Boulder Physical Therapists: Common Injuries We Treat in Runners, Cyclists, and Climbers
- Colin O'Banion, DPT
- May 13
- 5 min read
Spring has arrived in Boulder—which means the trails have dried out, bikes are back on the road, and climbing season is officially underway. In fact it already feels like summer. With events like the Bolder Boulder and the BStrong ride on the horizon, many athletes are ramping up their training.
And with this seasonal surge in activity, I see a familiar trend in my clinic: a rise in overuse injuries, repetitive strain, and tissue overload. As one of several Boulder physical therapists working closely with the city’s active population, I regularly treat athletes across these sports—helping them recover from injury while staying as active as possible.
I don’t coach runners, cyclists, or climbers—but I do specialize in helping them resolve pain, restore function, and understand what’s driving the breakdown in the first place. Whether it’s movement inefficiencies, poor recovery habits, or cumulative lifestyle stress, my job is to take a whole-body view of the problem.
That starts with a detailed evaluation and full-body movement assessment. From there, I combine hands-on techniques with tools like shockwave therapy, dry needling, interactive neuromuscular stimulation, red light therapy, and a customized rehab plan that’s designed to fit an athlete’s real-world schedule.
In this post, I’ll walk through some of the most common injuries Boulder physical therapists treat in runners, cyclists, and climbers—and how physical therapy can help you keep training while you heal.
Common Injuries in Runners
I'm a casual runner -- just a few miles once or twice a week on a beautiful day. Boulder’s runners are some of the most consistent and dedicated athletes I work with. But it seems most of Boulder’s runners don’t just jog a few miles—they train hard, race often, and love to rack up big elevation. With spring trail races, the Leadville 100, triathlons and the Bolder Boulder 10K on the calendar, I’m seeing a surge of running-related injuries in my practice while my clients are training.
The most common issues include:
Proximal hamstring tendinopathy – often worsened by uphill efforts and long durations in hip flexion.
Plantar fascia irritation – aggravated by foot mechanics, terrain, and footwear.
Iliotibial band syndrome (ITBS) – especially prevalent in runners logging long downhill descents.
Runner’s knee (patellofemoral pain) – linked to poor tracking or glute/core imbalance.
Achilles tendon overload – from rapid increases in mileage or insufficient recovery.
Sciatica symptoms – often tied to spinal loading patterns or post-run posture.
My role as a physical therapist isn’t to coach running form or set your training schedule—but to help identify the underlying issue contributing to the breakdown and guide your recovery process. I do that with a thorough evaluation process and treatment session. When possible, I work to keep you running while adjusting load and mechanics.
How Physical Therapy Helps Runners Stay on Track
I rarely recommend full rest unless absolutely necessary. Instead, I help runners modify training to reduce tissue stress while we address the root cause. This might include:
Joint mobilization and manual therapy to restore movement and reduce compensations
Shockwave therapy for tendon healing and pain reduction
Dry needling to address deep muscular tension or referral pain
Interactive neuromuscular stimulation to re-engage underperforming muscle groups using the NeuXPro.
Red light therapy to reduce inflammation and accelerate recovery
We’ll also look at movement patterns, strength deficits, recovery practices, and—when appropriate—connect with coaches or running specialists to ensure long-term results. The goal is to keep you running.
Common Injuries in Cyclists
Cyclists in Boulder are some of the most disciplined athletes I see. As Boulder cyclists are doing more group rides and prepare for events the Boulder Omnium or the B Strong Ride, I’m seeing a wave of bike-related injuries—most of which stem from repetitive postural strain and long hours in flexion.
Common complaints I'm treating include:
Neck and upper back pain – from long hours in the drops and poor head positioning
Ulnar nerve compression – numbness and tingling in the ring and pinky fingers due to bar pressure
Patellofemoral pain (cyclist’s knee) – from tracking issues, quad dominance, or poor core engagement
Hip impingement or tightness – often from restricted hip mobility or poor saddle fit
Low back pain – from prolonged lumbar flexion and lack of trunk stability
Physical Therapy Treatment Strategies for Boulder Cyclists
Because cyclists spend so much time in static, compressed positions, treatment often focuses on releasing overloaded tissues and restoring postural balance. My focus is to help you relieve symptoms, improve movement, and correct underlying contributors—so you can get back on the bike with more comfort and less risk of recurrence. I typically incorporate:
Hands-on spinal and rib mobilization to restore extension and mobility
Shockwave therapy or dry needling to reduce muscle guarding and resolve persistent pain
Neuromuscular stimulation to activate deep stabilizers and postural muscles
Targeted core training to support spine and pelvis alignment
Of course if it appears that a bike positioning may be an issue, I would refer to a local fit specialist.
By treating both the symptom and the system behind it, cyclists not only recover faster—they often improve comfort and power on the bike.
Common Injuries in Rock Climbers:
Spring and summer bring big goals for climbers in Boulder and beyond. Climbers are pushing limits—and injuries are common this time of year. I frequently treat climbers dealing with pain from high training volume, dynamic movement, or long-term overload.
Here are some of the most frequent issues I treat in climbers:
Finger pulley injuries (A2/A4) – often from dynamic moves or crimping under load
Shoulder instability and impingement – often from overhead stress without full scapular control
Elbow tendinopathies – medial or lateral, typically linked to high grip demand
Medial and lateral epicondylitis (climber’s elbow) – from constant gripping and strain
Scapular and thoracic stiffness – common in those with a “climber’s posture”
Neck and upper back tightness – especially in frequent belayers
Bicep strains or partial tears – from explosive lock-offs or climbing under fatigue
How PT Supports Climbers Without Stopping Their Training
My goal is to treat the injury and support healing. That means addressing the source while keeping as much training volume as safely possible. My job isn’t to coach your technique—but to support your ability to climb pain-free and restore the underlying systems that may be contributing to overload. I do this by incorporating:
Joint mobilization and soft tissue work to restore shoulder and thoracic function
Dry needling and shockwave therapy for tendon issues and deep muscle tension
Neuromuscular stimulation to improve control and support at the shoulder and scapula
Customized loading progressions to rebuild tendon strength without shutting down climbing
Red light therapy to reduce inflammation and accelerate tissue recovery
I also might assess grip strength balance, and even recovery habits—because climbing injuries are often multifactorial.
Why I As a Boulder Physical Therapist, Focus on Treating the Root Cause
As a physical therapist, I don’t coach these sports—but I do specialize in helping athletes recover from the kinds of injuries that come with consistently pushing limits.
The key is early intervention and a clear, personalized plan. By identifying the true driver of pain—whether it’s a movement issue, tissue overload, or something deeper—we can create a treatment strategy that helps you heal without losing momentum.
Whether it’s hands-on work, advanced modalities, or modifying your current training, my job is to help you recover while staying as active as your injury allows.
Ready to work with a Boulder physical therapist who gets your lifestyle? Book a consultation and let’s get you back to what you love—stronger, smarter, and pain-free.
How to Connect with Me:
Colin O’Banion, Doctor of Physical Therapy
Colin is a licensed Physical Therapist and founder of Colin O’Banion Physical Therapy in Boulder, Colorado. With 20 years of experience, he specializes in solving complex and chronic pain cases through a root-cause, integrative approach. Colin combines advanced manual therapy, shockwave therapy, dry needling, and movement re-education to help clients return to the activities they love. His one-on-one practice is dedicated to clients seeking lasting solutions when traditional PT has fallen short.
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