Cycling Knee Pain 101: Causes Chart & Prevention

Medically Reviewed By | Dr. Kate Panawash, PT, NCS, DPT

Many cyclists are all too familiar with knee pain, but you don’t have to accept it as an inevitable part of biking. Unfortunately, knee pain is one of the most common injuries for cyclists. Knee pain can arise for several reasons, but on the bright side, there are many precautions you can take to avoid it. 

Understanding the potential causes of knee pain is the best way to prevent it from flaring.

Where Is My Knee Hurting?

Where in the knee your pain shows up may be able to give you valuable information about why you are experiencing pain at all. 

Pain can present itself in any of the following areas:

  • Anterior: The anterior region is the area in the front and center of the knee, around the kneecap. Cycling pain in this area is usually the result of patellofemoral pain (PFP).
  • Posterior: The posterior area refers to the back of the knee. This area is less likely to be injured than the others, but pain here can result from excess tension or a strain in the hamstring muscles.
  • Lateral: Lateral pain refers to pain outside the knee. Lateral injuries are most often the result of an unnatural knee movement, so they are less common for bikers. In cyclists, lateral knee pain is most often the result of iliotibial band (ITB) syndrome.
  • Medial: Medial pain occurs in the inside part of the knee.Medial knee pain may be attributed to a medial meniscus tear, which is less common in cyclists but still possible if the knee takes a harsh impact or moves unnaturally. Arthritis and bursitis can also cause knee pain.

What Causes Cycling Knee Pain?

In reality, there is a long list of potential causes for knee pain in cyclists. Still, there are a few conditions that are more common than others. The biggest risk for cyclists is overexerting the muscles, tendons, or ligaments in and around the knee. 

The following are some of the most common causes of cycling knee pain.

Patellofemoral Pain

Patellofemoral pain (PFP) is one of the most common reasons for cycling knee pain and occurs when the tissue under the kneecap becomes irritated. Women tend to be at a higher risk for PFP than men. 

The biggest risk factor for PFP is muscle imbalance or weakness, especially in the quadriceps, making PFP a more common occurrence toward the beginning of the cycling season. The most common symptoms are:

  • Aching in the front of the knee
  • Pain when bending your knee
  • Discomfort or pain when sitting with a bent knee
  • Popping in the knee when standing up

Iliotibial Band Syndrome

Iliotibial band (ITB) syndrome is one of the most common reasons for lateral knee pain in cyclists. This condition occurs when the IT band becomes inflamed or irritated due to overuse or tension that causes it to rub against the thighbone or knee. Your body mechanics and training techniques could also lead to increased friction and shear forces in this region.

The IT band is a group of fibrous tissue that runs down the outside of the thigh, from the hip down to the knee, so pain can occur in a range of locations.

Pain from ITB increases during activity and consistent bending and straightening. It may also result in a popping sound. ITB may result from improper positioning of your foot on the pedal.

Plica Syndrome

If you have medial pain in the knee slightly above the joint line, you may have plica syndrome. A plica is a fold in the tissue lining your knee joint. Plica syndrome occurs when this fold becomes irritated or inflamed. 

Symptoms are similar to other knee conditions, including swelling, a clicking or popping sound, pain, and instability. Sometimes plica syndrome can be confused with a torn meniscus. Cyclists can experience a torn meniscus, but a meniscus tear is more likely to occur from an impact or lateral bend of your knee. “Twisting and pivoting are also common mechanisms of meniscus injuries,” adds Katelyn Panawash, Doctor of Physical Therapy (DPT) and Board Certified Neurologic Clinical Specialist (NCS).

Other Causes of Knee Pain

Your knee pain could result from many factors. If your symptoms don’t seem to match any of the above conditions, then you may have any of the following:

  • A dislocated kneecap
  • A sprain
  • Tendonitis
  • A torn ligament
  • Torn cartilage
  • Arthritis
  • Bursitis
  • An infection

You should never try to diagnose yourself. If you think you have any of the above conditions, contact your doctor to receive a thorough assessment and accurate diagnosis. “Healthcare providers like your physician or physical therapist will closely examine your signs and symptoms and will conduct special tests to help determine the root cause of the pain,” Dr. Panawash comments. 

Cycling Knee Pain Causes Chart

Pain Area

Potential Cause


Anterior (Front)

Patellofemoral pain syndrome

Raise your saddle to avoid excess strain on the knee, strengthen your quadriceps

Posterior (Rear)

Hamstring or tendon strain

Lower your saddle to avoid overextension, strengthen your hamstrings, warm up and stretch

Medial (Middle Inside)

Plica syndrome

Ensure your foot is positioned on the pedal so your knee is straight to reduce tension on the plica

Lateral (Outside)

Iliotibial band syndrome

Strengthen your glutes, warm up and stretch your legs, work on your hip, knee, and ankle alignment throughout all phases of the cycling motion to reduce friction

How Do I Treat Cycling Knee Pain?

