Cycling Knee Pain: Causes and Solutions

Cycling is a highly recommended physical activity for all kinds of people, including those with joint problems. Being a low-impact exercise, it is easy on your body. Unlike weight-bearing exercises (such as running) cycling is considered safe. Injuries are less common—but not non-existent.

Unfortunately, most cyclists report knee injury at some point in their lives. It is easy to ignore the first time you feel a slight discomfort and only get concerned when it becomes too much. But sometimes, pain is an indication that you need to change something.

To establish the cause of your knee pain and the possible solution, you need to understand your knee pain.

Key Takeaways

  • Cycling is a low-impact exercise but it can cause knee pain if done incorrectly or excessively.
  • Knee pain can be classified into four types: anterior, posterior, lateral/medial, and IT band pain, each with different causes and solutions.
  • Adjusting the saddle height and position, the cleat alignment, and your pedaling technique can help prevent or reduce knee pain.
  • Strengthening and stretching the leg muscles, especially the quadriceps, hamstrings, and gluteus, can also help prevent or reduce knee pain.
  • Resting, icing, massaging, and seeing a doctor are some of the ways to treat knee pain if it persists.

Types of Knee Pain

a. Anterior/Front Knee Pain

This pain is felt at the knee cap or around it and is also referred to as patella pain. It is as a result of either one of these two injuries: Patellofemoral Syndrome or Patellar Tendonitis. This problem is common among runners and is even known as the ‘runner’s knee’.

Unfortunately, cyclists get it too.

Your quadriceps are greatly used while pedaling. Force comes from there and travels through the knee, pressuring it. Now, your knee can only bear so much force. The pressure becomes too much when your saddle is lower or too much to the front than ideal, when you ride too much than you are accustomed to or when you start pushing very big gears.

Causes of Anterior Knee Pain

• Poor saddle setting
• Suddenly increasing duration and intensity
• Pushing big gears


When your bike’s pedal is at the floor, it is not necessary to have the entire foot resting on it. Your saddle should be at a height where only your toes rest on the floor. Setting the saddle lower causes the knee to be under a lot of pressure. The same happens when your saddle is too much to the front.

The first thing you should do is make sure your saddle is set right. If you cannot figure out the sweet spot, visit a pro bike fitter.
Sometimes, it is easy to feel like you have too much energy and that you can take on big gears. Pushing yourself beyond limits can be fruitful—but only when done in moderation.

Avoid riding your bike like it’s the last day. Cycling is fun, no doubt. But too much of a good thing can become a bad thing. Rest (it’s okay). Give yourself days off in a week and allow your body to recover. If you want to increase the duration and intensity of your exercises, do it gradually.

Straighten out your leg. When sitting, lying in bed or in a place where you can, gently stretch out your leg and keep it that way for a while. Ice will help too.

b. Posterior/Back Knee Pain

Unlike anterior knee pain, this one is not that common. It occurs at the back of the knee and has to do with the hamstrings—the muscles at the back of your upper leg. The pain comes about when you over-extend your knee or strain the popliteus (a muscle across your knee, at the back).

Causes of Posterior Knee Pain

• Poor saddle setting
• Not completing a pedal stroke


When the saddle is too high or too far back, your knee is forced to extend awkwardly. When you push it too much, the hamstrings will also have to be pulled hence pain the back of the knee. Lower your saddle and move it forward to a comfortable position.

Learn to pedal properly, completing the full circle. The next time you get on your bike, follow this guide to pedal smoothly and efficiently.

If you constantly ride fixed-gear bikes, take a break once in a while and just freewheel.

Take a rest. Do not worry; you will not forget how to ride if you take a few days off. Ice will also ease the inflammation. Use it in short intervals— about 15 minutes.

c. Lateral and Medial Knee Pain

This pain is felt at the sides of the knee. Lateral pain is at the outside while medial pain is in the inside. This issue affects the collateral ligaments. Like the anterior pain, lateral and medial pain is common among cyclists.

