Hip Pain While Cycling? Here’s What to Do About It
Hip pain can bring your cycling to an abrupt halt. Whether you had a bad crash that caused a deep bruise on your side and hip or you’re just noticing a niggle in the hip after a few miles of riding, hip pain should be taken seriously, and dealt with before it goes from minor twinge to massive pain.
So, we spoke to Phil Cavell, master bike fitter at the Cyclefit Store in the U.K., and his colleague Nichola Roberts, a physiotherapist who specializes in cyclists, to get all the intel on likely causes of hip pain, what to do about it, when to seek expert help, and—if you’re not currently in pain—how to avoid it in the future.
Common Causes of Hip Pain
There are many causes of hip pain, from acute incidents where you directly hit your hip and cause a lingering injury to more chronic causes that can stem from bike fit, past traumas, and even the way you sit at your desk at work. Here are the most common for cyclists:
Bike Position
The ultra-aero position can lead to hip pain for many cyclists, because it forces the hips to operate in a tighter range of motion repetitively. But in general, bike fit is often the culprit behind hip pain (especially hip pain that only presents when you’re riding your bike!). From seat height to the seat’s fore and aft position (how close to the handlebars it is) to your crank length and cleat position, there are so many small factors that can contribute to hip pain, says Cavell.
Even if you have a great bike fit, the way you’re shifting on the bike to avoid a saddle sore, hip or knee pain may be exacerbating aches. “People often adapt their posture for various reasons on the bike, which can lead to an overload through the front of the hip,” says Roberts. “Then, you have tight hip flexors and aggravation throughout your quads.”
Overstretching
Unfortunately, we often make matters worse by assuming our tight hip flexors are to blame for hip pain, and then repetitively stretch, stretch, and stretch some more preride and hope for the best. “People think that tight hip flexors just need to be stretched, but we need to look for the reason they’re tight rather than just stretching out your hip flexors forevermore,” Roberts says.
Too Much Sitting
Do you wake up, sit at breakfast, sit in your car, sit at your desk, pedal on your indoor trainer, sit down for dinner, sit on the couch, then repeat? Both the bike and a seated position put your hips at an angle, rather than letting them fully stretch out as you would if you’re standing. For some people, this can create hip issues.
Bony Change to Hip
Your bones themselves may be the culprit. “In the front of the hip, you can end up with a bony change in the hip joint that’s called a femoral acetabular impingement,” Roberts says. “This is around the socket or on the actual ball part of the hip. And these bony changes often occur in young people in their 20s to early 30s, usually if they played a sport like rugby or hockey. In regular life, it’s not often much of an issue, but it becomes an issue in cycling, because of the range of movement that we require at the hip. So it will present as groin pain, which can often feel like tight hip flexors.”
At the far end of the spectrum, this can be solved with surgery. But for most people, Roberts says that a good bike fit along with a prescription for specific mobility exercises can help resolve the issue. This pain also tends to be worse the more aggressive your bike position is, so switching from a time trial bike and ultra-aero position to a gravel bike or mountain bike will also help ease the pain.
Menopausal Changes
Your hormones may be to blame. “Around menopause, women may notice lateral pain in both hips,” says Roberts. “This is just due to the tendon changes, and it’s more common in running compared to cycling. But that’s another cause of hip pain that doesn’t seem to be going away. And unfortunately, it won’t respond to stretching. In fact, stretching it will make it worse. We need to change the load on those tendons, rather than pushing them.”
Hip Trauma
A common cause of hip pain is hip trauma. This can be a fall off the bike where you hit your hip, or falling on the ice or while hiking. From a deep bruise or hematoma that heals on its own to a fractured hip that requires surgery, hip trauma can obviously leave you with hip pain.
If you’re experiencing hip pain, look back in your history: Sometimes, acute hip injuries flair up months or even years later, says Roberts. “Often, people don’t realize that there’s still some residual stiffness in that previously injured hip. Their movement patterns have changed, but they’re not aware of it,” says Roberts. “And it might be that they’re getting hip pain, or even sometimes knee pain, because this hip isn’t moving correctly, and to adapt to it, they can even shift their body on the bike that can then cause saddle sores or hip pain in a different area. They often assume it’s caused by something different, but it actually just comes back to that old injury.”
