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7 Reasons of Knee Pain When Riding a Bike

Chronic knee pain is something we wouldn’t wish on our worst enemy. What often starts as a twinge of discomfort can sometimes turn into chronic, excruciating pain that requires time off the bike at best and surgery and months of rehabilitation at worst. It doesn’t matter whether you’re a casual commuter, a local racer, or a professional cyclist surrounded by a team of doctors and physios, knee pain can affect everyone, but it doesn’t have to. With the right precautions, you can avoid knee pain when riding a bike and learn how to deal with it if it starts to bother you.

Knee Pain Symptoms and Remedies

Knee pain symptoms, including swelling and limited mobility, can be alleviated with remedies such as rest, ice, compression, and elevation (RICE), along with proper rest and consultation with a healthcare professional for a comprehensive treatment plan.

  • Pain in the Front

When your knee hurts right on the patella (patella), it’s generally a product of your powerful cycling quads. Your quads attach to your shin through the patella, and when you pump, they could put too much shear force across the joint. Bike-specific issues to check to include seat height; saddle fore and aft and/or crank length. However, you may also feel sharp stabbing pain in knee comes and goes while riding a bike.

  • Pain in the Back

Pain behind knee is less common than pain in the front, and it’s generally easier to track down the culprit: overextending the knee, says Bresnick. Your saddle is too high or too far back. Try lowering the saddle a little or moving it a little forward relative to the handlebars. This pain is also more common in cyclists who spend a lot of time on fixed-gear bikes; when you ride hard, you use your hamstrings to slow down the pedal, which can put too much strain on the biceps femoris (the hamstring that runs down the back of the leg toward the outside of the knee) and irritate it. It can also help to give your legs a break from idling every once in a while.

  • Pain on the Inside

When you feel pain on the inside (or medial sides) of your knees, look down at your feet: Improper cleat placement is often to blame, says Veal. The position of the cleat affects your Q-factor, which determines how far apart your feet are when pedaling. Ideally, the distance should be such that the load from the knees to the pedals travels vertically without the knee pushing in or out, which stresses the collateral ligaments on both sides of the knee and can lead to pain. Cleats placed too close to the inside of your cycling shoes increase the distance between your feet, which can strain the medial collateral ligaments and cause pain on the inside (or medial) sides of the knees.

Too much swimming in your pedals can also cause medial knee pain. A little swim – about 4.5 degrees – is all you need to feel comfortable and not stress your knees. However, you may also feel this type of knee pain when hiking.

7 Causes Of Knee Pain When Riding A Bike

Knee pain when riding a bike can often result from improper bike fit or cycling technique, and it's essential to address these issues to prevent discomfort and injury during your rides.

1- Saddle Height

A saddle that is too high can cause the lower back to work too much. A lot of people think that you don’t really use your hamstrings when you’re cycling, but you do when you deadlift. This tends to shorten the hamstrings. If they are put under too much pressure, they can pull on the pelvis. Then the quads try to balance that, which can cause the hip to move, resulting in a leg length discrepancy – which can also put pressure on the knee.

2- Patellofemoral Pain Syndrome

Most knee pain while cycling is caused by a condition known as patellofemoral pain syndrome. This condition is commonly caused by athletic overuse or high-impact use of the knees (among cyclists, overuse is a more common culprit). Malposition of the patella (kneecap) can also cause or worsen problems. Patellofemoral pain syndrome causes pain both during activity and at rest; it can also cause popping sounds and sensations in the knee joint.

3- Elliptical Knee Tracking

This is so common. When the knee gives way slightly during the descent and then from the motorcycle during the lift. There is nothing wrong with this style and some would argue that it utilizes the greater involvement of the hip flexors in cycling. An idea debunked by Martin and Brown (2009) in a brilliant study on the co-production of energy.

This style is most likely due to a lack of control through the core causing external rotation of the hips, possibly too high a saddle, and a “bouncy” appearance to the rider. In any case, no washers or wedges should be used here.

