Indoor cycling’s popularity is due to a combination of many factors. Almost anyone can do it—regardless of fitness level, age or body type. Recreational cycling’s popularity fuels interest in the indoor option. And indoor cycling allows you to work extremely hard (at a high intensity) with very little impact, which provides a great alternative to other, higher-impact workouts such as running.

Some instructors forget that lessened impact does not always mean a decreased rate of injury. Yes, it’s true that cycling has very few “catastrophic” or acute injuries. Rarely does something scary happen on a bike that isn’t going anywhere! But long-term, chronic injuries are pervasive. Many instructors and participants forgo proper preparation and setup; choose inappropriate skills and drills; and bypass recovery and maintenance. The following tips are by no means a comprehensive look at injury prevention and are meant as a starting point for reference.

Knee Injuries

Pedaling produces great force, acts directly through the knee and occurs up to 5,000 times an hour. Therefore, the slightest incorrect load distribution—caused by inappropriate seat position or foot placement—can lead to pain. A variety of knee issues stem from general weakness, muscle tightness, faulty bike setup, and overuse. You may hear some of the following complaints from participants:

Anterior Issues. A general pain located at the front of the knee may be one of the following: patellofemoral pain syndrome (pain in the front of the knee arising from the joint between the kneecap and thigh bone), chondromalacia (abnormal softening or degeneration of cartilage) or patellar tendinosis (inflammation of the patellar tendon, which connects the kneecap to the lower leg bone). Improper knee tracking during the power phase of the pedal stroke is the most common cause of these pains. A weak vastus medialis obliquus can lead to and/or exacerbate the pain. Caution riders not to position the saddle too low, as this can cause compression through the knee joint.

Pain located along the outside edge of the knee may be attributed to iliotibial band (ITB) friction syndrome (overuse injury of the soft tissues in the lower thigh near the outside of the knee). The ITB is a thick band of fibrous tissue that runs from the hip down the outside of the thigh, attaching to the tibia. Repetitive friction of the ITB against the bone on the outer side of the knee causes the pain. A bike seat positioned too high or too far back can overstretch the ITB. Other contributing factors include anatomical issues, such as leg length discrepancies and excessive internal rotation.

Inside Edge Problems. Pes anserinus bursitis (inflamed bursa at hamstring tendinous insertion) and mediopatellar plica syndrome (inflamed thickened knee capsular fold), while less common, stem from excessive traction and an externally rotated tibial position, which can result from body structure or incorrect foot/cleat placement.

Pain that occurs along the back side of the kneecap may be categorized as biceps femoris tendinosis (inflamed hamstring tendon insertion). This type of pain may result from a saddle being positioned too high or too far back, which can cause increased stretch in the hamstrings. Excessive internal lower-leg rotation may also lead to overstretched hamstrings, contributing to this pain. Additionally, during standing drills, an increase in sheer force may occur if a rider is inappropriately positioned. When standing, always encourage a slight forward hinge at the hips to divert pressure from behind the kneecap.

Back Pain

Back muscles help support and stabilize the body during cycling and increase the transfer of energy from hip and leg muscles to the pedals. Improved energy transfer greatly influences workout quality. Prolonged forward flexion, which is prevalent in cycling, combined with poor riding mechanics can easily lead to back pain. Since aerodynamics doesn’t matter in indoor cycling, many problems may be lessened by simply raising the handlebars. The following are general complaints that participants might experience:

Lower-Back Pain. This may result from riding poorly and/or too much. Some lower-back pain can be eliminated with an adequate range of lumbar-spine and hip flexion when riding. Instruct the class to choose an appropriate saddle height. This will provide optimal range of motion in the spine and hips, allowing participants to fully activate the large trunk muscles. You may also tell riders to sit in a more anterior pelvic position. Spending extended periods of time with arms positioned too low or too far forward can compromise lower-back stabilization. Frequently change hand positions and the degree of flexion in the back (sitting or standing); this variety will help prevent lower-back pain.

Upper-Back Pain. The upper-back muscles (trapezius, teres major, teres minor and the infraspinatus) stabilize the body’s forward trunk and arm position throughout the ride. This position may cause constant compression, leading to upper-back and neck pain. The likelihood that participants will experience neck and upper-back pain increases if they position handlebars too low or ride without a slight bend in the elbows. Elevate the handlebars to increase comfort, and encourage participants to maintain a slight bend in the elbows. Combine this adjustment with frequent changes in hand and body positions throughout the ride.

Additional Pains

While back and knee pains are the most common complaints, there are a few other “trouble spots” you may encounter:

Hand/Wrist Pain. The ulnar nerve descends along the inside of the forearm and enters the hand on the palm side. It is susceptible to bicycle vibrations and any other body movements. Stress on this nerve can cause hand numbness, grip weakness or even loss of muscular control in the fourth and fifth fingers. Excessive weight distributed through the arms and hands can cause discomfort and potentially lead to (or exacerbate) carpal tunnel syndrome. Adjust (usually elevate) the handlebars and change hand positions. These two steps often help displace the pressure. Observe participants and encourage a firm, relaxed grip with straight wrists.

Shoulder Pain. This often occurs when participants place too much weight on the hands and/or ride with straight elbows. Encourage a slight bend in the elbows and a firm, relaxed grip with straight wrists.

Foot Pain. “Hot feet,” or a numbness and/or burning sensation in the feet, is another common complaint among studio cyclists. Have each participant check to make sure the forefoot of his or her shoe is wide enough to accommodate the foot. Encourage participants to wiggle their toes during the ride.

Injury Prevention

1. Be Strong, Stretched and Centered. To best prevent injury, first strengthen the muscles that are responsible for producing power (hamstrings, glutes and quadriceps), as these are constantly overstretched. Second, stretch the muscles that get chronically tightened or shortened from pedal stroke or body position. Third, introduce centeredness by adding movements that cyclists rarely experience, such as spinal extension, rotation and lateral flexion.

2. Ensure a Good Fit. Proper saddle height and fore/aft positions are necessary in order to allow maximal range of motion for the hip and knee joints. The saddle height should provide approximately 25–30 degrees of knee flexion at the bottom of the pedal stroke with a neutral foot. Gauge the fore/aft positions by knowing that a plumb line from the most forward knee position should intersect the ball of the foot and the pedal’s axle. Set the handlebars at an appropriate height for comfort. The rider should easily be able to reach them and feel adequate upper-body support.

3. Reduce Careless Injury. Many indoor cycling injuries can be avoided through proper bicycle upkeep and maintenance, cadence control and correct resistance. Check that all bike adjustments are secure before riding, and periodically check pedals and shoe cages for stability. Speeds should be in a safe range that allow riders to maintain and manipulate an appropriate amount of resistance (not too much, not too little).

Instructor Training

Quality education is at the heart of injury prevention for indoor cyclists. The American Council on Exercise suggests that instructors possess a group fitness or personal training background, as well as an indoor cycling specialty certificate. Look for an instructor training program that

  • emphasizes coaching versus entertaining;
  • is rooted in science versus philosophy; and
  • provides tools to ensure participant safety and success.

A well-instructed indoor cycling class has the potential to reach a wide variety of people through simple, low-impact exercise. Educate yourself and inspire a new group of exercisers.