Finally, if you’ve had hip surgery, expect some issues in range of motion or movement compensations, says Cavell. “This will likely require a strategy decided on by the surgical team, physiotherapist, and bike-fitter to resolve pain on the bike,” he adds.
How to Treat Hip Pain from Cycling
1. See a Doctor
Cavell’s number-one rule: “If your pain is severe, you need to see your doctor or go to the emergency room,” he says. This is true whether or not the pain is caused by an acute injury or if it’s come on suddenly. If it’s a 7 or above on the 0 to 10 pain scale, seek medical help.
If your hip pain continues well after you’re done with your ride, that’s also a sign to seek expert help. In that case, you should look for a physical therapist who’s familiar with cyclists. Often, there are muscular imbalances that need to be addressed, and unfortunately, the hips are complicated and it’s impossible to guess at what could be going on.
Roberts also notes that hip pain can be an indication of a back issue, which requires professional diagnosis.
2. Figure Out if It’s a Bike or Body Issue
If a couple of days off the bike eases the pain, or the pain only comes on while you’re pedaling, your issue is likely bike-fit related, says Cavell. “If the pain is cyclical, where it hurts on the bike and then you don’t cycle for a couple of days and it goes away, a bike fitter may be able to help,” he says. But he still may recommend following up with a physical therapist because your hips may need some TLC to make them more resilient.
On the other hand, if you have pain that isn’t not going away after you get off the bike and it’s lingering all day, every day, a physical therapist should be your first stop. “In this case, your first goal is to work out what’s happening with your hips, get you a program to dampen the pain down, and then make you more resilient and stronger, and then go back to tweak your bike fit,” says Cavell.
3. Assess Range of Motion
It can be helpful to get a better sense of where the pain is coming from, which can be hard to do when you’re pedaling. Roberts suggests checking the range of motion in each hip.
“Lie on your back with both legs out in front of you, then bring one knee up toward your chest and hug it in while keeping the other leg straight out in front of you, pressing the back of your knee on that leg toward the floor to keep your pelvis stable. See how close you can pull the first knee to your chest. Reset, and check the other one,” says Roberts. “Your goal is to compare how far you can get each knee toward your chest. You’d expect to get closer than 90 degrees without pain. If doing this assessment causes pain, or if it’s difficult to get either leg closer than 90 degrees, that’s when you should see a physical therapist, because the issues exist off the bike as well during the ride.” (Keep reading for some tips on improving range of motion at home, too!)
Note: If the pain is equal on both sides during this test or during your ride, that’s an indication that it’s not coming from your hips, it’s more systemic or referred pain. This could be menopause-causing tendon issues, or it could be an indicator of a back issue—or again, a bad bike fit.
4. Check and Tweak Your Bike Fit
There are a few things you can test out with your bike fit if you don’t have access to a pro fitter in your area, and in fact, it’s worth playing with things like saddle height a bit on your own even if you plan to seek professional help, says Cavell. That way, when you are at a fit session, you can give them info about what has or hasn’t worked.
Unfortunately, hip pain can stem from many bike fit factors, so it may take some trial and error to find what helps. “Hip pain can be caused by almost anything on the bike, like cleat position, saddle height, saddle fore and aft, wrong crank length, or drop from the saddle to the bars,” says Cavell.
Here are a few common tweaks he makes:
Look at the drop from your saddle to your bars. The higher your seat is compared to your bars, the higher chance it’s going to cause hip pain, because the angle the joints get forced into becomes more severe as the distance you need to bend over to reach the bars increases. You can alleviate the pressure by raising your handlebars using spacers.
Check your saddle height from bike to bike. If only one bike is causing hip pain, the wrong saddle height may be the issue. Make sure you measure from the saddle to your pedal at its lowest point, and compare that measurement between bikes. The same is true for your saddle’s fore and aft position: If you recently swapped saddles, you may be sitting slightly farther forward or backward from where you were before, depending on the saddle’s length. So you always want to check again.
Cavell also recommends making these simple changes:
Swap your cycling shoes for flat pedals/sneakers temporarily
Swap to ultra-short cranks (150-160mm)
Swap to flat-bars and/or elevated bar position
If you’re on a new bike and have it set up with your previous geometry, look for differences between the two bikes. The seat height might be the same from the floor to the saddle, but is it actually the same distance from the bottom of the pedal to the saddle? Is the fore/aft of the saddle the same? Make sure those measurements are translated correctly from your old bike to your new bike.
