Cyclists With Hip Pain

When treating the cyclist, I often run across reports of anterior hip pain.  That is usually described as pain in the front of the hip or groin region.  The pain behavior usually follows a pattern of increase in symptoms with prolonged sitting, cycling, or a motion described as bringing the knee up towards the chest.  There are a number of structures that may be involved when one of my patients describes this type of pain and this pain pattern.  I want to describe to you some of the common causes I run across as it is related to pain in the front of the hip.

  • Pain that is referred from the Lumbar Spine (low back):  The back can refer pain to the hip and must always be ruled out as a cause of hip pain before proceeding.  

  • The hip joint/capsule:  If there is restriction in the joint or capsule this could result in limited range of motion and “impingement syndrome” of the hip with positions that require hip flexion (a motion of bringing the knee up towards the chest).  

  • Muscle tightness:  The Psoas (pronounced “so az”) can be responsible for anterior hip pain.  We often find ourselves sitting throughout the day (wither working at the computer or driving) which can allow for shortening or tightening of this muscle.  When a muscle is tight it can result in pain of the hip and even in the low back.  

So how do you fix your hip pain?  I recommend that you see a Physical Therapist followed by a consultation with an expert in performing a bike fit.  I always make it a point to work together with the bike fitter so we can discuss the physical limitations that I find and how the bike can be set up to adjust for these imbalances.   You can always get into a more aero dynamic position once the body allows it…

Too many times I have seen a cyclist want to be in a more aero dynamic position thus sacrificing the body to get there which ends up in pain and a visit to my office.


John R. Thomas, PT, DPT, OCS
Doctor of Physical Therapy
Orthopedic Certified Specialist