Cycling knee pain

June 3, 2019


I have a question related to knee pain.

First a little background, I’m a 54 year old cyclist, I came back to cycling in 2014. I did 100 miles yesterday and by 80 miles I had moderate medial and lateral knee pain (left knee only), which got worse for the remaining miles. I do a reasonable annual mileage. 2400 ish so far this year.

I don’t normally suffer from any knee pain. there was a short period in spring 2015 when I was having IT band pain, just moved my cleat position a few mm so my foot was closer to the pedal and it went away. since then no joint issues at all until yesterday.

no changes in bike setup for at least the last year, same shoes and cleats. only thing new was bibshorts with a slightly thicker/firmer pad. any advice gratefully received


June 3, 2019

Despite a good run of gently building up your mileage, you’ve been tipped over the edge into symptoms.

I think you’ve got an issue with the way your kneecap moves over the front of your thighs bone when you bend and straighten your knee. This causes some very mild swelling (and probably not really visible) as it behave a little like a bruise sitting on the backside of your kneecap.

So you can either downgrade your loading (so less for a few weeks – slightly boring) or improve the way you load your kneecap and knee.

You need to maximise the surface area where your kneecap moves – and you do this either locally (taping your knee) or getting better control around your hip/pelvis – work on glutes control (not strength) and/or improve your foot control (cleats).

I don’t think I’d move too much around trying to find your perfect setting but instead go back to basics see videos here Really focus on thoracic spine mobility before and during riding and improve the quality of hip stability and lower limb alignment.

Pills and ice may help – but change the causes of why rather than just chase the symptoms around.

The Guru

Guru Responded

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