Most are best-treated by a doctor but others might be alleviated by another kind of expert.
As a hardcore rider Warren Lanier chews up 60-70 miles a week and often feels it.
"I definitely feel some pain on the outside of my knee, and get a lot of patella pain in the points of my knees," he says.
So, he underwent the mechanical version of a trip to the chiropractor. But, instead of tweaking Matt's back, bike fitter Paul Kundrat with the Endurance Training Center tweaked his bike.
"So, outside of the knee pain, did you say some pubic area, any sort of back, neck, shoulder issues?" he asked Lanier.
He started with a precise measurement of Lanier's feet and bike cleats.
"They're probably a little too far forward, for sure," he told Lanier. "Your right knee definitely pronates outward, but we'll get into that a little later."
The process, known as bike fitting, involves dozens of precision measurements, like the distance between joint and pedal. It employs instruments ranging from protractors to a carpenter's level.
"The heel, I was leveling that out to get a feel for deflection of angle of his knee," explained Kundrate. "Okay, so we'll take a look at the front of the bike, see what's going on up there."
Over the course of about two hours Kundrate analyzed, adjusted, and swapped out nearly every moveable part on Lanier's bike. A laser helped align and correct Lanier's position on the bike, and correct his ergonomics to minimize stress on his problem knee.
By the end of the fitting Kundrate told Lanier, "You're straight up and down. And, actually the left leg looks good too. Right now you're just boom, boom, boom, boom, boom."
Interest in bike fitting has increased with the popularity of long-distance riding and the repetitive stress issues that can follow.
And, it is serious business.
Riders pay anywhere from $150 to $400 per fitting.
The process is something of an art as well as a science, Kundrate says many of the techniques were refined from long-distance competitions like the Tour de France.
"A lot of times in cycling it's the very minute adjustments that make a huge change, particularly if you're talking about riding for 3,4,5 hours. You want to be comfortable and these little things will make a big change" said Kundrate.
Besides knee and hip problems, they say another common complaint from long-distance riders is pain in the shoulder and neck area, which can also be the result of bad riding posture.
