By David Dodgin, M.D. • July 31, 2018
Bicycling is gentle on your knees – until it’s not. If you ride a bike, you may be all too familiar with knee pain. Knee pain can prevent you from getting the most out of your pedaling stroke, or even keep you out of the saddle and on the sidelines. Luckily, there are several ways to manage knee pain and get yourself ready to ride.
About Your Knee
According to the American Academy of Orthopaedic Surgeons, the knee is the largest joint in the human body - as well as one of the easiest to injure. It has many different components, which makes your knee joint especially vulnerable to injury.
Your knee is made up of bones, cartilage, tendons that connect muscles to bones, and ligaments, which are tough tissues that reduce friction between bones as they move against each other.
Three bones meet to form the knee joint:
- Femur (thigh bone)
- Tibia (shin bone)
- Patella (kneecap)
Your patella sits in a groove on top of your thigh bone called the trochlea. When you bend and straighten your knee - as you do when riding a bike - your kneecap slides back and forth in this trochlear groove.
Cartilage helps your patella glide back and forth against the trochlear groove smoothly and a thin layer of tissue covering the knee joint, known as the synovium, lubricates the cartilage. A small pad of fat just below your kneecap cushions your patella and acts as a shock absorber for each movement you make that includes your knees.
About Knee Pain
Patellofemoral pain and patellar tendonitis are painful knee conditions that commonly affect cyclists.
Patellofemoral pain is the result of overusing the tendons, fat pad and synovium that keep your knee moving smoothly. These injuries cause inflammation and irritation where your kneecap meets your thigh bone.
Patellar tendonitis affects the patellar tendon, which connects your kneecap to your shinbone and works with the muscles at the front of your thigh to bend your leg at the knee. Overuse of this tendon can cause inflammation in a condition known as patellar tendonitis.
About Your Knee
The main causes of knee pain during cycling are overuse, weak muscles and improper bike fit.
When you cycle, your knee repeats the same motion hundreds of times during a single ride. Compounding that motion with riding too long or riding too strenuously for too long can lead to more wear than your knee can handle. Overuse in this way can cause strain to the different segments of the knee, especially the tendons.
Due to the repetitive nature of cycling, overuse injuries are common among cyclists. Researchers in one study of 116 professional cyclists found that 94 percent of the participants experienced an overuse injury within the previous year, and 23 percent of those cyclists reported knee pain.
Weak muscles are another common cause of cycling-related knee pain. Strong muscles move the bones of your joints smoothly and provide stability to the joint. Conversely, weak muscles can cause your joints to become unstable, which makes them more prone to injury.
Having your saddle in the wrong position can also cause knee pain. Riding with your saddle too low or too far forward can make pedaling more strenuous, leading to patellofemoral pain. Pedaling in the wrong gear can also make cause your knees to work harder during pedaling.
One last source of knee pain can be linked back to irritation of the iliotibial band, which is a thick cord of tissue that runs from your hip bone to your shin bone on the outside of your leg. Riding with your saddle too high or pedaling with your toes pointed inward can aggravate the iliotibial band and lead to more knee discomfort.
How to Prevent and Treat Knee Pain from Cycling
There are several ways you can reduce your risk of knee pain from cycling.
- Create a reasonable riding schedule and cadence to avoid overuse injuries, such as patellofemoral pain and patellar tendonitis.
- Exercise and strengthen your muscles, especially the leg muscles that move your knee (talk to your doctor about exercises that would work best for you).
- Use good form and position your saddle correctly to optimize pedaling and avoid giving your knees extra work.
If you’re already experiencing some knee pain, stay off your bike for a week or two to give your knee a chance to rest and heal from overuse injuries. When you return to bicycling, be sure to ease back into your regular workout to avoid re-injury.
Manage your pain through proper form and exercise. Having strong muscles and good form allows your knee joint to move with maximum efficiency and stability, and wearing a knee brace may help.
Medical care and medications, such as nonprescription pain relievers and anti-inflammatory drugs, can also help alleviate discomfort. Depending on your condition, your doctor may recommend injections to relieve pain and inflammation. Physical therapy may also help improve your overall form.
If conservative approaches don’t offer relief, your doctor may recommend surgery. Knee replacement surgery can help people with certain types of knee issues get back on their bikes.
| Depending on your specific condition, you may be able to ride a stationary bicycle one to two weeks after knee replacement. |
You’ll have to wait a bit longer to mount your regular steed, but personalized care and following a recovery plan can help you get back on your bicycle more quickly.*
Muve Health provides a differentiated option for cyclists who want an extraordinary experience and an optimal outcome from knee surgery. The total joint replacement specialists at Muve focus on recovery support and education that are distinctly designed to help people get back to their specific, personalized goals as safely, quickly and enjoyably as possible. If you’re experiencing knee pain from cycling, Muve can help you get back in the saddle again.