Incorrect saddle height
Saddle height is a common cause of cycling knee pain. You can tell whether you have a saddle that’s too high or too low depending on where the pain is.
- Saddle too low: A low saddle position increases flexion in the knee, placing excessive pressure on your kneecap, resulting in pain around the kneecap.
- Saddle too high: A high saddle forces the leg to overextend, straining the hamstrings, resulting in pain at the back of the knee.
Improper cleat position
Your cleats setup defines how wide your stance is. If you do this wrong, you can end up with knees slightly misaligned with your feet during the pedal stroke, leading to uneven force distribution and potential knee strain.
Pain on the side of your knee is typical for this problem, inner or outer side of the knee, depending on whether the cleats are positioned too far inwards or outwards. It’s usually a sharp, localized pain that feels like a strain or pulling sensation during the pedal stroke. You would feel it most during hard efforts, climbs, or sprints.
Muscle imbalances
Muscle weakness or imbalance is another common cause of knee misalignment during pedalling which can be painful. The type and location of the pain depends on the muscle groups involved.
- Weak hip muscles typically cause pain on the outside of the knee.
- Dominant quadriceps and weaker hamstrings cause pain in the front around the kneecap.
- Tight hamstrings typically result in back of the knee pain.
The pain is usually dull and gradually builds up as the ride continues, especially on longer or more intense rides. It may feel like stiffness or fatigue in the knee.
Iliotibial band syndrome
A common reason for knee pain is an inflamed Iliotibial (IT) band, which is connective tissue that runs on the outside of the thigh from the hip to the knee. Tendonitis of the IT band can be caused by poor bike fit, weakness of hip muscles, and muscle tightness, especially when combined with overuse or overtraining. The resulting pain is typically felt on the outside of the knee where the IT band crosses the joint. It’s sharp, stabbing pain that worsens with continued activity.
It can be quickly relived by massage and foam rolling which relaxes the tightened IT band. But the only long-term solution is to address the underlying causes by stretching and strengthening the surrounding muscles.
Overuse and overtraining knee pain
Overuse is another common cause of knee pain, especially for cyclists that ride very often with not enough rest in between, like bike couriers, ultra-endurance cyclists, or competitive amateurs. But it can happen to anyone who suddenly increases training volume by too much.
This pain is typically diffuse and hard to pinpoint, but commonly felt around the kneecap or deep within the knee joint. It’s a dull, aching pain that worsens with prolonged cycling or after rides.
The cycling knee
Just like tennis players have their elbow pain, us cyclists, we have knee pain. If you combine a little bit of everything, muscle imbalances, poor bike fit, and overuse, you may just develop something that is called Patellofemoral pain syndrome, or the cycling knee.
This happens when the cartilage under the kneecap becomes irritated due to poor tracking of the patella. This pain is typically located at the front of the knee around or under the kneecap. It’s a dull ache or pressure that worsens with activity. There may even be a grinding sensation when bending or extending the knee.
How to prevent and manage knee pain as a cyclist?
If you already have knee pain, try to address the specific issues causing it. Hopefully this article helps you narrow down the list of possibilities. If your pain is not very specific or only appear sometimes, here are three best practices that will help you prevent pain in the future.
Proper bike fit: Make sure your bike is correctly fitted to your body size and riding style, especially the saddle height and cleat position.
Strength and flexibility: Stretch regularly and include strength exercises, especially for quadriceps, hamstrings, and hips into your training routine.
Gradual progression: Avoid sudden increases in training volume. Build up training gradually to allow your legs to adapt.
If you’re unable to improve the knee pain on your own, don’t hesitate to seek professional help. Talk to your healthcare professional, such as a sports medicine specialist or physical therapist, for a proper evaluation and treatment plan.
