Frequency of Overuse Injuries and Associated Risk Factors in Competitive Road and Off-road Cyclists: A Narrative Review

Giacomo Belmonte , Carlo Rossi , Domenico Savio Salvatore Vicari , Alberto Canzone , Patrik Drid , Valerio Giustino , Antonino Patti , Antonino Bianco

Journal of Science in Sport and Exercise ›› : 1 -7.

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Journal of Science in Sport and Exercise ›› :1 -7. DOI: 10.1007/s42978-025-00335-x
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Frequency of Overuse Injuries and Associated Risk Factors in Competitive Road and Off-road Cyclists: A Narrative Review

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Abstract

Purpose

Competitive road and off-road cyclists train hard and participate in many races in the same season, decreasing rest periods and increasing the risk of overuse injuries. Hence, this study aimed to investigate the major overuse injuries in competitive road and off-road cyclists and to identify potential associated risk factors.

Methods

We searched PubMed, Web of Science, and Google Scholar databases to identify English-language sources using the following terms: “overuse injury” AND “competitive road cyclists” OR “competitive off-road cyclists”; “risk factors” AND “overuse injuries in cyclists”. Studies investigating overuse injuries in recreational cyclists and triathletes were excluded.

Results

Although the characteristics and performance patterns of the two cycling disciplines are very different, the main overuse injuries observed in competitive road and off-road cyclists were knee pain, low back pain, and buttock pain. Possible risk factors that emerged were bike fitting, training volume associated with low cadence, a rapidly increasing training load, prolonged lumbar flexion, anterior pelvic tilt, a weakness of abdominal and lumbar muscles and overweight or underweight conditions.

Conclusions

This study describes the overuse injuries and the associated risk factors that competitive road and off-road cyclists might experience. These findings could help coaches and athletes prevent the occurrence of these injuries.

Keywords

Cycling / Cyclists / Biomechanics / Kinematics / Overuse injury / Risk factors

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Giacomo Belmonte, Carlo Rossi, Domenico Savio Salvatore Vicari, Alberto Canzone, Patrik Drid, Valerio Giustino, Antonino Patti, Antonino Bianco. Frequency of Overuse Injuries and Associated Risk Factors in Competitive Road and Off-road Cyclists: A Narrative Review. Journal of Science in Sport and Exercise 1-7 DOI:10.1007/s42978-025-00335-x

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