top cycling injuries and how to avoid them-part I

Jan 6, 2021

Dr. Tim Woo, PT, DPT – @SoCalBikePT


Sorry to break this to you…you were not designed to ride a bicycle.

The bicycle is a relatively new invention in the timespan of human existence. Cycling is just not what we were made for. Walking, Running, Squatting…this is what we were designed to do.  I am going tell you exactly what you need to live like you ARE designed to ride a bicycle and rip legs off on two wheels.

When you ride a bicycle around for hours and hours, your body will start to adapt in some good and not-so-good ways. Being leaner, better cardio, and looking better with tan lines are some of the good ways.  Massive muscle over-compensation and unbearably high volume of load that leads to knee pain, back pain, and generally just feeling ancient are some of the not-so-good ways.

The most common complaint I hear is about knee pain. So much in fact, it feels like the bicycle was invented as this “knee-torture” device that also costs an arm and a leg. Most of the riders I speak with that have experienced knee pain said they first went down the Dr. Google rabbit hole (do not make an appointment to see Dr. Google) and freaked themselves out about all the knee pain “syndromes”.  IT Band SYNDROME, Patella Femoral Pain SYNDROME, (Insert any other scary words) SYNDROME. It’s daunting…it’s scary…and none of them tell you what is  “actually wrong” or how to fix it.

Example of Dr. Google’s equation for knee pain: name of anatomical knee region + =scary/fancy word for pain=some type of SYNDROME).

To save you time and confusion, I will give you a simple formula for building #BulletProofBikeKnees no matter where you are on the knee joint integrity spectrum.

You need 2 things…THAT’S IT!

  1. Indirect Knee Protection
  2. Direct Knee Protection

There you go…you’re welcome.

Here’s what that means…

Indirect Knee Protection

If it is NOT DIRECTLY attached to the knee but INDIRECTLY contributes to knee stability, strength, and control…it is INDIRECT KNEE PROTECTION.

Indirect Knee Protection includes …

The Hips: GLUTES baby! That’s right, the biggest, strongest, most important muscle in the generation of power is ALSO least fatigable. The Glute muscles help indirectly control the knee joint by controlling the upper leg bone, the femur. Glutes are what allow for that nice, smooth knee tracking and the foundation of power generation that we all strive to build upon.

The Core: You can’t fire a cannon from a canoe…and your legs are serious cannons. Your core is the canoe. The canoe is the stable platform from which to apply power to the pedals. The strength and coordination of the abdominal muscles, diaphragm, and spinal control muscles are directly responsible for the ability to sustain the riding position in order to generate power while fueling the motor with big, controlled belly breaths.

Ankle/Foot: If your knee is in pain, look above and below…remember that.

Below the knee is the ankle and foot. They work together as one beautiful system to apply power to the pedals and influence the knee from below based on the stability of the ankle. If you don’t have good balance and control here, then whatever is stacked on top of it is going to have a rough time. Think of a table with 4 loose legs…what’s YOUR confidence in putting the birthday cake on THAT! No thank you. 

Stay tuned for Part II of Top cycling Injuries and How To Avoid Them where we will cover Direct Knee Protection. 

Dr. Tim Woo earned his Doctor of Physical Therapy degree from Western University of Health Sciences and holds a Bachelor of Science Degree in Movement and Sports Science from University of La Verne. He is an avid racer, a member of the cycling community in Southern California, and treats pro, amateur, and recreational cycling athletes.  Please visit to see how he can help get you riding at your highest level.

Bike Legal, APC is a full-service personal injury firm.  If you or someone you know has been injured in an accident, please contact us for a free case evaluation at (877) BIKE LEGAL or visit                   

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