Cycling and Hip Pain – How a Physio Bike Fit Can Help
How lucky are we in South East Queensland to have such a wonderful cycling environment. Cruising along the Brisbane River, heading out across the bridge to Redcliffe, hill climbs up Mt Coot-tha or Mt Nebo, trail riding in Daisy Hill and the Brisbane Valley Rail trail or even hitting the trainer on those rainy days you can’t avoid. But cycling with hip pain can certainly put a dent in the enthusiasm!
I personally got into riding for triathlon training. Prior to, I had only really used my road bike for commuting, shorter distances, and not trying very hard. So, once I decided to start pushing myself for tri training, various aches and pains started showing up here and there. Some of the more the persistent ones were around the hip and groin. I would try standing up out of the saddle for a period, constantly change my hand position on the bars, I tried to be better about stretching post rides, even before some rides too and sometimes it helped but not consistently enough. I had to get my bike fitting better to my body, and when I did, it made a big difference for me.
Often, the hip pain experienced on the bike isn’t just about the hip but rather related to the body interacting with the bike. Hence, having a physiotherapists’ biomechanical eye to assess how you move on and off the bike can provide a beneficial fitting of your own body to your specific bicycle.
This blog will cover the following topics on Cycling and Hip Pain:
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Our Brisbane Physiotherapy Clinic, services areas including: Salisbury, Brisbane, Tarragindi, Mount Gravatt, Holland Park, Rocklea, Yeronga, Annerley, Camp Hill, Carindale, Coorparoo, Salisbury, Sunnybank, Greenslopes, Seven Hills, Acacia Ridge, Indooroopilly, Woolloongabba, etc.
Because of our expertise in hip conditions, hypermobility, sports injuries, and dance injuries and performance, we also have people visiting us from all over Queensland, Australia and even international visitors. We also have a telehealth service for remote patients.
How cycling can lead to hip pain
Cycling has a repetitious nature in its mechanics. Lower limbs fire up and down like pistons, over and over, driving the pedals. With longer rides one can have 10s of thousands of these pedal revolutions. Even a small error in movement, or biomechanical disadvantage from cycling set-up, can lead to amplified stress on a body part that builds over the ride.
Furthermore, some common factors that may contribute to developing hip pain while cycling. Holding a forward lean in the seated position over a prolonged period limits the range of motion of the hip to more of a flexed position. If the seat post is set too low or the saddle is drawn back too far this may lead discomfort around the hip and groin.
If the seat post is set too high, this can lead to pelvic rocking side to side. In an attempt to maintain downward pressure on the pedals, over- reaching can lead to side-to-side rocking of the pelvis. This may lead to discomfort across the low back and pelvis or even lead to pressure soreness in the inner groin or perineal area.
Poor motor control of the hips and pelvis or strength deficits of musculature of the deep hip can lead to biomechanical issues and pains turning up on longer rides.
Even past injuries may have an impact - decreased range of motion of the hip or surrounding joints can can lead to adverse loading of the hip while cycling. The hip is part of a larger working motion of the entire lower limb, therefore an old injury to the knee or ankle may have an impact farther up the chain. Also, pelvic and spinal control and range of motion will have a similar effect on the hip. All the more reason to have your PhysioTec Physiotherapist provide a comprehensive clinical assessment prior to mounting your bike and assessing for the right fit.
Hip and groin pain while cycling can be frustrating — especially when it starts to limit the rides you love. Whether it’s discomfort at the front of the hip, pain around the sit bones, or aching that lingers after you’ve clipped out, these symptoms are often linked to how your body is interacting with your bike rather than “just” the hip itself.
Because cycling involves thousands of repetitive pedal revolutions, even small setup errors or underlying strength and mobility deficits can gradually build into persistent pain. Saddle height, handlebar reach, cleat position, pelvic control, and previous injuries can all influence how load is distributed through your hips and pelvis.
If your hip pain has been lingering, worsening with longer rides, or starting to affect your walking or running, a comprehensive assessment can help identify the contributing factors and guide both your bike setup and rehabilitation plan.
Book in with one of our PhysioTec physiotherapists for a detailed clinical assessment and physio-led bike fit to help you ride stronger, longer, and more comfortably.
Common Hip Related Pains and Conditions Cyclists Experience
Hip flexor tendinopathy
The tendons of the Illiacus and Psoas Major muscles can be sources of pain at the front of the hip. These hip flexors function together as a unit to draw the femur upward. In cycling, it’s easy to see how these muscles play an important role for the upward driving motion in pedaling. The Illiacus and Psoas may become overloaded or subjected to compressive forces that may become irritating and therefore being fit properly to your bike is crucial to help reduce this risk.
