Why does biking hip pain happen?
We will first cover the front of the hip.
Not all hips bend the same
What we want to look at here is the ability to bend the hips. This is called hip flexion, where we bring the knee towards our chest.
Similar to how some can do a split while others cannot, some can bend their hips a great deal while others cannot. Not only because of muscular stiffness, but because of joint. Most have an intuition when they see a gymnast bend there is something genetically different about them. They aren’t that flexible merely because they stretch a lot.
What can happen is the hip bones are shaped differently. Notice how this hip pinches the pelvis once the thigh raises up a certain degree:
This can happen for all sorts of reasons:
- The top of the hip is wider than usual
- The hip socket is deeper than normal
- You may be more familiar with the opposite of this: very shallow sockets. We call that hip dysplasia. Just think about a joint which dislocates easily. It’s not snug in the socket. It can move too easily. (More mobility isn’t always beneficial.)
- The head or neck of the thigh (femur) is wider than typical
Some examples. We’re looking down at the hip, where the femur is on the left in each photo; the pelvis is right:

Image credit: http://www.hipandgroinclinic.ie/fig8.jpg
Some may have come across the term femoroacetabular impingement, FAI. That’s partially what we’re talking about here. The femur and acetabulum impinge against each other, for one reason or another.
For more technical discussions on bony differences in the hips:
Note this does not automatically mean something structural or bony is going on. This can happen because the muscles which hold the femoral head in the socket aren’t working like they should. Therefore, the head moves around more than it should, causing a pinching sensation, but it’s important to appreciate mobility isn’t always a muscle tightness issue.
This is relevant with biking because many cyclists lean over the handles a good deal. For some, it’s habit. Others it’s a means of being more aerodynamic. This brings their chest closer to their knees, which increases hip flexion.
Biking lower back pain
If one hip cannot bend like the other, then it’s common to compensate at the lower back. For example, if the right hip cannot flex straight up as much as the left one, then the person may rotate their back to try and get that movement. Because they can’t move the hip enough, they move somewhere else to try and help.
Notice how this woman sits into her left hip more than her right (think of her as in a horizontal seated position):
Her right hip can’t bend like her left, so it pokes up in the air i.e. the lower back rotates to compensate. See how her back isn’t flat anymore. It’s tilting.
Rotation is a two way street. If one side pokes upwards, the other side downwards. (If one side moves backwards, the other side forwards.)
Or notice this guy. When he rocks back past a certain point, his lower back rounds:
He has no more hip range of motion, so his back starts to round to compensate. He also has a difference between sides though:
You can see his hips aren’t going straight back.
This hip rocking position on all fours is similar to a bike, because the knees are close into the chest. All a bike is doing differently is bringing the hips in one at a time. Look what happens if one hip can’t bend enough:
Notice how when the right knee comes up (hip flexion), the back rotates:

You can even see how the shirt has wrinkles in it when the right knee is up, but not when the left knee is up.
It’s either move the back, or pinch the hip.
Moving the back isn’t a deal breaker. At least not initially. However, the back is a column. As such, it handles compression much better than rotation.
Think about playing Jenga. Compressing the pieces is no big deal, regardless how high you go. Twist those blocks just a tad though? It comes tumbling down.
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Why the back of the hip pain while cycling?
There are nerves which run from the lower back to the hip:
By excessively bending and or twisting the lower back we also bend / twist the nerves around that area. Making it easier for them to get pinched, compressed, or rubbed on. That irritation radiates down the leg some, such as to the back of the hip, or even lower. You may get pain down the back of the thigh, knee, or even into the foot. Commonly referred to as sciatica.
Again, if you can’t bend the hip, you may bend the spine. Many of us have heard “don’t lift with a rounded back.” While biking isn’t as intense as deadlifting, you’re still resisting gravity. You’re lifting your own body weight.
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What do we do about this?
First, we need to figure out is the issue functional or structural. Is it because of how our muscles and joints are working, or is it because of how we’re built?
If it’s because of how muscles are working, we can change that. We can stretch, strengthen, change our habits.
