5 Reasons You Could Have Knee Pain While Riding & 3 Exercises to Help Alleviate It
The Why
Why do riders get knee pain?! One thing we all can agree on is that it is the pits to have your knee hurt every time your foot goes around the pedal. Also that it is terrible to limp the first couple steps after sitting for a little bit. This post is going to go over knee pain that has come on slowly, not from an injury or crash.
I’m going to go over 5 reasons why your knee can be hurting. This is not an all-inclusive list. I have also included 3 exercises that I would include in programs made for people with knee issues through The Ride Life.
Reason 1: Hip Muscles
So a knee has many things going on, but mostly it acts like a hinge. It likes to move in a bending and straightening way (flexion and extension). It doesn’t like to be kinked, twisted, or rotated and then bent and straightened.
Now imagine you riding your bike… Do you kink or twist your knee as you ride? Can you start to see where an overuse or stress point could be?
Now let me ask the question... Do you know what controls the twisting and potential kinking of the knee?
Your HIPS! Your gluteal muscles more specifically. Glute Max and Med. These muscles control the rotation of your thigh. Therefore, controlling your knee. Another important muscle group that could throw things out of alignment are your groin muscles. If these are overworking, then it will pull your knee inward. Or if they are under working your knees will be pulled outward.
Can you also see how if your hip muscles are not turning on at the right time, you may be twisting your knee as well? Even though your hip muscles are strong. Timing is important.
Reason 2: Core
This reason goes back a bit to reason 1. However, it dives in a bit deeper to why your hips may not be working causing both timing and strength issues. People tend to either use their hip flexors and their lower back to support and control their pelvis or the pattern of abdominal muscles and buttock muscles.
Obviously, you can already guess which one is better. Do you have tight hips and or a tight low back. This might be the sign that you need to work on your core and buttock muscle combination. How you do that is by focusing on core strengthening.
Reason 3: Tightness
Tight hips can be caused from reasons 1 and 2 but might need some extra exercises to reduce and loosen up. If you are too tight in an area in your hip, then you might be pulling your knee off track causing that pinching of the hinge (your knee). Even with activating and using the right muscles you may need to add in a bit of stretching to assist the overall movement.
Reason 4: Quads
Now you are thinking… what about my quadriceps? (The muscles on the front part of your thigh) … what about my hamstrings? (The muscles on the back part of the thigh)
Yes, they are important too, but for knee pain they can be working too much or not be in sync with the hip muscles.
Hamstrings can pull on the back of your knee and need to help your buttock muscles. They are very important, but can be overused if you aren’t using your buttock muscles as well.
The quadriceps are very needed for knee movement and stability. The quad, when it contracts pushes the knee cap into the knee to straighten the lower leg. When it is working too much, this can place excess pressure into the knee. It can also place more tension through the tendons on the front of the knee. If this continues then you can develop tendonitis or other pain on/in the front of the knee.
Now you are thinking… what about my quadriceps? (The muscles on the front part of your thigh) … what about my hamstrings? (The muscles on the back part of the thigh)
Yes, they are important too, but for knee pain they can be working too much or not be in sync with the hip muscles.
Hamstrings can pull on the back of your knee and need to help your buttock muscles. They are very important, but can be overused if you aren’t using your buttock muscles as well.
The quadriceps are very needed for knee movement and stability. The quad, when it contracts pushes the knee cap into the knee to straighten the lower leg. When it is working too much, this can place excess pressure into the knee. It can also place more tension through the tendons on the front of the knee. If this continues then you can develop tendonitis or other pain on/in the front of the knee.
Reason 5: Feet
Everyone knows that having a good base support is important for a house, but it is also important for your body. Your feet are the base support for your knees. If you have a structural issue in your feet, your knees will feel the stress. With flat feet, your knees will be stressed inward. With high arches, your knees will be stressed outward.
This is the same concept that can be and may need to be altered in your biking shoes with insoles or with foot muscle exercises (not shown below, but let me know if you want some).
Now, this isn’t a comprehensive list of reasons why you can have knee pain, but it does cover many global views to decreased repetitive stress on your knee.