5. Check Indoor vs Outdoor Riding
Does the pain happen more frequently indoors versus outdoors? Sometimes, your indoor setup is the cause of hip issues, rather than the bike itself. “The problem with riding indoors is that the trainer doesn’t move,” says Cavell. “When you’re riding outside, there’s a lot more body movement than you may realize: You’re constantly shifting, standing up, moving around on the bike to corner… But as soon as you’re on a trainer, then you’re completely fixed. You often start to pedal a different way.”
You can alleviate this issue by remembering to stand up to pedal regularly during trainer rides, or even by taking breaks to hop off the trainer and do some air squats, push-ups, or other bodyweight exercises to break up the ride.
The other trainer issue tends to happen in ERG mode, where the trainer sets the power and you’re forced to keep up. If you let the pace drop, you have to push on the pedals and slowly turn them over to get your cadence back up, which Roberts says can stress those hip joints. If you find yourself constantly mashing on the pedals to get back up to speed in ERG mode, stop using it for a while and do your intervals the old-fashioned way—by paying attention to your power output!
Finally, you may actually be pedaling at an angle inside. Use a level and make sure that the floor your trainer is on is actually flat. “People can be training on a non-flat surface that they don’t realize, and in doing so, they’re getting imbalanced from one side to the other,” says Roberts.
5 Ways to Prevent Hip Pain
If you’ve managed to fix your hip pain by tweaking your bike fit, it’s time to make sure it doesn’t happen again.
1. Build Strength and Stability
Roberts recommends adding strength training in order to build strength and stability, rather than focusing solely on stretching and mobility. This gets even more important as we get older, she says: “As you get older, we lose strength. So we need to add in more loaded resistance training to avoid that as much as possible.”
These are two of Roberts’s go-to exercises for hips:
Straight-leg deadlift: “You’ll get a lengthening of the hamstrings, glute engagement, and posterior chain activation,” she says. “It’s also great as a unilateral [single-sided] activity. We tend to think of cycling as using both legs, but we use them at different times. So sometimes you can have an imbalance on one side to the other that you don’t know about. Unilateral movements make you more aware of these imbalances so you can work to correct them."
Goblet squat: “In a goblet squat where you’re holding the dumbbell and squatting, you’re keeping your back straight as you come into the squat, which gives you some back extension as well,” she says. (These are also great since they don’t require a squat rack!)
2. Focus on Release
Pigeon pose may help loosen up those hips, but to really get some release for tight hips, Roberts suggests using a lacrosse ball.
Lie faceup with your knees bent up, and put a lacrosse ball directly under your glute and let your knees fall out to the side, and slowly shift your body to let the ball work into those hard-to-reach muscles, pausing and breathing when you find a tight spot. “You’re getting into those structures around the top of the pelvis, around the side of the hip, into the tensor fascia latae [a small muscle on the side of the hip],” she says.
3. Stand Up
“We didn’t evolve to sit down all day,” says Cavell. “Standing resets the pelvis and gets the glutes firing.” This means standing more often on the bike, but also getting up and walking around throughout the day, especially if you work a desk job.
“The more you expose your body to the variations, the better,” adds Roberts. “If you sit at a desk all day in one position, then sit on a bike in one position, it’s not great. Varying your activities makes you more robust and gives you a buffer to avoid injuries.” (She notes that you don’t need to stand at a standing desk all day, but standing for part of your workday and adding in some walks and other forms of movement throughout the week is ideal.)
4. Get Chaotic
Chaotic movement is not programmed or linear and includes things like hiking, snowshoeing, paddleboarding—any kind of movement that has your body going outside of the normal straight line.
Cavell adds that as riders age, they should be adding in more cross-training modalities, even if it means less time on the bike—and don’t worry, it will help your cycling, not hinder it!
5. Switch Up Your Riding
Speaking of cycling, it can also be helpful to switch up the bikes you’re riding. Off-road—gravel or mountain biking—is more “chaotic” than riding on the road or an indoor trainer. If you’re prone to hip pain on the bike, shifting to a more off-road discipline may help.
“I think mountain biking is better than road riding, because you’re encouraged to get in and out the saddle,” says Cavell. “Anything that encourages you to stand up and pedal or even get off the bike and walk for a bit is great.”
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