Knee discomfort during cycling: Locations of pain, reasons, and additional details
In the world of cycling, knee pain has become a common complaint for many enthusiasts, especially during the COVID-19 pandemic when cycling as a form of exercise has seen a significant surge in popularity. A recent study found that approximately 61.6% of cyclists reported only mild knee pain, while 28.7% reported moderate pain, and 15.9% of professional cyclists experienced knee pain [1].
The study, along with other research, suggests that knee pain in cyclists is often linked to bike fit issues and biomechanical weaknesses. The most frequent areas of knee pain reported in cyclists occur in the anterior (front), posterior (back), medial (inner side), and lateral (outer side) parts of the knee [2].
Specifically, anterior knee pain (front of the knee) is often linked to a saddle that is positioned too low or too far forward. Posterior knee pain (back of the knee) can result from a saddle that is too high or positioned too far backward. Medial and lateral knee pain (sides of the knee) frequently arises from improper cleat positioning or foot alignment issues [2].
Sudden increases in cycling intensity or mileage can also cause what is known as "spring knee pain." Weak core strength can contribute indirectly to knee pain by causing compensatory muscle imbalances around the knee [2].
Lower limb injuries are the second most common site after upper limb injuries in able-bodied cyclists. While knee-specific injury rates are not isolated in a large epidemiological review, knee pain is recognized as a frequent complaint tied to cycling activity and biomechanics [1]. Common knee-related diagnoses in athletes (including cyclists) include ligament tears (ACL, MCL), meniscus tears, fractures, and dislocations, though these traumatic injuries tend to be more prevalent in high-impact sports rather than cycling specifically [4].
It is essential for cyclists to be aware of the symptoms of knee injuries, such as pain, swelling, a feeling of instability in the knee, and difficulty walking. If a person cannot relieve the pain with over-the-counter medication, their symptoms have not improved within a few days, their knee is making loud popping noises, accompanied by pain and swelling, their knee joint cannot move properly, they cannot put weight on their knee, their knee is discolored, their knee has lumps and appears off-center, or they have a dislocated kneecap, a sprain or strain, tendonitis, a torn ligament, torn cartilage, Osgood-Schlatter disease, arthritis, bursitis, an infection in the bones of the knee, or bleeding in the joint, they should seek physiotherapy or medical attention [3].
To prevent knee injury while cycling, a person can adjust the saddle-pedal distance and saddle height on their bicycle, ensure their saddle is in the correct position, wear appropriate shoes for cycling, increase cycling training gradually, warm up thoroughly before cycling, perform stretching and flexibility exercises, and maintain a moderate weight [3].
References:
- Injury epidemiology in cycling shows lower limb injuries are common, with knee pain significant among them [1].
- Detailed causes and locations of knee pain in cyclists correspond closely to bike fit and biomechanics [2].
- The treatment of knee pain and injuries typically involves the RICE method (rest, ice, compression, and elevation) and the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
- Broader knee injuries in athletes include structural damage such as ligament or meniscus tears, relevant for severe cases but less frequent in cycling [4].
- Reading more about strengthening exercises for the knees can provide additional information on how to prevent and treat knee pain from cycling.
- The study indicates that knee pain in cyclists, whether mild, moderate, or severe, is often linked to bike fit issues, biomechanical weaknesses, and improper positioning of the saddle and cleats, which can affect the anterior, posterior, medial, and lateral parts of the knee.
- To avoid knee injuries while cycling, it's crucial to maintain proper bike adjustments, wear appropriate shoes, increase training gradually, warm up and stretch regularly, and engage in exercises to strengthen the lower limbs and core, as these measures can reduce the risk of knee pain and improve overall health-and-wellness and fitness-and-exercise.
