Real Advice: Avoiding Knee Pain

Knee pain is one of the most common complaints from cyclists of all levels. Whether you’re a seasoned pro or just starting out, sudden knee pain can be severe enough to make you want to stop riding altogether. But a fix can be easier than you think.

Cycling is usually a pretty easy activity to engage in—especially for people who have bad knees or other issues. It’s a no-impact, single plain exercise that is easy on joints and other tissues that can be stressed by activities such as running. However, because it is a highly repetitive exercise, improper technique or fit can lead to knee issues.

The good news is that alleviating knee pain can be fairly straight forward, and can usually be fixed with a few simple alterations to your riding style and bike fit. Please remember though that this is only a rough guide. For persistent or severe knee pain, you should always consult with a doctor or physical therapist. Bike fit can also be fairly complicated, so we recommend that you visit one of our retail locations and have your local Spin Doctor professionally fit your bike for you.

For a more in-depth guide to bike fit, check out our video.


1. Saddle Height

Bike fit is incredibly important. You will spend several hours seated in a very small number of positions, forcing your legs through the same motions over and over again. Even the smallest problems with bike fit can cause big problems for your knees. The biggest mistake most riders make is having a saddle height that is too low, which can cause huge stress to the tendons in the front of the knee and the Achilles tendon. Conversely, a saddle that is too high will cause the knee to hyper-extend, stressing the tendons in the back of the knee and the menisci in the front.

A rough guide to proper saddle height is this: sitting on your saddle with your hips squared, you should be able to place the heel of your shoe on the pedal at the bottom of the pedal stroke (6 o’clock position) and lock out your knee. If your knee is bent or if you can stand up, it’s too low. If you can’t reach it or have to lean to one side, it is too high.

2. Saddle Position

Having a saddle that is too far forward or too far back will cause some of the same problems as saddle height. If it’s too far forward, you will stress the patellar tendons in the front of the knee. Too far back, and you’ll end up hyper-extending your knee.

To find the proper saddle position, sit on your saddle and move the pedals to the 9 and 3 o’clock positions. Using a string with a weight on the end, place one of the string on the front of your knee cap and let the weighted end hang down. The string should be in line with the end of the crank arm.


3. Cleat Position

Don’t just slap your cleats on to your shoes and call it a day. Most people’s feet are either toed slightly inward or outward, and the cleats on your shoes need to be adjusted to account for this. Having your cleats rotated too far inward can cause medial (inside) knee pain by stressing the medial meniscus and the pes anserine bursa. Cleats rotated too far outwards will irritate the patellar tendon and the IT band. If your knee pain is related to cleat position, you may also benefit from using a cleat or pedal system that offers more float, like Time or Speedplay.

Additionally, fore and aft cleat position needs to be accounted for. Having a cleat too far forward can cause Achilles tendonitis, while a cleat that is too far back can cause you to alter the way you sit on the saddle, and push your knee too far forward. Ideally, the cleat should be centered 5mm behind the ball of the foot.

For more information on cleat position, click here.


4. Spin, Don’t Mash

Spinning is your knee’s friend. Mashing is their worst enemy. We all want to go fast and push big gears, but unless you’ve trained for it this is usually a recipe for disaster. Pedaling at a cadence of 70-100 RPM in an easier gear is better for you and your knees than pushing a bigger gear at a lower RPM. Plus, most cyclists are at their most efficient when they pedal at about 90 RPM. Don’t believe us? Just look at the pro’s. Most of them are twirling away for a good portion of the race.


5. Crank Arms

Another issue could be that your crank arms are too long, forcing your legs to push a larger lever than they’re able to. A difference of even a millimeter or two can have a huge impact on how much work your leg is forced to do. If you’re having persistent pain in the front of your knees or in the VMO muscle, you may want to consider moving down to a different crank size.


6. Strengthening and Lengthening

Sometimes our bodies just aren’t ready to do what we’re asking them to. If you’re having persistent knee pain, you might want to consider a weight training and flexibility program. Most pro cyclists usually take several months off the bike in the winter to lift weights, do yoga, and work on strengthening muscles that we don’t use much in cycling.

Working on stretching out areas like the IT band, quads, hamstrings and calves can help improve your range of motion and loosen tight areas that might be forcing your leg to move in a constricted, harmful way. Using a foam roller can also help to release muscle adhesions and knots, improving your range of motion.

Lifting weights can help your muscles, ligaments and tendons become stronger and more accustomed to doing heavy workloads, making you stronger and more resistant to injury on the bike.

Before beginning any weight or flexibility program, always consult with a physician or physical trainer.


7. Anatomical Differences

This is where visiting a bike fitter can be a real benefit.  We’re all built a little differently, and the reality is that shoes, pedals, saddles and bike frames are all built to accommodate most people—but not all people. If you have a leg length discrepancy of even a few centimeters, have knock knees, a valgus foot position, or another anatomical difference, you will want to visit one of our Spin Doctor bike fitters who can help you find insoles, spacers, wedges, and other solutions to some of these fairly common problems.



Front of Knee:

Possible Issues: Patellar tendonitis, patellofemoral pain syndrome, softening of cartilage under kneecap, quadriceps tendonitis, anatomical differences, overuse

Possible Causes: Saddle too low or too far forward, pushing too big of a gear, crank arms too long, cleats rotated too far outward (forcing toes inward)


Back of Knee:

Possible Issues: ACL or MCL strain, Baker’s cyst, overuse

Possible Causes: Saddle to high or too far forward


Medial (Inside) Knee:

Possible Issues: Pes anserine bursitis, meniscus damage, VMO strain, overuse

Possible Causes: Cleats rotated too far inward (forcing toes outward), knock knees, tight inner thigh muscles, saddle height too high


Anterior (Outside) Knee:

Possible Issues: IT Band Syndrome, meniscus damage, overuse

Possible Causes: Cleats rotated too far outward (forcing toes inward), saddle too high, saddle too far back, tight IT band

General Cycling