If you experience a sudden onset of knee pain, immediate and careful treatment is the best way to minimize your time away from your bicycle. 

The popular RICE approach, consisting of rest, ice, compression, and elevation for the first two days after the pain arises, is considered out-of-date, according to Dr. Panawash: “There is actually more and more literature coming out that this isn't the optimal way to treat an acute injury. The person that came up with this method no longer supports it in its totality anymore.”

Instead, she advises that the best thing to do to treat your knee pain is reduce the frequency, time, and intensity of activity as much as possible. “The best medicine is still movement, and finding activities that your body can tolerate is a great way to ensure blood flow and that your body’s natural healing processes can take place,” she notes. 

If your knee pain does not go away within the span of a few days, even with at-home treatment, then you should see a doctor. Most knee pain can be resolved with the right physical therapy, however in some cases a doctor may recommend surgery.

You should see a doctor even sooner if you experience any of the following:

  • Difficulty putting weight on your injured knee
  • Discoloration of the knee
  • An inability to bend your knee
  • Loud popping noises with pain and swelling
  • Bumps on the knee or the knee cap appears off-center

How Do I Prevent Cycling Knee Pain?

The best way to treat knee pain is to prevent it. Fortunately, taking the proper precautions can help you avoid overexerting your muscles and ligaments and make your cycling more efficient.

Adjust Your Bike Setup

Although anyone can ride a bike, it is vital that you choose a bike that is both the right size for you and adjusted properly. The wrong bike size and seat positioning will put unnecessary strain on your knees and greatly increase your risk for knee pain. 

Always get advice from an expert before making your final purchase to ensure that the bike you choose fits your needs. Adjust the saddle of your bike so that your legs can remain comfortable. 

The pedals should be far enough away from the saddle that your knees are only slightly bent when they are at their lowest point. Your knee should be bent at a 90-degree angle when each pedal is at its highest point. Any more bend in your knee means there may be extra force into the joint every time you press the pedals.

Warm Up

Always warm up your muscles before any physical activity to reduce your risk for injury. Cold muscles are less flexible and more susceptible to strains or tears. Before your ride, do a light warm-up, like walking for five to 10 minutes, or try some dynamic stretches, like short lunges.

Dynamic stretches and mobility work involve light motion rather than staying still. These movements help promote blood flow to the area and increase your range of motion, which prime your body and muscles for your activity. A warm-up also helps raise your heart rate before jumping right into activity.

After you wrap up your ride, stretch your leg muscles using static stretches, and consider using a foam roller to massage your muscles and reduce tension. Stretches and light massages are some of the easiest ways to reduce muscle and joint tension, increase blood flow, and promote faster recovery.

Know Your Limits

Overexertion is one of the most common reasons for knee injuries in bikers. There’s nothing wrong with having a high ambition for your bike rides, but your body needs the right conditioning before taking on anything too strenuous. Nobody just rides their bike for 30 miles without the right preparation.

Don’t worry if your limits are not as far as you’d like — we’ve all been there. If you have a target distance you want to reach on your bike, then work up to your goal over time. Train yourself for longer distances and more difficult rides by gradually increasing your distance or elevation over time.

Gradually increasing the difficulty of your rides allows you to strengthen your muscles and tendons gradually. Stronger muscles result in less fatigue and more support for your joints, reducing the risk of injury.

Try Incrediwear

Incrediwear has a collection of comfortable sleeves and braces for various body parts to support athletes. With Incrediwear, you can get back on your bike confidently and without discomfort. Incrediwear products work to promote the health of the target area using Incrediwear’s proprietary technology.

This technology uses semiconductor elements embedded in a comfortable fabric. Body heat activates these elements, causing them to release ions, which activate molecular vibrations that increase blood flow.

The target area receives more oxygen and nutrients with increased blood flow, and harmful by-products are more quickly removed.

Wearing aknee sleeve with Incrediwear technology while cycling helps promote the body’s natural healing response and relieve pain to help you enjoy your bike ride the way you should. Incrediwear can provide the support you are looking for, whether you hope to treat or prevent knee pain.

Get Ahead of Your Knee Pain

Knee pain is nagging for many cyclists and can occur for many reasons, but that doesn’t mean you have to let it stop you from doing what you love. By taking the correct preventative measures, you can ride in total comfort. 

At Incrediwear, we strive to provide you with the support you need to stay active and pain-free. Browse our collection of cycling products to make your rides more comfortable.

Learn more about Incrediwear technology and the difference our products can have by providing relief for your muscles and joints. Explore our complete collection of sleeves and braces to see how you can support your body.



Patellofemoral pain syndrome - Symptoms and causes | Mayo Clinic

IT Band Syndrome: Knee Pain Symptoms & Treatments | HSS

Plica Syndrome: Symptoms, Causes, & Treatment | Cleveland Clinic

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