too high, handlebars too low and increased stem length can increase the weight the hands bear. The bar tilt and type may also affect which area of the hand bears more weight.

Bringing your handlebars closer with a shorter stem and putting spacers on the steerer tube to raise the handlebar height may help by reducing the weight beared by the hands.

Lower back pain

Similar to experiencing lower back pain while sitting or standing for long periods, some people experience pain when spending long durations on the bike.

Sometimes, back pain on the bike can be related to your riding position. A more stretched out and leant forward position can make your spinal muscles have to work harder to maintain that position, increasing stress on your back. A more upright position is commonly more comfortable, placing less stress on your back when riding at the expense of aerodynamic advantage. This can be achieved by riding a more endurance oriented frame, adjusting handlebar position to be higher and closer and adjusting the saddle to be lower or closer (however, when adjusting the saddle position, note that it may affect pedalling efficiency and movement of the knees).

Again, this stress is good and can be adapted to so as you get more kilometres under your belt in a more upright position you can start to gradually revert to your previous position if you desire a more aerodynamic position on the bike.

Groin/saddle pain

Pain around the groin and buttocks is also quite common in cyclists. This can develop from a combination from the pressure of your bodyweight, friction, sweat and heat which irritates the skin. Often this stress can be adapted to and your body just gets used to the pressure on this area. Especially for beginner cyclists, it is common to experience this and as you build up to doing more kilometres on the bike, it usually eases to an extent. Bike saddles aren’t lounges after all and on longer rides some discomfort may be experienced. Some strategies for reducing this discomfort are wearing cycling specific shorts or bib, using a chamois cream (a lubricating cream usually applied to the perineum, inner thighs and other areas you experience friction) and trying to find a saddle suited to your pelvis. These can be helpful in reducing friction and pressure on sensitive areas.

Male cyclists can also experience numbness down there when riding. It is believed that this is due to pressure on the pudendal nerve at the perineum, however this is still unclear. There are some strategies that can be implemented to relieve pressure on the perineum to avoid/alleviate this sensation. Using a no-nose saddle, a saddle with a cutout and standing out of the saddle regularly are effective strategies in reducing the pressure in this area.