Ever hit the brakes on your cycling journey because of knee pain? You’re not alone. Knee pain is a common complaint, especially among cyclists, but it shouldn’t stop you from enjoying the ride.

This guide dives into the most frequent causes of cycling knee pain and how physical therapy can help, empowering you to identify the culprit behind your discomfort and get back on track. 

Common Culprits of Cycling Knee Pain 

Weak or Tight Muscles

Patellofemoral pain syndrome (PFPS) can arise from weak hip or knee muscles, as well as, tight quads. These muscles help stabilize your kneecap during pedaling, while tight quads can add compression and friction to the joint under the knee cap. This combo cab creates a painful sensation under or around the knee cap. 

Solution: Let’s strengthen your quadriceps and loosen those quads to keep your knees happy! Here are some exercises you can try:

• Straight leg raise: Lay on your back with your opposite leg bent and engage your quadriceps.  Keeping the knee straight raise the leg to the level of the opposite bent knee. Repeat 10-12 times, 2-3 sets.
• Quad Stretch: Stand tall and grab one foot behind your calf. Gently pull your heel towards your glutes until you feel a stretch in the front of your thigh. Hold for 30 seconds, repeat on the other side. 

Incorrect Saddle Height

Pain in the back of your knee? Look to your saddle height. A saddle that’s too high forces your hamstrings to overextend during the pedal stroke, leading to tightness and pain behind the knee. 

Solution: We’ll help you find the perfect saddle position for a pain-free ride. Here’s a quick tip: Sit on your bike with one foot on a pedal at the bottom of the stroke. Your knee should have a slight bend when the ball of your foot rests comfortably on the pedal. 

Poorly Placed Cleats

Improper cleat placement can wreak havoc on your knees. Inward-tilted cleats force your knees to track inwards, putting stress on the inner knee joint. Cleats too close together stress your joints, and cleats positioned too far out can cause your feet to splay outwards, affecting knee alignment.

Solution: We’ll ensure your cleats are positioned for optimal knee alignment. A professional bike fitting can also analyze your entire cycling posture and make adjustments to optimize efficiency and comfort. 

Overused IT Band

The iliotibial band (IT band) on your outer thigh is a thick band of tissue that helps stabilize your hip and knee. Overuse or poor knee mechanics can irritate and inflame the IT band, leading to pain on the outside of your knee. 

Solution: We’ll address any imbalances and recommend exercises to keep your IT band happy. Here are a few examples:

• Foam Rolling: Use a foam roller to apply gentle pressure on the hip and thigh muscles around, but not on, the IT band.  Including the tensor fascia lata (TFL) and quadriceps.  Roll slowly back and forth for 30 seconds per area.
• Sidelying hip abduction:  Lay on the floor against the wall.  Keeping your top leg straight and your core engaged, lift the top leg while sliding it up the wall.  Perform 2-3 sets of 12 repetitions.

Doing Too Much Too Soon

Spring knee is a real thing! Increasing your mileage or intensity too quickly can lead to overuse injuries like tendinitis, causing pain around your kneecap. 

Solution: We’ll help you create a safe training plan that gradually increases intensity to avoid pain. Here are some tips:

• The 10% Rule: Increase your weekly mileage by no more than 10% each week. This allows your body time to adapt and reduces your risk of injury.
• Listen to Your Body: Take rest days when you need them, and don’t push through pain. Pain is a sign that something’s wrong. 
• Strength Train: keeping your body strong helps improve performance and tolerate the demands on training.

Preventing Cyclist Knee Pain 

An ounce of prevention is worth a pound of cure! Here are some additional tips to keep your knees happy on the road:

1. Maintain a Strong Core: Your core muscles help stabilize your pelvis and spine, which takes pressure off your knees. Exercises like planks, bird dogs, and dead bugs can strengthen your core and improve your overall cycling posture.
2. Warm Up and Cool Down: Don’t jump straight into a hard ride. Start with 5-10 minutes of light pedaling and dynamic stretches to warm up your muscles and increase blood flow. After your ride, cool down with static stretches to improve flexibility and prevent tightness.
3. Maintain a Healthy Weight: Excess weight puts extra stress on your knees. Losing weight can significantly reduce your risk of knee pain.
4. Choose the Right Shoes: Supportive cycling shoes with good arch support can help distribute pressure evenly across your foot and ankle, ultimately taking stress off your knees.
5. Ensure Proper Bike Fit: A professional bike fitting can address any postural imbalances that might be contributing to knee pain. A properly fitted bike ensures optimal power transfer and reduces stress on your joints.
6. Listen to Your Body: Pay attention to any pain signals your body sends. If you experience pain, don’t ignore it. Take a break, adjust your position, or reduce your intensity. Pushing through pain can lead to more serious injuries.

Cycling should be an enjoyable and rewarding activity. By understanding the common causes of knee pain and taking steps to prevent it, you can keep your knees happy and conquer those climbs with confidence.

If you’re experiencing knee pain, don’t hesitate to seek professional help. At Mend Colorado, our experienced physical therapists will work with you to identify the source of your pain and create a personalized treatment plan to get you back on the road, pain-free. Contact Mend today and schedule an appointment to keep your cycling journey rolling!