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I Love Bicycling

I Love Bicycling is a website that is geared towards cycling for beginners with road cycling tips, training articles, nutrition tips, weight loss, how to’s and bike repair articles.

The Reasons Behind Your Cycling Knee Pain

January 4, 2023 by Eric Lister

The two main areas that cause cyclists the most headache are the lower back and the knee. Ride long enough and you are almost guaranteed to experience some sort of pain, discomfort or injury in one or both of these parts of the body. Today we are going to focus on the knee, why cycling knee pain occurs, and what we can do to prevent it from happening.

Man with cycling knee pain

Halfpoint/Adobe Stock

When a particular sensation is prevalent amongst athletes participating in the same sport, it can be tempting to throw the baby out with the bath water and think that the sport itself is the problem. Take running for example. A large percentage of the population believes running is bad for the human body, when in fact the evidence supports an entirely opposite hypothesis, that human beings are actually the best and most efficient runners in the animal kingdom. 

Cycling also carries some of these stereotypes. 

Because so many cyclists have knee problems, the conclusion must be that cycling is bad for your knees – right? We don’t think so. In our view, the fact that it’s a commonly experienced problem simply means that most people’s knees are not prepared to do the work that they’re doing on the bike, and/or perhaps are doing that work improperly.

Just like running, everybody thinks riding a bike is just riding a bike. Something you learned when you were a kid and kept with you for the rest of your life. How could you mess it up? But they fail to consider the differences between these two time periods. The truth is cycling as an adult is far different from riding your bike as a kid, and our bodies are quick to remind us of that through the telltale signs of pain and injury.

Let us consider these differences, and take into account everyone from beginners to professionals, by analyzing some of the causes of knee pain from cycling.

Increasing Volume Too Quickly

A classic mistake of anybody entering into a sport or trying to regain their fitness after injury is doing too much too soon. It doesn’t help that many people are recommended or even prescribed cycling as an activity that is low impact that they can do despite their lack of overall strength, health and wellness (this is the case for several elderly people, for example). 

Our sport is indeed a great way for people to get their health in check, but that doesn’t mean its unique demands on the body can be disregarded and instantly capitalized upon. You have to earn a healthy body, and the price is not small. Going from zero to 50 miles a week on your new road rig is an approach that is going to humble you very quickly.

The knees are uniquely positioned to cause you agony in this scenario. Because of the tremendous forces produced by our quadriceps (front thigh muscles) while pedaling, and our position on the bike in general, the knee joint is susceptible to the bulk of those loads being constantly transferred across it. If it has not had the time to slowly adapt to such loads, you could be in for a painful awakening. 

Cyclist’s knee is a broad term used for conditions such as patellofemoral pain syndrome, patellar compression syndrome, patellar tendinitis, and a host of other names that are describing pain on the front of the knee, just below or above the kneecap, and even inside the knee joint itself. Often increasing with use and subsiding with rest. 

It is outside the scope of this article to go into each of these with detail, but it should be noted that they can all be exacerbated by an unprepared knee that the athlete is asking too much of in their training. Like any sport, jumping on the bike is going to have you using your muscles in new ways you’re not used to. You have to give the body time to adapt to these new demands, by slowly and thoughtfully increasing training volume when it is ready to do so.

knee anatomy

Axel Kock/Adobe Stock

Weak Hips

A sport can be looked at as a more advanced level of physical activity, just like going to university is a more advanced level of education. To get into university, there are prerequisites; the attainment of certain grades or passing of certain exams, for example. In sports, there are also prerequisites, we just don’t usually consider them before participating. 

One of these prerequisites for a new or current cyclist should be having strong hips. Having strong hips not only stabilizes the pelvis and contributes greatly to the overall function of the body, it also helps keep the knees in good alignment. Strong hips are not going to develop on the bike, however, adding to the importance of this particular tip.

