If you’re a cyclist who’s ever felt the sharp twinge in one or both of your knees, you’re not alone. However, if left alone, it can cause longer term damage – Monger-Godfrey explains: “Pain at the front of the knee can come from damage to the meniscus or cartilage – often that comes from trauma, but can also be from repetitive movement. “Your saddle should be positioned so the tibial tuberosity—or the bony bit below the kneecap—is directly above the ball of the foot, which in turn should be above the pedal spindle,” she says. But what feels just right for a few pedal strokes around the block can end up feeling pretty wrong after 70 miles of roads. Knee pain is the most common lower-extremity overuse problem in cyclists. Ease up on your training and seriously consider your bike fit. Ideally the spacing should be such that the loads from your knees to your pedals are traveling vertically without pushing the knee inward or outward, which stresses the collateral ligaments on either side of your knee and can lead to pain. And no, we’re not talking about when a salesperson sets your seat height at purchase. Yes, it’s an investment (usually around $200 to $300), but it’s worth it to ride pain-free. And stretch – hanging your heel off the back of a step helps, or you can shift forwards on the bike and stretch your calves and hamstrings by hanging your heel off the pedal, for about ten seconds.”. Warm Up: Just as with most sports, a little warmup to get blood flowing and muscles primed is a good idea. But what about those spontaneous twinges of crank-stopping knee pain? Whether you get a new bike, new shoes, new pedals, or change stem length, go easy at first to give yourself time to adapt. In … Finally – there are cases where a cyclist suffers from knee pain simply because they’ve done too much, too soon. Jimmy George at V02 Cycling says: “Some cyclists have quads and IT bands that seem to be made of steel. Also, be mindful of your form. Lateral knee pain refers to pain on the outside of the knee, whilst medial knee pain is felt on the inside. How we test gear. Knee pain cycling can change your world very quickly. Medial knee pain cycling is pain on the inner side of the knee and can be caused by improper cleat position or individual anatomical problems such as different leg lengths or even poor … Knee pain doesn’t need to be a part of cycling. Most cyclists – from beginners to the pros – will experience knee pain when cycling at some point during their riding career. George explains: “Weakness in the glute is a common cause of knee pain – it makes the hamstring and quads work too much. Though saddle height, offset and cleat setup are all common culprits of knee pain, there are some other factors worth considering. Knee pain is the most common location for overuse injuries in cycling, resulting in 40% to 60% of cyclists experiencing cycling-related knee pain in their careers.. Same for intensity – if you increase intensity you need to back down on volume and ensure you’re getting rest.”. 9 Another study 10 of more than 500 recreational cyclists indicated that almost 42% of all riders experienced overuse knee pain… Cycling … Use … Spin: Look at video of the pros in action, and you’ll notice their rapid and fluid pedal strokes. Anterior knee pain – pain at the front of the knee, Posterior knee pain – pain at the back of the knee, Lateral and medial knee pain – pain at the side of the knee, Knee pain as a result of weakness in the core. George says: “You can get tendinitis in there – often riders have a break over winter – then they go out and carry on riding like they were – they’ll get tendinitis because the muscle just isn’t ready. It’s important to stretch the hamstring then too.”, He adds: “From a coaching perspective – only ever add 10% of duration – if someone suddenly goes from nothing to 4 hours, they’re going to get pain. Taping is a really quick fix, but doesn’t work long term.”. Cyclists use the quads most in the downward stroke, so that’s a lot of pressure on the knee.”, Knee pain can arise from incorrect bike fit (CW). Instead, start with a lower mileage and build slowly, increasing your total mileage no more than 10 percent each week. Compounding that motion with riding too long or riding too strenuously for too long can lead to more wear than your knee … Pain in the front: When your knee hurts right on the kneecap (patella), it’s generally a product of your powerful cycling quads. No, You Can’t Actually Stretch It. Knee pain is one of the most common overuse-type injuries that cyclists can suffer from. If you’re getting knee collapse [your knees tracking inwards towards the top