If it’s because of how our bones are put together, while we’re unlikely able to change the bone -again, some people, no matter how much they stretch, are not going to do a split- we can modify how we move, how the bike is set-up, to a point where cycling is at least comfortable. Not everyone will be able to comfortable in a position like this,
But we can at least bike and enjoy a pain free back and hip.
To get that info, check out the $12 guide.
(You will be redirected to a PayPal page, but you do not need a PayPal account.)
Remember this guy from earlier:
He was able to do this, with little modifications:
Learn what he learned by getting the guide. It comes as a password protected link to your email.
In it you’ll learn,
- How to differentiate between a structural vs functional issue
- Four exercises aimed at improving the ability of the hips to bend
- Includes videos going over technique
- We go over the order of progression, and recommended sets, reps, days per week
- Bike modifications
- Handle and seat set-up
- Height, angle and distance
- Tradeoffs between healthier joints vs biking performance
- Pedal technique
- The perfect set-up trap to avoid
- Handle and seat set-up
Jason
March 9, 2018
This is such a great post (I say that mostly because it feels super relevant to my experiences). I’ve had right side hip/back pain cycling ever since I started (even as a young adult). After reading your page, and a few others the last few years I’ve started to become aware of the rotation through my lumbar while cycling. I can usually road bike or spin pain free… but when I get into some chunky mountain biking with lots of transitions from seated to standing, and absorbing big hits… I tend to go back into pain mode.
It’s pretty taxing mentally to brace my trunk to resist rotation while trying to keep the rubber side down over roots…drops…rocks etc..
Do you usually see the back pain opposite the side of restriction?
Ex. a left hip with poor flexion creates over activity through the lumbar to counter rotate the shoulders/thorax?
I always felt the pain more in my right hip despite a more restricted left.
I think thats because it was doing work in an overly horizontally-abducted state, which caused groin pain. That’s my guess anyway… i don’t know.
Great post – easily a new fav…I’ve been waiting for more cycling posts.
b-reddy
March 14, 2018
Hey Jason,
Glad you liked the post!
Can’t say I’ve noticed any relationship between which way a person has rotation issues, and which side their low back pain is on. It’s more when a person does have one sided back pain, you look for a rotation issue. Although, you also want to be aware of a flexion problem too.
You do see a relationship with the hip though e.g. the side that’s limited in hip flexion, tends to be the side more prone to pain.
Something to consider with the manual- you actually won’t find anything about trying to brace the core to keep the low back still. The modifications are different than that. Think there are easier ways to approach it. As you hit on, it can be tough to maintain that kind of bracing.
Chris
March 24, 2018
Hello Brian,
as I understand the guide is for people who have problems to bend the hip. Do you have a guide for problems with rotation? A recent bikefit discovered that my lower left back collapses/rotates back under higher load. This is also confirmed with saddle pressure mapping that shows the rotation at my sitbones and higher pressure on the saddle on the backwards rotated side.
b-reddy
March 27, 2018
Hey Chris,
I’m not sure I’m understanding your question, but bending the hip is one priority of the manual, yes. Rotation at the lower back is another.
Rotation of the hip, as in pure femoral internal / external rotation (https://b-reddy.org/wp-content/uploads/2013/05/internal-and-external-hip-rotation.jpg or https://b-reddy.org/wp-content/uploads/2013/05/hip-motions.jpg), is considered, but it’s not as much of a priority considering biking doesn’t allow much rotation. That is, the feet have to be on largely fixed pedals. You can rotate some, and the manual discusses this, but there are other, easier, modifications when this is a concern.
What you may be referring to as rotation of the hip -such as seeing the hips turn some- tends to be more rotation of the lower back. That is, the pelvis twisting is more a lower back concern than a hip.
Hope that’s clear!
Chris
March 27, 2018
Helllo Brian,
thanks for your reply.
Indeed I did not mean external or internal rotation of the femor,
I think twisting is the better verb instead of rotation. I mean twisting in the transverse plane. I is for sure, that the lower back is involved.
So I will happily purchase your guide.
b-reddy
March 30, 2018
Sounds great! Hope you get something out of it.