Biking and exercise can make us happy, but they can also make us hurt. Injuries from cycling can come from falls, overuse, or an improper bike fit and form. Early identification and treatment are important to keep you on the road once pain begins.

It all starts with the bike: having a well-fitting bike is crucial. Alysia Bedgood, M.D., a primary care sports medicine physician affiliated with Memorial Hermann IRONMAN Sports Medicine Institute, says, “A saddle that is low or too far forward causes your foot and knee to flex in ways that can add strain.” This can lead to patellofemoral syndrome (pain behind the knee cap or in a horseshoe around the interior part of the knee cap that is worse with walking up stairs and going from sitting to standing), IT band syndrome (pain in the outer knee associated with a tight iliotibial band), trochanteric bursitis (tenderness and pain in the side of the hip), Achilles tendonitis (stiffness and pain in the back of the foot just above the heel), and plantar fasciitis (foot pain in the bottom near the heel, usually felt with the first few steps of the day and after being on your feet for long periods). Shortening the distance to the handle bars or raising the tilt of the saddle 10 to 15 degrees can also lessen back pain and neck strain in some people.

Simple adjustments to your bike and treatment of the site of inflammation can get you back to riding comfortably. Few would call a traditional bike seat comfortable, but numbness or tingling in the legs and even erectile dysfunction can be related to nerves being pinched in the posterior leg and groin. Usually time heals this discomfort, but a nose-less or cushioned saddle can relieve the pressure on you and your nerves.

Another area that can have numbness from riding is the hand. Resting the pinky finger side of the hand too long on the handle bars can compress the ulnar nerve. Switch your hand position often and wear cushioned gloves to lessen that I-just-hit-my-funny-bone feeling.

Once your bike is properly set, the next project is you. Areas of tightness or weakness can predispose you to pain. Weak glute and quad muscles get more easily fatigued and allow your form to go downhill faster than an all-aluminum frame. This can strain the knees and hips leading to patellofemoral pain, IT band syndrome, trochanteric bursitis and irritation of osteoarthritis. Foam-rolling a tight IT band can help but getting to the root of the problem can keep it away. If you wake up with a sore back or neck the day after a ride, this may mean your core is weak and in need of attention.

Lastly, there are injuries that you can’t avoid. A fall can leave you with road rash and aching parts. Dr. Bedgood says, “The best way to stave off infection is a good clean with soap and water and protecting the skin until a scab forms. If the scrapes become very red, painful, have pus on them or if you develop a fever, it’s time to see a doctor.” Wrists can take the brunt of a fall, and if they remain swollen or you are unable to do daily tasks like opening jars or doors, they may be hiding a fracture.

Wherever your pain, don’t ignore it. By treating an injury early, you can keep an injury from dismounting your training plans.

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