Whether you’re chasing podiums on the road, sending it on the singletrack at Tiger Mountain, or exploring endless gravel roads, your connection to the bike is a core part of your identity. But when pain or injury keeps you out of the saddle, it’s more than just a physical setback—it’s a frustrating disruption to your passion.
At Union Physical Therapy, we don’t just treat injuries; we restore performance, build resilience, and help you get back to riding stronger than before. We are cyclists helping cyclists, and we understand what it takes to perform at your best.
Why Choose a Cycling Specialist at Union PT?
Your body is the engine, and your bike is the machine. To achieve peak performance and avoid injury, both must work in perfect harmony. Our approach is built on a unique foundation that you won’t find anywhere else:
- A Team of Dedicated Cyclists: Five of our Doctors of Physical Therapy are experienced mountain, road, and gravel cyclists themselves. We speak your language because we live it. We know the difference between “hero dirt” and “brown pow,” and we understand the physical demands of a “gnarly” rock garden or a 100-mile gran fondo. This shared passion means we are uniquely invested in getting you back to the sport you love.
- Integrated, PT-Led Bike Fitting: We are one of the few clinics in Seattle to offer professional, evidence-based bike fitting as an integral part of your therapy plan. We don’t just adjust your bike; we conduct a comprehensive musculoskeletal evaluation to understand why you’re having pain, addressing the root cause in both your body and your equipment.
- An Unwavering Commitment to Evidence: Every treatment plan, exercise prescription, and bike fit adjustment is grounded in the latest high-level scientific research. We use proven methods to accelerate your recovery, enhance your performance, and provide you with the knowledge to manage your body for a lifetime of riding.
Common Cycling Injuries We Treat: Get Back to 100%
We specialize in treating the full spectrum of cycling-related injuries. Our process goes beyond simply treating the painful area; we conduct a holistic evaluation to understand the complex interplay between your body, your bike, and your riding style.
For the Mountain Biker: From Nagging Pain to Sending It with Confidence
Mountain biking subjects the body to a unique combination of intense aerobic effort, explosive power, and high-impact forces. We know that crashes are “part of the game,” but the nagging overuse pain from long climbs can be just as debilitating. We treat both traumatic injuries from falls—such as fractures and concussions—and common overuse injuries like low back pain and knee pain that sap your power. Our approach builds the core stability, hip strength, and neuromuscular control you need to rail berms faster and reduce your risk of a season-ending crash.
For the Road Cyclist: Pain-Free Miles and Peak Performance
The road demands efficiency and the ability to hold a static position for hours, making road cyclists highly susceptible to overuse injuries. Whether you’re dealing with:
- Anterior Knee Pain (Patellofemoral Pain Syndrome)
- Lateral Knee Pain (IT Band Syndrome)
- Debilitating Neck Pain
- Numbness in your hands and feet
…we have an evidence-based solution. Our treatment plans focus on optimizing biomechanics to eliminate pain, improve pedaling efficiency, and allow you to generate sustainable power for thousands of pain-free miles.
For the Gravel Rider: Conquer the Unpaved Road, Injury-Free
Gravel riding demands the endurance of a road cyclist and the bike-handling skills of a mountain biker. The injuries are similarly mixed, from overuse pain due to long hours on unpredictable surfaces to acute injuries from unexpected washouts. Our programs for gravel riders focus on building durability and adaptability to maintain control and comfort when the road gets rough.
The Union PT Medical Bike Fit: Your Foundation for Performance
A proper bike fit is the single most important investment you can make in your cycling performance and health. But not all bike fits are created equal.
A standard fit adjusts the bike to your body’s current state. A Union PT medical bike fit improves your body to meet the demands of cycling, then dials in your bike to match your new capabilities.
Our PT-led bike fit includes:
- Comprehensive Physical Screen: We identify your unique anatomical characteristics, flexibility limitations, and strength imbalances before you even get on the bike.
- Dynamic, Data-Driven Analysis: We use slow-motion video analysis to assess your position and movement under load, ensuring your fit is optimized for real-world riding conditions.
- Clinical Reasoning & Integrated Exercise Prescription: If you can’t achieve an optimal position, we determine the physical reason why and give you the tools—a customized exercise program—to fix it.
This integrated approach is the key to unlocking your true potential, resolving chronic injuries, and ensuring a lifetime of healthy riding.