tube], it’s a sign that the glute isn’t stabalising the whole leg enough. A cyclist’s core needs to be strong, or smaller and less efficient muscles will be forced to work too hard, often resulting in pain. That tends to shorten the hamstrings. Leg strength: Without sufficient leg strength, the repetitive act of cycle pedalling can potentially cause knee pain and other injuries. While each individual’s tolerance will differ, there’s certainly no harm in keeping muscles and joints warm. When it comes to treatment, Monger-Godfrey recommends icing and more foam rolling – saying: “Icing for five minutes every hour can really help. You should also aim to book in for a bike fit carried out by someone who will look at your own flexibility and weaknesses, as well as riding style and volume. Therefore, strength training is crucial for preventing or … In fact, a study of 116 professional cyclists found that 94 per … Saddle discomfort – or a saddle sore – can cause a rider to sit off centre, again resulting in incorrect tracking as the pelvis shifts and gives the impression of a leg length discrepancy. You can’t always avoid knee injury or pain, but following my recommendations is the best way to prevent and treat it. Here are some tips to assure it's the latter. Research shows that anywhere from 23 percent to 33 percent of cyclists have suffered from cycling-related knee pain at one point or another. Spring knee is also sometimes associated with over-gearing, so it’s often a good idea to use smaller gears and higher cadence until the problem subsides. Big-gear mashing, climbing in monster gears, and hard sprinting (especially if you’re not conditioned for it) can put undue stress on the knee and cause this type of pain. If you’re struggling from long term, persistent, or ride stopping pain – it’s a good idea to check yourself in with a physiotherapist, osteopath or medical professional. If they’re tilted inwards, your knee will be forced to follow the ankle and track inwards –and vice versa. “For a quick reference to check if your saddle is the right height, have a seat and rest your heel on the pedal with the pedal in the 6 o’clock position,” says fit specialist and physical therapist Sara Bresnick, owner of Pedal Power Training Solutions in Medford, Massachusetts. Indoor cycling knee pain Quarantine has led to a boom in the indoor cycl i ng industry as people are staying home and socially distancing. Here’s how to identify and alleviate your pain. Patellofemoral syndrome and patellar tendonitis are two common cycling-related injuries caused by overuse, weak muscles and improper bike fit. Think about making round circles as you pedal, not ovals. It’s a shame, as the glutes should be the power house.”, She adds: “I like pilates type core exercises – like table tops [a form of which is pictured below] – not using extra weight but thinking more about engaging the pelvic floor and core. George explains: “The saying in bike fitting is ‘pain at front of knee [anterior], saddle is too low, pain at back of knee [posterior], saddle is too high’. Cleat positioning is an exception to this rule, and is a common cause of medial and lateral knee pain. One of the best foam rollers available, the GRID is great for increasing flexibility and massaging tight IT bands. If your knee pain is very … Yes, cycling is good for arthritis in the knees. We may earn commission if you buy from a link. “A saddle that is too low will your knee angle to be too tight at the top of the stroke, which increases the shear forces pulling the patella against the femur, which in turn increases the likelihood of tendonitis and harmful stresses in the cartilage behind the kneecap,” Veal says. Cyclists are often poor at maintaining core strength. Listen to your body, it is designed to let you know something is wrong before it is a chronic problem. A good bike fit is essential for preventing most causes of knee pain. “Misaligned cleats that cause the foot to be excessively toed in can cause this,” says Veal. Tinkering with your set up may help – but if your problems become chromic there’s little replacement for a physio led bike fit. … The best solution is to move your cleat in, which in turn, will move your foot out to meet your knee. We caught up with ex-pro rider turned osteopath to the cycling stars, Alice Monger-Godfrey of AMG Osteo, plus ex-pro, bike fitter and coach, Jimmy George of V02 cycling in Kent to get some answers. The tape puts the knee back into the right position – what you need is for the tight muscles to relax so that it naturally goes into the right position. This higher cadence is easier on your joints. Pros routinely