One of the best low-impact sports one can perform for the best of his or her fitness is cycling. It off course cannot be denied that cycling has been a wonderful activity that can help us stay fit mentally and physically. However, cycling has some of the flaws and one of them being the Cycling knee pain. In this article we will know about the cycling knee pain and also know how to prevent the knee pain while cycling. Hope this would be a beneficial read for you if you are one amongst those bicyclists who has experienced the knee pain while cycling.

Cycling Knee Pain

Common Conditions of Cycling Knee Pain:

There are some common cycling knee pain complaints which are discussed below:

  1. Anterior Knee Pain Due to Cycling: Anterior knee pain is the pain on the front side of the knee and can be because of various symptoms of conditions like quadriceps tendinosis, patellofemoral pain syndrome, patellar tendinosis, chondromalacia etc. in common.

    • In case of anterior knee pain due to Quadriceps tendinosis while cycling, there is a degeneration of the quadriceps tendons or there is damage at the cellular level that is chronic, though not an inflammation. It is known that 80% of the patients experience the knee pain due to this condition may recover completely and require rests as the best treatment.
    • Patellofemoral pain syndrome is one more condition that may lead to anterior knee pain while cycling. An increased amount of stress between patella and femur wears out the cartilage on the patella and may cause abnormal movements of the patella. In case of cyclists, the pain usually begins from the center of the knee cap and occurs after exercise. It is essential to minimize your cycling for some time once you experience knee pain due to this while cycling.
    • Patellar tendinosis is one more condition one may experience anterior knee pain while cycling where the patellar tendon is very painful. This may be caused due to wrong cleat position and also due to soft tissue restrictions of the legs and the hips.
    • One more condition leading to anterior knee pain while cycling is Chondromalacia patella where there is a serious pain behind the knee cap. Ample amount of rest is essential for the treatment.
  2. Medial and Lateral Knee Pain While Cycling: Pain on the inner side and the outer side of the knee is the medial and lateral knee pain and can be due to improper bike fit as well as some anatomical problems. There are conditions like Pes anserinus, IT band syndrome, Plica syndrome etc. which may cause medial and lateral knee pain while cycling.

    • Pes Anserine Buristis is a type of cycling knee pain where there is pain, swelling and tenderness in the Pes anserinus or the portion on the front and inside of the shin bone. Overuse can cause the condition.
    • Cycling knee pain can also be a result of IT band of Iliotibial band syndrome that occurs when there is an inflammation in the fascia of the Iliotibial band. Snapping sensation on the outside of the knee, tight or painful knee etc. are some of the symptoms of this syndrome.
    • Plica syndrome is one more condition that leads to medial and lateral cycling knee pain. Clicking, snapping or knocking of the knee are some of the common symptoms of plica syndrome.
  3. Posterior Knee Pain While Cycling: Posterior knee pain among cyclists is very rare. This usually occurs in case the saddle is set too high or too far back and the biceps tendon can get aggravated. Bicep tendinosis is one of the most common conditions causing posterior knee pain.

Causes of Cycling Knee Pain:

One of the common complains amongst avid cyclist is the cycling knee pain. There are two prime causes of this cycling knee pain we will look below along with some other causes of cycling knee pain.

  1. Overtraining or Excessive Cycling Can Cause Cycling Knee Pain: The first cause for cycling knee pain is over training. Cyclist usually gets too ambitious while their cycling training and they do excess of the sport which may lead to the knee pain.

  2. Nature of the Bicycle That Can Cause Cycling Knee Pain: The second cause for cycling knee pain is the nature of the bicycle one rides. There is a man-machine-interaction while cycling. Just like the cyclist exert force on the cycle, it also exerts force on you. Any misalignment will put a lot of stress on either system; however only the bicyclist will develop pain. Thus, it is essential to check the bike setup and your body's setup so as to determine any extra causes for the cycling knee pain.

    • The saddle height of the cycle may cause cycling knee pain in case it is too low or too high or in case the saddle is too far forward or too far backward.
    • Apart from the saddle height, a large crank arm length can also cause knee pain while cycling because it will expose your knees to extra forces.
    • A wrong cleat rotation will also increase the rotational forces on the knee and may cause medial knee pain or even anterior knee pain due to patellar tendinosis.
  3. Anatomical Causes for Cycling Knee Pain: There are specific anatomical features which may contribute to the cycling knee pain in individuals biking. Let us know some of these anatomical causes for cycling knee pain.

