Cycling Knee Pain: Why Do You Have It, How You Can Treat It | Explained

January 26, 2021
7 Minute Read
7 Minute Read
January 26, 2021

Cycling knee pain is a common discomfort all riders experience, regardless of whether you’re a professional or a hobbyist.

In a study, 23% out of 109 pro cyclists experience knee pain within the last year, and 13 of those injuries were severe enough to force them to take time off from the road.

Does this mean you shouldn’t pedal like you’re competing for Tour de France?

Well, no.

As a matter of fact, recreational cyclists have it far worse. In another study involving 518 bikers (all of which are hobbyists), 41.7% experience knee pain, which means casual riders have a higher tendency to become injured.

We’re going to cover the common causes of knee pain from cycling and how you can fix it in the next few minutes.

Anterior Knee Pain (Front Knee)

Among the four knee pain areas, anterior knee pain is the most common. This is due to the tightness of your fibrous tissue (quads) that goes up to your outer leg, which causes you to pull on your knee cap.

Your quad muscles could be using too much force from pedaling that may cause discomfort to your front knee. Your bike set-up may be the culprit of this occurrence, including your saddle height and crank length. Of course, these can be easily adjusted.

If the height of your saddle is too low, it’ll throw off your knee angle, making it too close-fitting at the peak of your stroke. This pulls your knee cap (patella) against your femur, increasing the chance of having tendonitis. It’ll also cause damaging stresses in your tendon at the back of the patella.

Solution

So, how can you tell if your saddle is too low? Here’s a quick four-step process to see if you’re at optimal saddle height.

  • Seat on your saddle
  • Put your heel on the pedal
  • Position your heel at 6 o’clock

Your knee should be straight to be in an optimal position, so that when you are cycling it’ll have a twenty to twenty-five-degree bend.

If you’re cycling with your bike seat too close to the handle it can also be the cause of discomfort. Position your saddle appropriately where your tibial tuberosity is located directly above the ball of your foot.

Your form also plays a part in your front knee pain, which means you should avoid a dramatic shift in gears, climbing in giant gears, and hard sprinting when you’re not conditioned for it.

Having bike cranks that are too lengthy imposes an inappropriate angle for cycling, wearing tight cleats causes a strain as well from recurrent clipping.

To treat the tightness of your muscles, it all boils down to foam rolling and stretching. Stretch the problem area, massage the buttocks to loosen and release tension, and lightly foam roll.

Do not use the foam roll to hurriedly maneuver it up and down, it does nothing to help your muscle fibers to relax. It’s going to take time – slowly, smoothly, and progressively.

Posterior Knee Pain (Back Knee)

Posterior knee pain is not a popular injury among cyclists, but it is easier to catch the culprit. It’s mostly linked to your hamstrings, and it’s from overextending your knee.

You may have to adjust your saddle accordingly, it may be too high or situated too far to the back. Lower your saddle and move it forward to your bike’s handlebars.

Back knee pain is a common occurrence for riders who often use fixed-gear cycles, this is because the hamstrings exert effort to decelerate pedal stroke. It places your biceps femoris tendon under a lot of stress, which leads to irritation. Freewheeling from time to time helps a lot.

Solution

Aside from optimizing your saddle height and distance to the handlebar, there are other measures you can do to fix your posterior knee pain.

Icing is an effective method for immediate pain relief, although the pain does not completely fade, it does make it more bearable. Put ice on the target area for a five-minute duration every hour.

Another tip that’ll work like magic is foam rolling and stretching your posterior chain, meaning your hamstrings, calves, and glutes should be loose.

Medial and Lateral Knee Pain

Medial knee pain refers to the inside while lateral knee pain means the outside of your knee. Usually, you experience pain in these areas due to the tightness of your IT band and the quads.

Cyclists often notice having this discomfort during the first time they are using cleats in their ride. Or if they are using a brand new pair of shoes or spare cleats.

Solution

The culprits here are your bike and gear. If you’re using poorly placed cleats whilst biking, it’ll negatively affect your foot's position or the Q angle. Or it may lead to extreme rotation of your knee joint, which places stress on the collaterals.

Double-check your cleats if they have excessive wear and tear from time to time. Experimenting with different types of cleats helps as well, you’ll eventually find the right amount of float that suits you.

For first-timers in using cleats, follow this quick tip for a good starting position. Sit at the edge of your table with your hips, knees, and ankles at ninety-degrees (relaxed).

Take a look at the position of your legs – follow the natural dangle your legs make when you’re using cleats. This will prevent experiencing medial and lateral knee pain.

Weak Core and Glutes

Cyclists are fond of working out their quads and calves, solely focusing on these two body parts as they make the most visual representation of professionals. However, this means other areas are left untrained, which the following are: lower back, abs, glutes, and hip flexors.

Core training is important, a biker needs to have strong abdominal muscles to compete in road bike racing. If the core is left, your body compensates by forces less competent muscles to put in work, which leads to discomfort and pain.

Having a weak glute is a common trigger for knee pain as it forces the hamstring and quads to work more than it should. If you notice your knees are collapsing, it’s an indicator that your glute isn’t strong enough to stabilize the entire leg. This tracks your knees inwards, making them sore.

Solution

Work on your glutes and core regularly, one of the most effective workouts to follow is the single leg touch down. Here’s how you can do it:

  • Stand with your legs and hip at least a width apart
  • Simultaneously raise your left arm and left leg
  • Reach down
  • Touch the floor where the position of your foot would be
  • Prevent the standing leg from collapsing at your knee
  • 8 reps per side

Lunges

  • Stand with legs together
  • Put one leg forward while engaging your core and pelvic floor
  • Dip down (make sure your knee is not collapsing)
  • 8 reps per side

Spring Knee and Overtraining

If you have stretched, foam rolled, adjusted your bike saddle, and you’re still experiencing knee pain, it may be simply because you’re overloading yourself with training.

This is what you call spring knee, this happens when you surprise your body by cycling longer and farther without progression. Don’t do this, there’s a possibility of getting tendinitis.

When cyclists take a break during winter, and then they return to their bike saddles, ride as if the break didn’t happen, there’s a high chance of tendinitis due to unprepared muscles.

Solution

You only increase 10% of your ride duration, nothing more and nothing less, to safely improve your muscle endurance. Skipping a few mileage in hopes of improving faster will only lead to knee pain.

The 10% is also applicable to intensity training. For the first few times, you have to cut down on volume to make sure you aren’t abusing your body.

It could also be from over-gearing, so when you’re experiencing a spring knee, use only the lower gears with a higher cadence.

3 Tips To Prevent Cycling Knee Pain

While most knee pain injuries can be treated over time or with professional help, this does not mean you can take your body for granted. After all, it’s better to stay out of trouble than dealing with it.

Here are 3 quick tips that’ll prevent knee pain from occurring in the first place.

  • Stretch your muscles properly, especially the big muscle groups. Do this after your training routine.
  • Do not drastically change your training routine without progressive changes over weeks. Major changes in your bike setup are not advisable as well.
  • Train your core regularly, your abdominal muscles help bigger groups of muscles whilst cycling, so you can train longer without experiencing knee discomfort.

Use A Knee Pillow

A knee pillow is an effective and affordable product that can help alleviate cycling knee pain. Using a knee pillow stabilizes and balances the hip, which decreases the pull on your spine and lowers back.

What’s more, it alleviates stress from the knee by evenly distributing the pressure on your thighs whilst appropriately aligning your hip and spine. As a bonus, it makes you sleep better as well!

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