Knee Pain with Cycling Explained
What muscles to focus on to fix your knee pain on the bike
Knee pain with cycling is a common condition. But it’s also an easily fixable one. When it comes to knee pain with cycling, there are two aspects that must be addressed:
1. Bike Fit
2. Force Generation
I already covered bike fit variables in my blog here, so make sure you also read that one to ensure you’re addressing both common causes of knee pain on the bike.
So let’s talk about force generation, i.e. how you create power to pedal your bike, and how changes in what muscles you use can cause knee pain with cycling. Just like in my bike fit blog, I’m going to break this down by specific locations of knee pain and what muscles need to be addressed to change your particular knee pain.
Knee pain in the front of your knee
Usual culprit: Overuse of the quad
Why: We cyclists are really good at using our quads, and less great at using some of the muscles further up the hips that help stabilize us so we can generate force. Over time, that results in the quad doing the work both stabilizing the hip and driving force through the pedal, resulting in overuse of the quad, and pain at the front of the knee where the quad tendon passes over the kneecap.
How to fix it:
Quad foam rolling to lengthen the quad
Clamshells for hip stability (Psst – if you’ve done clamshells before, you’ve probably done them wrong and used them to strengthen your glutes instead of the hip stabilizers under the glutes. Watch this video and try these clamshells to actually help take some load off your quads)
Knee pain in the back of your knee:
Usual culprit: Decreased hamstring length
Why: Hamstrings have to work to help us pull up in the back end of our pedal stroke, and also have to work to counteract our quads. Because we sit in a flexed position on the bike, it places the tops of the hamstrings in a lengthened position, and at the bottom of our pedal stroke, lengthens the bottoms of the hamstrings as well. If the hamstrings constantly have to work at the end range of their length, it can cause discomfort and pain in the back of the knee. Additionally, hamstrings get tight (and painful) when they’re trying to lengthen and support a system that is overusing other aspects, such as low back. Increased hamstring tension can also result on pulling on the sciatic nerve, which passes right behind the knee, causing knee pain with cycling.
How to fix it:
Kitten pose to improve pelvic mobility and ability to tuck
Sciatic nerve glide to ease neural tension behind the knee
Knee pain on the outside of your knee:
Usual culprit: IT band
Why: The IT Band is connected to a muscle called your TFL, which attaches to the hips and melds into the fibers of the glute. The TFL helps flex the hip, and therefore works during each pedal stroke. It can shorten due to our position on the bike, creating tension on the IT band which connects to the outside of the knee.
How to fix it:
TFL foam rolling to lengthen TFL (don’t bother with the IT band itself. Read why here)
Hip Hikes for improved spinal stability
Clamshells for improved hip stability
Knee pain on the inside of your knee:
Usual culprit: Adductor shortening or decreased hip stability/rotator capability.
Why: The adductors are the muscle group that run in the inside of the leg. If they shorten or tighten, they will pull on the inside of the knee and cause pain at that location. Our hip rotators help our knee track underneath our hip. When they can’t generate force efficiently, it can cause our knee to dive in as we pedal, putting strain on the inside of the knee
How to fix it:
Adductor foam rolling to decrease adductor tension
Clamshells to improve hip stability for better force generation
You’ll notice there’s a them with the fixes for knee pain, regardless of its location. I often say the knee is the victim of the hip and the foot; it will have to endure increased load if either of the other joints and muscles above and below can’t support it. Since our feet are attached to pedals when we ride, the bigger culprits that affect knee pain are often found at the hip. A lot of the muscles at the hip are muscles that rotate us. Cycling is a sport that moves only forward, which means it doesn’t strengthen those rotating muscles. But it doesn’t mean we don’t need them when we ride; it just means they are at a disadvantage. So strengthening the hip stabilizers and rotators is the first order of business in most cases of knee pain.
Note – I know clamshells are a pretty bread and butter exercise. But, in my experience, the exercise has been used to strengthen the glutes. Cyclists don’t need stronger glutes – they need better force generation from the muscles underneath the glutes (such as the gemelli, piriformis, obturator internus, and quadratus femoris). So make sure to watch the clamshell video posted above to see how you can make some small but important tweaks to the clamshell exercise to make it way more effective to fix your knee pain with cycling.
Second note – as stated before, knee pain on the bike is typically two fold- how we’re riding on the bike matters, but so does bike fit. So make sure you also read my blog here for information on how to ensure your bike fit isn’t causing your knee pain.
Next steps for you:
Check out below👇 to grab my free resource Ultimate Bike Fit Checklist, and if you’re ready to make real moves, grab my Virtual Bike Fit Rx and get back to riding your bike pain-free now!
Suffer on the bike, not because of it. Get my Virtual Bike Fit Rx and get back to riding pain free!
