How to Ensure Your Knees Stay Healthy While Cycling

We all know it’s important to stay active and maintain regular exercise for a healthy lifestyle. This can be easier in theory than in practice, especially if you’ve had knee problems.

Perhaps you’ve suffered an injury practicing a high-intensity sport, are looking for a new hobby, or you’re simply starting your physical recreation due to doctor’s orders. Whatever your reason for considering adding cycling to your routine, we’re here to tell you what cycling means for your knees.

A cyclist's view looking down at her own knees while riding
© Megan Ann | Creative Commons

Is cycling bad for your knees?

Both new and experienced cyclists question whether biking is good or bad for your knees.

We have good news: When performed properly, cycling is good for and helps strengthen the muscles around your knees. However, if you experience knee pain while cycling and you choose to ignore it, that can lead to injury and long-term damage.

Due to the repetitive motion involved in cycling, many cyclists experience knee issues from overuse. Fortunately, many of these can be easily treated, especially when caught early.

Benefits of cycling

Cycling is a low-impact form of exercise and is actually recommended by physiotherapists who are helping people recover from knee injuries. Regular cycling helps strengthen your hamstrings and quadriceps, two leg muscles that support your knees.

Side view of a racing cyclist's knee
With proper form, cycling can develop strength around your knees.

Since biking is not a weight-bearing activity, it’s gentler on your knees and other joints than running or even walking, because there’s no contact with the ground. Your body has little force to absorb, which makes cycling a great activity if you suffer from knee joint pain or osteoarthritis and are still determined to stay active.

Overuse issues

Knee problems arise when the joint is overworked. If you’ve been training for some time, overuse issues are most likely to occur when you suddenly alter the intensity, mode or duration of your time on the bike. Of course you want to get better, faster and push yourself, but it’s best to make changes gradually to avoid knee issues and therefore having to pause training to heal.

Factors that cause knee pain 

A number of factors can contribute to knee pain. Some of them, such as genetics, are out of your control, but most are manageable and require only a small adjustment.

Overuse

As mentioned above, overuse is the most common contributor to knee pain for both beginners and experienced athletes. This can be avoided through a smooth progression into the training season. Many enthusiastic cyclists try to get a head start and ride too hard too quickly.

Failing to stretch

Another common culprit is not properly stretching before a big ride. Many people think of biking as a hobby or method of transportation and don’t take the time to help their bodies adjust to the motions.

Make sure you stretch before hopping on your bike to avoid unnecessary knee pain. If you don’t have time to warm up your muscles at the start of your ride, ease into the ride. Go slow, let your body adjust to the movement and build up to your regular speed. Going from zero to 15 mph is hard on your legs.

Lack of core strength

Many people underestimate the importance of core strength for cycling. If you have a weak core, you’ll have a tendency to put more pressure on your legs and back. Instead of using proper form with your core supporting the rest of your body, you may ride more hunched over or compensate in other ways. This compensation has negative effects on your legs and knees.

Poor bike fits

Often the issue stems from your bike itself. If it’s a bad fit for you, this will cause more stress on your limbs. Or perhaps the gear you’re using is not right for you. Your cleats could be too big, too small or just not clipping in the right position. All of these factors could make your time in the saddle harder than it has to be, so make sure your bicycle provides good ergonomics.

Genetics

As for genetic factors, there’s not a lot you can do about that. Be aware of them, try to take precautions, give yourself plenty of time to rest and don’t compare your progress to other riders.

Types of knee pain and common causes

The knee is such a complex joint that it can cause you pain from every angle. That’s not great news, but once you’re able to locate where your pain is concentrated, it will be easier to pinpoint the reason you’re experiencing it and hopefully find a solution. Let’s start at the top.

Anterior knee pain

Anterior pain, or pain at the front of your knee, is quite common due to strain in your quadriceps or an outer thigh muscle called the iliotibial band (IT band) pulling on your kneecap. The kneecap, or patella, is supposed to glide over the joint. When your patellar tendon starts to click or feel stuck you know you’ll have a problem.

