Knee Pain from Cycling – Is It Avoidable, and How Do You Fix It?

I’ll
be
real
with
you:
knee
pain
can
feel
like
the
ultimate
buzzkill
when
you’re
trying
to
enjoy
a
ride.

You
push
through
for
the
love
of
cycling,
but
the
dull
ache
(or
sharp
stab)
can
creep
in
and
ruin
the
fun.

So,
how
common
is
it,
why
does
it
happen,
and
what
can
you
do
to
get
back
to
pain-free
pedaling?

Let’s
break
it
down
so
that
you
know
what
to
do
and
whether
you
should
contact
a

knee
pain
specialist.

How
Common
Is
Cycling
Knee
Pain?

A

2017
research
shows
that
around
40-60%
of
recreational
cyclists
and
36-62%
of
professional
cyclists
deal
with
knee
pain.

The
majority
report
it
as
mild
discomfort
(61.6%),
but
for
some,
it
hits
harder—28.7%
describe
it
as
moderate.

It
can
stem
from
how
your
bike
is
set
up,
your
fitness
level,
or
even
what
other
activities
you’re
doing
when
you’re
not
on
two
wheels.

Where
Does
It
Hurt?

Your
knee
has
four
main
“zones,”
and
the
pain
you
feel
will
depend
on
where
the
issue
is
brewing.
Let’s
talk
about
the
most
common
ones:

1.
Front
and
Center
(Anterior)

According
to
a

study,
pain
at
the
front
of
the
knee
happens
more
often
than
anywhere
else.

It’s
usually
linked
to
patellofemoral
pain
syndrome
(PFP)
and
might
feel
like:

• A
  dull
  ache
  that
  gets
  worse
  after
  cycling.
• Pain
  flaring
  up
  during
  exercise
  or
  when
  you
  bend
  your
  knees.
• Popping
  or
  cracking
  sounds
  when
  you
  move.
• Discomfort
  after
  sitting
  for
  long
  periods.

2.
Back
of
the
Knee
(Posterior)

Pain
here
is
less
common,
but
when
it
happens,
it’s
often
due
to:

• Tight
  or
  overworked
  hamstrings.
• A
  saddle
  that’s
  positioned
  too
  high.
• Overextension
  during
  pedaling.

This
pain
can
make
walking
difficult
and
might
even
come
with
swelling.

3.
Outside
of
the
Knee
(Lateral)

Lateral
pain
rarely
pops
up
in
cycling,
but
when
it
does,
it’s
typically
from
an
impact
that
pushes
the
knee
inward.

Symptoms
include
swelling,
instability,
and
pain
on
either
side
of
the
joint.

4.
Inside
of
the
Knee
(Medial)

Inner
knee
pain
might
come
from
conditions
like
bursitis
or
a
medial
meniscus
tear,
or
it
could
be
from
a
direct
blow
to
the
outer
side
of
the
knee.
You
might
notice:

• A
  snapping
  or
  clicking
  sound.
• Pain
  during
  bending
  or
  flexing.
• Inflammation
  that
  limits
  mobility.

What
Causes
Cycling
Knee
Pain?

A
lot
of
things
can
mess
with
your
knees,
but
here
are
some
top
culprits:

• 
  Bike
  Fit:
  Saddle
  too
  high
  or
  too
  low?
  Pedal-to-saddle
  distance
  off?
  Even
  a
  small
  mismatch
  can
  mess
  with
  your
  knee
  alignment.
• 
  Riding
  Style:
  Long,
  intense
  rides
  without
  building
  up
  gradually.
• 
  Shoes
  and
  Cleats:
  The
  wrong
  footwear
  or
  cleat
  positioning
  can
  throw
  off
  your
  form.
• 
  Weight
  and
  Fitness
  Level:
  Extra
  weight
  or
  weak
  muscles
  (especially
  the
  quads
  and
  core)
  can
  put
  unnecessary
  stress
  on
  your
  knees.
• 
  Other
  Sports
  or
  Activities:
  
  Cross-training
  is
  great,
  but
  overdoing
  it
  can
  lead
  to
  overuse
  injuries.

How
Do
You
Fix
It?

Start
with
RICE

This
classic
approach
works
wonders
for
mild
to
moderate
knee
pain:

• 
  Rest:
  Give
  your
  knee
  a
  break—don’t
  push
  through
  the
  pain.
• 
  Ice:
  Apply
  cold
  packs
  for
  20
  minutes
  at
  a
  time
  to
  reduce
  swelling.
• 
  Compression:
  Use
  a
  bandage
  or
  wrap
  to
  stabilize
  the
  joint.
• 
  Elevation:
  Prop
  your
  leg
  up
  to
  help
  fluid
  drain
  and
  ease
  inflammation.

Medication

💊Non-steroidal
anti-inflammatory
drugs

#NSAIDs
are
among
the
most
commonly
used
drugs.
NSAIDs
include
nonselective
cyclooxygenase
(COX)
inhibitors
(ibuprofen,
aspirin,
diclofenac,
naproxen)
&
selective
COX2
inhibitors
(celecoxib,
rofecoxib,
etoricoxib,
lumiracoxib,
valecoxib).🧵

pic.twitter.com/8WfkUab4t3

—
Dr
Melvin
Sanicas
(@Vaccinologist)

April
20,
2020

Nonsteroidal
anti-inflammatory
drugs
(NSAIDs)
like
ibuprofen
can
help
manage
the
pain
and
swelling.

