Knee Pain Cycling

KNEE PAIN CYCLING:

Knee pain and dysfunction is an unfortunate but common issue for many cyclists and triathletes.

Contributing factors, assuming well-fitting shoes, appropriate orthoses, smooth pedaling technique, include but are not limited to the following variables:

Cleat Position

Inappropriate cleat position including medial/lateral position on the shoes, medial/lateral cant angles via wedging and/or inappropriate shimming can cause dysfunctional or asymmetric recruitment of leg muscle

Cleats positioned too far forward increase toe clawing and lower leg engagement/stabilization requirements

Cleats positioned too far back, although not as problematic on the knees as cleats set too far forward, reduce the ability to quickly apply force into the pedal for climbing and sprinting which can lead to over taxed muscles

Cleats positioned too medial or lateral increase tension on the medial or lateral aspects of the knees

Cleat Float

Cleats positioned inappropriately in a rotational aspect can cause unwanted tension in the ankles, knees, hips and back

Fixed cleats with no float force the feet and knees into a fixed plane throughout the pedal stroke

Crank Length

Cranks that are too long can increase shearing forces at the ankles, knees and hips

Cranks that are too short, although not as problematic as cranks that are too long, can cause changes in leverage requiring different gearing combinations for sustained speed which can lead to knee discomfort\

Saddle Height

A seat positioned too high causes leg over extension which can lead to posterior knee discomfort

A seat positioned too low, although not as problematic as a seat too high given the same distance, causes leg under extension which can lead to anterior knee discomfort

Saddle Fore/Aft

A seat positioned too far forward can cause over recruitment of the knee extensors can lead to anterior knee issues

A seat positioned too far rearward, similar to being too high, can overtax the glutes/low back muscles leading to pelvic instability and likely posterior knee issues

Handlebar Location

A bar positioned too low and/or too far forward increases posterior chain activation in the upper and lower body leading to increased tension at all major joints can increase knee tension

A bar positioned too high and/or too close to the rider, although not as problematic as bar position too long or low, can cause a cramped rider compartment causing unwanted shoulder and arm muscle recruitment causing overall body discomfort which in turn can result in more knee tension

Tip:

Adding a heavily loaded water pack or back pack to a rider on a position optimized without the pack can lead to increased posterior chain activation from the neck to the knees causing similar issues to having a seat set too high