Does Getting a Bike Fit Help with Knee Pain?

‍Cycling is a low-impact activity, meaning you have less risk of strain or injury to your joints than high-impact exercise (like running, jumping rope, and playing tennis). Because of this, it’s often a recommended form of exercise for older people, people with mobility issues, and unfit people.

But just because it’s low-impact, it doesn’t mean there aren’t any risks of aches and pains - especially if you have a habit of pushing yourself too hard or are dealing with pre-existing injuries.

Here are some of the common areas cyclists experience knee pain:

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• Anterior knee pain (pain in the front of the knee)
• Posterior knee pain (pain at the back of the knee)
• Lateral knee pain (pain on the outside of the knee)
• Medial knee pain (pain on the inside of the knee)

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The causes of knee pain in cyclists are as varied as cyclists themselves, and even something unexpected (like having your handlebars too low) can fatigue your lower back. This causes your natural movement to change, leading to knee pain.

While knee pain isn’t rare among cyclists, the good news is that more often than not, the pain isn’t chronic and can be fixed by fitting your bike correctly, improving your core strength, or a combination of both.

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How Your Bike Should Fit

In an ideal world, you’d buy a bike from your local bike shop, and a store assistant should be able to help with a basic setup.

If you bought your bike used or online, you wouldn’t have had many opportunities to ask questions and make the necessary adjustments. Here’s a fantastic video that outlines how you can do a basic bicycle fit:

https://www.youtube.com/watch?v=fiHt9uiMpio&ab_channel=BikeShopGirl

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Handlebars

If your handlebars are too low, or you struggle with flexibility, you’re likely to also be experiencing pain in your neck and upper back. If you’re constantly leaning forward to reach your handlebars, this can also lead to knee pain as your back becomes fatigued and your natural range of motion is disturbed.

Finding the optimum height of your handlebar is tricky without a professional bike fit because it all comes down to what kind and size of bike you’re riding, how long your arms are, and ultimately what’s comfortable for your body.

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Saddle

Proper adjustment of your seat height, angle and position is important in order to avoid injury and improve cycling efficiency. Three primary adjustments can be made to the saddle: The seat height, seat angle and front-to-back adjustments.

One of the most frequent mistakes beginner cyclists make is having their saddle too low.This causes stress on the knees, especially around the kneecap.

When you’re sitting in the saddle with your foot on the pedal, and the pedal is at the lowest point of the revolution, your leg should be fully extended. Make sure that your leg isn’t straining to reach the furthest point in your pedaling motion - it should be comfortably straight with a very slight micro-bend in the knee.

If your seat is tilted too forward, your knees and upper body will exert a massive amount of effort to keep you from slipping forward. If you’re a beginner, you should start with your saddle parallel to the ground, and as you define your riding style, you can experiment with tilting it backward or forwards by a few degrees.

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Cleats

If you’re riding with cleats, your feet are the most inflexible part of your body. If they’re misaligned, it can cause problems everywhere from your ankles to your knees to your lower back - so it’s vital you get the fit right.

• Start by putting your shoes on and standing in an upright position.
• Press on the left and right sides of your foot to feel where the big toe and small toe protrude on the sides.
• Put masking tape on those points and use a ruler to figure out where the centrepoint is.
• Wherever the centrepoint of this imaginary line is, is where you want to install the pedal axle.

From there, you can refine the angle of your cleats. When it’s time to hop on your bike, ensure your cleats center the ball of your foot over each pedal axle. This is easier if you have a friend or family member double-check where the ball of your foot is sitting.

Once it’s in the correct position, pedal and pay attention to your ankles, knees, and hips to check whether there’s any pain or tension. If it doesn’t feel comfortable, make adjustments to the position and angle of your cleats.

When to Get a Professional Bike Fit

The human body is weird, wonderful, and complicated. While a DIY bike fit can help you address some of the more minor adjustments you can make at home, the only way to be sure your bike fits you properly is to get a professional fit.

You might not want to cough up the cash for a bike fit right away if you’re a beginner cyclist, but if any of the below apply to you, you should consider consulting a professional:

• You recently started cycling.
• You started cycling again after a prolonged period of time off the bike.
• You have a pre-existing injury.
• You want to improve your performance.
• You’ve tried a DIY bike fit, but it still doesn’t feel quite right.
• You’re experiencing pain that’s putting you off cycling.
• Your body has recently experienced drastic changes (e.g., weight loss, weight gain, pregnancy).

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Exercises to Strengthen Your Knees

If you’ve gotten a professional bike fit but are still experiencing knee pain while cycling, it’s probably not your bike fit that’s the problem. If you’re new to cycling or recently increased how long and hard you train, it could be that you’ve simply overexerted your body and need to take a break until your pain is gone.

If you have any old injuries - even from decades ago - it’s worth speaking to a physiotherapist or doctor. Your other muscles may have compensated for the injury over time, making you more vulnerable to re-injury.

Once you’ve managed to figure out the source of your knee pain, here are some exercises you can do to help them become less prone to injury:

• Squats. Depending on where you are in your fitness journey, you can do wall squats or weighted squats.
• Step-ups. You can do this on a raised platform or the first stair of a staircase.
• Toe touches. These stretch the hamstrings at the back of the legs.
• Quadriceps stretch. Bend one knee and grab your ankle, pressing it towards your glutes.
• Side leg raises. Lie on one side supporting your head, and raise your upper leg as high as you comfortably can.

Remember, no exercise should be painful. If you feel a sharp, shooting pain while performing any of these exercises, stop and check in with your physiotherapist or doctor before doing any more exercises.