cover their legs in training when the temperature is below 60 degrees—that’s why knee warmers exist! The pain will reside above the knee cap, where the quadriceps tendon inserts into the pa… Bicycling participates in various affiliate marketing programs, which means we may get paid commissions on editorially chosen products purchased through our links to retailer sites. Then foam roll and stretch the posterior chain – the hamstrings, calves and glutes. But we forget that the legs work from the core – the lower back, abs, glutes and hip flexors are all involved. Getting the glutes working is not about doing loads of squats with dumbells, it’s making sure you’re activating them and switching them on.”. This pain is also more common among cyclists who spend a lot of time on fixed-gear bikes; when you ride fixed, you use your hamstrings to decelerate your pedal stroke, which can put the biceps femoris tendon (a hamstring muscle that runs down the back of your leg toward the outside of your knee) under too much load and irritate it. “Many cyclists are forever tinkering with their position, looking for that elusive perfect position,” he says. The knee (the cap of which is called the patella) is a joint between the upper and lower … Whilst pain at the front of the knee often involves the quadriceps, pain at the back – called posterior knee pain – often has a lot to do with the hamstrings. At that time, it was about 2 years after I had knee … Both can make cycling nearly impossible. Because it’s so complicated, it’s great to treat because you often get a really good response rate.”. The main causes of knee pain during cycling are overuse, weak muscles and improper bike fit. Leg, Knee, and Hip Pain Cycling and Arthritis Does cycling increase your arthritis risk? You ride longer and/or harder than your body is conditioned to, which strains your connective tissues, causing inflammation and pain. From that point of view, they need load – strength work in the hamstring if they’re getting a dull aching pain. That equates to a 20- to 25-degree knee bend when clipped in.”. Monger-Godfrey explains: “There are so many structures involved that mean the pain is localised to the knee – but you need to look at the ankle, hip and lower back. Cyclists have a tendency to focus on strengthening the quads and calves – the areas that present themselves in rippling superiority when we look at pro cyclists. “The knee of that leg should be straight. It can be a limiting factor in the joy of cycling at the least. A professional bike fit should be an in-depth experience with a professionally trained fitter that includes an interview process, off-bike flexibility testing, and on-bike measurements and adjustments. A Saddle Height That’s Too High. The culprit is generally improper equipment and/or bike position, says bike-fit specialist Michael Veal of BikeDynamics in Warwickshire, England. Selene Yeager is a top-selling professional health and fitness writer who lives what she writes as a NASM certified personal trainer, USA Cycling certified coach, Pn1 certified nutrition coach, pro licensed off road racer, and All-American Ironman triathlete. Cycling is gentle on the joints—until it’s not. Incorrectly angled cleats can cause knee pain when cycling (CW), There are many intricate alterations a professional bike fitter can make to find the optimum cleat position. Since cycling is characterized by repeated flexing and extending of the knee, it only makes sense that cyclists would be prime candidates to experience this overuse injury. First – it’s a good idea to check your bike fit. You may be able to find the same content in another format, or you may be able to find more information, at their web site. Pain at the front of the knee – on and around the knee-cap (patella) – is the most common presentation of cycling overuse injuries, in part due to the anatomy of this area. Everyone talks about patella tracking, or malfunction of the patella, basically the way the knee cap glides over the joint. 7,8 In one recreational long-distance bicycling tour, 65% of all riders reported knee pain. Most cyclists – from beginners to the pros – will experience knee pain when cycling at some point during their riding career. It was about a 2700 mile trip and lasted about 2 months. Stronger and more flexible muscles will help keep the knee joint safe from injury. Whilst professional riders do of course expose themselves to a much greater training load, they’ve also got physiotherapists and osteopaths at their disposal on a regular basis – so if almost a quarter of them are struggling with a pain in the knee, you can bet that it’ll be an issue for a high number of amateurs. A little float—about 4.5 degrees—is all you need to be comfortable and keep your knees from getting stressed. To fully handle knee arthritis, it is best to integrate cycling with a solid strength training and stretching program. Often racers feel they get more power down that way, with their teeth on the bars – but that means they’re sitting on top of the knee and pushing a lot of force through it.”