Knee Pain – Common Causes

In this quick tip Victor talks about some of the most common causes of knee pain in cyclists

The most common offenders are

  • Saddle Height
  • Worn cleats
  • Cleat rotation adjusted incorrectly
  • Too much too soon
  • Mashing the pedals
  • Low cadance




Links: Previous show on Bicycle Fit

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  1. Hi,
    I had a sudden onset of pain located on the back side of my right knee in the middle of February. I rode all last summer, building up to the 100k in August. There was nothing really out of the ordinary about the ride on which the discomfort started (around 30 miles at an slightly above average pace). I took several weeks off, but the pain returned immediately once I got back on the bike and tried to pedal. I noticed that pointing my toes down seemed to help some with the pain, so I moved my cleats as far back as possible which has allowed my to ride about 10 miles before the discomfort returns. I’ve noticed it is almost completely alleviated if I sit straight up on the saddle (without my hands on the bars at all).

    I’ve been to my local bike fitter who didn’t see anything drastically wrong with my fit. I’ve also been to an orthopedic surgeon, but my x-rays were clean and he couldn’t really provide any kind of diagnosis. I went to physical therapy a few times, but they didn’t really have any answers either.

    Other potential useful information: I’m a 31 year old male, riding for 2 years. I have fairly severe case of miserable malalignment syndrome, which causes me to toe out as far as possible when riding get my knees more in line with the rotational plane of the pedals.

    I’m a big fan of your show! I started listening my way through every episode (I’m currently in the Nov 2012 podcasts).

    Not being able to ride is incredibly frustrating, and I would really appreciate any advice you may have.

    Thank you!

    • Brandon

      I know how frustrating this can be. Dont worry though. Many people with much worse problems have found ways to ride without discomfort.

      Unfortunately there are no clear and simple answers. Though from your description I strongly suspect that there may some things that could be done with your position that could help accommodate. There may also be some things with your technique and body strength that could help improve things.

      I wish I could just tell you to make xx simple adjustment and things will be fine but that is rarely the case. If you really want to dive in and evaluate the problem shoot me a private email.


      Thanks for listening

  2. mark rogers says

    Hi Victor,

    Do you think of your saddle height as a fixed measurement that once you zero in on it you leave it at that height? Or do you ever adjust your height relative to how you want to ride or how you may feel?


    • Hey Mark

      Your saddle ht should stay the same generally. Though if something changes; fitness levels, flexibility, or riding style. It should no however changes day to day with the exception of different bikes like mtb or road etc.

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