Cycling knee pain: What do you do?


“One knee says to another knee..”

I mentioned yesterday on Twitter that I’ve been having some knee pain recently. A little during cycling and then occasionally when I’m resting.

I got some really helpful suggestions back:

  • aj_ux I forgot to tweet "also try an ibuprofen gel".
  • petermeanwell I raised my seat as wasn’t getting full leg extension, plus adjust my toeclips towards the outside of the pedals, and it went
  • phips73 Saddle too high? Do you rock side to side when you ride?
  • AidanFarrow get rid of your old shoes (i’m talking ordinary shoes, not cycling shoes), replacing badly worn soles worked wonders for me.
  • Roaders more seriously, I assume you have checked SPD setup and have knees covered below 10°C?
  • bashthebox Try adjusting saddle position – that did it for me. Or your cleat position – helped a friend. Rest until the pain is gone.
  • AndyKewell read this and get some Arnica gel. 😉
  • cyclelizzy try a knee support. Found it helped me last year. All fine now.
  • ecstaticgaucho Do stretches and have a bit of a rest… possibly see a physio..
  • Anne24solo (puts physio head on). Suggest you dont ride through the pain. Get you and the bike looked at.
  • tobycastle What sort of pain? Sharp stabby or dull ache? RICE best course of action. Rest Ice Compression Elevation.
  • cyclegaz do you stretch after you ride? I have problems with my knee if I don’t stretch
  • arthurpanos I had the same thing mate. rode through it but braced up my knee. all good now. good luck!
  • presentedbynt have a good rest matey – you can always enjoy cycling after the rest! good osteopath can help you too good luck
  • cgwlambert Rest, don’t ruin the chance to get out in the upcoming good weather. Riding will only make it worse… temp – 10C on Saturday
  • nodgerjeffries @aj_ux also use single speed..but pain gone, put it down to cold xmas weather, ok since. Web full of cyclist bad knee probs
  • Roaders use the other leg?
  • ruthbowes select a gear or two lower than you normally would for a few days – it’s slower but also less strain on your knee. Helped me.
  • nodgerjeffries Happened to me, knee prob common for cyclists, gave bike a rest and it went away. Put it down to cold – now wear trousers.
  • dbfhorses 2 weeks rest and adjust the geometry of your riding position.

It was great to have everyone chime in with ideas. I’m going to put it down to two reasons: The cold and some trekking I did recently when we were on very rocky terrain.

As for the solution I think a rest is the best option. I’m going to keep cycling to a minimum and when I do go out only for very short runs and without putting too much pressure. If things persist I’ll talk to the doc and think about my bike fitting.

Never nice to realise you are fragile! Also I was recommended this article on Knee pain.

Anything I’m missing?

Image via mikebaird twitter

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32 Responses to Cycling knee pain: What do you do?

  1. Knit nurse 04/02/2011 at 8:44 am #

    Rest is the best solution but I find a five minute series of leg stretches after every ride helps on a long term basis. Stretching your calf muscles, quads and hip flexors should do the trick, build it into your daily routine and you should notice the difference.

  2. Tim Lennon 04/02/2011 at 8:58 am #

    What, and not a single person said “Go and see a professional?” Surely only a flat earther would avoid going to get an opinion from someone who specialises in making people better? After all, you can always ignore their advice!

  3. Mike 04/02/2011 at 9:13 am #

    As Tim Lennon suggests – go and see a professional. I went to my GP who was very helpful and arranged an MRI scan (on the NHS) within 10 days. The good news was that the damage to my medial ligament was minor – the bad news was there was nothing he could do about it. However he advised that cycling would be beneficial, and six months later – no pain.

    • Andreas 04/02/2011 at 10:32 am #

      I’m hoping it’s a little more minor than a 6 month pain. But the advice is much appreciated and pleased to hear about the NHS doing well.

  4. Alina 04/02/2011 at 9:16 am #

    I think it depends on what causes the pain. Mine comes from muscle problems so cycling is actually beneficial – but needs to be in lower gears…but if you say yours comes from the cold and trekking then I’d probably agree with rest is best. Have you considered buying cycling trousers with fleecy knees. They are awesome.

  5. thereverent 04/02/2011 at 9:23 am #

    The short term advice of RICE (Rest Ice Compression Elevation) is good.

    Definitly worth streaching after a ride as you don’t fully extend your leg when cycling your hamstrings can become tight.
    I have found glucosamine & chondroitin supplements useful (I do plenty of running as well as cycling).
    If it persists see a doctor or physio.

    In the future keeping your knee warm while you ride often helps.

    • Andreas 04/02/2011 at 10:33 am #

      Think I’ll grab a couple of knee warmers for sure. Not too expensive recommendations?

