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Stretches for Cyclists: Treat and Prevent Knee Pain

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Stretches for Cyclists

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

Pedaling requires work from the the quads to straighten the knee and push the pedal forward and downward with enough power to propel the bike forward. In addition, the IT band contributes to that same movement, although less intensively. These efforts, although low-impact, can lead to problems with knee pain. Tendinitis of the kneecap can be a painful condition, and can keep you off your bike. Stretching these muscles can both prevent and treat these issues, resulting in a more comfortable and flexible range of motion.

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. To help in recovery, and to prevent further knee pain, try stretching the muscles surrounding the knee on a regular basis.

4 Best Stretches for Cyclists to Treat Knee Pain

Bilateral Hamstring Stretch

This stretch is effective for all cyclists because of the involvement of the knee flexor muscles in the repetitive pedaling motion. It is also great for those who experience discomfort in the inner or outer face of the knee, which likely originates at the insertion of the ischiotibials.

Stretches for Cyclists

Stand with you feet shoulder width apart and slow bend at your hips towards the floor. Rest your hands on your shins, or step your hands down to the floor if you can. Your knees should be straight, but not overextended or locked backwards. You should feel the stretch in the backs of your thighs and knees.

Lunge with Ankle Flex

If you feel tension or strain in your calves, Achilles tendon, or the back of the knee then this is an important stretch.

Stretches for Cyclists

Stand with your hands on your waist, one leg slightly in front of the other, with your knees straight looking ahead. Slowly lunge forward with the front foot, keeping your rear foot in its original position. Both feet should be making full contact with the floor, including the heel. As your center of gravity moves forward and downward, the rear ankle will act as an anchor and increase the stretch.

Flamingo Position

Because of the involvement of the knee extensor muscles in the pedaling motion, the flamingo position is a great stretch to relieve discomfort in the quads and patellar tendons.

Stretches for Cyclists

Use a chair or wall the steady yourself, and raise one foot by bending your knee. As you hold the front of your ankle, slowly pull it upwards and gently push your hips forward. As the hip extension increases, you will feel the stretch in the front of the thigh.

Supine Pull to Chest

Stretching the muscles that rotate the hips, specifically the glutes and piriformis, can have a positive effect on the knees. As mentioned previously, each segment of the leg is connected, and each area can have a domino effect, especially through the knee.

Stretches for Cyclists

Lie on your back with your neck relaxed and head resting on the floor. Cross your right ankle over the other and place your hands on your left thigh, pulling your legs towards you in a figure four position. Slowly pull on your thigh to increase the stretch, feeling it in your glute. Repeat with the left side.

Knee pain can be disheartening, but most cases are not cause to give up on your training. However, if pain persists despite proper rest, stretching, and 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. You can also try targeted, daily stretching with Dynamic Cyclist to treat and prevent your knee pain.

Knee Pain Causes When Cycling

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Cycling is relatively easy on your knees. There is no impact and you move the joint, keeping it in good condition. It is refuge for athletes that developed bad knees in other sports. That said, you still have to be careful with your knees and listen to them when cycling as knee pain causes can range from bike fit to previous issues.

knee pain causes

Preventative Knee Care

As always, avoiding injury is the best way to deal with any potential injuries. Despite the large load knees carry, they are fragile if used improperly. For starters, they only bend on one plane, and with a limited range. Try not to strain ligaments by twisting your knees or spending extended time at the limits of flexion or extension. Think of standing with knees locked or squatting like a baseball catcher giving signs before the pitcher delivers.

Second, they do not have very much insulation. When you are riding and it is fifty to sixty degrees Fahrenheit or below, cover them. You can cover them with knee warmers, leg warmers, or tights. You should also do a warmup before going into any big efforts to get maximal blood flow to warm your knees. Embrocation will not help; it only gives the illusion of feeling warm. It does this by irritating the skin and bringing blood to the surface. There is no temperature change at the crucial ligaments.

Bike fit is important to ensure knees track on the correct plane without any undue strain. There are many factors of bike fit that can impact knees – seat height, seat fore-aft position, sit bone support of the saddle, leg length discrepancy, cleat position, and cleat float. Small changes in these positions can influence how your knees feel while riding. The right position will put your body in the right position to produce power and keep your body in proper alignment.

Knee Pain Causes

Knee pain causes can strike a lot of people at different times. If you have chronic pain that makes riding unenjoyable, you need to figure out what is causing your pain. Craig Abrams, DC says, “Knee pain comes from hip and glute dysfunction until proven otherwise.” Think of the placement of the knees in body, and think of your body as a funnel. Any movement up above your knees will eventually have an effect on your knees and the biggest influencers are the large complex of bone and muscle at your hips and glutes. Bike fit and core strength are therefore the two biggest influences on knee pain while cycling.