FAI
FAIS or Femoro-acetabular Impingement Syndrome is a diagnosis describing joint related pain, generally in the front of the hip which can be linked to the shape of the hip joint, bony alignment and growth (CAM or Pincer morphology) and it may involve the labrum, cartilage and other hip joint structures.
It's also possible to have this bony shape but without pain (FAI), so you may have FAI and not even know yet. Even if the hip is not painful, the range limitation can affect the pelvis, lower back or knee, that need to work to compensate. The specifics of the diagnosis can be addressed during a thorough assessment and history discussion with your physiotherapist and will help to develop a well-suited fit for your body’s structure on your bike.
Proximal Hamstring Tendinopathy
The hamstrings are a group of long muscles stretching from the posterior knee to the posterior lower buttock/ pelvis. The upper portion of the hamstring has an attachment on the sitting bones of the pelvis. This can become a tender area for a cyclist with a seat set too high leading to over reaching for the pedals and leaning too far forward hinging at the hips with too great a degree.
Pubic Pain or Peroneal Pain
Pubic pain and perineal (pelvic floor region) pain can be common in cyclists. In some instances this pain can be related to adjusting to sitting in the saddle or beginning to increase riding volume and spending more time in the saddle.
In other cases, this pain may be related more to pelvic position on the bike and lumbo-pelvic motor control in the saddle.
Why chose a PhysioTec Bike Fit?
While a standard bike fit may suffice, a physio-led bike can offer something different. Your physio can have a deeper conversation regarding past injuries or health conditions and understand what impacts that might have. We also provide specific strength, mobility, motor control, load tolerance and functional tests to develop a clear picture of your biomechanics before clipping-in. At PhysioTec, we have the privilege of world class physiotherapy training and professional development from physiotherapist and researcher Dr Alison Grimaldi, a leader in hip pain research and physiotherapy management. Our expertise can offer a unique perspective on your hip pain before and after you get on the bike.
What to expect in your bike fit:
1. Clinical Testing (Off Bike)
- Joint range of motion
- Muscle strength and endurance
- Motor control
- Functional movement screening
- Past injury discussion
2. On Bike Testing
- Saddle height and setback
- Handlebar reach and drop
- Cleat position
- Pedalling symmetry
- Knee and hip angle measurements
3. Post Ride
- Any necessary strength/movement training exercises, or stretching/mobility exercises may be provided by your PhysioTec physio, depending on any diagnosis and treatment plan after fitting is provided.
- To have the best fit possible and provide a management plan to help compliment your love of cycling!
"When should I get assessed?"
- My hip pain lasts longer than 2 weeks and is consistent with my cycling.
- My pain worsens with the more cycling I do.
- My pain lingers post ride and continues into the night, it may disturb my sleep as well.
- I’m often experiencing clicking, locking or catching feelings in my hip when I ride or after I ride.
- Now my pain is beginning to affect my walking or running as well, affecting more of my life than just riding.
An earlier intervention can help to reduce the severity of your hip pain when riding. Consult our PhysioTec Physios if you’re beginning to feel concerned regarding whether your bike set-up is really right for your body, and you'd like to try a Physio Bike Fit.
Experiencing hip or groin pain when you ride?
Noticing discomfort that builds during your cycle or lingers long after you’ve finished?
Let one of our experienced PhysioTec physiotherapists assess your movement both on and off the bike, identify what’s contributing to your symptoms, and guide you through a personalised bike fit and management plan tailored to your body.
Helping you ride stronger, move comfortably, and get back to enjoying every kilometre with confidence.
Key Takeaways
Try not to ignore small aches if they persist. Yes, there is always an adjustment period to changes in cycling load, however those aches should fade. If they don’t, you may need to adjust.
If a small adjustment to the saddle position isn’t proving the relief you require, a more thorough assessment may be required.
Strength training is important. Don’t forget to compliment your riding with strength work. Consider reading Eric’s Blog regarding strength and conditioning for cyclists if you want more information.
Hip mobility and motor control (control of movement patterns and muscle recruitment strategies) of the hip and pelvis are crucial factors for cyclists as well as strength.
Consider consulting your physio if your pain persists. We are here to help you get the most out of your riding!
Dealing with hip pain and want to get back to your cycling goals?
Book a Hip Assessment at PhysioTec and we’ll evaluate your movement on and off the bike, identify what’s contributing to your pain, and create a personalised plan to get to your best form.
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Author
This blog was written by Tyler Cultum, one of our Sports and Strength & Conditioning Physiotherapists. He has broad interests in sports and musculoskeletal physiotherapy, with special interests in strength and conditioning, the shoulder and hip. You can read more about Tyler here.
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References:
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