Hip abduction (moving the leg away from the midline) and hip extension (moving the leg behind you) are severely limited when cycling. The saddle immobilizes the pelvis, and the degree to which your hips flex and extend is nowhere near their full range of motion. This, played out over a long enough period of time, is likely to get us hurt.

When doing a squat, for example, one of the functions of your glute (butt) muscles is to keep your knees from collapsing inward. In fact, a common cue when having someone squat is telling them, “push your knees out”, this activates the gluteals and helps you maintain balance and activation in the hips when squatting. If you see a person’s knees falling inwards during a light-moderate intensity squat, they likely have weakness in their hips.

Why does this matter for cyclists? If you have weak hips, your knee is likely collapsing inward while you pedal. This is a problem, because you are going to further exacerbate this imbalance the more you ride your bike, and this can lead to your muscles developing improperly, pulling structures like your patella (kneecap) out of alignment. 

Supplementing your time on the bike with a balanced strength and conditioning program is going to help ensure that you maintain balance throughout your body, and reduce the chances of your cycling causing knee pain down the line.


Rido/Adobe Stock

Saddle Height

Your bike fit can have a tremendous amount of influence over how your body feels and functions while riding. The saddle height in particular can be a culprit when it comes to cycling knee pain, because the loads on, and angles of, your knee are going to be different depending on where your seat is positioned. 

Having a seat that is too low is going to be the most detrimental when it comes to developing pain in the front, sides and inside the knee. This is because it’s going to keep your knee in a more bent position throughout the whole pedal stroke, and you’re going to be pushing from a mechanically disadvantaged position that puts huge force right through the knee joint. This also leads to quicker fatigue and overall breakdown of form in the athlete.

Having your seat too high isn’t good either, however, because now you’re going to be at risk of hyperextending the leg, and putting excessive strain on the internal ligaments of the knee (ACL/PCL) as well as the hamstring tendons and calf musculature in the back of your leg. The lower leg will also take more load than necessary, putting tissues like the achilles tendon at risk of developing further problems.

A correct saddle height will leave you with a slightly bent knee at the 6 o’clock pedal position. If you straighten your leg in this position your heel would drop 1-2 cm below the pedal. This position keeps the knee stable, and allows enough extension to properly utilize the force of the quadriceps, hamstrings and lower leg, but not too much to overextend and strain the ligaments of the knee.

Knee Rehab Program for Cyclists

Looking for a program that will help you address the muscle imbalance that is likely causing your knee pain? Dynamic Cyclist is an online training platform designed to help cyclists become stronger and faster while riding pain free for years to come. Complete your regimen with an all-inclusive program that addresses mobility, flexibility, strength and injury prevention, all for a fraction of the cost of one physiotherapy appointment. Try out their 6 Week Functional Rehab Program and experience the results for yourself. Click here to try 7 days free!

The Types of Knee Pain from Cycling

January 22, 2020 by Sarah Lauzé

The knee is one of the most complex joints in the body, so it makes sense that it is often the first place we experience pain. Although it’s not a muscle, stretches for cyclists are key to ensuring everything connected to the knee remains flexible and in place.

Many cyclists think knee pain means taking time away from the bike and resting up, but that’s not necessarily true. It could be caused by something as simple as a saddle adjustment or new cleats. So, if you’re experiencing knee pain, figure out what it may be stemming from and adjust your training accordingly.

The Types of Knee Pain from Cycling

Main Types of Knee Pain

Knee pain can show up in a variety of forms and for different reasons. These are some of the main types and common causes:

1. Anterior Knee Pain

Anterior knee pain is at the front of the knee, on and around the kneecap (patella). It is most commonly caused by overuse. The quads are attached to the shin via the kneecap so each time you pedal, forces are transmitted across the joint, essentially squishing it against the thigh bone. The part of the tendon attached to the kneecap can become inflamed and sore to the touch. Often referred to as ‘runner’s knee,’ it can happen to cyclists as well.

