Cycling knee pain explained. Here are tips on how to prevent it

Though cycling is considered a low-impact activity, there’s still plenty of room for mistakes. Let’s first pinpoint where pain is coming from and then find out what we can do about it. There are five types of discomfort and knee pain after biking:

• Posterior knee pain (back of the knee)

Pain at the back of the knee – or posterior knee pain - is usually due to excessive strain on your hamstring – back
of your thigh - (or occasionally, the calf) tendons at their attachment points at the back of the knee. This issue is usually caused by a saddle that is positioned too high or set too far back, leading to knee overextension at the bottom of the pedal stroke.

• Anterior knee pain (in front of the knee)

Pain in front of the knee (anterior knee pain) is the most common, with the main issue being at the patellofemoral joint. Less common sources of anterior knee pain include issues with the patella tendon (quads), bursas surrounding the knee or the fat pad. Patellofemoral pain is quite a vague discomfort beneath or around the kneecap (patella), and it often happens during or after loading. Normally the kneecap moves along the thigh bone (femur) - or ‘tracks’ in the trochlear groove when you use your leg, however, pain can occur when there is excess pressure on a specific part of the joint. Excess pressure and incorrect ‘patellar tracking’ are usually due to weakness or inadequate activation of the vastus medialis oblique (VMO) muscle located on the inner quad. Annoyingly, pain or swelling in the knee can further hinder VMO function and make posterior knee pain worse.

• Lateral and medial knee pain (outer side of the knee and inside)

Outer side of the knee and inside knee pain (lateral and medial knee pain) is usually caused by the compression of the iliotibial band (ITB) where it attaches to the side of the knee. It happens if there are muscle imbalances around the hip, inadequate control of knee rotation, or incorrect stance width and saddle positioning. Medial knee pain (on the inner side of the knee), is typically caused by swollen tendons that attach to the inner knee, these include the sartorius, gracilis, and semimembranosus. Like outer-side knee pain, this is also usually caused by a lack of control of knee rotation and inappropriate stance width, which leads to excessive inward rotation and dropping of the knee.

• Spring knee pain (just above the front of the knee)

A pain just above the kneecap – or spring keen pain – is often caused by overloading. It’s often worse when climbing hills, or pedaling in higher gears, when the load on the joint and muscles is more. Again, it can be due to muscle imbalances – often more powerfuI quad muscles (thigh), which are used for powerful pedaling. Sometimes adjusting your saddle height and its position to be nearer or further from the handlebars, can improve your riding position and reduce the pain.

• Weak core pain (usually associated with back pain)

What are the main causes of knee pain when it comes to cycling? If you’re suffering with knee pain when you’re riding – or when you get home, then you should look at these three things: Saddle height, saddle position and your form. Getting your saddle height right is important to avoid your knee joint being overextended. If your saddle is too low, it’ll put too much pressure on your knee joint at the top of the stroke. This can then lead to tendonitis (swelling of the tendons) and stress in the cartilage behind the knee. Use our Guide to Find Your Ideal Bike Size, to make sure your frame and saddle is the right fit.

Saddle position is also important, you want to make sure that when you’re sitting on it, your kneecap is above the ball of your foot, which is above the pedal spindle. Any other position will put undue pressure on the knee and the tendons that attach to it. Finally, when it comes to form, if you’re not familiar with riding hard and heavy in big gears, then build up to it. Climbing in heavy gears and all-out sprinting when you’re not trained for it can all put excess pressure on your knee and lead to pain – and time off your bike to recover.

• Tip 1: Warm up before biking

No matter where you're off to, you should always do some warm-up exercises before jumping on your bike. All it takes is just 15 to 20 minutes! Warm-ups don’t just wake up your body, they also improve your range of motion, give you better stability when you cycle and help prevent muscle injury. This is especially important if you’re riding in the morning when it's cooler outside. It’s like cooking a meal – you have to warm up the pan before you can begin channeling your inner chef! Ready to start? We recommend trying out dynamic stretches that mimic your cycling movements. Morning yoga is another great option (and our personal fave!) - choose from tons of videos on YouTube for tips from the pros. Even a power walk around your house or the block will get your blood pumping and warm you up – the point is, just warm up your muscles!

• Tip 2: Go slow and steady

When people train for marathons, they don’t just run the entire distance on the first day! And, it can take up to 20 weeks to master a new sport - the same goes for cycling. It’s always smart to start slowly and not overdo it. Here’s why. There are many factors that can cause discomfort. It could be that you’re sitting and pedaling in the wrong position. It could be that you’re overexerting yourself, or that you didn’t warm up properly. Cycling more than you’re used to can cause anterior or spring knee pain (in front and above the knee), the most common types of cycling knee pain. This is largely because of how our knees are structured and how the repetitive motion of bending our knees and not aligning properly can cause things inside to rub in the wrong way. So don’t rush and enjoy the ride!

• Tip 3: Watch your posture!

Exerting pressure when your legs aren’t in their natural alignment is a surefire way to cause discomfort. The same goes for when we’re on our bike. Cycling for long periods in an uncomfortable or unnatural position can lead to lateral and medial knee pain (outer side and inside the knee). But there’s a simple way to check your positioning to avoid this: start by sitting on the edge of a chair or bench, with your knees at 90 degrees, and observe how your legs naturally bend. Then follow this natural form when you’re sitting on your bike. And if that’s not working, sometimes it’s not the way we’re positioning our legs but where our feet are placed. Don’t be shy to ask a professional for help in adjusting your pedal cleats (the pedal area) so that your legs are well aligned.

• Tip 4: Check your bike seat height regularly

For every person out there, there’s a bike that’s just right for them - and their lifestyle. If you love stylish and comfortable electric bikes like us, our Ultimate Buyer’s Guide will help you choose your perfect bike. After you’ve found your chosen bike and customized the components to your needs, give the bike a whirl for a week and see if you feel uncomfortable during and after. If you’re feeling pain in front and above the knee, try adjusting the height and distance of your saddle. That can make all the difference! You want to make sure your leg is never fully extended (approx. 80-90%) when your foot reaches the bottom of each pedal stroke. Your bike should be fitted in a way that enables you to use the power of your bum, thighs, and calves.

Remember, the less pressure on your knees, the better!