Causes of Lateral and Medial Knee Pain

• Poorly positioned cleats
• A foot issue


Many cyclists never stop to give the cleats position much thought. The contact between your foot and the pedal is crucial to the entire riding experience. That means that cleat positioning plays an important role.

First of all, the cleats should not be worn out. Next, ensure that they are well-positioned. Cleat position can be a complicated topic and you may have to visit a bike fitter. However, the neutral position is under the ball of your foot and pointing straight. This may not suit everyone so here is an in-depth guide. When they are too far outside or inside you will have a poor Q angle, hence the pain.

If your cleats are okay, the problem may be coming from the foot. Your foot is meant for walking/running and you, therefore, have to train it to pedal. Failure to that, it will bring the walking mechanics into pedaling. Assume the right angles and foot positions all through the pedaling motion.

d. IT Band Syndrome

Otherwise known as iliotibial band syndrome, IT band pain can be such a nuisance. The IT band is a connective tissue running from the pelvis, through the thigh to the knee. As you can imagine, this band goes through a lot of stretching and stressing. Over time, inflammation may occur and every time the knee bends, you will experience irritation.

Causes of IT Band Syndrome

• Weak gluteus
• Overuse
• Cleat placement


As already mentioned in the solution for medial and lateral pain, make sure your cleats are pointing straight.

Perform exercises that strengthen your gluteus muscles. If you are very sore, start with stretching exercises. Take on the strengthening exercises gradually to avoid further damage. Massages are very helpful with this issue too.

Remember to rest and use ice.

How to Prevent Cycling Knee Pain

1. Don’t Just Cycle

Bike riding is an amazing exercising—no argument. Nonetheless, some muscles like quadriceps end up being used more than others. In the long run, the less used muscles (such as gluteus) become weaker. The imbalance can be rough on your knees.

Even if cycling is your favorite exercise, mix it with others. Focus on strengthening muscles and especially your leg muscles (from the hips all the way to the calves).

2. Adopt a Smooth Pedal Stroke

Pro cyclists usually appear so graceful when cycling. Even when going up a hill, they never seem to be struggling. They have worked on their pedal and learned how to do it in a fluid motion. This technique ensures the effective use of muscles and fewer chances of a cycling knee injury.

3. Warm Up

Stop jumping on your bike and going straight to beast mode. Start by warming up, just as you would do with any other exercise. If you do not have the time or you only cycle for leisure, start slow. Get the blood flowing and your muscles ready.

4. Proper Fit

You would be surprised to know the issues that can be solved when you get your bike fitted. This does not just refer to the saddle. The pedals can also negatively affect your knee. They should neither be too far nor too close to the bike. You may make some of these adjustments yourself but seeing a bike fitter is the better idea.

5. Check Your Posture

Assume the right posture and not only when riding. In addition to avoiding knee pain, you will appear more confident and a lot more attractive.

6. Be Careful with Change

Every once in a while, you may need to change your gear or bike. Understand that your body is used to the old gear and arrangement. Be keen and attend to any discomforts.

7. Do Not Be Too Eager

Regardless of how motivated you feel, increase everything gradually. Everything here refers to gear, duration and intensity. You will get more out of this than doing it all at once.

8. Massages and Stretches Are Important

Do not wait until there is an issue to get a massage. Make a habit of it—it does not have to every day. Your muscles need it. Do a few stretching exercises on a regular basis too.

Important note: anti-inflammatory drugs are more of a short-term solution. If the pain won’t go away even after trying out all the above solutions, see a doctor.


A knee injury is not something that any cyclist looks forward to, but it comes anyway. Knowing what to do and what causes the various types of pain is great.

However, you should be more focused on preventing the situation. Adjust your bike and cleats or have a pro do it for you. Do not push yourself too hard.

Another thing, learn to listen to your body. When you experience knee pain, pause and find a solution. Remember, seeing a physiotherapist is always a wise thing to do.

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