Common Cycling Injuries & Bike Fit

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It's not hard to see that cycling is following a similar trajectory that running is. Looking at Centennial park and the hills around the Eastern suburbs, IT IS BOOMING. The roads are nearly as full as the local coffee shops. So I wanted to do a blog series on some of the things I see in the clinic that are known to keep people off the bike. In this blog series, we’ll break down some of the most common cycling-related injuries, explore how bike fit plays a role, and explain when it’s time to consult a physiotherapist. Each instalment will focus on a specific area of the body, common bike setup contributors, and how a physio with bike fitting knowledge can help keep you riding comfortably and pain-free.

This Week: Lower Back Pain & Cycling: Why It Happens and How A Passionate Bike Riding Physio Can Help

Lower back pain is one of the most common complaints among cyclists, affecting riders across all levels from weekend warriors to competitive athletes. While it’s often blamed on “poor core strength” or time spent in a flexed position, the reality is usually a combination of repetitive load, bike setup, and how the body adapts over time.

Common Lower Back Issues in Cyclists

Cycling places the spine in a sustained forward-flexed position, particularly in road and performance-focused setups. Over time, this can lead to:

  • Mechanical lower back pain from sustained spinal loading

  • Facet joint irritation due to repeated extension or rotation during pedalling

  • Disc-related irritation, particularly in riders who train frequently or aggressively

  • Muscular overload or fatigue, especially through the lumbar extensors and hip stabilisers

These issues often develop gradually rather than from a single incident, making them easy to ignore until they start impacting performance or enjoyment.

Bike Fit Factors That Contribute to Back Pain

From a bike fitting perspective, lower back pain is rarely caused by one factor alone. Common contributors include:

  • Saddle height too high, causing excessive pelvic rocking and lumbar strain

  • Reach that’s too long, forcing the rider into sustained spinal flexion

  • Handlebars set too low, exceeding the rider’s current mobility or tolerance

  • Saddle position too far back, increasing lumbar load during the power phase

  • Cleat or foot position issues, subtly altering hip and pelvis mechanics and altering spinal load

Even small deviations can have a big impact when repeated thousands of times per ride.

How a Physio With Bike Fit Knowledge Can Help

A physiotherapist can help with bike fitting by looking beyond measurements alone. Instead of simply adjusting the bike to “ideal angles,” they assess how your body moves, loads, and compensates on the bike.

This may involve:

  • Analysing spinal posture, pelvic control, and hip mobility on and off the bike

  • Adjusting saddle height, fore–aft position, and cockpit setup to reduce lumbar strain

  • Modifying reach or bar height to better match your current capacity

  • Identifying movement patterns that may be increasing load through the lower back

The goal isn’t just comfort, it’s creating a setup your body can tolerate sustainably.

Preventing Recurrence: Exercise & Load Management

Bike fit alone is rarely the full solution. A physio will also address the physical capacity required to maintain your riding position comfortably.

This often includes:

  • Improving hip mobility to reduce compensatory spinal movement

  • Building trunk endurance, not just strength

  • Addressing asymmetries in strength or control

  • Gradually increasing riding load in a way your body can adapt to

When bike setup and physical capacity are addressed together, riders often notice not only reduced pain, but improved efficiency, comfort, and confidence on the bike.

Seb Hardy