Thanks to Peloton, NordicTrack, and other interactive fitness equipment, bicycling has never been more popular. With health benefits that include cardiovascular fitness as well as muscle strengthening, cycling is an ideal low-impact exercise option. However, the repetitive nature of cycling can sometimes lead to knee pain and injury from overuse.

What causes knee pain?

One of the most common overuse injuries is kneecap, or patellofemoral, pain. This can feel like an ache or sharp pain around the kneecap, and it worsens with repetitive activity. Patellar tendinopathy, or pain in the tendon below the kneecap, is another overuse knee injury. Finally, some cyclists will experience pain on the lateral side of the knee joint, or iliotibial band (ITB) pain, which causes compression at the side of the knee, resulting in inflammation and pain. These injuries are aggravated in cycling due to the repetitive movement of the knee extending against resistance.

How to manage the pain

Of course, pain management is based on a number of individual factors, and severe or persistent pain requires an orthopedic exam, but cyclists can start addressing the pain by doing the following:

  • Monitor your mileage and intensity – Increased miles and training volume also increases your chances for injury. Start your ride at lower intensity to reduce the training load and aim for a higher cadence and lower gear.
  • Incorporate strength training – By including resistance training and leg strength exercises in your workout, you can improve power output and make you a stronger rider less prone to repetitive injury.
  • Check your bike fit – Often, an improper bike setup can impact the loading on your knees while pedaling and create a problem over time. Assess your cleat and saddle positions to make sure they are correct.

Bicycling provides an outstanding workout and can be a tremendous cross-training alternative, but like any exercise it requires proper technique and equipment to avoid injury. Make sure to monitor your workouts to protect your knees from overuse injuries.

Authored by Zach Meeker, Research Assistant for Midwest Orthopaedics at Rush University Medical Center

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