Get Back in the Saddle: Our Return-to-Sport Program
Recovering from an injury can be a frustrating and uncertain process. Our Return-to-Sport Program provides a clear, structured, and evidence-based roadmap to get you back on the bike safely and with confidence. We utilize a criterion-based progression, meaning you advance through the stages of rehabilitation by meeting objective milestones, not just the passage of time. This personalized approach minimizes the risk of setbacks and is divided into four phases:
- Phase 1: Unload & Heal: Focus on reducing pain and inflammation while maintaining mobility.
- Phase 2: Restore Motion & Activate: Re-introduce pain-free movement, often starting on a stationary trainer.
- Phase 3: Build Strength & Endurance: Gradually increase training volume and intensity with sport-specific strengthening.
- Phase 4: Return to Sport: A carefully managed progression back to your specific discipline, ensuring you return stronger and more resilient than before your injury.
Our goal is not just to get you back to your baseline but to identify and correct the factors that led to your injury in the first place.
Begin Your Recovery in Seattle Today
Don’t let pain dictate your time in the saddle. Whether you’re recovering from a crash, battling a chronic overuse injury, or looking to unlock your next level of performance, our team has the expertise to help you achieve your goals.
Schedule Your Cycling Assessment or Book Your PT-Led Bike Fit today and discover the difference that a truly specialized, evidence-based approach can make.
Frequently Asked Questions
What should I do after a bicycle crash?
If you have hit your head, you should be evaluated for a concussion immediately. For other injuries, seek a medical evaluation to rule out fractures. Once cleared, a physical therapist can assess for musculoskeletal damage, manage swelling and pain, and design a rehabilitation program to safely return you to riding.
How can I stop my hands from going numb when cycling?
Numbness in the hands is usually caused by compression of the ulnar nerve from excessive pressure on the handlebars. A bike fit can address this by adjusting handlebar height, shape, and hood position to create a more neutral wrist posture. Off-bike, exercises to improve core and shoulder stability can also significantly reduce the weight being placed on your hands.
When can I get back on the bike after an ACL injury?
Return to cycling is criterion-based, not calendar-based. After an ACL reconstruction, you can typically begin easy spinning on a stationary trainer once you’ve achieved sufficient pain-free range of motion and quad control, often within the first few weeks. Returning to challenging mountain biking requires meeting specific strength, balance, and confidence milestones, which our evidence-based protocols will guide you through safely (Wilk et al., 2012).
Is a physical therapist bike fit better than a bike shop fit?
Yes, for anyone with a history of injury or pain. A PT-led bike fit integrates a deep understanding of anatomy and pathology to treat the root cause of your issue—addressing limitations in your body first, then adjusting the bike. This clinical approach provides a more comprehensive, long-term solution than a standard fit (Bini & Priego-Quesada, 2022).
What causes knee pain in cyclists?
The most common cause is Patellofemoral Pain Syndrome (PFPS), often resulting from a combination of factors including improper bike fit (like a saddle that’s too low), muscle imbalances (weak glutes or quads), and training errors. Our comprehensive evaluation identifies the specific cause to create an effective treatment plan (Willy et al., 2019).
What Our Patients Are Saying
References
Bini, R., & Priego-Quesada, J. I. (2022). Cycling Biomechanics, Comfort and Injury Potential. In Biomechanics in Sports: Performance Enhancement and Injury Prevention.
Wilk, K. E., Macrina, L. C., Cain, E. L., Dugas, J. R., & Andrews, J. R. (2012). Recent advances in the rehabilitation of anterior cruciate ligament injuries. Journal of Orthopaedic & Sports Physical Therapy, 42(3), 153–171. https://doi.org/10.2519/jospt.2012.3741
Willy, R. W., Hoglund, L. T., Barton, C. J., Bolgla, L. A., Scalzitti, D. A., Logerstedt, D. S., … & Torburn, L. (2019). Patellofemoral pain. Journal of Orthopaedic & Sports Physical Therapy, 49(9), CPG1-CPG95. https://doi.org/10.2519/jospt.2019.0302
Written by: Dustin Steffan, DPT
As a Doctor of Physical Therapy and SEO specialist, Dustin combines clinical expertise with digital strategy to create authoritative, patient-focused health content.
Medically Reviewed by: Mitch Owens, DPT, OCS on September 5, 2025.
Mitch is a co-owner of Union Physical Therapy, a Board-Certified Orthopaedic Clinical Specialist, and an avid cyclist.
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Bike fit is the process of determining and implementing an ideal position on a bicycle. An ideal position varies from cyclist to cyclist. For the purposed of this post we will only focus on a preventative fit and a fit for an injured/recovering cyclist. Performance fits are similar, in that both fits should make your […]