Below are the easier problems to diagnose. If your pain continues after making the recommended adjustments, seek out a professional to examine your knee. Remember that you not only have to examine the pain at the immediate area of the knee, but also your overall fitness, core and otherwise, and also bike fit.

Pain on the Outside of the Knee

Pain on the outside of the knee is often the result of a saddle that is too high. It is the result of overextending the ligaments on the outside of the knee. The fix is easy; lower your saddle. Do it incrementally. Dramatic changes can result in other problems arising. Think about what caused the pain here. It is not the knee itself, but your hip position relative to your knee.

Pain on the Inside of the Knee

As you may have guessed, pain on the inside of the knee is often the result of a saddle that is too low. It requires more force from the complex of ligaments on the inside than they should be putting out, causing pain. The same applies from pain on the outside of the knee, but in reverse. Again, raise your saddle incrementally to control for any other issues that you may otherwise cause.

Pain on the Front of the Knee

Pain on the front of the knee is often tendonitis from doing too many or hard miles when your body is not prepared for them. The solution is dial back the volume and intensity until the pain subsides. Additionally, ride at lower force and higher cadence to reduce strain on the knee. The preventative measure is to gradually build to your fitness to get to a place where you can comfortably do big volume and intensity. Additionally, if your saddle is too low and/or too far forward, it can cause strain and thus pain at the front of the knee. Raise your saddle incrementally and also move it back if it’s too far forward. (See the Seat Setback section in How to Do a Proper Bike Fit)

Pain on the Back of the Knee

Pain behind the knee is often the result of your saddle being too high. This causes the back of your leg to have to over extend and when under pressure from trying to pedal, a lot of strain is placed up and down the back of your leg with the key pain point often being right behind the knee. Lower your saddle so you are not reaching for your pedals. Your legs should never be straight at the bottom of the pedal stroke.

Stay Away from Knee Pain Causes!

Knees are delicate and you should treat them accordingly. They do a huge amount of work that you may take for granted when they are healthy. If they suffer an injury, you will really know it. Preventative measures like regular stretching are best to stave off injury, but one day your knees may succumb. If they do, be prepared beforehand so you remedy the injury in the early stages.

Anterior Knee Pain Cycling – Causes and Solutions

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Anterior Knee Pain Cycling - Causes and SolutionsAnterior knee pain cycling is pain on the front part of the knee and can be caused by improper saddle height, fore aft saddle position, crank arm length, cleat positioning and gear selection. The ultimate reason you feel pain on the front part of the knee is due to injuries called Patellar Tendonitis or Patellofemoral Syndrome. We will help you solve the anterior knee pain cycling by discussing how to isolate each cause to find out what your individual problem really is and then we will tell you how fix it.

Reasons

Patellar Tendonitis

Patellar tendinitis is an injury to the tendon connecting your kneecap (patella) to your shinbone. The patellar tendon works with the muscles at the front of your thigh to extend your knee so you can kick, run, jump and bike.

Pain is the first symptom of patellar tendinitis, usually between your kneecap and where the tendon attaches to your shinbone (tibia).

The pain in your knee may:

  • At first be present only as you begin physical activity or just after an intense workout
  • Worsen until it interferes with playing your sport
  • Eventually interfere with daily movements such as climbing stairs or rising from a chair

Patellofemoral Syndrome

The cartilage under your kneecap is a natural shock absorber. Overuse, injury or other factors may lead to a condition known as patellofemoral pain syndrome.

Patellofemoral pain syndrome usually causes a dull, aching pain in the front of your knee. This pain can be aggravated when you:

  • Walk up or down stairs
  • Kneel or squat
  • Sit with a bent knee for long periods of time

Causes & Solutions

Saddle Height

Cause: The saddle height is too low putting unnecessary pressure on the front of your knee.
Solution: Raise your saddle to a proper saddle height.

Saddle Fore Aft Position

Cause: The saddle is too far forward.
Solution: Move your saddle back to its ideal aft position.

Crank Length

Cause: The crank arms are too long.
Solution: Replace your current cranks with ones that are 2.5mm shorter.

Leg Length Discrepancy

Cause: Your seat is set for your shorter leg
Solution: Either raise the saddle height to set your saddle height for your longer leg or purchase orthotics or shims to put on your shoes.

Cleat Positioning

Cause: Your foot is too far forward on the pedal.
Solution: Move your cleat position so that your foot is set further back on the pedal.

Gear Selection

Cause: You are pushing too big of a gear, straining your knee.
Solution: Stop thinking you are Jan Ullrich and increase your cadence.

