Assessment
A detailed history, then a thorough examination of movement, strength and the affected area. You leave knowing what is wrong, why it happened, and exactly what we are going to do about it.
Concern
Cycling Injuries Treatment in London
Most cycling injuries are overuse and bike-position problems, not damage. We rebuild the capacity behind your knee, back or hand pain so you ride pain-free again.
Our cycling injury team
Overview
Understanding cycling injuries
Cycling spares the joints from impact but loads them in a sustained, repetitive position, so its injuries are overwhelmingly overuse and position-related rather than traumatic. Load and bike position, not damage, are usually what drives the pain.
Is it my body or my bike fit?
Often both, and we treat them together. NICE and BJSM support graded loading and relative rest as first-line care, so you rarely need a scan. We rebuild knee, hip and postural capacity and flag the saddle, reach or cleat factors a bike fit can address.
We treat commuters, road cyclists and indoor riders across our Soho, Liverpool Street and Marylebone clinics. Self-referral; no GP letter needed.
Why it happens
What causes cycling injuries?
-
Pedalling volume, gear and cadence choices and saddle or cleat position that load the front of the knee: the driver of cyclist's anterior knee pain
-
Sustained flexed riding posture over long rides, irritating the low back and neck when postural capacity is limited
-
Prolonged handlebar pressure compressing the ulnar or median nerve, producing handlebar palsy in the hands
-
Bike-fit factors: saddle height, reach, cleat position and bar setup, that concentrate load on one region
-
A spike in riding volume or intensity without a gradual build-up, the classic overuse trigger
-
Strength, mobility or control deficits in the knee, hip, trunk and neck that leave tissue under-prepared for sustained load
Physiotherapy for cycling injuries can help to:
Settle the knee that hates the climbs
Anterior knee pain in cyclists is usually patellofemoral, driven by pedalling volume, gearing and position factors, with hip and thigh strength deficits underneath. We rebuild the strength and control around the knee and flag the saddle and cleat factors concentrating load on it.
Separate the body problem from the bike problem
Load and position drive most cycling pain, and they usually work together. We treat the capacity side: strength, mobility, control, and tell you plainly which saddle, reach or cleat factors deserve a professional bike fit. A fit holds far better on a stronger body.
Build a back and neck that last the ride
A sustained flexed position asks a lot of the spine's postural muscles, and long rides expose the shortfall. Graded strengthening, with controlled Reformer work for trunk capacity, builds the endurance that lets the last hour feel like the first.
Take the numbness out of your hands
Tingling or weak hands after long rides is usually handlebar palsy: nerve compression from sustained pressure, and it is generally reversible. We advise on hand position, padding and bar setup, and screen for the other nerve causes that need a medical look.
Keep you riding while it recovers
Most cycling injuries respond to adjusted volume, intensity and position rather than time off the bike. We set a level the tissue tolerates, keep you commuting or training indoors where it helps, and progress the riding as capacity comes back.
Make the fix survive your biggest week
The test of the plan is not one comfortable spin: it is the sportive, the tour, the biggest week of the season. We finish the programme at that demand, with the strength, position habits and load management to keep the problem behind you.
At your first appointment we look for the cause: your history, how you move, and what your work, sport and life ask of your body.
The assessment covers a detailed history and a thorough examination of movement, strength and the affected area. We explain what we find and agree a working diagnosis and plan you understand before you leave.
You go home with a written summary and a home-exercise programme built around your diagnosis and goals, so progress continues between visits.
From pain to performance. Pain relief that lasts is not enough on its own: we rebuild the strength behind the pain so it stays gone.
- Three central London clinics: Soho, Liverpool Street and Marylebone, plus home visits across London and online sessions.
- Led by physiotherapist Sam Harvey: 15 years of clinical practice and an elite-sport background across football, rugby and GAA.
- Physiotherapy, strength and nutrition under one roof: three clinicians, three disciplines, joined-up care.
