Whether you’re a weekend rider, a daily commuter, or a lycra-clad road warrior clocking up serious mileage, cycling is a brilliant way to stay fit, get outdoors and feel the freedom of the open road. But there’s one thing that can quickly turn a joyful ride into a frustrating slog: hip pain.

Cyclists are often surprised to find their hips grumbling. After all, cycling is considered a “low-impact” sport compared to running. Yet hip pain in cyclists is surprisingly common and can stem from a mix of overuse, poor bike fit, muscle imbalances, and sometimes underlying hip conditions.

At London Bridge Orthopaedics, our hip specialists see many riders, from casual commuters to competitive athletes, who come in with cycling-related hip problems.

The good news is that most issues can be managed without surgery. The even better news? With the right approach to bike setup, training, and recovery, many cases can be prevented in the first place.

In this blog we take a look at the common causes, what you can do about them, and when it’s time to see a specialist.

Why Cyclists Get Hip Pain

Cycling involves thousands of repetitive pedal strokes in a fixed range of motion. Unlike sports such as football or tennis, which involve lots of twisting, jumping and sudden direction changes, cycling is all about repetition.

That’s brilliant for endurance – but it also means that if your biomechanics are even slightly off, or your position on the bike isn’t quite right, those little errors get repeated again and again until the hip starts to complain.

There are three broad categories of hip pain we tend to see in cyclists:

1. Overuse injuries – this the result of repetitive strain on muscles, tendons and joints.
2. Mechanical issues with bike setup – especially the saddle height, tilt and position.
3. Underlying hip conditions – sometimes a structural problem such as hip impingement or arthritis makes itself known through cycling.

Overuse Injuries in Cyclists

Many cyclists’ hip problems are essentially overuse injuries. Think of them as the body saying: “You’ve asked me to do the same movement too many times, and I’m not happy about it.”

Some common examples include:

• Hip flexor tendinopathy – The hip flexors do a lot of work lifting the knee up with each pedal stroke. Over time, they can become tight, sore or inflamed, especially if you sit for long hours at a desk before hopping on the bike.
• Gluteal tendinopathy / bursitis – Pain on the outer side of the hip, often worse when lying on it at night, can be caused by irritation of the gluteal tendons or the bursa (a fluid-filled sac that reduces friction), or both of these structures!
• Piriformis syndrome / deep gluteal pain – That dull ache deep in the buttock, sometimes radiating down the leg, can be from an overworked piriformis muscle compressing the sciatic nerve. (This can sometimes mimic symptoms of sciatica which is a different condition affecting the lumbar spine)
• Muscle imbalance – Cyclists often have very strong quadriceps but relatively weaker glutes or core muscles. This imbalance shifts stress onto the hips and can contribute to pain.

The tricky part with overuse injuries is that they often creep up gradually. A little stiffness here, a niggle there, until suddenly you realise you can’t get through a ride without pain, but it can be difficult to pinpoint exactly when it all started or what flared it up.

The Role of Saddle Position

If you’ve ever wondered why professional cyclists spend hours with bike fitters adjusting their saddle by millimetres, here’s why – Your saddle position is crucial for your hip health!

• Saddle too high: Forces the hips to rock side-to-side, straining the lower back and outer hip.
• Saddle too low: Increases the compression going through the hip joint and overworks the hip flexors.
• Saddle too far forward: Can overload the quadriceps and hip flexors.
• Saddle too far back: May overstretch the hamstrings and glutes.

Even saddle tilt matters. Too nose-down and you’re constantly pushing yourself back onto the seat, straining the hip flexors. Too nose-up and your pelvis may be forced into an awkward angle.

A professional bike fit is one of the best investments a cyclist can make – not only for performance but for injury prevention.

Could It Be Hip Impingement?

Sometimes, hip pain in cyclists isn’t just about overuse or saddle position. A structural issue such as femoroacetabular impingement (FAI) can be the culprit.

FAI occurs when the ball and socket of the hip don’t fit together perfectly, causing the bones to pinch the soft tissues. Cyclists are particularly prone to noticing symptoms because of the constant hip flexion (knee coming up towards chest) involved in pedalling.

Typical symptoms include:

• Pinching pain at the front of the hip or groin.
• Pain when bringing the knee up or rotating the hip.
• Clicking, catching or stiffness.

Left untreated, hip impingement can lead to labral tears (damage to the cartilage rim around the hip joint) and, over time, increase the risk of arthritis.

When Hip Arthritis Joins the Ride

Older cyclists, or those with a history of hip injury, sometimes develop hip osteoarthritis.

Cycling is actually an excellent activity for people with early arthritis, as it’s low impact and keeps the joint mobile. But when arthritis progresses, the hip can become painful and stiff, making rides less enjoyable.

The important thing is to distinguish between “normal muscle soreness” after a long ride and persistent joint pain that may indicate arthritis or another structural problem.

Preventing Hip Pain on the Bike

The good news; most cycling-related hip pain can be prevented or managed with some simple steps.

• Invest in a proper bike fit: It’s not just for the pros, it’s for anyone who wants to ride comfortably and avoid injury.
• Strengthen off the bike: Add core, glute and hip strengthening exercises to your routine. Pilates and yoga can also help maintain flexibility.
• Don’t ramp up too quickly: Gradually increase mileage and intensity. Your hips need time to adapt.
• Stretch smartly: Gentle stretching of hip flexors, glutes and hamstrings can help keep things balanced.
• Listen to niggles: Don’t ignore early warning signs. Rest, adjust, and seek advice before it becomes a bigger problem.

Treatment Options – From Conservative to Surgical

At London Bridge Orthopaedics, our hip specialists always start with conservative treatments wherever possible. These might include:

• Physiotherapy to strengthen weak areas and correct imbalances.
• Bike fit assessment and ergonomic advice.
• Anti-inflammatory measures such as rest, ice, and sometimes injections.
• Shockwave therapy or guided physiotherapy for tendon problems.

For structural issues like FAI or labral tears, if symptoms persist despite non-surgical treatment, hip arthroscopy (keyhole surgery) may be an option.

This allows our surgeons to reshape the bone, repair damaged tissue, and relieve impingement, often with excellent results in active patients, including cyclists.

For more advanced arthritis, treatments range from injections to eventually hip replacement surgery. Thanks to modern minimally invasive techniques, many patients are back to cycling once they’ve recovered.

When to See a Specialist

So, when is it time to stop “pushing through” the pain and get checked out?

We recommend seeing a hip specialist if you experience:

• Hip pain that lasts more than a few weeks despite rest and bike adjustments.
• Pain that interferes with daily life or sleep.
• Clicking, catching or locking in the hip.
• Groin pain when bringing your knee up to your chest.
• Stiffness or reduced range of motion.

It’s always better to get assessed early, rather than waiting until the problem becomes harder to treat.

Riding On – Pain Free

Cycling is a fantastic sport and, with the right care, you should be able to enjoy it for life. Hip pain doesn’t have to mean hanging up the bike.

Often, a few tweaks to your setup, a strengthening routine, and maybe some professional input are all it takes to get back to smooth, pain-free riding.

At London Bridge Orthopaedics, our hip specialists are experienced in diagnosing and treating the full range of hip conditions that affect cyclists – from overuse injuries to complex structural problems. Whether you’re struggling with a niggling ache or a more persistent hip issue, we’re here to help you get back in the saddle.

So next time your hip grumbles mid-ride, don’t just pedal through it. Listen to your body, make the right adjustments, and know that expert help is available when you need it.

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