No matter how long you have been cycling, you may have knee pain cycling in your life.

As is known that most of the knee pain occurs because of cycling overuse, but that is not the only cause why you experience knee pain cycling. Factors that affect you knee, and cause knee pain, can be specific to cycling, specific to your cycle (height of saddle, fit of bike, appropriate pedals and cleats), or because of your muscles being damaged or weak.

Knee pain cycling causes is divided on the basis of the area this pain is felt around, that is, at the front (anterior pain), at the back (posterior pain), on the sides (pain laterally), or on inside (pain medially).

In this article we have discussed:

Further in this article we are going to discuss:

Before starting to discuss about causes, we will have to go through basic anatomy of the knee for you to understand the cause of your pain in a better way.

Knee is made up by two different joints- one is between the femur (or what is known as the thigh bone) and tibia (also known as shin bone). This joint is known as the tibiofemoral joint. Another joint is patellofemoral joint. This joint is made between your knee cap (or patella) and the thigh bone (or femur).

Patella is connected with quadricep group of muscles (which includes vastus medialis, vastus lateralis, vastus intermedius, and rectus femoris) with the help of a tendon of the same name. It is also attached to tibia bone with the help of tendon of patella.

On the posterior side, there is a group of three muscles called the hamstring (which includes semitendinosus, biceps femoris, and semimembranosus). Also, to keep in mind, there is a very thick band of tissue called the Iliotibial band that runs the whole length of your leg on the outer side.



This is one of the most common presentations of knee pain cycling causes. Anterior side of the knee is made up of your knee cap or what is known as patella.

Anterior side knee pain is mostly because of pedalling.

Pedalling affects our knee movement via patellofemoral joint and quadricep muscles. This might cause a lot of pain, which might be brought under the single term of patellofemoral pain syndrome.

If you are someone who is involved in aggressive sports, or severe cycling the knee pain cycling causes may be coming from a condition what is known as patellar tendonitis. This occurs when the tendon that connects your kneecap (or patella) to the shinbone (or tibia) is injured and inflamed.

All these injuries may cause a diffused and generalized pain in the anterior side of your knee and around it.


To manage is, and thereby save yourself from further damage, you should try keeping your leg straight. Not only should you take a break from cycling but also anything that makes you bend your knees as you are going to put stress on your patellofemoral joint.



Because, as already mentioned, on the posterior side of your knee Hamstring muscles (semitendinosus, biceps femoris, and semimembranosus) are present, hence any injury to this group of muscles causes knee pain in and around the posterior side of the knee.

This usually happens because of using poorly fitted cycle equipment- usually because saddle height is very high.

Whenever you sit on a saddle that is very high, you stretch your hamstring muscles (semitendinosus, biceps femoris, and semimembranosus) way too much which causes you severe pain.

Because this pain is at the back of your knee your doctor might have to distinguish it with another condition that occurs at the posterior side of your knee called Baker’s cyst, particularly if your pain doesn’t go away and remains no matter how much rest you take.

Treatment and Prevention:

To get away with the pain, you have to take complete rest. You can use RICE technique (where R stands for rest, I in the word stands for ice compression, C stands for a tight compress, and E stands for elevation in case you have a swollen joint). Do not forget to check the height of your saddle, and fix it to prevent yourself from getting in same situation.



Lateral side means the side of your knee that faces outwards, and medial what faces inwards. Knee pain cycling causes on lateral and medial sides is mainly because of poorly fitted cleats.

Lateral side pain of knee may also be caused by iliotibial syndrome, which causes a sharp pain when your iliotibial band is injured and inflamed.

Prevention and Treatment:

To get rid of the pain, do some stretching exercises and use RICE (rest, ice, compression, elevation) technique to relieve yourself of the pain. To prevent this pain to occur again you will have to check if your cleats are properly fit.



There can be many presentations of knee pain cycling causes. Based on what anatomical structure is injured and how severe the injury is you will have a set of symptoms.

Some of the presentations are:

  • Iliotibial band syndrome: It occurs when the iliotibial band of your leg is injured and eventually inflamed. The pain usually starts as a mild pain, and eventually grows very sharp and feels like someone is stabbing you.
  • Patellofemoral pain syndrome: The pain it causes is generally in the anterior side of the knee. But it is not limited to anterior part only, it can also involve areas around or also the posterior part. Along with pain, you may also hear popping sounds and your knee would be swollen.
  • Hamstring tendinopathy: This happens when hamstring muscles (semitendinosus, biceps femoris, and semimembranosus) are overused and stretched more than required.