Fees and booking
You can self-refer and book directly: no GP letter needed, and every new patient can start with a free 15-minute consultation call. The same fees apply across our Soho, Liverpool Street and Marylebone clinics.
- Physiotherapy: a full 60 minutes for £145, whether it is your first visit or a follow-up
- 30-minute follow-ups at £90, with video appointments from £70
- Strength training and Reformer Pilates £120, sports massage from £75
- VALD performance and strength testing with a written report, £195
- 5% off a block of five sessions, 10% off a block of ten
- An itemised receipt with every session, for claiming back where your policy covers physiotherapy
Your journey
with Physio and Performance
Everything starts with finding the cause. Whether the goal is a marathon start line or a week at your desk without pain, we treat what is driving the problem, then build the strength that keeps it fixed.
Treatment
Hands-on manual therapy combined with a progressive, tailored exercise programme. Sports massage, dry needling, shockwave or Reformer Pilates are added where they help your specific problem.
Rebuild
Coached, progressive strength work restores the load tolerance your body lost, paced to where you start. This is the stage that decides whether the fix lasts.
Perform
Each follow-up reassesses you against your baseline, with VALD testing where useful, so your return to work, sport or training rests on measured readiness. Discharge happens by mutual agreement when you can manage independently.
We specialise in:
- Physiotherapy and sports rehabilitation
- Coached strength and conditioning
- Reformer Pilates
- Sports massage and soft-tissue therapy
- Dry needling and shockwave therapy
- VALD performance and strength testing
- Post-operative rehabilitation
- Running and gait analysis
- Sports nutrition and dietetics
Treatment approach
How do we treat cycling injuries?
Physiotherapy & Sports Rehabilitation
£145Sports physiotherapy is the core treatment: accurate diagnosis of the knee, low-back, neck or hand problem, a graded loading and rehabilitation plan, and clear flagging of the position factors a professional bike fit can address, with a criteria-based return to full riding.
See treatment detail →Strength Training
£120Targeted strength and mobility work rebuilds the knee, hip, trunk and postural capacity that sustained riding demands, addressing the deficits behind cyclist's knee and the back and neck pain of long rides and reducing recurrence.
See treatment detail →Reformer Pilates
£120Reformer Pilates builds the core strength, control and mobility that support a sustained, flexed riding posture, helping ease the low-back and neck load of long rides and complementing the physiotherapy plan for position-related cycling pain.
See treatment detail →FAQ
Frequently asked
questions
Why does cycling give me pain at the front of my knee?
Anterior knee pain in cyclists is usually patellofemoral pain, driven by pedalling volume and position factors such as saddle height and cleat setup, often with hip and thigh strength deficits. Treatment rebuilds the strength and control around the knee and flags the bike-fit factors concentrating load on it. Rest alone rarely fixes a position-related problem.
What is handlebar palsy and is it serious?
Handlebar palsy is numbness, tingling or weakness in the hand from prolonged handlebar pressure compressing the ulnar or median nerve. It is usually reversible with changes to hand position, padding, bar setup and ride duration. We assess and advise, but persistent or worsening numbness warrants medical review to rule out other nerve causes.
Can a bike fit fix my cycling pain?
Often it is part of the answer. Saddle height, reach, cleat position and bar setup strongly influence how load is shared across the knee, back, neck and hands, so a professional fit frequently helps position-related pain. But fit works best alongside rehabilitation: addressing underlying strength or mobility deficits is what makes a fit hold.
Should I stop cycling completely while I recover?
Usually not. Most cycling injuries respond better to adjusted load and position than to complete rest, which only deconditions the tissue. We typically reduce volume or intensity, modify position factors and address the underlying deficits to a level the tissue tolerates, then build back up your riding gradually.
Get Started
Ready to begin?
Book today.
Physio and Performance • 111 Charing Cross Road, Soho, London WC2H 0DT
BookAppointments typically available within 1–2 weeks