    • Leg Length Discrepancies Can Cause Cycling Knee Pain. In this case, your one leg will be correctly fitting the bike while the other may not. This in turn will put the ill-fitted leg under more stress and thus may causing hip pain and knee pain.
    • The wide hips, especially in women compared to men can be one more anatomical cause leading to cycling knee pain. Women are at a more risk of developing knee pain or hip pain because they have a wider hip or have a higher angle at which the hip bone meets the knee. So women are more likely to have ACL injuries than man while cycling.
    • Flat Fee Can Cause Cycling Knee Pain. Flat feet can be one more anatomical cause for cycling knee pain in individuals. If you have flat feet then you are more likely to pronate excessively and while doing this you may put a lot of stress on the IT band at the knee.
    • One more reason for cycling knee pain can be the muscle length restrictions and soft tissue quality. Our body slowly adapts to whatever anatomical positions we put to selves. So, in case an individual sits at a desk all week then the central nervous system will prevent specific muscles from extending enough and on top of that the prolonged sitting would lower the tissue quality.This would in turn even further reduce the flexibility. This can again lead to further injury and develop the risk of cycling knee pain.

Preventing Cycling Knee Pain: How to Prevent Knee Pain While Cycling?

Now that we are known to the conditions and the causes of cycling knee pain, let us now take a look on certain ways to prevent knee pain while cycling.

  1. Prevent Knee Pain While Cycling Caused due to Wrong Bike:

    One of the most important things to keep a note so as to prevent cycling knee pain is to keep a check on your overall bike fit. Let us know about preventing knee pain while cycling caused due to wrong choice of bike.

    • Make sure your saddle is not too high or not too low so as to prevent cycling knee pain due to improper saddle height. You can go for a quick saddle height check by measuring your inseam or inside leg while barefoot with your feet shoulder with apart and then multiplying this result by 0.883. This can be just an approximate saddle height from the middle of the bottom bracket axle to the top of the saddle.
    • Check that the crank arm length of your cycle is not too large.
  2. Preventing Knee Pain While Cycling Caused due to Over Training:

    Over training or excessive cycling can cause cycling knee pain. So, make sure you are not over training and having appropriate rest. Apart from this, make sure you are pedalling in smooth circles and do not push down and mash the pedals which may put more stress on your hamstrings and gluteus muscles and cause cycling knee pain.

  3. Prevent Knee Pain While Cycling Caused due to Anatomical Causes:

    Below are some of the ways you can prevent cycling knee pain due to anatomical causes.

    • In order to prevent cycling knee pain due to leg length discrepancies do check for your leg length at home if you can find do it by lying on your back with your knees flexed at 90 degree angle and your feet placed flat on the surface. By doing this, you can know if one leg is longer in case one knee is higher than the other. In case you feel this, then go for more precise and appropriate diagnosis from a professional orthopaedist or a sport medical professional and get treated to the best.
    • For preventing cycling knee pain due to wide hips or the Q- angle causing knee pain while cycling, you are required to move your cleats so that you are exerting least amount of stress on your knee.
    • Using orthotics can be one of the most known treatments for preventing or fixing cycling knee pain caused due to flat feet and also the knee pain caused due to improper posture.
    • Using rumble roller would help you prevent cycling knee pain due to decreased soft tissue quality.
  4. Various Other Preventive Measures for Cycling Knee Pain:

    Following are some other preventive measures for cycling knee pain.

    • Make sure you have a proper pedalling technique and pedal stroke and do not allow your knees to push inward or outwards.
    • Make sure you take appropriate rest and do not over train. Also stop cycling for some time soon you start experiencing knee pain. Be sure you are resting.
    • Take healthy and anti- inflammatory diet. Avoid alcohol, refined carbs, caffeine, trans fat etc. and add more of cold water fish containing more of omega 3 fatty acids, grass fed and grass finished meat, eat more of fruits and vegetables, add spices like ginger and oregano and drink enough of water. Adding this nutrition will help you heal your body naturally and also help you prevent cycling knee pain caused due to inflammation.
    • Add more of anti-inflammatory supplements that can help you deal with your cycling knee pain. Fish oil capsules supplying EPA and DHA should be at the top list of your anti-inflammatory supplements.


We are now known to various causes and conditions leading to cycling knee pain. Hope this was pretty beneficial for you if you are in to cycling. Make sure you are not in to a rush, going with your body and not just over training because your mind loves to cycle. Seek professional advices from doctors in case of any pain while cycling.

Make cycling more enjoyable and effective with appropriate precautions.

Written, Edited or Reviewed By:


Last Modified On: May 23, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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