Inner Knee Pain in Cycling and How to Fix It
Knee pain is common in cycling due to the extensive movement the knee goes through during a ride. Cyclists commonly feel pain on the inside of their knee for a variety of reasons including muscular pain, arthritis, and tendonitis. Strength imbalances, poor bike fit, and poor pedaling technique can contribute to pain on the inside of the knee.
…most cases of medial knee pain can be resolved with physical therapy.
The good news is that with a combination of addressing strength impairments, discussing riding volume, and considering pedaling technique, most cases of medial knee pain can be resolved with physical therapy.
An Improper Bike Fit Can Contribute to Knee Pain and Other 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. To make things easier, we will make the assumption in this article that your bike fit is proper and you are comfortable in the position you have been fit to.
What Contributes to Inner Knee Pain in Cyclists and How Do You Fix It?
Poor Groin Strength
The Problem: The muscles in your groin and inside of your thigh are referred to as the adductors. They have multiple roles, but in cycling, they are the primary muscle used for pushing down on the pedals when you are in a bent-over position. They work with the glutes (your butt) and quads (the front of your thigh) to perform this motion and should be very strong for cycling. Two of your four hamstrings attach at the inside of your knee, and can be a victim of overuse injury if adductors are not doing their job or are fatigued
The Fix: Deep squats, lateral lunges, and lateral slide lunges.
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. Problems arise when these muscles fatigue and cause changes in your pedal stroke. A balance between all of these muscles is important for controlling the forces on the knee.
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.
Pulling Through the Bottom of the Pedal Stroke
The Problem: It is important to be able to pull backward through the bottom of your pedal stroke. A cue that coaches frequently give is to “scrape the gunk off of the bottom of your shoe.” While this is a good cue, this can eventually become overused, especially if the inside hamstrings are dominant and cause the knee to rotate in during this pull.
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 versus sticking to one for a whole ride. Romanian deadlifts are an exercise that will help build your outside hamstrings to counter the inner ones. Performing reverse slide lunges and focusing on not letting your knee rotate inwards will also be helpful in translating over to your pedal stroke.
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.