  6. Kevin Campbell's Blog 04/02/2011 at 9:28 am #

    so i guess my suggestion was of no help, but i will say again that if you do go out just take it easy, so very slowly and in a light gear so you do not put much pressure on the knees

    take care

    • Andreas 04/02/2011 at 10:33 am #

      I need to do a tiny amount of cycling over the weekend so I’ll be keeping it in a low gear and taking it easy

  7. nilling 04/02/2011 at 10:56 am #

    If it’s muscle ache then use heat but otherwise use an ice pack applied to the knee for a maximum of 5 minutes, otherwise you could get burnt. If it persists go and see a qualified sports injury therapist or GP. Bear in mind that just because the knee is hurting at the moment, the problem could be elsewhere.

  8. Dave Escandell 04/02/2011 at 11:16 am #

    I’d be suprised if your GP was able to provide any additional advice to that which you already have, unless you made repeated visits. The NHS waiting list from non urgent physio would be a couple of months at best.

    A physio would probably want to try and tie you into a couple of sessions at between £30 – £50.

    So, I would also take the rest option.

    The alternative Andreas, is for a physio session as blog research in trade for a blog article and plug??

    • Ruby 14/02/2011 at 5:12 pm #

      Tried the rest option. I was a couched potatoe for months on end. First time i strained my knee (was simply doing up some stairs) I felt a sharp pain immediately.

      I do not like wearing knee support because it effects the blood flow so i resorted to physio. I was a new man within days.

      Personally, it was worth the money.


  9. Anne Dickins 04/02/2011 at 11:57 am #

    Hi Andreas,
    I am a Physio specialising in cycling injuries.
    There is lots of good advice on here but your specific situation needs specific treatment. Happy to chat through some ideas with you.
    twitter : anne24solo

  10. Jon 04/02/2011 at 12:08 pm #

    I had a problem with my right knee making clicking noises while going upstairs and crunching noises when I squatted down. I also had pain under the knee cap while cycling.

    The pain while riding turned out to be misaligned cleats. It is very important to get them aligned properly as you can damage your knees over time. Another source of pain was when I had my seat too high and my knee was over-extending. To correct this, place your heel on the pedal and rotate the crank to 6 O clock. At this point your leg should be straight and your heel flat against the pedal.

    I also took myself off for a few sessions at my local osteopath clinic which was money well spent. It turned out that the muscle above my knee cap was over developed and was giving the knee cap little room to move. After manipulation of the leg and knee I felt much better. I was given stretches to do which would allow the knee cap to move more freely and loosen it up. Apparently the clicking and crunching was not a problem, which is what alarmed me the most!

    Over the last few weekes I have been cycling less due to the awful weather and have noticed that my knee clicks much less so I would guess in your case the pain will subside with a good dose of R&R!

  11. Craig 04/02/2011 at 3:00 pm #

    Tim Lennon’s advice is probably the best for pain that continues, but here are a three suggestions to help avoid the physios couch and the doctors medicine bag.

    1. Pay attention to how you pedal – is your strong leg doing more work ie pushing earlier in the rotation than your weak one. Work on balanced pedalling over speed.
    2. How is your core muscle fitness? Stronger abs and back along more flexible hips will reduced the impact on your knees.
    3.Is you bike set up correctly for you? In fact do you have a bike that is the right size?! There are a few things you can do to ensure that the bike is comfortable eg seat height and handlebar reach, but if knee pain is becoming a problem it might be worth paying for a professional to get the settings right.

  12. Liz 04/02/2011 at 4:58 pm #

    Hi Andreas,
    I had a problem last year found a good knee support helped me. Used for a few weeks and knee seemed to improve.

  13. Offa Thegrid 04/02/2011 at 6:23 pm #

    First thing to do is see a good sports physio to get a proper diagnosis and stretching/exercise routine.

    Also try using a foam roller every day and stripping through the ITB. Painful as hell but works wonders.

    I did the above and also shifted my seat forwards slightly and now sorted.

    • Pete 05/02/2011 at 7:01 pm #

      Second this post. My foam roller is an essential bike accessory now and regular use keeps my ITB happy. As well as many other body parts [it can be used for many of those “need to stretch” parts of the body].

      Read more about ITB here

    • Brent 07/02/2011 at 7:29 pm #

      Third this post. I had knee pain that I couldn’t shake for months. A visit to the doctor gave me nothing, but I had fears of having to undergo surgery. Then, a physical therapist suggested the foam roller. Three weeks later, I was back on the bike, pain-free.

  14. Ruby 04/02/2011 at 7:50 pm #

    I did last year’s Dunwick Dynamo on a brand new bike and I did not set it up correctly. Result: sheer pain in my groin, calf and knee.

    Luckily i went for a cycle assesment and I was back on the bike in no time. I doubt i’ll hurt myself this coming DD.

