Recreational and competitive cyclists make up a growing population in the physical therapy clinical setting. This group presents with a unique set of injuries, overuse syndromes, pain, and dysfunction. Understanding the common pathologies seen in this group of patients and how to readily identify and treat them will make clinical sessions more effective and efficient. Additionally, a comprehensive approach to these patients that also involves their position on their bicycle and how and when to change the components that can alter that position in order to reduce pain, injury, and dysfunction will further improve the clinician’s ability to treat these patients most effectively.