Exercises
Exercise 1: Bridge with Knees going out against band
Objective
- To utilize core with glute engagement
Perform:
- 5x times a week
o Before Riding to warm up for a ride
- Do 20-40 reps 2-3 sets
Things to Note:
- Do not let your back arch
- Push through hips
- Feel in abs and in buttock muscles
Exercise 2: Hands and Knees: Leg Extension
Objective
- To utilize core with glute engagement along with knee tracking
Perform:
- 5x times a week
- Do 20-40 reps 2-3 sets
Things to Note:
- Do not let your back sag downward – stay strong through core
- Think about how your knee is tracking…not pointing inward or outward
- Feel in abs and in buttock muscles
Exercise 3: Front and Inside of the Hip Stretch
Objective
- To open up the front and inside of the hip
Perform:
- Daily
o After Riding to recover
- Hold for 15 sec x 6 reps
Things to Note:
- Let your hip relax into the movement
- Be gentle with the stretch
- The wider the stance the more the stretch
About the Author:
Liz Koch, PT, DPT is a physical therapist that knows exactly what it is like to have pain. She has been to many PTs over her life, which directed her to becoming one. She has been a mountain biker since she was a kid and has recently opened up her own clinic in Western North Carolina, Blue Ridge BioMechanics that treats mainly mtn bikers. She wants to share the knowledge that you don’t have to be in pain when riding and you don’t have to stop riding to get out of pain. She has focused this mission to Rad Mountain Biking Ladies on Facebook and through her online business, The Ride Life.
Let her know if you have questions.
*If you have pain please consult with a doctor or physical therapist for further evaluation, Liz Koch and companies are without liability if you injure yourself while performing these exercises*
MENTIONS: @theridelife
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Anyways, I got a stress fracture in my foot after about two weeks to a month of training in them and my family physician was sure it was the Vibrams. He's an avid marathon runner and absolutely despises them. If you want to walk, and do some lifting in the Vibrams, that's probably fine, but I was advised to never run in them from a doctor/avid runner.
Running is great for your cardiovascular system and overall health (especially for offsetting the stiffness and mobility issues that sitting and biking will cause), but really not that good for your joints & ligaments (hence Waki's IT band comment). Running shoes are designed to alleviate the constant and repeated impact, use them!
20km If Fox 36 at 50% off was at the end of the run. Regular person will barely do 5 in that time.
I get occaisional pain in the front of my left knee. The cause for me I believe is driving, using the clutch pedal with my seat set too far back for many years. I now drive an auto, and in a manual I set my seat further forward than I used too. I usually have no pain nowadays.
I support the hip stretches too, it's a great feeling when you loosen tight hips.
I don’t claim to know anything, however.
If my IT band gets tight, I get some meniscus pain. Massage and foam rollers help with that a ton.
Additionally, I’ve seen some research showing longer cranks, may hurt the knees more. Shorter cranks keep the knees more extended and less stress while deeply flexed. I’m going to try some 170s to see if that helps going back to clipless on certain days.
One thing that could be happening so you can help things now is that you need support for the transverse arch (the ball of your foot) or that you are trying to compensate for weak hips with your feet. Also making sure your ankle movement is good and equal on both sides is key.
I also foam roll the piss out of my IT band
I sort of simulated it on a 3D software and to keep similar movement angles I ended up using 2 different cranks (one 170mm and one 175mm) and 2 different pedals (XPedo detox 20mm thinck and XPedo Spry 11mm thick).
Small crank and thick pedal on the shorter leg, longer crank and thinner pedal on the long leg.
So the overall difference compensation goes from 0mm to 10mm depending on where the foot is.
It hasn't hurt ever since, though I still feel a difference depending on which foot I put forward.
I had a full Retul fit done so I could find the right TT bike and while checking flexibility, the guy found it.
They weren't on my balls they were in front. Hence on my toes like a ballerina.
I used to hack shoes up so I could get my cleats / feet on the balls. But that's expensive way to ruin brand new shoes and have something that then leaks like a bastard and falls apart.
Apart from 5.10 no one makes wide shoes that aren't to long. Especially clipless shoes.
Glad I gave up clipless anyway. Bad habits, bad riding technique, pain in the arse. Not like I needed to pull up on a power stroke like a roady gimp anyway.
I learned to ride midfoot and discovered it’s pros only because I started riding on OneUp pedal with a big bearing by the crank arm, colliding with the base of the big toe. It forced me to move my foot more forward so that she/foot no longer conflicts with the bearing. Suddenly bunnyhopping, manualing, dirt jumoing became much easier. We can all expect clipless shoes in the future to have cleat ports moved further to the midfoot area. Vast majority of pros in all disciplines from road, XC to DH run their cleats furthest back.
For me it's below the kneecap, top of Tib on the outside/ front at about 10:00 and in back/ outside at about 8:00. Will give these a try. Thank you!
Both in terms of strenght as well as flexibility.
Especially if you have Desktop job.
Sucks to have a torn Meniscus
2.5 years on it feels as strong as ever, doesn’t lock up, can ride just as hard.