How Do I Prevent Knee Pain?

It’s a common complaint for cyclists, but there’s a lot you can do to avoid or overcome knee pain.

- Michael Donlevy

Knees are important. Without them we’d be like elephants – unable to jump or ride a bike – so it seems cruel that for so many of us they can be a source of pain. Yet it can be prevented, and cycling can be a way of warding off and even curing knee problems.

‘Knee pain generally stems from a muscular weakness or tightness, or both,’ says Paul Butler of PB Cycle Coaching. ‘If one muscle is tight it pulls the kneecap one way, but if the opposing muscle is weak it can’t pull the kneecap back the other way to keep it aligned. This leads to cartilage wear behind the kneecap – and pain. Other causes include infections, repeated impact from running and knocks from falling, plus degenerative cartilage wear brought on by ageing.’

‘In my experience, most cyclists with knee pain have come to cycling from running,’ says sports therapist Ian Holmes, a soigneur for Madison Genesis. He takes a slightly different view to Butler: ‘The knee is a complicated joint, but most knee problems are with the soft tissue and can be improved by cycling. The fixed position of the knee actually reduces knee pain for most.’

You can prevent – or ease – knee pain by refining your technique. ‘You can learn to use some muscles more than others,’ says Butler. ‘When pedalling, most of the work is done by the quadriceps [thighs] and gluteals [buttocks] on the down stroke and, if you pull up on the pedals, by the hamstrings on the upstroke. The common imbalance among cyclists is being too quad-dominant’. The glutes don’t do enough of the pushing, so the quads pull excessively on the knee.’

If the bike fits