The knee initially seems fairly straightforward: It’s essentially a hinge joint that allows our legs to travel in a circle when we pedal. But so many distinct pressures engage on it—the four muscles of the quadriceps, the three making up your hamstrings, one of the hip adductors, and the iliotibial band—that it’s actually pretty difficult. “All of those pass through the knee joint, and the different lengths and stresses aren’t always in balance,” explains Frank Baptiste, a certified strength and conditioning coach in New York City.
And it plays a significant function in your riding. “Power comes from the huge muscles in our hips and thighs when we cycle,” explains John Feldman, MD, an orthopedic expert at the Orthopedic Institute at Jersey City Medical Center. “In order to transfer that power to the point of propulsion—our lower legs and feet—energy needs to be passed through that knee joint.”
Given its complexity, it is not surprising that knee injuries are among the most frequent among cyclists; a 2018 study published in the Open Access Journal of Sports Medicine found that up to 33% of riders had experienced knee pain.
That’s also a result of how much pedaling puts pressure on our knees. “If you’re spinning at a hundred revolutions per minute for 100 minutes, you’re looking at 10,000 repetitions,” adds Baptiste. Your risk of developing overuse injuries, which are brought on by repeated stress or harm to a specific location, increases if your body alignment is slightly incorrect or if you have a tiny muscular imbalance elsewhere. Fortunately, Feldman notes that most of these wounds are rather minor. But if you ignore them, they might persist.
Stop allowing that to happen to you. This guidance is intended to help you put knee pain behind you and stop it from holding you back again.
Where Does It Hurt?
FRONT
Feels like: A throbbing, dull discomfort near the kneecap
➥ Patellofemoral pain syndrome is the issue.
➥ What it implies is that every time you press the pedal forward, your quads are working hard. The vastus medialis, one of the four muscles in each, is responsible for extending your knee. According to Feldman, the stronger quadriceps muscles can move the kneecap to the side of the knee if one particular muscle is relatively weak in comparison to the others.
➥ Fix it: According to Portland, Oregon-based physical therapist and bike fit expert Kevin Schmidt, if your saddle is too low, it could place undue strain on your quadriceps, patella, and ligaments. At the straightest point of the pedal stroke, try to maintain a knee angle of 32 to 35 degrees. The knee should only have a very tiny bend at the bottom of the stroke, according to him, so have someone keep the bike steady for you while you ride backward with your heels on the pedals.
BACK
Feels like: Back of knee pain or stiffness, or top of hamstrings close to glutes
➥ Overextension of the hamstring is the issue.
➥ Why it matters: Your hamstrings, a group of three muscles that traverse the back of your thigh, assist you draw the pedal back up to the top of a stroke by flexing your knee and extending your hip. The posterior knee structure and hamstrings are “placed in a lengthened, stretched, and often inefficient position” every time the leg extends past the bottom of a pedal stroke, according to Schmidt. Pain is guaranteed when there are numerous repetitions spread out over a long ride.
➥ Fix it: Try lowering the saddle a bit and shifting it a few millimeters closer to the handlebar to prevent such overextension. However, don’t go too low; according to Schmidt, your knee angle at the bottom of a pedal stroke should never be less than 30 degrees.
OUTSIDE
➥ Feels like: A severe discomfort on the knee’s outside.
➥ Iliotibial (IT) Band Syndrome is the issue.
➥ Why it matters: The IT band, according to Feldman, is a lengthy section of fascia—a web of connective tissue under the skin—that runs from your hip past your knee to the top of your tibia on the [outside] of your leg. It stabilizes the knee, which is involved in every component of a pedal stroke, and aids in bringing the hips and thighs closer to the midline of your body. The IT band thus slides back and forth over the exterior of the knee joint during repetitive sports like cycling, according to him. Inflammation in that connective tissue can develop over time as a result of constant rubbing.
➥ Fix it: You can’t really stretch the IT band because it is connective tissue and not a muscle, but foam rolling can help to relax the muscles around it and reduce stress, according to Feldman. Those nearby muscles can be stretched and strengthened to ease discomfort. Visit bicycling.com/ITband to learn how to perform beneficial activities.
INSIDE
➥ Feels like: A severe ache on the inside of the knee.
➥ The issue: Incorrect foot alignment
➥ Why it matters: When the cleats are positioned too far to the inside of the foot on the shoe, it results in a posture that is “too broad,” according to Schmidt. Additionally, your heel may spin outward if your cleat is mounted to your shoe with an external rotation. Your knees are more inclined to buckle inward as a result, which increases the strain on it during each pedal stroke. Because their stance will naturally be wider, smaller riders, those who utilize a triple gear in the front, and those who ride fat bikes may be more prone to this type of pain.
➥ Get a bike fit to fix it. When viewed from the front, your hip, knee, and foot should all be in a perfect vertical line, advises Schmidt. A qualified bike fitter can provide equipment and positioning ideas to help your legs stand more straight.