Cycling is fun only if the fit is perfect. In case of cycling on a poorly-fit bike, you’ll experience knee pain cycling causes.

What is important for a good-fit bike?

  1. A frame size that is proper:

The bike shop you buy your bike from should help you with this. Bike frames are specifically built for according to your gender, and height.

If you’re borrowing cycle from someone, or buying it from someone other than who owns a bike shop, you’ll have to do this simple thing- stand over your bile, and lift it up till the upper tube comes in contact with your crotch, and see if the wheels of your bike are 1-2 inches (2.5-5cm) off the ground.

  1. Right height of the seat:

Bike seat is also known as the saddle. There are a few points to know about having a right seat height.

Heel on pedal:

You sit on the saddle, and height of it should be set so that your leg does not have a bend at the knee (fully extended) when your heel is on the pedal when the downward stroke is set at its lowest.

Inseam formulas:

You have to measure the inseams of your legs (in centimetres). It is said and popularly acclaimed to multiply this amount with 1.09 to check the distance from the top of seat to the top of pedal when downward stroke is set at lowest.

  1. Angle of the saddle:

For most of the people seat angle is set parallelly to the ground. But according to professional cyclists, nose of the saddle (or your bike seat) should be angled down a little bit.

  1. Handlebar Height:

Handlebars should be adjusted in a way that they are above the saddle (or seat) height to have a comfortable ride. However, if you’re racing enthusiastic, you may have to set your handlebars 5-8cm below your seat to have a forward-leaning position.

You can fine tune your bike-fit by 1/4-1/2cm a time and ride a few kilometres, then decide whether you want to keep the adjustments or change them.



We always start with what is most important and easy to manage. First and foremost, what you can do is to check your gear and equipment. Saddle height, paddles, and cleats matter in what causes you pain. Knee pain cycling causes you can also be because of overexertion. You can always spend less hours cycling, or take proper precautions while cycling for longer hours.

Get a proper bide to ride. Learn exercises and religiously follow them to stretch your body and muscles, especially those around your knees. Keeping yourself warm while cycling so that your muscles and joints are relaxed.

If you experience knee pain on the side, you can try lowering your seat and moving it a bit forward. If you experience pain in the front of knee, you can raise your seat or move it backward. If pain is at the back of knee, you can lower your seat or saddle.



Knee pain cycling causes is usually temporary, which means it goes away with proper rest and care. The basic thing that you can do if your knee pains because of cycling is to take enough rest, do light exercises, and then go back to cycling for shorter periods.

You are recommended to take rest and go to cycling when you no longer feel pain (which should be in a few days). If you feel like your pain is not manageable, you can take over-the-counter pain relievers. Try using RICE method (taking proper rest, using ice compression, wearing a tight compression across the joint, and elevating your legs to get the swelling away).



Even though the knee pain cycling causes is not going to stay for a long time, but there are some cases where cycling might have done a lot of damage causing you severe pain and discomfort, for which you will have to see a doctor.

There are certain signs or what are known as red flags, which when seen, you should see a doctor as soon as you can. These red flags include:

  • Severe, sharp pain.
  • Pain that worsens with time.
  • Pain that doesn’t go away with home-remedies.
  • Pain that meddles with your daily life and activities.
  • Swelling of the joint.
  • Knee joint getting locked.
  • Popping or cracking sound of the joint.
  • Numbness or weird feeling in knee.
  • Pins and needles in leg, or back.

Even if you see any of the above-mentioned symptoms, there is no need to be afraid. Your doctor will get a thorough check-up, run some imaging tests to get a better view at what is causing you knee pain. Remember that all these injuries, no matter how serious, are reversible, and will not cause you any irreversible damage.



Knee is a complex joint which, not only carries all our body weight, but also is used (sometimes overused) in sports- cycling being one of them. Knee pain cycling causes can be because of longer hours of cycling, because of using poorly fitted equipment be it saddle or the cleats, and also injuries to your muscles and associated area and structures of your knee joint.

Based on the severity of your injury and the type of cause, you’ll find yourself in pain in different areas of your knee- be it anteriorly, posteriorly, laterally or medially.

Knee pain cycling causes usually goes away with you taking proper rest and with some home-remedies. But in case the pain persists, worsens, or you see some new symptoms developing you are recommended to see a doctor.


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