2. Posterior Knee Pain

The fair less common posterior knee pain shows up behind the knee and is usually a more simple diagnosis. Overextending the knee, with a saddle that is too high or too far back, causes posterior knee pain in most cases, so make sure your saddle is the proper height and adjustment for you.

3. Medial & Lateral Knee Pain

Pain located at the sides of knee in the collateral ligaments is most commonly caused by the feet. In cycling, this would come down to your cycling shoes or the position of the cleat. How far apart your feet are positioned can stress one of the collaterals, causing medial or lateral knee pain during or after a ride.

4. Iliotibial Band (IT Band) Syndrome

The IT band, running along the outside of the thigh from the pelvis to just below the knee, is a thick strap of tissue that can often become tight or inflamed. This is usually caused by over use, weakness of the gluteus medius muscle, or cleat placement. If the IT band has become inflamed, then rest and ice are in order. If it is tight and sore, then regular stretching and rolling will be your best course of action.

The Types of Knee Pain from Cycling

What can cause knee pain?

Although cycling is a low impact sport, too much of anything can lead to stress and strain on the body. Pedalling is a repetitive motion with the constant bending and extending motions flexing the knees and hips. Naturally, with overuse these are the most common sites of chronic-use injury.

Too much too soon

The number one cause of knee pain with cyclists is going too hard or far too soon. It is great to challenge yourself, but going further than your ligaments and muscles can handle will only hinder you progress. Endurance is something that is built up over time, conditioning your muscles over miles and hours. Ligaments take even longer to develop than muscles, with issues often arising from tightness or inflamation.

Improper bike fitThe Types of Knee Pain from Cycling

The little adjustments you can make to your bike can make all the difference when it comes to addressing or avoiding knee pain. The height and position of your saddle and the placement of cleats on the bottoms of your cycling shoes can cause or help avoid knee pain, depending on how well they are adjusted for you.

Not Enough Stretching and Rolling

Flexibility or lack of, is a cyclists nemesis. Eventually if you do not stretch or roll your muscles will tighten so much that you will have difficulty walking never mind riding. Make sure to do stretches that especially focus on the muscles surrounding the knee.

Knee pain can be disheartening when it comes to cycling, but most cases are not cause to give up on your training. However, if pain persists despite proper rest, stretching, or bike adjustments, then it may be a good idea to see a physiotherapist to see if there is an underlying issue that needs to be addressed.

Knee Rehab Program for Cyclists

Looking for a program that will help you address the muscle imbalance that is likely causing your knee pain? Dynamic Cyclist is an online training platform designed to help cyclists become stronger and faster while riding pain free for years to come. Complete your regimen with an all-inclusive program that addresses mobility, flexibility, strength and injury prevention, all for a fraction of the cost of one physiotherapy appointment. Try out their 6 Week Functional Rehab Program and experience the results for yourself. Click here to try 7 days free!

Knee Pain Cycling – Causes and Solutions

October 24, 2013 by Lee Agur

Knee Pain Cycling
Knee Pain Cycling

Unfortunately, I have had a lot of experience with knee problems. What is even worse is that most of the knee injuries I had could have been prevented if I knew what I know now.

Even though cycling is prescribed for so many different injuries as a rehabilitation process due to its low impact nature, it is a very repetitive motion and so overuse injuries can occur. On average a cyclist will pedal 5000 strokes an hour, that is 1 million pedal strokes every 200 hours! Per knee!

If something is out of line, you are likely going to feel it after 1 million pedal strokes… if not before. Make sure you are set up properly.

Bike Fit

One of the first things that should be looked at is the overall bike fit. If you are able to afford a professional bike fitting I highly recommend it, not only will it save your knees but it will put you in the most comfortable and powerful cycling position. Some key areas are as follows:

Cleat Position and Cleat Float

Your cleat position and amount of cleat float have a lot to do with knee injuries. For a proper cleat position read my previous post by clicking here.

