How to Treat and Prevent Cycling Knee Pain

Whether you cycle competitively, as a hobby, or simply as a free and carbon-neutral way to get from A to B, you may have experienced some form of knee pain after long stretches on your bike. Cycling knee pain is particularly common at this time of year as the weather improves and we venture out of hibernation and back onto our bikes, stressing joints that may not be used to the movement after a few months of choosing the sofa over the saddle!



So-called ‘spring knee’ can dampen our excitement to hit the tracks again, or be a frustrating obstacle to our daily commute. But this doesn’t have to keep you off your bike – read on for our advice on treating knee pain and preventing it from recurring (or happening in the first place!), so you can make the most of the sunny weather and longer evenings on two wheels.


What causes knee pain?


Patellofemoral knee pain refers to any pain in your knee (in front, behind and around the kneecap). The interesting thing about knee pain is that it’s rarely caused by an issue with the knee itself; more often the knee is the expression point for issues stemming from the hip, ankle and even the lower back.


The first step to treating your knee pain (and prevent it from reoccurring) is to identify what’s causing it. There are several different types of knee pain, and the solution will differ depending on the source of the pain.


Anterior Knee Pain (pain at the front of the knee)

This is most often caused by excess force through the knee joint, causing inflammation to the patella (a small, flat bone where the thighbone and shinbone meet). Ideally when bending and straightening the knee, the patella should be sliding smoothly over the joint. Achieve this by stretching your quads to avoid over-tightness, which can pull on the patella.


Be mindful of fully extending your leg when pushing into the pedal, as not doing so can cause an imbalance in the muscles that run down the inside and outside of your thigh, over time pulling our patella slightly out of alignment.


When it comes to your position on the saddle, ensuring your saddle isn’t positioned too low or too far forward will alleviate strain on the knee joint


Posterior Knee Pain (pain at the back of the knee)

This is almost always caused by overextending the knee during pedal strokes. Adjust your saddle so that it’s not too high or too far back - this will stop you from overstretching the tendon at the back of your knee and quickly alleviate posterior knee pain.


Tight hamstrings can also be a contributing factor, so take some time to stretch before and after your ride.


Medial and Lateral Knee Pain (pain at the inside and outside of the knee)

The culprit here is most likely improper cleat position causing your foot to be tilted inwards or outwards on the pedal and stressing collateral ligaments either side of the knee.


Cleats should be positioned directly under the ball of the foot, so that the force travels straight down from knee to pedal, rather than forcing your knee towards or away from your bike.


Ensuring your bike is properly set up for your body shape is essential for keeping your joints safe while cycling, so we recommend either booking in for a professional bike fit or following DIY instructions from a reliable source.


It’s worth noting that often pain in one part of the body can be ‘referred pain’ with the source in another area, so we recommend checking in with a professional Physiotherapist who can help you find and treat the true cause of your knee pain.


If you’re suffering from knee pain after cycling, or are looking to take up cycling but worry about stressing your knee joints, why not book an appointment with one of our experienced Physiotherapists and Osteopaths? Our friendly and professional team can help identify the cause and guide you through effective solutions to treat pain, as well as offer tailored advice to prevent pain occurring in the first place.

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