In this article, you will find out everything you need to know about knee pain caused by cycling and the most effective ways to treat it, including an advanced treatment called prolotherapy.
Cycling Knee Pain Overview
Cycling knee pain is widespread among cyclists, both beginners and professionals. Research shows that about 94% of professional cyclists experience a knee injury annually, and 23% report knee pain. Studies indicate that 36% to 62% of cyclists experience knee pain, making it the most frequent and recurring injury in the sport.[1]
The most common cause is “patellofemoral pain syndrome,” which results from repetitive knee movement and high-impact use. This can limit mobility and normal knee function.
In Which Region Knee Pain Occurs Due to Cycling
- Anterior knee pain (front of the knee)
- Posterior knee pain (back of the knee)
- Lateral or medial knee pain (sides of the knee)
- Iliotibial band syndrome
Anterior Knee Pain
Pain at the front of the knee, around the kneecap. It’s often caused by stress on the patellofemoral joint during pedaling, especially with improper knee alignment.
Posterior Knee Pain
Pain at the back of the knee, less common, often due to over-straightening the knee or hamstring overuse.
Lateral or Medial Knee Pain
Pain on the sides of the knee, often persistent and can affect the feet. It’s frequently related to improper bike fit or technique.
Iliotibial Band Syndrome
A rigid band of tissue runs from the pelvis to below the knee. Repetitive motion can cause irritation and pain as the band moves over the thigh bone, especially during knee flexion and extension.
Common Causes of Knee Pain
Ageing
As cyclists age, bone and cartilage can weaken, especially without proper nutrition. This increases the risk of knee pain. Cyclists should prioritize nutrition and exercises that support knee cartilage regeneration to maintain joint health and prevent injuries.
Anterior Cruciate Ligament (ACL) Injury
The ACL connects the shin bone to the thigh bone. High-impact activities, including cycling, can strain or tear this ligament, causing pain and instability.
Knee Bursitis
Inflammation of the bursa (a fluid-filled sac) can result from repetitive motion or trauma, causing pain and swelling.
Dislocated Kneecap
The kneecap can become dislodged, leading to pain and limited movement.
Previous Injury or Fractures
Old injuries or fractures can be aggravated by cycling, causing pain, swelling, and stiffness.
Wrong Technique
Incorrect cleat placement, saddle height, crank length, or bike fit can all contribute to knee pain. Professional bike fitting and proper technique are essential for injury prevention.
Symptoms of Knee Pain Due to Cycling
- Swelling and redness around the knee
- Difficulty moving the knee
- Weakness and cracking sounds
- Inability to bear weight
- Fever (in severe cases)
- Limited extension and flexion
How to Treat Cycling Knee Pain
Prolotherapy
The structures in and around the knees have a poor blood supply, which is why they can struggle to heal on their own. It is the oxygen and nutrients in our blood supply that help to heal these structures and reduce knee pain.
Prolotherapy involves the injection of a regenerative solution into these structures to provide a direct supply of what is needed to heal them and provide pain relief.
As the treatment is helping to treat the root cause of the problem, it is deemed to be a permanent fix.
Treatment is based on the underlying cause. Mild cases may be managed at home, while severe cases require medical attention.
- Pain relievers and anti-inflammatory medications
- Physiotherapy and targeted strength exercises
- Over-the-counter anti-inflammatories
- Surgery (rare, for severe or unresponsive cases)
How Is it Diagnosed?
Diagnosis may include:
- X-rays: To check for structural issues
- MRI: To evaluate soft tissue injuries
- CT Scan: For detailed imaging of inflammation or injury
- Ultrasound: To visualize soft tissue in real time
- Blood tests: To rule out arthritis or gout
Once diagnosed, your doctor may recommend treatments for immediate relief for gout pain or other underlying conditions, as well as lifestyle changes and physical therapy.
Preventive Measures to Avoid Knee Pain Due to Cycling
Be Careful While Cycling
Avoid pushing too big a gear, which can strain your knees.
Avoid Continuous Cycling
Take regular breaks to relax your knee joints and prevent overuse.
Maintain a Healthy Weight
Excess weight increases stress on the knees. Weight management is crucial for injury prevention.
Appropriate Sitting Position on Cycle
Ensure your saddle height and position are correct. Poor posture or saddle height can alter knee biomechanics and cause pain. Invest in a bike with comfortable handlebars and a professional fit.
Strengthen Your Back and Core
A strong core (abs, lower back, hip flexors, glutes) supports your legs and knees. Incorporate strength training into your routine to prevent injuries.
Frequently Asked Questions
What is the most common cause of knee pain in cyclists?
Patellofemoral pain syndrome is the most common cause, resulting from repetitive knee movement and improper bike fit.
How can I prevent knee pain while cycling?
Ensure proper bike fit, use correct technique, take breaks, maintain a healthy weight, and strengthen your core and leg muscles.
Is prolotherapy safe and effective for cycling knee pain?
Yes, prolotherapy is considered safe when performed by a qualified practitioner and has shown benefits for pain relief and joint regeneration.
When should I see a doctor for cycling knee pain?
If you experience severe pain, swelling, fever, or inability to move your knee, consult a healthcare professional promptly.
Can cycling knee pain be cured without surgery?
Most cases improve with conservative treatments such as rest, physiotherapy, medication, and prolotherapy. Surgery is rarely needed.
Contact ProHealth Clinic Today for Your FREE 15-Minute Discovery Call
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Author Bio
Having performed over 10,000 procedures, Mr Eaton is one of the UK’s leading practitioners in the field of treating knee pain, with patients travelling to see him from across the UK, Europe, and the Middle East.
With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with knee pain and providing effective treatment options to alleviate them.
He qualified in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy. He continued on to complete further qualifications at the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.
Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
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References
- Clinic, M. (2021, May 11). Knee pain. Mayo Clinic. Retrieved January 9, 2022, from https://www.mayoclinic.org/diseases-conditions/knee-pain/symptoms-causes/syc-2035084
- Advanced Solutions International, I. (2019). Preventing cycling injuries. Cycling Injury Prevention. Retrieved January 9, 2022, from https://www.stopsportsinjuries.org/STOP/STOP/Prevent_Injuries/Cycling_Injury_Prevention.aspx
- Health, B. (2021). Cycling – preventing injury. Cycling – preventing injury – Better Health Channel. Retrieved January 9, 2022, from https://www.betterhealth.vic.gov.au/health/healthyliving/cycling-preventing-injury
- Pedia, P. (2022). Cyclist’s knee. Physiopedia. Retrieved January 9, 2022, from https://www.physio-pedia.com/Cyclist%27s_Knee
- Radar, B. (2021, April 13). Why do my knees hurt? cycling knee pain explained, and how to manage it. BikeRadar. Retrieved January 9, 2022, from https://www.bikeradar.com/advice/fitness-and-training/cycling-knee-pain-the-problem-areas/