L u m b a r S p i n e an d L o w e r

E x t rem i t y O v e r u s e I n j u r i e s
Tracey Isidro, MD, Elaine Gregory, MD, Laura Lachman, MD, Stacey Isidro, MD,
Angela N. Cortez, MD*

KEYWORDS
 Cycling  Low back pain  Lower extremity pain  Overuse injury

KEY POINTS
 Lower extremity pain is a common source of overuse injury for cyclists.
 Knee pain is the most commonly affected area for overuse injuries in the lower extremities.
 Low back pain is a common source of overuse injury for cyclists.
 Understanding the relationship between the athlete and the bicycle can be an important
component of treating both lower extremity pain and low back pain.

INTRODUCTION

Both lower extremities and the lower back are common sources of injury for cyclists.1,2
In order for providers to optimize care within this specialized area of sports medicine,
they need to understand the most common sources of injury in this population. To
achieve this, cycling presents a unique challenge: treating both the athlete and the
complex relationship between rider and bicycle. Physicians, however knowledgeable,
should not replace the role of a professional bike fitter and should view these individ-
uals as integral members of the team to alleviate current and prevent future injury. This
article explores the most common lower extremity and lumbar back overuse injuries in
cyclists and their medical management.

CYCLING-RELATED LOWER EXTREMITY PAIN

Cyclists can experience chronic overuse injuries in multiple parts of the body from re-
petitive movements.1 Various studies report that the knee is the second most affected
area for overuse injuries overall and the most commonly affected in the lower limb.3,4

H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine;
7200 Cambridge Street, Houston, TX 77030, USA
* Corresponding author. Baylor Medicine at McNair Campus, A10.264, Houston, TX 77030.
E-mail address: angela.cortez@bcm.edu

Phys Med Rehabil Clin N Am 33 (2022) 201–214

https://doi.org/10.1016/j.pmr.2021.08.014 pmr.theclinics.com
1047-9651/22/ª 2021 Elsevier Inc. All rights reserved.