REF-921 · Clarsen et al., 2010 · The American Journal of Sports Medicine, Vol. · Paper · PubMed

Overuse injuries in professional road cyclists

B+moderate evidenceMeasured on elite to world-class athletesWritten before October 2026, being re-checked

At the training camps of 7 professional teams, the researchers interviewed 109 of 116 riders (94%) about overuse injuries over the past 12 months. An injury counted if it needed care from medical staff or cost time off the bike; extra questionnaires covered anterior knee pain and lower back pain.

Of 94 injuries, 45% involved the lower back and 23% the knee; among time-loss injuries, the knee accounted for 57%. Lower back pain and anterior knee pain were the commonest overuse problems: knee injuries were the most likely to cost time off the bike, while lower back pain led to the highest rates of functional impairment and of medical attention.

Participants

n=109 professional road cyclists (109 of 116 riders from 7 teams, 94%). Age and sex are not given in the abstract.

Protocol

Interviews at team training camps on overuse injuries experienced in the previous 12 months.
Registered: injuries needing care from medical staff or causing time lost from cycling.
Additional specific questionnaires on anterior knee pain and lower back pain.

Key Results

Lower backKnee
Share of all 94 registered injuries45%23%
Share of the time-loss injuries22%57%
Riders with pain in the previous 12 monthsFifty-eight percent (lower back pain)Thirty-six percent (anterior knee pain)
Riders who sought medical attention for it41%19%
Riders who missed competitions because of it6%9%
Twenty-three time-loss injuries were registered; 13% of them were in the lower leg.

Practical Application

Among 109 professional road cyclists interviewed about the previous 12 months, fifty-eight percent had had lower back pain and thirty-six percent anterior knee pain; the lower back accounted for 45% of all registered overuse injuries, but the knee accounted for 57% of those that cost riding time. To "is back or knee pain normal for a cyclist?": both are the common overuse complaints in professionals — back pain is the more frequent, knee pain the more likely to stop a rider.
Few riders missed competitions for either (6% for the lower back, 9% for anterior knee pain): most of this pain was ridden through, with medical attention.
Inference, not tested here: common is not the same as harmless; the survey counted complaints and did not follow what happened to riders who kept riding.
Not from this paper; the base's own practice: saddle height as one candidate cause of knee pain is in REF-882, and the triage — red flags, swapping the load that hurts, symptom-gated return — is in SYNTH-73.

Limitations

Retrospective recall over 12 months; minor problems that needed no medical attention and cost no time were not registered.
Professionals only; no amateur or female sample is described in the abstract.
Descriptive: no risk factors, bike-fit data or training-load data.
Traumatic (crash) injuries are outside the scope.
Written from the abstract and record metadata only (full text not read).
How this entry was checked and changed
Why this level

cross-sectional interview study with n=109 (94% of the riders approached); injuries recalled over 12 months