Front Of Knee Pain in Cycling and How To Fix It
Knee pain is common in cycling due to the amount of use the knee goes through during a ride. Cyclists commonly feel pain on the front or top of their knee due to strain over the top of the pedal stroke into the push-down phase of the pedal stroke. Strength imbalances, poor bike fit, and poor pedaling technique can cause pain in the front of the knee.
The good news is with a combination of addressing strength impairments, discussing riding volume, and considering pedaling technique, most cases of anterior knee pain can be resolved with physical therapy.
An Improper Bike Fit Can Contribute to Many Injuries
A physical therapist will be able to help you determine if your injury is more due to physical causes, or due to your bike fit. When reading this article, we will make the assumption that your bike fit is proper and you are comfortable in the position you have been fit to.
What Contributes to Anterior Knee Pain in Cyclists and How Do You Fix It?
Overused Pedaling Mechanics
The problem: If you haven’t thought about your pedal stroke, it may be time to. There may not be a “bad” pedal stroke, but overusing one style past fatigue may become problematic. Pedaling at high power/resistance in a circle can increase the stress on the front of the knee over the top of the pedal stroke. This will be more exaggerated at lower cadences but can happen at high cadences with high power as well. Not being able to drop your heel during the “push down” phase of the pedal stroke can also lead to increased stress through the knee cap.
The Fix: Thinking about your mechanics and having the ability to use different pedaling strategies is crucial. It is probably more important to be able to change up the way you pedal vs. sticking to one for a whole ride.
Poor Quad Flexibility
The Problem: One of your four quadriceps, the Rectus Femoris, tends to become tight in cyclists due to the position we spend so much time in. This can lead to increased compression of the knee cap against the femur and eventually become painful.
The Fix: A combination of stretching your quad while lying on your belly and surprisingly strengthening your core can help remedy this.
Poor Hamstring and Hip Flexibility
The Problem: Are you noticing a theme here? Hip stiffness may impact your ability to pedal fluidly or apply power at multiple angles. Eventually, this can lead to compensation straining the front of the knee. Stiff hamstrings will limit the ability of the quads to work efficiently as the foot gets further away from the hip.
The Fix: You could stretch if you want, but strengthening your hips through a full range of motion will most likely be the best use of your time. Lunge variations and Romanian Deadlifts will be phenomenal at improving how well your hips move while improving their strength.
Poor Quad strength
The Problem: You may think that riding a bike would be enough to get strong quads, but endurance training isn’t always enough for you to get strong. Endurance is your ability to repeat strength over and over. If your strength is poor, you may run into issues with endurance exercise. The Quad is the primary muscle in charge of decreasing the force on the knee joint and the knee cap.
The Fix: The simple knee extension machine at the gym is phenomenal for improving quad strength. Strong muscles allow your joints to handle more activity and decrease how much force goes through them. Squat variations, especially single-leg squats can also be beneficial in improving quad and whole-leg strength.
Core, and Hip Extension Strength
The Problem: Yet another theme. Your quads and hip extensors (adductors, glutes, hamstrings) work together on the downstroke of your pedal stroke. If the hip extensors are weak, the quad and front of your knee may get overused!
The Fix: Get That Hip Strong! Reverse lunges are my favorite exercise for this issue. Core strength is essential in being able to use strong hips well. Some isolated core exercises will be helpful for a short period of time, but this needs to be progressed into standing, heavy exercises like deadlifts to continue improvement that carries over to hard exercise.
I’m Still in Pain, and I Need Help.
If you’re having trouble managing your pain and recovering from an injury, request an appointment today with one of our highly trained physical therapists. At Summit Physical Therapy, you are always evaluated and treated by a licensed physical therapist which means the highest quality care and treatment for your injury—to get you back to doing what you love.
DISCLAIMER: This information does not substitute for medical advice.