Cause: This is a bike-position issue caused by your saddle being set to low.

Side view of a woman riding a bike with her upper knee bent at an extreme angle
A low saddle puts your knee at an extreme angle when you pedal. (© Richard Masoner | Creative Commons)

Solution: Raise your saddle and test it to ensure your knee is bending at the recommended 45 degree angle during your pedal stroke. Ideally you’ll be maintaining a cadence of 60 rotations per minute or higher to minimize strain.

Treatment options

If you’re already experiencing anterior pain, osteopath Alice Monger-Godfrey recommends using a foam roller, slowly on your quads, inner thighs and IT band.

Kinesio tape can also help push the patella into the correct position.

Posterior knee pain

Posterior pain, or pain in the tendon at the back of your knee, is usually caused by an over-extension of the hamstrings. Your hamstrings are engaged with the pull-up stroke of the pedal rotation. If you’re struggling to pedal and cannot reach 60 rpm, this will become a problem.

Cause: Another bike-fitting issue. This time the saddle is set to high.

Solution: Lower your saddle and ensure that you are pedaling at the recommended angle to avoid a pain-inflicting stretch.

Treatment options

For posterior pain, Monger-Godfrey prescribes more foam rolling combined with icing and stretching. You can stretch your calves and hamstrings by hanging your heel off of the pedal. Ten seconds should suffice.

Medial and lateral knee pain

Medial knee pain is on the inner side of your knee (closest to the other knee) and lateral pain is on the outer side of your knee.

These two are lumped together because it can go either way, depending on the angle at which you apply force to your pedals. It also mainly occurs through strain on your quads.

Cause: Pain on either side of your knees is commonly caused by gear issues, and the angle at which your cleats clip into your pedals.

Close up of a cycling shoe clipped in to a pedal
Your cleats must clip in straight to avoid potential medial or lateral knee pain. (© Dave Gingrich | Creative Commons)

Solution: You’ll want to adjust your cleats to have them set up straight, so the ball of your foot is where the pressure of pedaling is applied. If your physiotherapist recommends it, you may need to have them slightly angled in the opposite direction to compensate and correct the original issue.

Treatment options

According to bike fitter and coach Jimmy George, you need to engage and strengthen core muscles in the back, abs and glutes to help prevent your leg muscles from being overworked. He suggests the best exercises are:

  • single leg touchdown
  • swiss ball bridge
  • leg extensions
  • lunges

You can find more good exercises in this Bike Radar article.

In extreme cases, you might need physiotherapy, pain management medication or (worst case scenario) surgery.

Another great resource for further information is the Chester Knee Clinic.

Cycling alternatives

In extreme cases of prolonged pain or knee damage that can’t be resolved, it may be time to consider alternatives to traditional cycling.

Fortunately, this is not the end of the road. You can always try switching to a different kind of bike. If you’ve always been strictly a road cyclist, trying out a cruiser maybe enough of a shift in body position that it will relieve the strain. Or, as funny as they may look, recumbent bikes are an extremely helpful option and will entirely shift your range of motion, keeping you sailing through the streets but with even less pressure on your knees and joints.

Side view of a man cycling on a recumbent bike
A recumbent bike may shift your body position enough to relieve your knee pain.

Riding your bike while suffering from knee pain is not fun. When you first start to notice the strain in your knee it can be scary, especially if you are in the middle of a long ride. I remember the first time I felt my knee giving me trouble. It would pop or click while I was pedaling. I started to wonder why this was happening and if this is just how things were going to be from now on. Fortunately, there are actions we can take to prevent and even reverse some of the effects.

Ensure your bike is properly fitted to you, your gear is in good working order, that you stretch before cycling and that you don’t overexert yourself too quickly. All this should help reduce the risk of knee pain, or at least make the pain more manageable.

After all, the goal is to stay in good health and keep yourself riding for as long as possible. Take care of your body and continue to enjoy your favorite sport.

Image at top: © Joerg | Creative Commons

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