Along with a killer wattage output and an enviable bike, one of the ultimate goals for cyclists is being able to enjoy any ride pain-free. Unfortunately, knee pain is all too common among cyclists and you may find yourself searching the web thinking ‘my knees hurt when cycling’ - well the good news is that you don’t have to suffer in silence. Read on to find out everything you need to know about cycling knee pain: the causes, the most common complaints, and most importantly, what you can do about it.
In general terms, the knee has three main areas where pain might present itself: the front of the knee (the anterior), the side or inside of the knee (the medial), and the back or behind the knee (the posterior). If one or more parts of your knee hurts when cycling, you should definitely stop and assess the source before you cause some serious, long-term damage.
One of the most common causes of any sport injury is overuse, and this should always be your first port of call when tackling pain when cycling, whether you prefer an outdoor bike or indoor smart bike trainer. Ask yourself if you’re overdoing it, either by cycling for too long at one time or overtraining. Be honest with yourself and look for other symptoms, such as chronic fatigue, irritability, and insomnia. If any of these ring a bell, all you need to do is ease back on your training (easier said than done, we know) and take a few rest days. You may well find the knee pain disappears by itself if this was the cause.
If you suffer from medial knee pain when cycling, you’re not alone - it’s one of the most common complaints among cyclists, with nearly a third of all cyclists reporting medial knee pain at some point in their cycling experience. While medial knee pain can be caused by a tight IT band or muscular imbalance, one of the easiest fixes is checking your cleat position. Cleats should always be set straight, otherwise you run the risk of creating weaknesses and imbalances in your legs.
If you suffer from pain at the front of the knee - better known as anterior knee pain - the good news is this generally isn’t as severe as medial knee pain. Anterior knee pain is usually caused by tight or overused quad muscles, as the quads join directly to the patella (or kneecap). If your pain is at the front of the knee, the first thing to do is check your bike fit and positioning. If your saddle is too low, you’ll be putting too much pressure through your quads and onto your kneecap, which will cause pain. You may feel like you get better power this way, but ultimately it will be at the expense of this important joint.
One of the best ways to treat anterior knee pain is with foam rolling. This technique is proven to improve blood flow and reduce tightness and inflammation in joints and muscles. Foam roll two or three times a week to ease the tension in your quads as well as keeping your IT band healthy.
In the same way anterior knee pain can be caused by your saddle being too low, posterior knee pain - or pain behind the knee - can be caused by the saddle being too high. Pain behind the knee when cycling could simply be down to over-flexion of the leg when pedalling. If your saddle is too high, your hamstrings will have to overstretch and this could present as pain behind the knee.
In order to counteract pain behind the knee when cycling, it’s a good idea to stretch the backs of your legs whenever possible. The easiest way to do this is by standing with your toes on a step and allowing your heels to stretch downwards. This will stretch your hamstrings as well as your calves, and should feel like a welcome relief if you’ve been suffering from posterior knee pain.
Every cyclist should take the time to have a professional bike fit before embarking on any kind of long distance cycling or intensive cycle training plan. The way your bike is set up will have huge implications on the way you ride, the way your joints and muscles move, and ultimately any pain you may feel. Check out the quick tips below to make sure your bike is set to its optimum position to prevent knee pain.
As mentioned above, a saddle that is too high could cause posterior knee pain, while a saddle that is too low could cause anterior knee pain. As a general rule, your saddle should be in line with your hip when you stand next to it. For a proper fit, sit on your bike with your foot unclipped, and put your heel on the pedal when it’s at its lowest point. Your leg should be completely straight, so that when you clip in there is a slight bend in the knee.
If you are uncomfortable in the saddle, you may end up sitting askew which will inevitably cause knee pain. Trial wearing underwear versus not wearing underwear when cycling, as some people find this has a huge effect on their saddle comfort. You can also test out different saddles to find the right comfort level for you. The more balanced you are in the saddle, the less likely you are to feel pain.
When it comes to handlebar set up, there’s a huge difference between settling for discomfort in favour of speed, or opting for ultimate comfort throughout your ride and compromising slightly on your aerodynamics. If you’re looking to adjust your handlebars to prevent pain, you should be prioritising comfort. This will mean a slightly higher position for your handlebars, and you can place more spacers under your stem to achieve this.
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