10 Tips on Keeping the Cyclist's Knees Healthy

Cyclists often believe they are immune to knee pain because "there is no impact." Nothing could be further from the truth, it precisely impacts that forces the knee to adapt and thicken the cartilage inside the knee. Quality impact (jumping with good form at low volumes, running with good form at low volumes, etc.) can protect your knees in the long ride from meniscus issues you just have to be mindful of the volume and technique. Cycling generally leads to strong quads at the expense of the hamstrings and gluteal. Here are 10 tips for cyclists to protect your knees.

Adjust the bike.
You should adjust your saddle in small increments to achieve the right height maybe using one of these calculators to give you a starting point: Bicycle Saddle Height Calculator. The absolute best approach is to get a professional bike fitting as they will not only adjust saddle height but also other aspects of the bike.

If your knees get pain when you ride the bike, the seat might be too low or too forward. The pain falling in the back of the knee means your seat is too high. Without a customized adjustment, the consistent pressure on the knees can induce worse knee injuries.

Go to a bike store and have a fitting (if you have not already done so). The difference a bike fitting can make is tremendous. Be sure to take your standard shoes if you use clipless pedals because a good fitting will also consider the cleat position of the shoe (poorly placed cleats can cause knee pain while cycling).

Get a pair of cycling shoes.
Cycling shoes are worn primarily because they are designed for cleats that attach to clip-in bicycle pedals (also confusingly called “clipless” pedals, originally because one does not need toe clips when the shoe clips to the pedal itself). In addition to having attachment points for the cleats, the cycling shoe has a stiff plate that the cleats attach to, and this plate distributes the pressure over a wider area of the foot; this allows the pedal itself to be much smaller than “flat” pedals that are used with normal shoes.

Assuming you are using clipless pedals the cleat position on your shoes can have an enormous effect on your cycling form, especially cleats with minimal float. A wrongly positioned cleat can make your knee twist slightly with each pedal stroke, or you heel drop too low, etc. You should check your cleats are properly aligned and if you get a bike fitting include them in the session.

The cleats must be the correct kind of the pedal, and the shoes must be the correct kind for the cleats. Cleats further back on the shoe will decrease the load on the knee and thus your knees can be protected.

Warm up before cycling.
Static stretching - holding a stretched position for 10-30 seconds or more, actually reduces power output by that muscle for about 20 minutes afterward. Meaning, you'll make yourself into a worse cyclist for the first 20 minutes of your ride. It’s hardly an efficient use of time.

What you might get benefit from is dynamic or ballistic stretching before your rides. Dynamic stretches are typically done to a slow or medium paced rhythmic bounce, you might hold the stretch position for only a couple of seconds at most and often less than a full second in a lot of cases.

Cycling in moderation.
If it hurts, stop and rest. You can do the activity without pain possibly after days or weeks if your knees are injured when you are riding. This means planning your bike rides with bail points (public transit, or shortcuts back) and/or doing them incrementally greater distance, so that you don't have to "power through" pain to get back home; you need to know your limits so you aren't further inflaming your knee.

You likely are getting knee pain because you are cycling in too high a gear and too low a cadence for the terrain. Efficient pedaling should be at 80+ rpm - most racers will pedal at 90-95+ rpm for everything but hard efforts. If your gear selection is wrong you are stressing the knee in the upstroke as you are stretching the knee joint and in the down stroke as you are engaging every muscle to push the pedals. Natural pedaling should evenly engage all your muscles through both the down and upstroke.

Keep it short and sweet: 5 mins on the treadmill or stairclimber; some light hamstring, glute, and quad stretching; lots of hip flexor, groin, and calves stretching and X-band walks.

Post-ride recovery.
It is recommended to do a recovery ride after a hard ride. If you want to ride harder you need more muscles doing more work in the same amount of time. Riding hard tears some of the muscles and only by resting when your body will build more muscles to try to adapt to the stress that you just created. Active recovery works better than sitting around because an easy effort will trigger more blood flow for the cleansing process and the knees can relax gradually. From a macro level, recovery efforts are planned into the training cycle so that you recover from a hard effort (or after several hard efforts) so that you can prepare the body for another set of even harder efforts. Or you can have a massage on your knees.Keep the Cyclist's Knees Healthy

Do periodical check on your knees.
With your face on the ground, can you touch your heel to your glutes? Can you comfortably put your back foot on a bench, front foot forward? If not, these muscles are too tight and they may be altering the movement of your knee so you probably need to stretch more. Chances are you need to stretch more, in addition to strengthening your hips, hamstrings, glutes, low back and calves.

