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Bike Injury and Pain: How to Diagnose and Fix

Problem Equipment Solution Bodywork Solution
Neck Pain Bring the rider more upright by
  • Raise handle bar
  • shorten stem
  • move seat forward
  • change handle bar width
  1. Improve posture no chicken neck[1]
  2. Strengthen back muscles[2]
  3. Stretch and loosen anterior neck muscle
  4. Chiropractic spinal adjustment
Numbness and tingling in pinky side of hand a.k.a. ulnar nerve palsy cyclist palsy
  1. Ergonomic hand grip[3]
  2. Change handle width
  3. Padded glove
  4. Bring rider more upright see above
  5. Larger diameter grip
  6. Change hand position frequently
  1. Teach rider to engage and strengthen back muscles so less weight is on hands
  2. Release tunnel of guyon with Active Release Techniques®
  3. Stretch forearm muscles
  4. Check to see that neck is not the cause
Numbness and or tingling on thumb side of hand also known as median nerve injury and carpal tunnel syndrome Same as above 1.Release Carpal Tunnel and the Pronater Teres[4] muscle with Active Release Techniques®[5]
Anterior knee pain in front of or just below or above your knee cap
  1. Change crank length
  2. Seat height, generally higher[6]
  3. Pedal a smaller gear
  4. Get stronger
  5. Adjust seat height[6]
  1. Release Iliotibal Band[7] and patella tendon[8] with Active Release Techniques® or foam roller
  2. Stretch Iliotibial band and/or Hamstring
  3. Stabilize pelvis with Pilates
Lateral or outside hip pain  
  1. Release Iliotibial band with ART or foam roller[9]
  2. Stabilize pelvis laterally with Pilates,
  3. Examine low back
Low back pain
  1. Bike Fit
  2. Ride more up right, see above
  1. Release low back muscles with Active Release Techniques®
  2. Stabilize  front back movement with Pilates
  3. Chiropractic
Foot numbness
  1. Arch supports[10]
  2. Medial lateral posting of the foot[11]
  1. Release foot muscle Active Release Techniques® or ball
  2. Exercise intrinsic foot muscles
Achilles tendonitis which is  pain in the lower part of the back of the leg were the calf muscle attaches to the heel
  1. Arch Supports
  2. Night splints to stretch the calf
  1. Stretch and strengthen the calf.
  2. Strengthen the muscle in the front of the lower leg primarily the Tibalis Anterior
  3. Release the calf and foot muscles with Active Release Techniques®
Metatarsalgia which is pain in the ball of the foot area Arch support, night splints to stretch the calf
  1. Release foot muscle Active Release Techniques® or ball
  2. Exercise intrinsic foot muscles
  3. Stretch and strengthen the calf.
  4. Release the calf and foot muscles with Active Release Techniques®

[1] Chicken neck is when the head is forward of the shoulders and chest

[2] By strengthening the back muscle this will pull back the head so it is in a more balanced position. This is best done initially with  a qualified pilates instructor, physical therapist or chiropractor

[3] Ergon hand grips are one choice

[4] The pronater Teres is a muscle in the upper forearm which has been shown to be the site were the median nerve gets squashed 91% of the time, most people diagnosed with carpal tunnel syndrome have this squeezing of the median nerve by the pronater teres muscle not the carpal tunnel

[5] Active Release Techniques® is the gold standard in soft tissue treatment. It is done primarily by chiropractors and physical therapists. The goal is to break up adhesions/scar tissue in all soft tissues. Soft tissues include muscles, ligaments, tendons, joint capsules, nerve sheaths and fascia. The breaking up of the scar tissue/adhesions will increase strength, flexibility, range of motion and this will decrease pain.

[6] The seat should be adjusted so that when your foot is at at the bottom on the stroke there is a slight bend in the knee and your pelvis is not wobbling.

[7] Iliotibial band (ITB) is a band of fascia that runs down the side of the upper leg (femur) over your pants seam. It controls the knee cap alignment and mechanics of the knee joint.

[8] The patella tendon connects the knee cap to lower leg bone(tibia)

[9] Releasing of the Tissue is best accomplish using Active Release Techniques® you can also release the ITB and with a foam roller and the feet with a golf ball

[10] Of the shelf supports from companies like super feet and sole are great first choices. If these do not help then have a chiropractor or podiatrist make you a custom  pair.

[11] Posting is putting a wedge under the inside or outside of the foot so that the forces are shifted.