When
to
See
a
Physiotherapist

Sometimes,
it’s
best
to
call
in
the
pros.
See
someone
if:

• Pain
  doesn’t
  go
  away
  after
  a
  few
  days
  of
  rest.
• Symptoms
  get
  worse
  or
  include
  swelling,
  popping,
  or
  visible
  deformity.
• You
  can’t
  put
  weight
  on
  your
  knee
  or
  it
  feels
  unstable.

Ways
to
Protect
Your
Knees

There’s
a
lot
you
can
do
to
keep
your
knees
in
good
shape.
Prevention
is
easier
than
recovery,
so
it’s
worth
paying
attention
to:

Get
Your
Bike
Fit
Right

Invest
in
a
professional
bike
fitting
if
you
can.
A
good
fit
will
consider:

1. Saddle
   height
   and
   position.
2. Pedal-to-saddle
   distance.
3. Cleat
   alignment.
4. Handlebar
   reach.

It
might
cost
a
couple
hundred
bucks,
but
it’s
worth
it
to
ride
pain-free.

Strengthen
Key
Muscles

Strong
quads
and

a
stable
core
take
the
pressure
off
your
knees.
Add
these
to
your
routine:

• 
  Lunges
  and
  Squats:
  Build
  strength
  in
  the
  quadriceps.
• 
  Planks
  and
  Side
  Planks:
  Strengthen
  your
  core
  for
  overall
  stability.

Stretch
It
Out

Tight
muscles
pull
on
your
joints,
so
keep
them
loose
with
regular
stretching.
Focus
on:

• Hamstrings
• Quads
• Hip
  flexors

Smart
Riding
Habits

According
to

Selene
Yeager,
a
USA
Cycling
certified
coach,
building
good
habits
can
make
a
huge
difference
in
keeping
your
knees
comfortable
and
pain-free.

These
simple
adjustments
and
practices
can
help
you
ride
longer
and
stronger
without
nagging
joint
issues.

Warm
Up
Before
Every
Ride

Start
with
10–15
minutes
of
moderate
spinning
to
wake
up
your
muscles
and
boost
blood
flow.

A
proper
warm-up
not
only
prepares
your
body
for
the
ride
but
also
reduces
the
risk
of
sudden
strain
on
cold
muscles.

Make
it
a
ritual,
especially
before
intense
climbs
or
sprints,
to
ease
into
the
rhythm
and
prevent
stiffness.

Mind
Your
Pedal
Stroke

Aim
for
smooth,
circular
movements
while
pedaling
to
distribute
the
workload
evenly
across
your
muscles.

On
climbs,
drop
to
a
lower
gear
to
reduce
stress
on
your
joints
and
maintain
a
consistent
cadence.

Practicing
controlled
pedaling
helps
prevent
jerky
movements
that
could
strain
your
knees
and
ensures
efficiency
over
long
distances.

Build
Mileage
Gradually

Don’t
go
from
zero
to
60
overnight;
your
knees
need
time
to
adapt
to
increased
demands.

Start
with
shorter
rides,
gradually
increase
the
mileage,
and
listen
to
your
body
for
signs
of
overuse.

Pushing
too
hard
too
soon
can
lead
to
inflammation,
so
pace
yourself
to
allow
your
joints
to
strengthen
naturally.

Ease
Into
Equipment
Changes

Got
a
new
bike,
shoes,
or
pedals?
Take
it
slow
to
allow
your
body
to
adjust
to
the
new
setup.

Even
minor
changes
in
gear
can
alter
your
posture
and
muscle
engagement,
so
give
yourself
a
few
rides
to
fine-tune
the
fit.

Pay
attention
to
any
discomfort
during
the
transition,
as
it
could
signal
a
need
for
further
adjustments.

Keep
Warm

Cold
muscles
and
joints

are
more
prone
to
injury,
making
it
crucial
to
dress
appropriately
when
temperatures
drop.

When
the
temperature
is
below
60°F
(15°C),
knee
warmers
or
leggings
provide
much-needed
insulation
for
your
joints.

Riding
in
freezing
conditions
without
protection
can
lead
to
stiffness
and
long-term
issues,
so
prioritize
comfort
over
style
when
gearing
up.

Final
Thoughts

Knee
pain
doesn’t
have
to
keep
you
off
your
bike.

With
a
little
planning,
some
tweaks
to
your
gear
and
riding
habits,
and
exercises
to
strengthen
your
legs,
you
can
prevent
most
issues
before
they
start.

But
if
the
pain
lingers
or
worsens,
don’t
ignore
it
–
get
it
checked
out.

Sources

1. PMC
   –
   
   THE
   INFLUENCE
   OF
   EXTRINSIC
   FACTORS
   ON
   KNEE
   BIOMECHANICS
   DURING
   CYCLING:
   A
   SYSTEMATIC
   REVIEW
   OF
   THE
   LITERATURE
2. NCBI
   –
   
   Knee
   problems
   and
   its
   associated
   factors
   among
   active
   cyclists
   in
   Eastern
   Province,
   Saudi
   Arabia
3. Bicycling
   –
   
   How
   to
   Address
   Common
   Causes
   of
   Knee
   Pain
   While
   Cycling