Solving the ‘Knee Pain With Bicycling’ Puzzle

Written by Kevin Schmidt, PT, MSPT, CMP, Bike PT

Reposted with permission – read this and more from Kevin at:

Knee pain is one of the most common (if not THE most common) symptoms a cyclists will experience while riding a bike. Here’s a quick guide to help solve the puzzle of knee pain while riding.

1) Training: “Too Much, Too Soon”

If you’re eager to get back in shape, we get it. Unfortunately, riding too long/hard initially is how a good majority of our knee pain starts. And once it begins, it’s tough to then stay the course to progress your cycling distance and intensity due to lingering pain. If you’re just getting back into riding, or are a beginner, start with a short, flat, 10-15mile rides, and less than 50miles/week to assess your body’s tolerance to this new demand.

2) Add a Warm-Up

Especially as we get older, we need to take care to ensure our tissues are warmed up, as our tissues have a bit of ‘plasticity’ to them, much like taffy or silly putty. If warm, it stretches and moves, if cold and we put torque on it, it’s likely to snap or injure. Ouch! Be sure to take the first 10-15minutes of your ride just to ‘soft pedal’ and spin >80 rpm (crank revolutions per minute) with very little load before adding resistance or higher intensity riding or climbs.

3) Temper the Cold Temps

Be sure to keep your knees warm not only with a light, active light warm-up period, but also be sure to wear leg warmers or tights if temps are below 60degrees. A colder knee from the surrounding temps + wind is a much more injury-prone knee with riding!

4) Check your Bike Fit

This is always a big reason for knee pain while riding longer distances- a poor bike fit. Over 85% of the time, knee pain is related to the saddle and/or cleat positioning for those with clipless pedals. Due to the repetitive nature of pedaling, precise, millimeter-sized adjustments in position can make a dramatic impact on your knees. Typically, the longer you can ride before symptoms arise, the smaller the adjustments needed. Conversely, if knee pain arises within the first 5miles, more significant changes are likely required.

5) Mobility/Flexibility Issues NOT at the Knee

Since the knee is basically a hinge, it’s positioning and control during pedaling requires adequate flexibility and mobility of the joints above and below the knee, including your ankle, hips and lower back. If you’re lacking motion in these areas, compensation can occur, leading to increased strain and atypical pedaling patterns that can cause knee pain.

6) Spin, Don’t “Mash” Your Pedals

The slower you pedal, the greater the torque through the knees, per pedal stroke. So, if you’re pedaling for an hour at <60 revolutions per minute, significantly more stress is being placed through the knees to produce more power. Be sure to use your gears, and when in doubt, pedal faster, not harder. Goal of long distance cycling is around 85-90 rpms for optimal endurance, injury prevention, power and longevity on the bike. This takes practice, so be patient!

7) Consult with a Bike-Centric Physical Therapist

If your knee symptoms continue to worsen on the bike, they can begin to start impeding on other aspects of your life when you’re not on the bike (such as walking, climbing stairs, squatting, or playing w the kids). A Physical Therapist who specializes in cycling and who understands proper bike fit can evaluate and pinpoint the underlying cause of your symptoms, and assess whether your knee pain is from the bike, from the body, or most common: a combination of both.

If you’re currently having knee pain while bicycling, feel free to call503-894-9038 or e-mail us to set to up a free, one-on-one Bike PT consultation today!