Pain versus Gain: Cycling Knee Pain

In the sport of cycling, knee injuries are some of the most common injuries. Cycling knee pain is often caused by iliotibial band syndrome. The IT band is a fibrous band of tissue that runs along the outside of the leg from the knee to the hip. When the band tightens and rubs across the sharp bones of the hip or the knee, severe pain can occur. For cyclists, tight and inflexible muscles in the lower extremities can worsen the condition, meaning cyclists with more muscular builds are actually more at risk for cycling knee pain.

Prevention and Treatment

Cycling knee pain is usually caused from overuse. Cyclists new to the sport or cyclists who are just beginning their spring training programs often attempt to do too much too fast, resulting in pain and injury. The first few weeks of any training program, regardless of the cyclist’s expertise, should be taken slow, with low pedal resistance. Hard riding and hill work should be limited, and stretching, especially in the lower limbs, should be added.

Cycling knee pain is most commonly caused by poor saddle height, poor crank length, excessively high gear use, poor cleat alignment or too much added leg work in the gym. Also, certain individual anatomies may make some cyclists more prone to cycling knee pain. For these individuals, added precautions should be taken regardless of the season. Some cycling knee pain is not caused by the knees at all. Week muscles in the lower back can often put extra stress on the muscles and joints of the legs; regardless of their sport, cyclists should always include lower back exercises in their weight training routines.

Cycling knee pain can be treated in numerous ways, but usually cyclists are unwilling to take a break and end up causing more injury in the long run. Cycling knee pain usually develops slowly over a number of days—it rarely happens suddenly and is usually not an emergency. Most competitive athletes have a fear of resting, yet resting is the most effective treatment of any cycling knee pain and most other cycling-related injuries. Cyclists should always visit their primary care physicians or sports medicine physicians first whenever consistent pain is felt.

Rest is the most helpful medicine for any kind of injury to the knee. After rest, rehabilitation is necessary. Cyclists should cut back their mileage and use lower gears for a few weeks. Leg work at the gym should also be reduced, but stretching should be increased. Drugs such as Tylenol or Motrin are useful for cycling knee pain, but they do not solve the problem—taking pills in order to bike through the pain is not the right use of medication.