. From a bike fit point of view, that’s the easiest thing to look at first.”, He added: “Posterior pain can be from overextension – if the saddle is too high the muscles get very tight and the knee cant cope with that degree of flexation. This can be down to bike fit, or tightness as a result of a lack of maintenance or overuse. Cranks that are loo long can also create a similar incorrect angle, and overly tight cleats can cause strain from repeated unclipping. But for a basic, neutral position, George says: “people try to do all sorts of clever things [with their cleats] – but really they should be under the ball of the foot – imagine standing on tip toes – they should be right there, that places the cleat directly below the ball of the foot so you shouldn’t have problems.”. But before you head to a bike fitter or medical professional, try a little self-diagnosis. This condition is commonly brought on by athletic overuse or high-impact use of the knees (among bikers, overuse is … Again, a tight IT band and quads can be to blame – but more often than not, Monger-Godfrey says pain here is simply referral from the causes mentioned above. Of course, what you do on your bike will also go a long way to promoting or alleviating knee pain. In the earlier days of cycling, the default was to tell the rider to bring their knees in to meet their feet. To Build Strong Legs, Start With These Exercises, BikeFit Cleat Wedges for Look/SPD-SL Pedals, 7 Exercises That Help Prevent Pesky Knee Pain, This content is created and maintained by a third party, and imported onto this page to help users provide their email addresses. Giving your legs a break with some freewheeling now and then can also help. Correct possible misalignment and potentially improve your pedaling efficiency with these affordable cleat wedges. Researchers found that people who cycled more than 30 minutes a day were twice as … Tight quads affect the pedalling action, and can be seen visually in advanced cases in a pattern we could refer to as ‘Kermit the Frog Syndrome’. Usually, it’s caused by tightness in the quads or the fibrous tissue that runs alongside the outer leg – the 
Iliotibial band – pulling on the patella (knee cap). Arthritis is used synonymously by many for joint pain, which from a medical perspective is a symptom in hundreds of diagnoses. When it comes to treating the tightness – be it a result of improper bike fit or simply originating from heavy mileage – it’s all about foam rolling and stretching. Knee pain is common among cyclists - but more often than not it's an indication of a problem elsewhere. The 2 most common causes of knee pain in … The 11 Best Canyon Bikes You Can Buy Right Now, NBC Sports Network to Shut Down by End of Year, Fuel Up for Your Indoor Rides With These Tips, Shimano Is the New Neutral Support at the Tour, 5 Woodchop Variations for Serious Core Strength, Tight IT Band? Monger-Godfrey says: “[Pain at the front of the knee] often arises from the saddle being too low and too far forward. Most cycling knee pain results from a condition known as patellofemoral pain syndrome. Commonly called ‘spring knee’ it’s frequently a result of a sudden increase in mileage in an attempt at last minute fitness gains. Build Mileage Gradually: Your first ride after the winter offseason shouldn’t be five hours long. It could end up being the best money you ever spent on your cycling habit. Monger-Godfrey comments: “Stretch the muscle that is the issue, loosen off the buttocks with massage and that will release some of the tension, then foam roll – gently.”, George adds his tips, saying: “Foam roll the quads, the inside of the thigh and IT band. Pain on the inside: When you feel pain on the inner (or medial sides) of your knees, look down at your feet: Improper cleat placement is often a culprit, says Veal. This kind of cycling knee pain is a degeneration of the quadriceps tendon or in other words: there is damage at the cellular level that is not inflammation but chronic! The causes of joint pain … It’s very rare that the problem is actually with the knee itself. This content is imported from {embed-name}. Gear-obsessed editors choose every product we review. In fact, a study of 116 professional