Knee pain in cyclists is not uncommon at least 90% of professional cyclists have experienced pain from overuse during a period of 12 months.
Among professional bikers or those who cycle daily for commuting, overuse is the more common culprit. You may have heard this condition referred to as patellofemoral pain syndrome. Patellofemoral pain syndrome is a general term that describes any pain at the front of your knee, behind, or around your kneecap.
It is essential to understand why your knee is hurting to prevent ongoing issues which may result in further damaging the knee. Here we discuss…
Cycling Knee Pain Symptoms and Remedies
As well as pain due to overuse, improper equipment set up or positioning can cause a multitude of issues for the lower joints.
Bike fit sessions can give you a better understanding of your riding position and help you stay comfortable and injury-free, as well as increasing efficiency.
For now, we want to break down knee pain into four simple categories to help you on your way to recovery and prevention.
Pain in the front of the knee – Anterior knee pain
Pain in the front of the knee is generally caused by your saddle position being too low or too far forward. This causes the knee angle to be too tight at the top of the stroke and causes the rider to push a lot of force through the knee. In turn this adds excess stress to the cartilage behind the kneecap.
Equally, steep hills, sprinting and excess use of high gears can have the same effect on the cartilage behind your knee.
Treatment and prevention of anterior knee pain when cycling
Adjust your bike seat – Place your heel on the pedal and fix your pedal to reach the six o’clock position. Your knee should be completely straight.
Ride in lower gears – Lower gears will reduce the strain on your knees. If you are out riding and your knees should start to feel painful, reduce your gears and allow your knees time to recover.
Straighten up your position – Avoid leaning in to cycle or leaning too far back. Straighten your knees to ride and allow them time to recover.
If making these adjustments does not reduce knee pain or your knee pain becomes a common issue, try strength-building exercises for the vastus medialis oblique muscle to help balance out the stabilising forces on the kneecap.
Pain in the back of the knee – Posterior Knee Pain
Pain in the back of the knee is generally caused by your saddle position being too high or too far back., causing the knee to over extend.
It can also be a problem for cyclists who use fixed gears as they rely on their hamstrings to slow the pedal stroke.
Treatment and prevention of Posterior Knee Pain when cycling
Check your fore/aft – Your saddle fore/aft position is set by placing your knee directly above the pedal spindle with the crank at the 3 o’clock position. This is called KOPS – Knee Over Pedal Spindle
Adjust your seat height – Lower your seat to help gain the KOPS 3 o’clock position. The back of the knee cap should be in line with the ball of the foot.
You should stop and give your legs a rest if you are experiencing pain in the back of the knee while cycling. If riding, you can do this by simply hanging your leg off the pedal and stretching your hamstring. While at home, try icing for 5-10 minutes every hour.
If you are suffering from persistent pain in the back of the knee you should seek medical treatment to rule out a Baker’s Cyst.
Pain on the inside of the knee – Medial Knee Pain
Improper cleat placement is often the cause of medial knee pain. The cleat attaches to the sole of your cycling shoe and, if posted incorrectly, can lead to you tilting your knee inward or outwards, causing stress to the inside collateral ligaments and causing pain in the inner sides of your knees.
Treatment and prevention of anterior Medial Knee Pain when cycling
Adjust your cleat position – Your cleat should be put directly under the ball of your foot.
You can treat this pain very easily at home by resting your leg, and icing.
Pain on the outside of the knee – lateral Knee Pain
As above, improper cleat placement is often the cause of lateral knee pain for the same reason.
For overall knee pain prevention when cycling be sure to –
- Warm up
- Stay warm
- Gradually build mileage
- Seek a professional bike fit
- Maintain good core strength
Although a lot of the issues above relate to the equipment, it is important to maintain good core strength. Strength in the lower back, abs, glutes and hip flexors contribute to power, efficiency, and injury prevention.
If you need further help with knee pain or would like to speak to one of our physiotherapists, why not contact us today.
