Factors associated with overuse injury in cyclists: A systematic review

To identify risk factors associated with overuse injuries in cyclists.Systematic review.Data sources: Medline, CINAHL, EMBASE, SPORTDiscus, and the Cochrane Library were systematically searched. Reference checking and citation tracking of included articles were undertaken. Grey literature searches and a review of key publications by known experts in the industry were conducted.Studies evaluating the association between specific measures of the bike, the cyclist's body and load characteristics, and overuse pain or injury in cycling.Of the 3596 studies yielded in the search, 18 studies were included in the review with only 3 of these studies deemed to have a low risk of bias. The best evidence synthesis showed moderate evidence of a relationship between load and symptoms, as well as moderate evidence of no relationship between cycling overuse injury or pain and many measures traditionally used in bike fitting. Conflicting evidence of a relationship exists between seat height and symptoms.Cycling is popular on a world scale for transport and exercise with cyclists experiencing a high prevalence of overuse pain and injury. Many theories exist as to the cause of these symptoms, however there are limited high quality studies of risk factors for overuse injuries. This review highlights that there is no strong evidence relating any measure of the bike, body or load to cycling overuse pain or injury.