1. Pain in the front: is generally a product of you being quad dominate. Your quad muscles attach to the shin via the patella, and when you’re really pumping, they might deliver too much shear force across the joint. Bike-specific issues to check for are Saddle Height and/or crank length.
“A saddle that is too low will cause your knee angle to be too tight at the top of the stroke, which increases the shear forces pulling the patella against the femur, which in turn increases the likelihood of tendonitis and harmful stresses in the cartilage behind the kneecap,” says Veal. “Likewise when the cranks are too long for your leg length, the knee joint is also too tight at the top of the stroke.”
“For a quick reference to check if your saddle is the right height, have a seat and rest your heel on the pedal with the pedal in the 6 o’clock position,” says fit specialist and physical therapist Sara Bresnick, owner of Pedal Power Training Solutions in Medford, Massachusetts. “The knee of that leg should be straight. That equates to a 20- to 25-degree knee bend when clipped in.”
2. Pain in the back: Is typically due to over-extending the knee. Your saddle maybe too high or too far back. Try lowering the saddle a bit or moving it forward a bit in relation to the handlebars.
3. Pain on the inside: When you feel pain on the insides of your knees, look down at your feet. Improper cleat placement can often be the cause. Your cleat position affects your how far apart your feet are laterally when pedaling. Ideally the spacing should be such that the loads from your knees to your pedals are traveling vertically without pushing the knee inward or outward, which stresses the collateral ligaments on either side of your knee and can lead to pain.
4. Pain on the outside: is often caused by iliotibial band (IT-band syndrome)—a stabbing pain that happens when the IT-band (a fibrous connective tissue band that runs from the hip along the thigh to the tibia) becomes stressed and inflamed. Improper cleat placement that cause the foot to be excessively toed in can cause this.
A local bike shop should be equipped to help you with a bike fitting if you are experiencing any knee pain. If you are continuing to have pain after your bike fitting and are looking for a new treatment approach, please give the offices of Integrative Health Solutions a call to schedule an initial evaluation and treament with Dr. Boaz, Doctor of Physical Therapy at 858-254-5433.