Cycling is a form of exercise that has many benefits: it improves your cardiovascular endurance, helps strengthen and build muscles in the legs, it gets you outside in the fresh air (if you’re not using an indoor bike), and if you use it to commute it’ll save you petrol money while reducing pollution. It’s a win-win. And one of the many benefits touted in favour of cycling is the reduced impact on your joints compared to other activities like running. Nonetheless cycling knee pain and injuries from cycling are not unknown phenomena.
A study that looked at prevalence of knee injuries among triathletes found that the running portion of the event accounted for some 72% of knee injuries. So while it’s clear that running puts the knee at more risk, a not insubstantial proportion of athletes reported injuries during cycling. Further research shows that a combination of the prolonged changes in posture and the repetitive motion are the main causes of injury and pain in the leg and knee in cyclists.
What’s Causing Your Knee Pain?
The knee is a very complex joint, in fact it is made up of two joints called the tibiofemoral joint (this joins your thigh bone and your shin bone) and the patellofemoral joint (which joins your thigh to your kneecap). Because of its complexity, and the fact that it is subject to a lot of impact, repetitive motion (and torque in certain movements) the knee is at high risk of acute and chronic injury. It’s also important to remember that the knee sits between two other joints: your hip and your ankle. So issues in the hip/lower back and the ankle/lower leg can result in problems and pain in the knee.
If you’re suffering from cycling knee pain you need to identify what is causing the pain and then work to alleviate the issue. The main types of knee pain caused by cycling are the following.
Anterior Knee Pain From CyclingAnterior knee pain (that means at the front of the knee) can be caused by a range of issues but in cyclists this will often be related to issues in the quadriceps muscles and the iliotibial band. The quads and iliotibial band both pull on your kneecap, and when they are stiff or overused they can cause pain in the knee.
If your saddle is too low then your knee will be bent too tight at the top of your movement and over time it can cause the tendons and cartilage to be damaged and become inflamed. So be sure to check your saddle height isn’t forcing your leg into an awkward angle.
Your quads will also become tight from overuse, especially if you don’t counteract the activity with stretching. Carrying out a simple quads stretch after cycling and on non-cycling days will help to maintain flexibility in the quads.
Posterior Knee PainPain in the back of the knee when cycling is usually caused by problems with your hamstrings, and often traced back to a saddle that is too high. As you overextend the leg at the bottom of the pedalling motion you’ll put a lot of strain through the hamstring where it connects to the knee, and a saddle that is too high will make this worse.
Again, saddle adjustment to ensure the knee isn’t being overextended during the pedal stroke will help fix the source of the problem. Be sure to stretch your hamstrings and calf muscles to alleviate tension.
Lateral and Medial Knee Pain
Pain on the outside of your knee (lateral) will commonly be an issue surrounding iliotibial band syndrome (ITBS). ITBS is a condition that occurs where the iliotibial band gets inflamed from overuse or trauma. The iliotibial band runs down the outside of your leg from the hip down over the knee to the shin. It can cause pain and swelling, and may get worse as you continue to cycle.
For cyclists this pain is most often caused by having your feet pointing in towards each other too much on the pedals. If you have cleats on your shoes that attach to your pedal it’s important that they are positioned neutrally to allow your feet and knee to sit naturally.
Pain on the inside (medial) area of the knee is again due to badly positioned feet and knees, which can lead to inflammation of the medial meniscus (a pad of cartilage in the knee joint) through repetitive incorrect pedalling.
How To Manage Cycling Knee Pain
As cycling knee pain is usually an overuse injury, as opposed to acute trauma, it can often be treated effectively at home. The NHS recommends rest and icing the knee.
Our cooling bandages give you 360-degree cooling around the knee and can be used for hours at a time as there is no risk of ice burn. Our rapid cooling bandages are ideal for dealing with cycling knee pain as you get a compression bandage for the knee plus additional coolant.
In addition to some rest and icing you should reduce your cycling intensity and duration for a time and then slowly build up, increasing distance/mileage by no more than 10% each week and backing off if the pain begins again.
If your knee pain is severe, or doesn’t resolve after a few weeks you should see your doctor or a physiotherapist as there maybe other issues causing problems, including muscle stiffness and weakness in other areas, and even skeletal issues like poor alignment in joints.
Some injuries can be self-treated whilst others require prompt medical attention. You should seek advice from a health professional if: the injury causes severe pain, swelling, or numbness; you can't tolerate weight on the area; the pain or dull ache of an old injury is accompanied by increased swelling or joint abnormality or instability.