Cycling a 'Pain in the Knee'?

As the summer season of Grand tours and week tours for the professionals is in full swing with the Giro well under way (come on Simon Yates) and the tour of California upon us. The hard men of the Classics have well and truly made way for the GC contenders.  So what have the GC riders been doing through the spring to condition themselves for the arduous season ahead. While the likes of Romain Bardet have dabbled on the Pave with one eye ahead on the Tour de France others have hidden themselves away for long blocks of herculean type training coming out of purgatory only to race the early stage races like the Tour of the Alps. 

Physiotherapist Nathan Allwork out for a ride up in the Italian Alps

Physiotherapist Nathan Allwork out for a ride up in the Italian Alps

It’s at this time of year the mere mortals amongst us turn our attention towards the longer sportives and perhaps even something more challenging in the form of the Etape or even the leg sapping La Marmotte. 

This all means or has meant for both professional or enthusiastic amateur more time on the bike in longer and often more intensive riding. Now for the general British cycling population this is probably largely because we can now move having shed the 13 layers of winter clothing that we’ve been use to wearing over what has seemed a very long winter this year.

Whether professional or clubman this time of year with the increased load placed on the body is prime time for over use injuries. In a recent study around 95% of professionals confessed to having some form of over use injury and of these nearly 25% reported knee pain. Which basically means almost 25% of the grand tour peloton will be suffering with knee pain. Now these guys are able to continue with comprehensive physiotherapy, sports medicine input, massage therapists bike mechanics and injury prevention and rehabilitation schedules. 

Physiotherapist Nathan Allwork from Move4 Physiotherapy cycling in Italy


At Move 4 Physiotherapy Northampton, due to the above reasons we unfortunately start to see far more knee injuries from our cycling fraternity as the miles start to build. So to try to stop this from happening we’ve put together a few little pieces of advice/guidance on how it may be possible to avoid time off the bike with a troublesome knee.  As always this is only a guide and if you have any concerns over your knees you should seek the opinion of a qualified physiotherapist. 

As is often the case with cycling, the first place to start is to make sure that you have a good bike set up, spend some time making sure your bike is set up properly for you or I would always advise spending some money and finding a good bike fitter to help you with this. The ones we would recommend for this are Corley Cycles in Milton Keynes or Pitsford Cycles in Brixworth.  

To give an example of how this can influence your knee health a seat that is too low or too far forward will cause you to overload the front of your knee giving you pain at the front of the knee. Poor bike set up variations leading to a variety of knee pathologies (and other injuries around your body) is almost endless so I’ll say again spend the time sorting it out. People spend a lot of money on bikes and all the apparel that goes with it then neglect the one thing that powers the thing your body, ok moan over but you get the idea!


Give your body a little bit of love at the end of your ride this will help massively with being able to back up a ride the following day and not be sore which means physically from a training perspective you’ll get far better results. This is in the form of spending around 20mins at the end of your ride stretching and rolling (see our videos for examples of stretches and foam rolling that can help with knee issues). You pay attention to your post ride nutrition why not give the aching legs a helping hand too!

Tightness in the Gluteal, Hamstrings, Quads, Hip flexors, calf muscles as well as the Iliotibial band can result in knee pain from over use therefore the above regime may well help prevent an unwanted build up of issues.

Strengthening exercises, which concentrate on maintaining good mechanics on a bike will all help to stave off knee pain and the physiotherapist having to intervene. Working on a combination of quad and gluteal strength combined with a balanced lower limb and core programme will help with not only efficiency and performance on the bike but help prevent those over use injuries. See just one example of an exercise to help with this on our videos.

Lastly riding technique, and this is definitely not my area of expertise so please find a coach far more knowledgeable than me to help you. But it stands to reason from a biomechanical point of view that churning a massive gear for hours on end is not going to help your knees, and will often result in anterior knee pain.

What ever your challenge is this summer enjoy and good luck and as ever (selfless plug) if you need any help don’t hesitate in calling Move4 Physiotherapy Northampton.

In the meantime...

Keep Moving!