This blog post covers 5 things to consider when experiencing knee pain whilst cycling.
Knee pain is the number 1 complaint in our clinic from cyclists. So common because there are many factors to consider. Overwhelmed by the Google searches for answers? Continue reading below for our top 5 recommendations.
1. Saddle Position
3 things to consider here, the height, setback, and angle of your saddle.
Height: when sat on your bike and the crank arm is at 6 o'clock on the clock face, your heel should be in contact with the pedal, whilst your leg is straight (not bent at the knee).
Setback: the ideal position is for your knee to be directly over the pedal spindle when at 3 o'clock on the clock face. You can use a plum line to help with alignment.
Angle: should be flat, with perhaps a slight downward tilt towards the front of the bike.
My top recommendation for this however would be to get a bike fit done by a professional.
2. Cleat & Pedal Position
2 things to consider here, cleat alignment and the amount of float.
Cleat alignment: the cleat should be in line with the ball of your foot. We should then look at how your feet dangle naturally when sitting on a high chair/table when your knees are bent at 90 degrees. Most people's feet will naturally supinate, ie. soles of the feet turn inwards. This should be considered with your cleat setup, so tweak as necessary.
Float: the amount of sideways movement your cleat has on the pedal. Float provides freedom for mini adjustments whilst cycling, and also enables you to find where you naturally want to place your foot on the pedal.
Again, it would be a strong recommendation for a professional bike fitter to assess this.
3. Knee Tracking
Arguably has been over-corrected by professionals over the years, hunting for the perfect hip-knee-foot alignment. Having said that, it could be causing you pain if saddle, pedal and cleat position are all sound.
Knees in: when the knees fall in towards the midline whilst pushing down the pedal stroke. This can be caused by a lack of hip and/or knee stability, and occasionally due to over-pronation at the foot.
Knees out: seen more often in beginner cyclists or those trying to unload the hip joint due to pain. Can also be caused by the saddle being too low.
Knee asymmetry: mobility, flexibility and/or strength imbalances in the legs can cause the knees to move asymmetrically. Something which can be tested thoroughly in clinic.
4. Overtraining
Cue eye roll from every athlete reading this, but something to take notice of this time of year. As tempting as it is to go out every sunny morning, keep in mind the amount of cycling you've done throughout the winter. Have you been consistent? Have you been progressively stepping up your mileage up until now? Overuse injuries in the knee such as patella tendonitis are extremely common in the summer months due to this very reason, so ensure you up your cycling mileage gradually.
5. Complimentary Strength Training
Cue second eye roll, but is an absolute MUST for those who want to perform well, and keep on the road. As alluded to above, imbalances are easily created with cycling due to the limited range of movement muscles work through. It is important for these to be identified and corrected through specific strength training exercises. They can also help rectify poor knee tracking and improve muscle, joint and tendon capacity so that overtraining isn't an issue either.
My professional recommendation would be to complete complimentary strength training twice per week for those competing this spring/summer. It doesn't have to be anything flash, bodyweight at home could be plenty.
If you're struggling with knee pain whilst on the bike, we would love to help you. Click on the link below to see one of our cycling specialists.
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