Cleat float refers to your ability to move your foot side to side while still clipped in. Suggested ranges are from 5 – 13 degrees of rotation. Many people tighten the pedal as tight as humanly possible so that they do not loose any power; however, in most cases, this does not allow your knee to track in its most natural line. It also prevents your foot from being in its most natural position. If this is you try loosening your cleats.

Saddle Height

If your saddle is too high you may develop knee pain in the back of the knee, if it is too low the knee pain will be at the front of the knee.

A quick check on proper saddle height can be done by measuring your inseam while barefoot, with your feet shoulder width apart. (Floor to crotch) Multiply this result by 0.883. This height should approximate your saddle height from the middle of the bottom bracket axle to the top of the saddle. (Measurement taken along the seat tube).

This is just an approximate height, adjust it according to your riding style i.e. if you point your toes excessively then the seat height should be slightly higher.

Saddle Fore and Aft Position

Get on a stationary trainer and rotate the cranks to the 3 and 9 o’clock position. Have someone grab a plumb line and measure from your forward tibial turberosity (the bony bump below the knee cap) to the pedal axel. Move your seat position fore or aft until the tibial tuberosity is in line with the pedal axel.

On a triathlon specific bike your knee will actually be a bit more forward than this.

Pedal Stroke

Make sure you have good pedaling technique bicycling and do not allow your knees to push outwards or pull inwards.

Too Much, Too Hard, Too Soon

When spring arrives it is nearly impossible for me to contain myself in any of these three categories… Hence all my knee injuries. Instead of cutting back when spring arrives I have beat indoor trainer boredom and prepped myself for the spring!

A general rule of thumb in cycling is not to increase these categories by more than 10% a week.

If I start to feel knee pain now, I am confident it is not my bike fit so I decrease these categories slightly (too much, too hard, too soon) and I actually switch to mountain biking more. Strangely enough, mountain biking hurts less because I am constantly changing my position, where as in road biking I am generally always in the same position doing the same repetitive motion.

Knee Pain Cycling Bonus Tips

Less likely to be the source of your knee pain cycling, but why risk it? Plus a great preventative measure.

Warm up

Let your joints, tendons and muscles warm up before committing to a hammerfest right out of the gate. Much more on this in a previous post called Cycling warm up benefits.

Spin More Mash Less

Especially on hills try to keep your cadence up, if your cadence slows then stand up out of the saddle to continue. Standing while climbing will be less strenuous on your knees if the grade is too steep to spin.

Keep Your Knees Warm

What is worse than cycling in the cold? Being cold and cycling in the cold! I wear some nice tights or bib tights, and if it gets really cold I actually wear the tights under some pants (Get it at your Local bike shop because you want to try it on first). I do not need any more excuses to not brave the cold. Dress properly and it can still be very enjoyable.

Different Leg Length

Knee pain cyclingI am hesitant to post this as I know people get shims in their shoes unnecessarily all the time.

A quick test is it to lie on floor and make a 90 degree angle with your knees while your feet are flat against the wall. If one knee sticks out more (away from the wall) then that tibia is longer. If one knee is higher up the wall (further from the ground) then the femur of the respective leg is longer. This is a quick test and is a starting point to investigate further. X-rays would be more reliable.

For most of us the left leg can be shorter one day and then the right leg shorter the next. Lie with your back on the ground and have someone pull your legs out… are they even? Good! You probably do not need shims you just need to stretch it out and have someone pull on your legs once in a while. More on this later.

Post Ride Massage – Prevention

A post ride massage on a foam roller was what saved my knees in the end. I had VERY tight IT bands and now I just spend a few minutes after a few hour ride on a roller and I am good to go. Read post ride massage – selfie for more information.

Summary

Knee pain cycling can change your world very quickly. My issue was always that I was doing too much, too soon and not allowing my body to recover. Listen to your body, it is designed to let you know something is wrong before it is a chronic problem. Act sooner rather than later. Ease up on your training and seriously consider your bike fit.

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