4 Go-To Moves That Prevent Knee Pain
Consider strengthening the muscles around your knees to maintain their health. According to Baptiste, “the knee doesn’t work by itself—it will constantly be working with the hip and ankle.” Consider compound actions that entail triple extension, in which the knee, hip, and ankle all flex simultaneously. This strengthens any weak links along the way by targeting all the muscles involved in the complete kinetic chain.
Additionally, you should practice single-leg workouts. One leg is moving forward at a time when riding a bike, according to Baptiste. You’re going to work on joint stability in addition to balancing your strength from side to side.
Perform these exercises twice a week. Baptiste advises beginning with three reverse-pyramid sets, each consisting of 15 reps on the first set, 12 on the second, and 10 on the third. Use weights that require you to exert 6 or 7 out of 10 effort levels, then increase the weight every set to maintain the same degree of effort while you reduce the reps. “Your final set should be the most difficult, but ‘leave two in the tank,’ which means you could perform 2 more reps if necessary. This will ensure that form doesn’t deteriorate at the end of your set, according to Baptiste. You can begin performing four sets of six repetitions with higher loads after four to six weeks, according to him, once you’ve developed your strength.
DEADLIFT
➥ With a dumbbell in each hand, stand with your feet hip-width apart. Hinge at the hips, moving your butt back and bending your knees while maintaining a flat back and a strong core. To stand up, plant your feet firmly on the ground and tighten your glutes.
LUNGE
➥ Put your hands on your hips and place your feet shoulder-width apart. With your right leg, advance with a strong step. Bend your knees and lower your hips toward the floor while maintaining a straight back until your right leg is roughly 90 degrees bent. Back away to begin. On the opposite side, repeat.
SQUAT
➥ With your toes turned out slightly, place your feet hip- to shoulder-width apart. With both hands at your shoulders, hold a dumbbell. Lower yourself as much as you can while keeping your weight on your heels and your chest tall; do not lean forward. Push your hips back as if you were sitting in a chair. Back to the beginning
STEP-UP
➥ Put a dumbbell in each hand and take a position in front of a box that is just over knee height. As you straighten your right leg, step onto the box with your right foot, pressing onto the heel. Bring your left foot up and over the box, meeting your right. Return slowly to the beginning, then repeat on the opposite side.
Can Supplements Help?
A diet that is well-balanced is the best way to obtain nutrients. According to Leslie Bonci, RD, owner of Active Eating Advice and co-author of Bike Your Butt Off, certain supplements that complement your diet can, however, help prevent joint pain, particularly for those who have nutrient deficiencies in their blood work or who follow more restrictive diets, like vegans. In fact, it may take two to three months to see benefits, so they are a part of the long game. It’s not the same as taking Advil, explains Bonci. “Seeing a difference takes some time and constant use.”
Collagen can aid in the growth and repair of cartilage, which facilitates easy joint movement. Researchers discovered that consuming a supplement decreased the amount of activity-related knee joint pain in a 2021 study that was published in the journal Nutrients. Bonci advises choosing one with vitamin C. She claims that daily intake of at least 15 grams of collagen and 50 milligrams of vitamin C appears to stimulate cartilage.
According to Bonci, the anti-inflammatory compounds curcumin and boswellia serrata can be protective.
In a 2020 meta-analysis published in the journal BMC Complementary Medicine and Therapies, boswellia, a gum resin extract, was considered to be an efficient and secure treatment for persons with inflammatory joint disease at doses of 100 to 250 milligrams per day. Additionally, 1.5 grams of curcumin, the active ingredient in turmeric, per day may improve performance by lowering pain, inflammation, and muscle damage, per a review published in Critical Reviews in Food Science and Nutrition in 2020.
Tamarind and curcumin / Tamarind is a tropical fruit with antioxidant and anti-inflammatory effects. According to Bonci, the addition of curcumin to that could be advantageous. In fact, a 2019 study published in The International Journal of Medical Sciences showed that taking Tamaflex (which combines the two) daily for 90 days could significantly reduce knee discomfort after physical exercise and enhance joint function in non-arthritic persons.
How to Protect Your Knees
Be more active Schmidt advises against remaining still for long periods of time. He continues, particularly as the terrain changes: “Stand up on the pedals, slip back on the saddle, and move around every ten minutes or so.” The system is refreshed and discomfort is prevented from developing by variety.
Increase cadence / According to Schmidt, pedaling slowly and forcefully just increases the strain on the knee. Spin quickly and lightly. For respite, change to a lower gear and increase your cadence to 90 to 100 rpm.
Pay attention to your pain. According to Feldman, ignoring pain almost never results in permanent harm but may add time to your recovery. Additionally, the longer you stay in therapy, the less time you can spend traveling. When riding a bike when your knee starts to hurt, stop immediately and figure out what you can do to fix it.
Use the exercises in this article twice a week to bolster your core, glutes, and hip flexors as part of a maintenance program. Additionally, Baptiste advises riders to warm up before each ride by cycling slowly for 10 to 20 minutes to activate the same muscle groups.
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