Overuse

Cause: Increasing intensity, duration and/or volume by too much.
Solution: Take a rest for at least 3 days. While taking a rest, make sure to speed up the recovery process by icing and heating your knee to stimulate blood flow to the area and potentially taking anti-inflammatories. Stretching can also help accelerate recovery. Start by doing 25% of your regular cycling routine and build back up to 50% over a period of 1 week. Assess the pain each ride and determine whether you should continue to build back up or take a longer break.

Assessing Anterior Knee Pain

Self assessing the root of the knee pain is extremely important to a speed recovery. Start by treating it as an overuse injury and taking a rest for 3 days, while icing and heating the area and perhaps even take an ibuprofen. Then make sure to test only one variable at a time. Perhaps you think it is due to a low saddle height, raise your saddle height a small amount and then get back on your bike and test out your theory. Make sure to not increase your training load to more than 50% of what it previously was until you have isolated the root cause of the knee pain and fixed it.

Do You Have Knee Pain In Another Area? Check these links below for the causes and solutions:

General Knee Pain Cycling

Medial Knee Pain – Pain on the inner side 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!

Medial Knee Pain Cycling – Causes and Solutions

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Medial Knee Pain Cycling - Causes and SolutionsMedial knee pain cycling is pain on the inner side of the knee and can be caused by improper cleat position or individual anatomical problems such as different leg lengths or even poor technique.

Reasons For Medial Knee Pain Cycling

Pes Anserinus

The pes anserinus is an area on the front and inside of the shin bone where three tendons join the tibia. The tendons can get inflamed and sore from overuse or misuse, and pain and swelling may follow.

Treat Pes Anserinus by addressing the causes listed below coupled with icing, resting and stretching. In extreme cases treatment options can include surgery.

Medial collateral ligament (MCL)

The MCL is a ligament that goes from the inside surface of the upper shin bone and attaches to the inner surface of the bottom thigh bone and is responsible for keeping the inside of the knee joint stable.

Treat the MCL just as you would treat the Pes Anserinus.

Causes for Medial Knee Pain Cycling

Cleat positioning

Cause: Cleats that are positioned too wide can cause the foot to be externally rotated (toes point out).

Solution: Narrow foot position by moving cleat inwards.

Cleat Float

Cause: Little, to no float in the cleat.

Solution: Increase pedal float to a minimum of 6 degrees. Different cleat styles allow for more or less float in addition to the settings on the pedals themselves. First try and loosen the float on the pedals, but it may require a new set of cleats.

How do you know if it is a cleat problem?

Self assessment can be done by taking a rest for 3 days. While taking a rest, make sure to speed up the recovery process by icing and heating your knee to stimulate blood flow to the area and potentially taking anti-inflammatories. After the three days is up, get back on the bike but stay in the small ring, also wear normal running shoes, and cut your training down to 25% of what it previously was.

Over a week, build back up to 50% of previous training load. If you notice improvements or the pain is no longer as severe, then it may be your cleat position. If the pain did not improve then it is likely an overuse injury and you will need to take a longer rest. It could be 4 to 6 weeks, but it may be time to include a medical professional for a second opinion.

Leg Length Discrepancy

Cause: Excessive impact (running), muscle tightness or imbalance or perhaps just a shorter leg.

Solution: Sometimes you are able to correct the leg length discrepancy through physio, stretching and strengthening. If this is possible then this is the best approach; however, some people have one leg shorter than the other and the only fix is to purchase an orthotic or put a wedge in the cleat.

How do you know if it is leg length discrepancy?

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.

Poor Technique, Tightness, Muscle Imbalance, Injury

Poor technique such as riding with your knees too far apart can cause medial knee pain. Tightness, muscle imbalance or an old injury can throw alignment off and cause your knee to track poorly and instead of moving in a perfect linear circle it can move laterally as well, opening you up to potential inner knee pain.

If your knee is moving side to side while pedaling, it will likely just be a matter of time before you start to feel a twinge. Try spinning rather than mashing. Really focus on your pedaling technique, and making sure that you are stretching properly (more specifically your IT band).

Medial Knee Pain Is Not Caused By…

Medial knee pain cycling is generally not caused by saddle height or an improper fore-aft saddle position as that will affect the posterior knee (back of knee) or anterior knee (front of knee). You are looking for a lateral issue and not a linear one.

Assessment

Assessing what is the root cause of the medial knee pain can be quite difficult, but will be one of the most important tasks. Make sure to change one variable at a time. Resting and cutting your training volume down by 50% will address overtraining, then look at leg length discrepancy and cleat position independently of each other. If you change more than one variable at a time how are you going to figure out what the issue is?

Last Words of Advice

Take extra care to warm up and cool down the ligaments that are now inflamed and sore, as ligaments do not receive as much blood flow as muscles and therefore take longer to warm up. Take particular care to dress properly in the cold to protect from further injury.

Take the recovery and assessment seriously. Most cyclists will tend to want to rush the recovery process further setting them back. Don’t be that person.

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

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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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