4- Tracking In the Knees

We mostly see this unusual style on new or less experienced cyclists commuting around London. Usually the simple answer is that the saddle is too low or they bought a bike that is too small. Another observation is those riders who are overweight and try to keep their knees from hitting their stomachs. It can also occur in cyclists who have hip pain and naturally “unload” the hip joint. This is definitely something that should be assessed by our physios and is usually dealt with off the bike.

5- Knee Asymmetry

This is obvious to anyone who notices, and it’s actually more common than you’d think if you’re looking for it in club rides. You’ll rarely see this in the professional ranks. As it’s almost always caused by rider asymmetry. Whether it’s a leg length discrepancy, a large muscle imbalance, or a hip abnormality. On more occasions than you’d think. We’ve also seen people ride with asymmetry because their saddle isn’t straight.

6- Weakness in the Core and Glutes

Cyclists tend to focus on strengthening the quads and calves—areas that appear overwhelming when looking at professional cyclists. But we forget that the legs work from the core – the lower back, abs, glutes, and hip flexors are involved.

7- Overload and Spring Knee

Finally – there are cases where a cyclist suffers from knee pain simply because he did too much, too soon. Commonly called “spring knee,” it’s often the result of a sudden increase in mileage in a last-minute effort to get fit. You can get tendinitis there – riders often have a break over the winter. Then they go out and keep riding like they are. They get tendonitis because the muscle just isn’t ready. From this point of view, they need weight-bearing strength work in the hamstring. if they experience a dull aching pain. Then it is also important to stretch the hamstring.

Are There Effective Treatments for Cycling Knee Pain?

Pain management specialists can provide you with comprehensive care that treats the cause of your knee symptoms and ultimately allows you to get back to cycling. Depending on the severity of your knee problem, non-surgical or surgical treatment may be recommended.

Nonsurgical options include RICE (rest, ice, compression, and elevation) physical therapy, anti-inflammatory medications, and the use of orthotics or support braces to stabilize the knee. If your condition is severe, arthroscopic knee surgery may be recommended as the most effective solution for long-term relief.

Some Stretches for Knee Pain

Stretching for cyclists can also be a means of injury prevention. While pain around the knee may seem unrelated to a specific muscle. The way our muscles and tendons are connected means there are plenty of other areas you can work on to relieve stress around the joint.

Some basic stretches you can try include:

  • Hamstring Stretch

Stand with your left foot slightly in front of your right and point your left toes toward the sky to rest on your heel. Bend your right knee, lean forward, and rest the weight on your right thigh. You should feel a stretch in the back of your upper left leg. To deepen the stretch, bend the left leg slightly and push the bottom part out.

  • Hip Flexor Lunge

Kneel on the floor, then step your left leg in front of you to be in a low lunge with the front knee bent at 90 degrees. Move your right knee back a little to feel the stretch in the front of your right thigh. Focus on rotating your tailbone down and your hip bones forward and you should feel more of a stretch. If that’s enough, stay here, or if you need a little more. lean on the front leg and keep the knee above the ankle. Repeat on the other side.

  • Back Twist

Lie on your back with your legs extended and feet together. Bring the right knee to the chest. place the left hand on the outer thigh of the right leg. place the right hand on the ground with an extended arm and guide the right knee to the left side of the body. You should feel a stretch on the outside of your right thigh.

You may be surprised to learn that ‘float’ – or the small rotational movement of the cleat and shoe around the pedal. A floater is not actually directly related to knee pain while cycling. But it can affect muscle kinematics and overall rider comfort. Increasing the amount of floating motion in your cleats may help alleviate knee pain by allowing more movement in the lower extremities. Although the science behind this is somewhat lacking.

Dr. Rao K. Ali M.D.

Dr. Rao Ali, a board-certified pain management physician, leads the clinic, which specializes in nonsurgical treatment. The physician has experience in the emergency room as well as training in pain management and rehabilitation. As a personal physician, he works with each patient to develop a treatment plan that will minimize or eliminate their pain. Providing expert diagnosis and treatment of a wide range of conditions, Pain Management In Dallas, PA provides a comprehensive range of services. These services include neck pain, back pain, hip and knee pain, fibromyalgia, neuropathy, complex regional pain syndrome, headaches, migraines, and many others.