Knee pain is one of the most common injuries among athletes. In fact, a 2010 study of professional cyclists found that knee pain was the cause for over half of the time spent off the bike. As one of the most complex joints in the body, it makes sense that it’s often one of the first places we experience pain. That being said, it is always better to try and prevent a problem then it is to deal with it. Knee stretches for cyclists can help keep all the components in the knee remain flexible and in place.
Pedaling requires work from the quads to straighten the knee and push the pedal forward and downward with enough power to propel the bike forward. In addition, the IT band contributes to that same movement, although less intensively. These efforts, although low-impact, can lead to problems with knee pain. Tendinitis of the kneecap can be a painful condition, causing you to lose power in your pedal stroke and even keep you off your bike. Stretching these muscles can both prevent and treat these issues, resulting in a healthy, flexible range of motion.
Many cyclists think knee pain means taking time away from the bike and resting up, but that’s not necessarily true. It could be caused by something as simple as a saddle adjustment or new cleats. So, if you’re experiencing knee pain, figure out what it may be stemming from and adjust your training accordingly. To help in recovery, and to prevent further knee pain, try stretching the muscles surrounding the knee on a regular basis.
The Anatomy of the Knee
The first step to preventing knee pain is to understand how the joint works, and what can go wrong. In simplified terms, the knee is a hinge with the quadriceps pulling the knee straight, and the hamstrings bending it. The iliotibial band (ITB) runs down the outside of the thigh and into the outside of the knee, connected at the other end to the glutes and hip flexors. The patella (kneecap) acts as a hinge and a connection point between it all.
To understand knee pain it is helpful to have a basic idea of what lies beneath the skin. In simplistic terms, think of the knee joint as a hinge where the quadriceps muscles pull the knee straight and the hamstring muscles bend the knee. The quadriceps run from the front of the femur (thigh bone) to the patella (knee cap). The patella acts as a pulley to increase the force generated by quadriceps which creates a greater torque on the tibia (shin bone).
To make matters more complicated, the ITB runs down the outside of the thigh and blends into the outside of the knee. ITB stands for iliotibial band and is a well known potential source of trouble for cyclists, runners and active people in general. The ITB is also attached to your gluteals (buttock muscles) and a hip flexors. Often when looking for the source of knee pain we have to pay close attention to hip flexibility and control.
Types of Knee Pain
Knee pain can show up in a variety of forms and for different reasons. These are some of the main types and common causes:
1. Anterior Knee Pain
Anterior knee pain is at the front of the knee, on and around the kneecap (patella). It is most commonly caused by overuse. The quads are attached to the shin via the kneecap so each time you pedal, forces are transmitted across the joint, essentially squishing it against the thigh bone. The part of the tendon attached to the kneecap can become inflamed and sore to the touch. Often referred to as ‘runner’s knee,’ it can happen to cyclists as well.
2. Posterior Knee Pain
The fair less common posterior knee pain shows up behind the knee and is usually a more simple diagnosis. Overextending the knee, with a saddle that is too high or too far back, causes posterior knee pain in most cases, so make sure your saddle is the proper height and adjustment for you.
3. Medial & Lateral Knee Pain
Pain located at the sides of knee in the collateral ligaments is most commonly caused by the feet. In cycling, this would come down to your cycling shoes or the position of the cleat. How far apart your feet are positioned can stress one of the collaterals, causing medial or lateral knee pain during or after a ride.
4. Iliotibial Band (IT Band) Syndrome
The IT band, running along the outside of the thigh from the pelvis to just below the knee, is a thick strap of tissue that can often become tight or inflamed. This is usually caused by over use, weakness of the gluteus medius muscle, or cleat placement. If the IT band has become inflamed, then rest and ice are in order. If it is tight and sore, then regular stretching and rolling will be your best course of action.
What can cause knee pain?
Although cycling is a low impact sport, too much of anything can lead to stress and strain on the body. Pedalling is a repetitive motion with the constant bending and extending motions flexing the knees and hips. Naturally, with overuse these are the most common sites of chronic-use injury.
Too much too soon
The number one cause of knee pain with cyclists is going too hard or far too soon. It is great to challenge yourself, but going further than your ligaments and muscles can handle will only hinder you progress. Endurance is something that is built up over time, conditioning your muscles over miles and hours. Ligaments take even longer to develop than muscles, with issues often arising from tightness or inflamation.
Improper bike fit
The little adjustments you can make to your bike can make all the difference when it comes to addressing or avoiding knee pain. The height and position of your saddle and the placement of cleats on the bottoms of your cycling shoes can cause or help avoid knee pain, depending on how well they are adjusted for you.
Not Enough Stretching
Flexibility or lack of, is a cyclists nemesis. Eventually if you do not stretch or roll your muscles will tighten so much that you will have difficulty walking never mind riding. Make sure to do stretches that especially focus on the muscles surrounding the knee (see below).
4 Best Stretches for Cyclists to Treat Knee Pain
Bilateral Hamstring Stretch
This stretch is effective for all cyclists because of the involvement of the knee flexor muscles in the repetitive pedaling motion. It is also great for those who experience discomfort in the inner or outer face of the knee, which likely originates at the insertion of the ischiotibials.
Stand with you feet shoulder width apart and slow bend at your hips towards the floor. Let your arms hang, or place them on the floor if you can. step your hands down to the floor if you can. Your knees should be straight, but not overextended or locked backwards. You should feel the stretch in your hamstrings and back of the knees.
Lunge with Ankle Flex
If you feel tension or strain in your calves, Achilles tendon, or the back of the knee then this is an important stretch.
Stand with your hands on your waist, one leg slightly in front of the other, with your knees straight looking ahead. Slowly lunge forward with the front foot, keeping your rear foot in its original position. Both feet should be making full contact with the floor, including the heel. As your center of gravity moves forward and downward, the rear ankle will act as an anchor and increase the stretch.
Because of the involvement of the knee extensor muscles in the pedaling motion, the flamingo position is a great stretch to relieve discomfort in the quads and patellar tendons.
Use a chair or wall the steady yourself, and raise one foot by bending your knee. As you hold the front of your ankle, slowly pull it upwards and gently push your hips forward. As the hip extension increases, you will feel the stretch in the front of the thigh.
Stretching the muscles that rotate the hips, specifically the glutes and piriformis, can have a positive effect on the knees. As mentioned previously, each segment of the leg is connected, and each area can have a domino effect, especially through the knee.
Lie on your back with your neck relaxed and head resting on the floor. Cross your right ankle over the other and place your hands on your left thigh, pulling your legs towards you in a figure four position. Slowly pull on your leg to increase the stretch, feeling it in your glute and hip. Repeat with the left side.
Knee pain can be disheartening, but most cases are not cause to give up on your training. However, if pain persists despite proper rest, stretching, and bike adjustments, then it may be a good idea to see a physiotherapist to see if there is an underlying issue that needs to be addressed.