cyclists found that 94 per cent experienced some sort of overuse injury over the period of a year, and 23 per cent of those riders reported knee pain. It’s basically overload. Then the quads try to counterbalance that, which can cause a hip movement that results in a leg length discrepancy – which can also put pressure on the knee.”, There are other causes, as well. Often people will say the patella gets ‘stuck’, feels like it clicks or gives way.”, The patella doesn’t get itself into trouble on its own – Monger-Godfrey says: “If you took the quadriceps away from the knee… it would basically fall off…if one side is tight, it pulls the patella in the wrong way, so it doesn’t track smoothly and can cause pain. Most cycling-related knee pain comes from “overdoing it,” as they say. Your cleat position affects your Q-factor, which dictates how far apart your feet are laterally when pedaling. I often see people pedalling with their knees going out during bike fits. In the case of posterior knee pain, the first thing you should do is check your saddle height and fore/aft – being too high and too far back could be the cause. Bike-specific issues to check for include saddle height; saddle fore and aft, and/or crank length. The knee will track inwards and therefore become sore.”, He adds: “The glutes, abs and core all work together – if they’re not working it will cause pain, and you need exercises to get them firing up.”, In particular, he suggests a single leg touch down – adding “over time, you can do this loaded with a bar – but you need to get proper form with the knee tracking straight – and not inwards – first.”, Monger-Godfrey agrees that a focus on core strength is hugely important – saying: “The core is paramount for everything- a strong core gives you a stable base, so anything that life throws at you – on or off bike – you can cope with change – which is where bodies often start falling apart. Though knee pain from cycling … All rolling needs to be done slowly. Cleats positioned too close to the insides of your cycling shoes increase the distance between your feet, which can stress the inside collateral ligaments and cause pain in the inner (or medial) sides of your knees. Stay Warm: Riding in 40-degree weather with red, chapped knees is a recipe for trouble. Monger-Godfrey explains: “The main thing to look at is the patella [knee cap]. Even overly low handlebars could be a cause – if the lower back becomes fatigued, changing the natural movement pattern. The hamstrings are being pulled and you’ll get pain in the hamstring and where the muscle inserts around the knee.”, A saddle that’s too high can cause knee pain from cycling (CW), A saddle that’s too high can cause the lower back to work too hard, Monger-Godfrey says: “A lot of people think you don’t really use the hamstrings in cycling, but you do in the pull-up stroke. Pain on the outside: Pain on the outer (or lateral) sides of the knees is often caused by iliotibial (IT) band syndrome—a stabbing pain that happens when the IT band (a fibrous connective tissue band that runs from the hip along the thigh to the tibia) becomes stressed and inflamed. ‘World Championships are decided by pacing’: How important is it to pace your ride for time trials, racing and sportives? Tony Martin sporting k-tape – often used to correct knee tracking and reduce knee pain (Sunada). Could Botox Help Eliminate Knee Pain in Athletes. Garner Pilat, a cycling instructor at SWERVE says where you feel the pain can also tell you about your seat adjustment. Too much float in your pedals also can cause medial knee pain. Monger-Godfrey pulls out one particular muscle – the popliteus –which sits across the back of the knee. The quads are so overused that the muscle is short and the only way they can get the leg to pedal right is to pull them out.”, Treated early, pain can be reduced very quickly. Most cycling-related knee pain comes from … Your quad muscles attach to the shin via the patella, and when you’re pumping, they could deliver too much shear force across the joint. “Try lowering the saddle a bit or moving it forward a bit in relation to the handlebars,” she says. Knee pain. Act sooner rather than later. Symptoms: Pain behind the knee or along the outside of the knee. Pain in the back: Pain behind the knee is less common than pain in the front, and is generally easier to trace back to a culprit: over-extending the knee, says Bresnick. There is only so much you can learn from the internet – and it’s important to understand that lack of strength, flexibility and bike fit are all very intertwined. Here’s a guide to help you trace what hurts back to the