Avoid Spring Cycling Knee Pain

If the warmer weather inspires you to go for bike ride after a long break, here are some tips to help you avoid knee pain .

Cycling is great exercise and a wonderful way to explore your local area and bike trails. But too much enthusiasm and not enough preparation can lead to a soft tissue injury known as ‘spring knee’.

“Spring knee is an overuse injury caused by the repetitive nature of cycling,” explains RACV City Club Fitness Centre Manager Con Kalogiannis. “It is common as the weather warms up and cyclists come out of hibernation and dust off the cycling kit.”

The most common symptom is pain at the front of the knee, either on and around the patella (knee cap). This pain may be a sign that a tendon has become inflamed, and it’s worth seeking medical attention if the pain persists.

Con says you can help protect your knees by adjusting your bike to suit the length of your legs and torso.

“Look at the three points of contact, the saddle, handlebars and foot pedals, and that will help you find the right balance between comfort and efficiency,” he says.

Another reason spring knee can occur is poor cycling technique. Australian Physiotherapy Association Musculoskeletal Physiotherapist Dr Paul Visentini says a survey of 518 recreational cyclists found 85% experienced one or more overuse injuries over a year, with 41% experiencing knee pain.

“Research in many sports shows that most injuries of this type are as a result of excess training, racing or returning to sport too quickly,” he says. “This is very much the case in cycling. After a quiet winter or a lockdown, a return to riding which is too rapid may overload the tissues and cause subsequent overuse injury.”

Dr Visentini says spikes in activity or sudden activity can cause injury. He says pain in the front of the knee is related to weak glutes and quadriceps and these muscles need to be strengthened to protect the knee. This can be done by slowly increasing the amount of cycling and exercise undertaken.

“A well-rounded approach to preventing spring knee is to optimise your body for cycling and check with your physiotherapist for a ‘bike fit’ appointment,” he says. “Another key point is that regular cyclists usually have a good bike set-up, which reduces their risk of an overuse injury.”

Dr Visentini says whether a person cycles a lot or a little, their body will always have a tipping point for overload. He recommends seek advice from a physiotherapist if any soreness or pain doesn't clear within two days.

Dr Visentini’s tips for avoiding spring knee

1. Make sure your bike is fitted appropriately to your body. If you have pain or aching in your knee, then you may need to adjust your seat, frame or pedals. It’s best to get advice from a physiotherapist.  
2. Slowly increase the amount of cycling and exercise you do. For example, start with easy pedalling, without intensity or hills, over a short distance and every second day. A general rule is to increase the distance or load by 10-20 per cent each week. You might start at 30 minutes per ride and increase by 10 minutes per week per ride. Once you progress to one hour of easy riding on flat ground then you can tackle a harder or longer ride on the weekends.  
3. Do a strength and conditioning program at the same time as returning to cycling. Generalised stretching as well as the use of a spiky ball in the glutes and a foam roller around the quadriceps can help to control soreness and recovery.  

Try the strength exercises with Nate Wells by clicking here.