The most common cause of knee pain in cyclists

At some point, one in three cyclists suffers from severe knee pain (Am J Sports Med, 2010 Dec;38(12):2494-501). This often happens with a new bike, when resuming cycling after a long break, or when trying to increase your intensity or mileage. If your knee starts to hurt while you’re on your bike, stop riding and try to find the cause.

The most common cause of knee pain in cyclists is that the seat is set so high that it forces you to fully straighten the knee when the pedal bottoms out. You are never supposed to fully straighten your knee when doing any type of exercise, especially cycling or running. If you set your seat too low, you will bend your knee excessively and run a high risk of developing pain behind the kneecap. Other common causes of knee pain are overtraining, adjusting your seat too far forward or back, having the cleats on your cycling shoes not adjusted properly, or the length of the crank arm not adjusting properly. is not correct.

seat height

Adjust your seat so that your knee is bent 20-30 degrees when a pedal is at its lowest level, and is not bent more than 70-80 degrees when the pedal is at its highest level raised. The ball of your foot should be directly above the pedal axle.
When the seat is adjusted too high: you may feel pain on the inside of your knee, on the lateral side of the knee (iliotibial band), the medial back of the knee (tendon pes anserinus), or the lateral back (biceps femoris) of the knee.
When the seat is adjusted too low: excessive bending of the knee causes the patella to rub against the femur, the long bone in the upper leg.

Distance from seat to handlebar

When sitting in your saddle, you should be able to reach the brake covers with your elbows slightly bent and relaxed. You can lean forward slightly, but you shouldn’t have to slide forward or backward on the seat. Move your seat backwards or forwards so that when you sit on it, your tibial tuberosity (the bump on your lower leg just below the kneecap) is directly above the ball of your foot when the pedal is in its most advanced position.
When the seat is too far back: you may feel pain on the lateral side of the knee (iliotibial band) or the back of the knee (hamstring tendons).
When the seat is too far forward: you may feel pain in the front kneecap (patellofemoral joint), the tendon just above the kneecap (quadriceps), or the tendon just below the kneecap (kneecap).

Cleat position

Pain on the inside or outside of your knee is often caused by adjusting your cleats so that your feet twist inward or outward.
Crampons turned too inward can cause pain on the outside of the leg at the knee.
Crampons turned too far outwards can cause pain and stress on the inside of the knee.

Grease the bolts of your cleats and install the cleats in the cycling shoes. Make sure the front middle of the cleat is centered in the middle of the cleat box. Adjust the fore-aft position of the cleat so that when you’re clipped into the pedal, the pedal axle is just behind the tip of your big toe and just in front of the tip of your little toe. Tighten the cleats. Clip and roll and make sure your feet feel comfortable in the pedals. If you don’t feel comfortable, ask your bike shop or other experienced riders for help.

Crank length

Having cranks that are too long for you causes the knee to bend excessively at the top of the stroke and straighten excessively at the bottom of the stroke. You may feel pain in the knee joint itself.

Find the cause of your knee pain

It is possible to do this on your own, but it will be much easier if you have a friend to help you. This may take several days because with each change you make you will need to roll for a while to see if your knee has stopped hurting. First, adjust your seat height: Sit on the seat in your cycling shoes with your heels on the pedals. Slowly pedal backwards. The seat height is correct when your knees straighten at the bottom of the pedal circles without needing to rock on the seat to keep your heels in contact. When tied at this height, you will have a 20-30 degree knee bend at the bottom of each stroke. Move the seat up or down until you get there. A quarter inch can make a difference to your knees.

If changing the seat height does not relieve pain, try the other changes listed above. You may be able to “break” an uncomfortable saddle, but trying to “break” painful knees will only lead to a serious knee injury. If one or both knees hurt while cycling, keep asking questions until you get a solution. Get help from more experienced riders, your local bike shop, or a bike repairman with a special bike machine. A bike assembly can cost you several hundred dollars, but is recommended for serious cyclists, especially if you are buying a new bike.

Republished from

Back To Top