If you have spent any time riding along the Steveston waterfront, out to Garry Point, or looping the dyke trails that make Richmond such a fantastic place to cycle, you already know this city takes its two wheels seriously. The Lower Mainland’s flat river paths, ocean views, and connected bike routes have made cycling one of the region’s most popular ways to stay active. But with more kilometres in the saddle comes something we see often at Richmond Steveston Physiotherapy & Sports Injury Clinic: overuse injuries.
Here is a number worth sitting with. Research on recreational and competitive cyclists has repeatedly found that somewhere around 85 per cent of cycling injuries come from overuse, not crashes. In other words, it comes from the same motion, repeated thousands of times, on a body that was not quite ready for that much repetition. Two of the most common overuse injuries we treat in cyclists are IT band syndrome and Achilles tendinopathy, and if either one sounds familiar, keep reading.
Why Cycling Sets the Stage for Overuse Injuries
Cycling is wonderfully low impact compared to running, which is exactly why so many people take it up after a knee or back injury. But low impact does not mean low load. A single ride can involve thousands of nearly identical pedal strokes, and that repetition is where things tend to go wrong.
A few contributing factors show up again and again in our assessments:
- Bike fit issues. Saddle height that is too high or too low, cleats that are rotated incorrectly, or a reach that is too long can all change how force travels through your hips, knees, and ankles with every single stroke.
- Sudden increases in volume or intensity. Ramping up your weekly distance too quickly, adding hill repeats, or training for an event without a gradual build gives your tissues no time to adapt.
- Muscle imbalances. Weak hip abductors, tight calves, or limited ankle mobility can shift stress onto structures that are not built to handle it long term.
- Pedaling cadence and technique. A very low cadence with high gear resistance loads the tendons more heavily than a smoother, higher cadence style.
- Limited recovery. Back to back long rides without rest days do not give tissue the chance to repair between sessions.
None of these factors are dramatic on their own. That is the point. Overuse injuries build quietly, which is exactly why they catch so many cyclists off guard.
What Is IT Band Syndrome?
Your iliotibial band, or IT band, is a thick band of connective tissue that runs along the outside of your thigh, from your hip down to just below your knee. For years, IT band syndrome was explained as a friction problem, with the idea that the band rubs back and forth over the outside of the knee until it becomes irritated. More recent research has shifted that thinking. IT band syndrome is now better understood as a compression injury, where the band presses a small, richly innervated layer of fat and connective tissue against the underlying bone with every knee bend, rather than sliding across it.
That shift matters for how you treat it. If weak hip muscles are letting your knee drift inward with every pedal stroke, that compression happens harder and more often than it should, which is why the result still looks familiar: a sharp or burning pain on the outside of the knee, sometimes radiating up toward the hip, that tends to show up at a predictable point in a ride and worsens the longer you stay in the saddle.
The short version we like to give patients is this: weak hips let the IT band get compressed more than it should, and treatment is about fixing the root cause, not just the sore spot.
Why You Cannot Actually Stretch the IT Band
If you have searched for IT band syndrome relief before, chances are you have come across advice to stretch it out or spend time foam rolling the outside of your thigh. It is one of the most common things people try, and unfortunately, it is built on a misunderstanding.
The IT band itself is dense, fibrous connective tissue, not muscle. It simply does not lengthen the way a hamstring or calf does, no matter how long you hold a stretch. Studies using cadavers and imaging have shown that the forces needed to meaningfully lengthen the IT band are far beyond anything a stretch in the clinic or at home could produce.
This also explains why foam rolling directly over the sore spot can feel counterproductive. Since we now understand IT band syndrome as a compression injury, pressing a hard roller into the very tissue that is already being compressed against the bone tends to aggravate it rather than help it. If foam rolling that specific area seems to make things feel worse rather than better, that is a good sign it is not the right tool for the job. The better approach is addressing why the compression is happening in the first place, which usually comes back to hip strength and control.
What Is Achilles Tendinopathy?
Your Achilles tendon connects your calf muscles to your heel bone, and it takes on a tremendous amount of load every time you push through the pedal, particularly if you ride with a lower cadence or push hard gears going uphill. Achilles tendinopathy develops when that tendon is loaded faster than it can adapt, leading to a breakdown in the tendon’s structure rather than a simple case of inflammation.
You will typically notice stiffness and aching at the back of the heel, often worse first thing in the morning or right at the start of a ride, that may ease slightly as you warm up and then return afterward. Left unaddressed, it tends to get worse rather than better, since continuing to load an already irritated tendon in the same way rarely gives it the chance to heal.
How Physiotherapy Helps With Both Conditions
The good news is that both IT band syndrome and Achilles tendinopathy respond well to the right kind of physiotherapy care, and you do not need to give up cycling to get better.
At Richmond Steveston Physiotherapy & Sports Injury Clinic, a typical treatment plan for these conditions includes:
- A thorough assessment. We look at your hip, knee, and ankle strength and mobility, and we often ask about your bike setup, training volume, and riding history to understand what is driving your symptoms.
- Hands-on treatment. Soft tissue therapy, IMS, or shockwave therapy can help calm irritated tissue and improve how it moves and loads, without targeting the compressed area directly in the early stages.
- A progressive, phased loading plan. Both conditions respond best to a gradual build rather than jumping straight into strengthening. A general approach looks something like this: a low load phase for around two weeks to calm symptoms and reduce compression or tendon irritation, followed by a moderate load phase of about three to four weeks built around closed kinetic chain exercises, such as squats and step-downs, that train the hip and calf in positions closer to how they work on the bike, and finally a heavy load phase of roughly four weeks to build the strength and capacity needed to handle long rides without symptoms returning.
- Bike fit and technique guidance. Small adjustments to saddle height, cleat position, or cadence can take a surprising amount of stress off an overworked structure.
- A gradual return to riding. Rather than telling you to stop cycling altogether, we build a plan that lets you keep moving while your body catches up to your training load.
Every case is different, and the exact timeline and exercises depend on how irritable your symptoms are and how you respond along the way, but that general low, moderate, heavy load progression gives you a sense of what to expect rather than a quick fix that does not last.
Preventing Overuse Injuries as You Keep Riding
Once you are feeling better, prevention becomes the goal. A few habits go a long way for Richmond cyclists logging serious kilometres on the dyke trails or heading out toward Steveston:
- Get your bike fit checked, especially if you have changed your saddle, shoes, or riding style recently.
- Build your mileage gradually, following roughly a ten per cent increase in weekly volume rather than jumping straight into longer rides.
- Add hip and calf strengthening into your weekly routine, not just cardio on the bike.
- Pay attention to early warning signs. Mild tightness or discomfort that shows up at the same point in every ride is worth addressing before it becomes a persistent injury.
An Encouraging Takeaway
IT band syndrome and Achilles tendinopathy are common, they are explainable, and they are very treatable. You do not have to choose between your knees, your heels, and your love of cycling. With the right assessment and a plan built around your specific riding habits, most cyclists get back to full distance, pain free.
If lateral knee pain or heel stiffness has been slowing down your rides along the Richmond waterfront, our team at Richmond Steveston Physiotherapy & Sports Injury Clinic would be glad to take a look. Reach out to book an assessment and let’s get you back on the bike feeling like yourself again.