Lower extremity overuse in bicycling.

Overuse problems in cycling can be attributed to several factors. First, the symmetric design of the bicycle matched against the asymmetric variants of the human body produce, on occasion, abnormally directed stress loads on tendons and muscles. Second, cycling involves a high number of repetitions compared with other sports, often as high as 5000 revolutions per hour. Last, with the advent of advanced pedal systems, the cyclist has become more "fixed" to the bicycle. It is critically important that these factors be understood and addressed when treating overuse injuries in cyclists. Standard modalities and therapies are essential components of the treatment plan for cycling-related overuse injuries that should not be overlooked. Surgical intervention should only be considered after prolonged nonoperative measures have failed to relieve symptoms.