source. While cycling is a more low-impact physical activity, knee pain is often a common complaint. Beware of Change: Your body likes consistency, so when you alter equipment, your knees often protest. As a general rule, aim for at least 15 minutes of moderate spinning before you attack the local climb or go hard on the flats. Research shows that anywhere from 23 percent to 33 percent of cyclists have suffered from cycling-related knee pain at one point or another. If the knee is held in wrong position for a long time it can really irritate the tendons where the quads attach at the front, just below the knee cap – you can get quite severe pain there where the tendon gets inflamed, and this can spread around the knee.”, Knee pain and saddle height are often related: saddle too low can cause pain at the front of the knee, saddle too high causes pain at the back, So what can we do about pain at the front of the knee? Knee pain from cycling, the same as for instance lower back pain, is, unfortunately, a common discomfort or injury for cyclists. Unless you’re correcting a specific issue, your cleats should be set up straight. Riding with your saddle too far forward also can cause knee pain in the front, says Veal. It’s important to remember that the knee is effectively a hinge between the hip and the ankle. Try this drill to improve your pedal stroke: The next time you are going up your favorite climb, use a gear at least two teeth lower (thus easier) than usual. Most cyclists encounter knee pain at some point in their careers: In fact, some studies estimate 33% of riders deal with some degree of chronic knee pain at some point. So can cleats that are placed too far to the outsides of the shoes, causing too narrow of a stance on the bike. My issue was always that I was doing too much, too soon and not allowing my body to recover. She says: “If you don’t optimise the round pedal stroke, you can put it under stress and cause irritation.”. Signs and symptoms … Hey Everyone, A few years back and a couple of years after my knee surgery (cartilage tear and ACL replacement) I went on a cross country bicycle trip. Your saddle is too high or too far back. You may be able to find more information about this and similar content at piano.io, A Step-by-Step Guide on How to Adjust Your Brakes, How to Conquer These 5 Common Cycling Fears. Knee pain after cycling can be linked to several factors, but there’s a few common culprits to watch out for. Even though their cleats are straight. Overexertion is an obvious, yet frequently overlooked, trigger for injury. By using warmers, you can easily slip them off mid-ride if you start to warm up. However, George says: “You can have it taped – but that’s a classic case of putting a plaster on the problem. “Likewise when the cranks are too long for your leg length, the knee joint is also too tight at the top of the stroke.”, How low is too low for a saddle? It might feel like they came out of nowhere, but they’re usually just the first noticeable symptoms of a long-brewing problem, and can leave you wondering why your knees hurt so much. Get a Bike Fit: If knee pain persists, consider getting a professional bike fit. Pain at the front of the knee is very common, and its proper name is ‘anterior knee pain’. Sadly, this may cause even more knee pain. Many people I spoke with at the time said cycling was a really good thing to do coming back from a knee injury/surgery. If they’re put under too much pressure, they can pull on the pelvis. This shouldn’t be … However, cycling can both help and hurt in knee arthritis. For temperatures ranging from 45 to 70 degrees Fahrenheit, these knee warmers keep your joints warm as you pedal through your training plan. Sometimes people go up and down like it’s a rolling pin – but that just flushes over the fibres, and doesn’t get into it – this needs to be one long smooth and progressive push through the fibres to add a bit of length into the muscle.”, Foam roll the quads to reduce knee pain from cycling, Kinesio tape – frequently used to increase blood flow to an injured area –  can also be used to push the patella into the correct position. A part of cycling 40-degree weather with red, chapped knees is a chronic problem and cleat are... Synonymously by many for joint pain, which from a medical perspective is a chronic.. Body, it ’ s tolerance will differ, there are some other factors worth considering misalignment and potentially your! And reduce knee pain is felt on the pelvis for joint pain, there ’ s a guide help. 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Saddle fore and aft, and/or crank length Leg should be set up....