    I went to Central-health for a full cycle assesment. Worth the money. Link to their page:

    Good Luck

    • Goonz 29/05/2012 at 12:25 pm #

      Hi I have just booked myself in for a cyclefit with these guys upon this recommendation. Have you not experienced any pain since?

      It would be good to know before I fork out c£100 for a fitting.


  15. Amoeba 04/02/2011 at 8:00 pm #

    First of all, I’d suspect saddle position and pushing too high a gear.
    Apart from that bent pedal spindle / cleat / shoe alignment.

    I wouldn’t bother with impossible medical treatments, double-blind tests show they’re no better than placebos. I’d avoid non-mainstream medicine altogether.

    I would recommend you talk to:
    a) Your GP, it’s possible that the problem isn’t cycling-related.
    b) CTC / LCC medical advisor, assuming you’re a member. They may be able to identify specific areas of concern / tests and treatments etc.

  16. Nicole 04/02/2011 at 11:20 pm #

    All the suggestions about saddle height and cleat set up are spot on I think. If you get saddle positioning wrong it can make a huge difference to leg extension and if your leg doesn’t get it’s full range of motion in a pedal cycle then you’re heading for problems. But what do I know? See a Pro, both on cycle fit and physio. You can ignore if you don’t think it’ll work for you, but if it does, it will be money well spent. At least you’ll know.

    I had a bad knee injury while skiing a couple of years back and whilst resting and physio, I bought some Arnica cream from a pharmacy in France called, imaginatively, ‘Arnican’. I think it’s triple the strength of that sold here and really, really helped me. Took the bruising down and a lot of the pain away before the longer term physio helped sort it out. Get some sent over or get some when you’re next there. It really calms the knee. I stock up and use it for everything now.

  17. Mike Smith 04/02/2011 at 11:39 pm #

    No matter how good everyone’s advice is (and some of it looks pretty good to me, a fellow knee-pain sufferer), there really is no substitute for a session with a sports physio who specialises in knee problems.

    It might not be cheap, but it will probably be worth every penny!

    Good luck with it,


  18. Becky 07/02/2011 at 3:42 pm #

    Depends on where the pain is. I have loose IT Bands, and it took a couple years to figure it out. I’d be fine riding one day and in pain the next. Since the bands were loose, stretching didn’t help. I now ride with a special strap that puts pressure where my IT band attaches just below the knee. This prevents the friction that was causing the pain. I have pretty dorky tan lines, but I was able to ride 7500 km in 3 months.

  19. Nixie 14/02/2011 at 5:57 pm #

    I took anti inflammatories , used cold pack gel rested for 5 days ,, was fine, back to spinning after that, and guess what. Knee Pain is back. Physio said inflammation used some Voltaren gell, only good for a couple of hours, pain returns. Cannot get rid of inflammation.

  20. Goonz 23/05/2012 at 10:37 am #

    Im so glad this article appeared on here!

    After my marathon 24hr london2paris ride last weekend I found that my right knee started to hurt along the last stretch of the 262miles. It got steadily worse and whilst I rested the day after I got back on the bike yesterday and the pain began.

    I’m not a very patient cyclist and started pedalling hard and the pain would come back along the way. It is right under the cap on the front and more to the left of the cap.

    I commute just under 100 miles a week and have never had this problem so I guess it could be from the over exertion?

    I have decided to take the rest of the week off the bike to recover and am also contemplating a professional bike fit to get things spot on once and for all. Expensive but probably money well spent.

    I’d hate to think I would be restricted to short rides just as I was starting to really enjoy cycling!

    • Rob 15/03/2013 at 3:40 pm #

      Hey Goonz, I have very similar issue with my right knee after a week heavy cycling in Spain in early March, lots of climbing. I’ve been messing with my saddle height and setback since then but I was thinking of getting it looked at professionally.

      Did you get that pro fit? How did it work out? Just over-exertion or did they fine something more underlying?

      Cheers, Rob

      • goonz 17/03/2013 at 9:02 pm #

        Rob hi, you wouldn’t believe it but I never actually got round to it last year. I made a few minor adjustments and it was ok and to be honest I didn’t do any other long rides to notice. I am hoping to get my act together this year and get it done.

  21. Tommy Anderson 01/11/2012 at 3:12 pm #

    I used to have pain after cycling in my knees until my physio rvideo recorded my posture and then made a recommendation of speedplay pedals. I highly recommend them if you want to ease that pain. My physiotherapist is a keen cyclist and I was so grateful he knew about these!

  22. Matthew Nicoletta 13/11/2012 at 6:58 am #

    Getting frequent muscle aches is common if you are doing some bodybuilding stuffs. If the pain is just too much, i just take some OTC pain killer.;

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