Preventing Pain Before a Bike Tour
On my first ever bike tour (from Atlanta, GA to Baltimore, MD), I developed a very deep aching feeling in my left knee which only grew worse as I continued to bike on. The pain was so bad that I began pedaling with only my right leg so my left leg could relax and “heal”. The pain didn’t go away and it was causing me to bike slower and for fewer miles. I gaslight myself into ignoring the pain so I could finish my tour whilst feeling a growing anxiety that I was causing permanent damage to my body.
When I finished that tour, I saw a doctor who told me I had patelo-femoral stress syndrome. He didn’t give me any advice on how to deal with it (which is wildly problematic), but said that it wasn’t actually causing my body to break down in any kind of concerning way- it was simply a “headache for the knee” which was inconvenient, but not a serious problem.
I had my third bike tour coming up, and I had an opportunity to get a free professional bike fitting in support of the bike tour mission. It was a 3-hour appointment with a bike shop in College Park, MD, where my sit bones, knee angle, and posture were measured, shoe inserts were given, and clipless pedal cleats were tweaked to perfectly align my body for my riding needs. I told the fitter about my knee problems, and she took extra care to ensure that my knees were properly taken care of. She said that getting a professional bike fitting was an excellent idea (thank you) because many people can get overuse injuries from so many hours on the bike, and getting a proper setup will reduce many of those pains to begin with.
While the bike fitting had alleviated many of my knee issues, biking across the entire USA (4000 miles) eventually did cause me some mild knee pain- biking an average of 60 miles a day, 6 days a week, is bound to push your body to some kind of extreme. Before my fourth bike tour, I saw a sports physical therapist who prescribed me a few exercises to help manage my knee pain. I had to work on my outer glutes doing side plank leg raises, because apparently that’s how you strengthen your knees. He said that patellofemoral stress syndrome is a typical overuse issue among female athletes and very easy to manage. On this tour I pedaled over much more challenging terrain, and the only thing which kept my knee alive was to keep doing these knee exercises.
I have experienced other pains before as well. I’ve had some mild wrist pain, neck pain, and some of the typical saddle pains which are expected. I write all of this to tell you that pain absolutely does suck, but it almost always can be worked on.
My recommendations for preventing pain on a bike trip
Every body is different, and some bodies develop pain more easily than others. If you are the type of person who tends to get hurt or sick more easily than others, I’d recommend following all of the points I have listed below.
Get a professional bike fitting.
There are 2 types of bike fittings: the casual, 20 minute fitting where someone from a bike shop eyeballs you into the right position and angle on your bike, vs and the more mathematical fitting which costs about $300 and takes 3-hours. Call your local bike shop and ask your friends about the options available to you in your area.
For some, the casual fitting is sufficient for their needs. I would recommend this fitting for people who do not have a history of skeletal/muscular/overuse injuries.
For people like myself who have been in and out of physical therapy since high school, the more serious fitting is what is needed. In this fitting you can expect the following: a measurement of your sit bones to help you pick a saddle which is right for you; measurements of your posture, spine, knee angles, flexibility, neck and much more; the positioning of your cleats on your clipless shoes; the addition of special shoe inserts into your riding shoes; the potential to swap out parts of your bike, such as the stem; a discussion about the type of riding you will be doing; a discussion of past issues you’ve dealt with; a detailed email report when it is all done.
Know that if you get a professional bike fitting, you have taken one big step towards preventing overuse injuries on the bike, especially when cycling for multiple days in a row! And you can copy this fit towards your other bikes to avoid paying for this service multiple times.
Go to a physical therapist- ideally one who works with athletes.
While many bike related pains can be prevented with a proper bike fitting, following a prescribed physical therapy routine can be the final touch to keep you riding pain-free. Most often you will see a physical therapist once a pain has started so they can prescribe exercises to work on your strength. Make sure that you do these exercises in anticipation of any bike trip you go on, and in general, to prevent pain down the line!
My final advice:
If you have a female body, please work on your outer glutes!!! It’s common for female-bodied people to have knee issues from cycling (and it is easy to prevent!
Exercises include: side plant with leg raises; single leg step ups with a weight; side plant clamshells; lateral band walks
If you have a history of injuries, please see a doctor to get a referral to physical therapy!
Before you go on a bikepacking trip, consider going on long rides (basically, 30+ miles) for two consecutive days at some point before the trip. This is a good way to push your body and see if any pains occur. Then you can assess what aspects of your bike need to be changed!