How to avoid pain from cycling

OK, we’re going to cover the most common cycling pains, what causes them and what to do about it (this excludes pain from hitting the ground after a fall).  I have a particular interest here as I’m about to become a bicycling Edinburgh osteopath, returning to the sort of distances I did when studying in London – 13 miles twice a day; though I’m aiming for only 4 days per week – I need the car on a Friday so I’ll park on the edge of the city and get a wee run on a Friday 😉  The clinic also looks after the City of Edinburgh Racing Club cyclists, so we have some pretty good insights from dealing with elite cyclists.

Common Cycling Pains

Lower back pain is common in cyclists, generally due to the angle of the spine and the exertion in this position.  It’s simple mechanics; if you lean forward and push hard and do it a lot, your back is going to get tired and sore.  Most important things to consider:

  • Vary your riding position – sometimes up, sometimes on the drops, sometimes standing up rather than in the saddle.
  • Try to flex at the hips and keep your lower back flat a lot of the time, rather than curled forward.


Knee pain, especially behind the kneecap, is common due to the sheer repetitive action of bending and straightening your knees. A slight misalignment in your pedalling action (letting a knee drop in), or pushing harder on one side than the other (more likely if one leg is a bit longer than the other) will tend to upset your knee after a while.  Only pushing on the pedals will also lead to imbalances and may upset a knee.  Tips:

  • Use toe-straps or clip-in pedals.


Neck and shoulder pain is likely, particularly on longer rides.  Again, this is a postural issue; leaning forward, the only way to look ahead is to tilt your chin up.  This puts the neck at an unnatural position, straining the muscles and joints at the base of the neck.  If you stay in this position for long enough you may irritate one of the nerves as it passes from the lower neck down through the shoulder to your arm… this can cause pins and needles in the arm and/or hand:

  • Try altering your posture a bit, keeping your chin down can help.


Headaches after cycling tend to be caused by neck position and tension, so

  • Follow the advice above.


Hand pain or pins and needles are likely to be caused by leaning on the heel of your hand (and particularly through a lot of off-road bouncing around); if you keep this up for long enough you can cause permanent damage to the nerve, so you may have to cut back on your cycling short term, but at the very least:

  • Try adjusting your riding position.
  • Supplement with Vitamin B6 which is good for helping nerves to repair.


Hip pain is fairly common too; again due to a lot of pressure on the muscles of the hip when leaning forwards.

  • Consider your riding position.
  • Do exercises to stretch these muscles frequently.


Perhaps the best pieces of advice and the ones that are always appropriate:

  • Make sure the bike is set up to fit you well; get help from a great bike shop (there are loads in Edinburgh)
  • Do exercises to balance the muscular tensions that you’re bound to build up if you cycle a lot – yoga can be a great balance to cycling (and sitting at a desk all day!).  Make sure your core abdominal muscles are strong – it gives you a more solid base from which your legs can generate power more easily.  We can give you a bespoke exercise regime if you like.


And finally, if you have pain from cycling, get early assessment, treatment and advice – we can help!

PS  If you’re out cycling, be safe, and make way for the cycling osteopath!

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