Chronic musculoskeletal conditions associated with the cycling segment of the triathlon; prevention and treatment with an emphasis on proper bicycle fitting.

Cycling-related injuries account for 20% of all injuries occurring during triathlons. Traumatic injuries caused by falls or accidents are thankfully rare but can be highly variable and very serious in nature. The best approach to these injuries is prevention. The majority of complaints arising from cycling are due to overuse or poor technique. The knee joint, lower back, neck, and Achilles tendon are the most frequently affected anatomic sites. Anterior knee pain, lower back and neck myofascial pain, iliotibial band friction syndrome, and Achilles tendonitis are the most common diagnoses. Initial treatment should always use rest, ice, compression, and elevation. Muscle strengthening and stretching as well as other physical modalities are helpful in the subacute setting. The need for surgery is rare. Improper bike fit contributes to the causation of a significant number of these conditions. Bike geometry may also be altered to alleviate symptoms.