The other thing that is not as easily checked by yourself is the TFL and Iliotibial (IT) Band. The TFL and the glutes balance this long tendon, that is often a contributor to lateral knee pain.

Typically you have to do some soft tissue work to lengthen and reduce the hypertonicity of the TFL, then strengthen the counterbalancing glutes to improve alignment mostly in the transverse plane. If that sounds like gibberish to you, it is recommended that you get a medical professional to take a look at the situation for you before it gets worse, it is far easier to address an issue like this before it turns into a real problem with a few simple assessments from a physio or a good trainer.

It's possible even that the hamstrings are an issue though I feel with biking this is unlikely, or that your posture higher up the chain is affecting this, which, in biking can often be the case due to the hunched posture.

Daily training.
Stretch (like everyone else says) but especially using a foam roller on your IT band. If your quads and IT band are tight, they are pulling your patella into its groove on the femur (and possibly off-line from the groove), which causes irritation and inflammation. If those muscles are a slacker, the patella can slide around more easily where it is supposed to. You can buy yourself a foam roller and stare rolling out the outside of my thighs (i.e., IT band), and do the standard runner's quad stretch every time before you cycle.

Consider adding strength training for the posterior chain. Deadlifts, glute bridges, hip thrusters, Single Leg Romanian Deadlifts (Hip Hinges), etc... to balance out all the quad and hip flexion work biking revolves around.

Deep squats can be useful because they hit the posterior chain more, but they wouldn't be my first choice for this issue. The Single Leg RDL contra-laterally loaded is typically the best in combination with learning a proper bridge or hip thruster on one leg.

Work towards some heavy lifting in a 5 rep range-ish. I like to see people deadlifting at least their body weight, preferably 1.5 times their bodyweight every now and then. This equates to a single leg Romanian deadlift that is roughly at least 50% of your body weight (i.e. you weigh 180 lbs, I think you should be able to do some high intensity, low volume training the SL RDL with 90 lbs on a bar or 45 lbs in each hand). Don't try this willy-nilly though, you have to work up to it, and it can take some time (a year or more in some cases) to learn how to train properly or you risk injuring something else (like your low back).

Knee braces can help with alignment.
The $10 drugstore Ace-bandage ones with a hole for the kneecap significantly increase how long I can bike or run before I start to feel discomfort or pain.

Have a good REST.
If you have injured your knee when cycling or from an accident, then the RICE therapy technique is recommended by physiotherapists. This is to “rest, ice, compression and elevate” the injured knee immediately. This can then later be followed up by thermal compression knee supports for your day-to-day activities to help ease pain and enhance your body’s own natural healing ability.

If your knee pain is due to degenerative joint disease, such as osteoarthritis, then using thermal knee braces can help to support your knee, maintain correct joint alignment and gentle soothe the pain. This can be especially good when walking to help prevent further joint damage while helping to strengthen the muscles surrounding the knee.

Have a balanced diet.
Eating a healthy balanced diet is great. The right kind of food nourishes you and keeps your bones and muscles strong. It can work miracles if you take this daily.

Mentioned below are the nutrients needed to keep joints in good health:

Calcium:

Adequate calcium should be a part of your daily meal. Eat foods filled with calcium such as milk, broccoli, kale, figs, etc. If you can’t take lactose, you can opt for soy or almond milk.

Vitamin C:

Vitamin C has anti-inflammatory properties. It helps maintain healthy connective tissue including tendons, ligaments, bones, and joints. Include fruits such as oranges, strawberries, grapefruits, guava, etc., in your diet for healthy joints.

Vitamin D:

Vitamin D is important to keep bones and joints healthy; it helps you absorb calcium from food. You can get your daily dose of vitamin D from cereals, soy milk, almond milk, and a variety of dairy products.

Protein:

Proteins are the building blocks of the body. They help build and strengthen your muscles. You can get your proteins from a variety of meats such as chicken, pork, beef, etc, fish (salmon, trout, tuna, etc., and eggs. Also, include legumes, soy products, and nuts.

Hope this tips could be a help for your knees protection when you are cycling.