Well, here we are in the height of summer and with these longer days come longer cycle rides and unfortunately, for some, knee pain can begin to occur.
Why does cycling cause knee pain?
The temptation for many in the early stages of cycling knee pain is to simply ignore it and write it off as a niggle or, more commonly, to push through the pain. Both are unfortunately a bit of a mistake.
Dr Google is often a first port of call and this comes with mixed blessings. Sometimes you will get lucky and come across an article that matches your symptoms and allows you to resolve them, but sometimes, and in reality more often than not, it doesn’t.
You try various suggestions and mess around with the saddle height, the fore and aft position and angle of tilt. You try new shoes, pedals etc. The list goes on, but the pain remains.
Fundamentally, cycling knee pain is about misalignment and this, in turn, relates to the fit of your bike, which is why, on occasions, Dr Google can supply the answer. You, however, remain in pain.
Cycling Analysis: Looking beyond the Bike Fit.
This is where The Reinge Clinic can help.
At The Reinge Clinic we specialise in cycling analysis. But what is cycling analysis exactly?
Well, when you book in for a cycling analysis we start by making sure your bike fits you correctly and make adjustments if necessary. We also film you on the bike, either on a turbo trainer or, often, outside on the road. Alongside this we assess your muscle balance, joint mobility and biomechanics.
Cycling knee pain doesn’t arrive for the sake of it and its source will usually lie within one, or occasionally several, of these areas.
Why a Bike Fit isn’t always enough.
Most people who come to see us with cycling knee pain have already had a bike fit, sometimes a very expensive one, and it’s worth noting these are rarely wrong.
In most cases it is the rider who cannot move correctly within that bike fit. This is something the rider is unable to see themselves, is usually quite subtle and, depending on the type of bike fit they have had, may never have presented as an issue during the fitting process.
When a movement issue does present itself during a bike fit, it will, if it has been a motion capture type fit, be noted in the report as present but unresolved by the fitting process.
If the bike fit cannot change this movement problem, then the issue lies with the rider and not the bike itself. However, in many cases of cycling knee pain, it can involve a little of both.
The most common cause of Cycling Knee Pain we see.
Let me explain.The most common movement issue we see, when a cyclist presents at the clinic with knee pain, is a figure of eight tracking pattern as the knee travels up and down through the pedal stroke.
This pattern will often be commented on within any bike fitting report that you have.
The most common cause of this pattern is over pronation at the foot. In recognition of this, several cycling shoe manufacturers produce products designed to limit the effect of this. These range from cycling shoes with a built-in 1–2 degrees of camber, to shims that fit between the shoe and the pedal.
However, what if you could simply fix the over pronation at the point it is actually occurring…the foot?
Well, this is often easy to do by performing the appropriate foot strengthening exercises, where suitable.
And that is where our old friend Dr Google comes in again.
There are a fair few foot strengthening exercises out there on the internet, but which one is right for you? Which structures of the foot are actually weak?
This is exactly what our bio mechanical analysis identifies, guiding you towards the most effective intervention.
Can your cycling pedals cause Knee Pain?
Pedals are another issue that we deal with a lot in relation to cycling-based knee pain.
A clipless pedal, so called because it doesn’t require a toe clip (those who have been riding since the 70s and 80s will remember these), has a degree of float built into it.
Float is the ability for the foot to rotate side to side upon the pedal and this is essential to safe and effective pedalling.
As a rule of thumb, the less expensive the pedal, the less float it tends to have built into it.
We see many bikes that cost thousands of pounds come in with £40 pedals fitted to them. If you bought your bike new there is a good chance it came with either no pedals or a basic flat pedal. It’s then human nature to choose a cheaper pedal to fit as there is often not a lot left in the kitty.
There are a number of pedal manufacturers who make pedals with up to 15 degrees of float. Virtually all professional cyclists use this type of pedal, and with good reason.
The more the foot can wander naturally on the pedal, the less twisting force occurs at the knee and, on a tour race that runs day after day, that’s quite important.
The downside is that you have to twist your foot further to unclip, which can be a challenge in stop-start traffic if you are used to less float.
It is also a quick way to get somebody with knee pain from London to Paris when they come in two weeks before the ride, while they slowly correct the underlying biomechanical issues in the background.
Are Clipless Pedals always the best option?
Over the years we have also persuaded a number of people to refit the flat pedals their bike originally came with.
Whilst this represents a loss of power, research shows that, outside of top-class riders, the power gain from using clipless pedals is actually minimal and, in many cases, arguable.
The biggest reason riders fit clipless pedals is because it’s what everyone else does and therefore anything else looks odd or suggests… beginner!
Anyone who has cycled for a while will have experienced the sometimes bizarre judgement and peer pressure cyclists can level at one another, but that’s another story.
Our advice for pain-free Cycling
As a parting suggestion from this article, I suggest everyone reading this take a quick look at touring pedals.
With an SPD clipless fitting on one side and a flat pedal on the other, used alongside a touring shoe, they give you the widest variety of options whilst out on a ride. Better still, once you’re clipped in they still look like a clipless pedal, so there’s less to worry about if you’re concerned about appearances!
If knee pain is stopping you enjoying your cycling, get in touch and we’ll work out where the problem is coming from.
If you’re new to cycling or looking for more riding advice, the British Cycling website has plenty of useful resources for cyclists of all abilities.