Cycling, whether for leisure or competition, is a highly beneficial activity for health and fitness. However, many cyclists—beginners and experienced riders alike—will experience knee pain at some point. These discomforts can quickly hinder performance, disrupt training, and, if left untreated, lead to chronic injuries.
As a sports physiotherapist in Basel, I regularly support amateur and professional cyclists in preventing and treating these knee issues. In this article, I explain the most common causes, mistakes to avoid, and practical physiotherapy solutions.
Common Causes of Knee Pain in Cyclists
1. Poor Bike Setup
A saddle that is too low or too high, incorrect saddle setback, or poorly aligned cleats can cause mechanical overload at the knee. This imbalance leads to pain that gradually increases over the kilometers.
2. Training Overload
Increasing volume or intensity too quickly is a common mistake. Muscles, tendons, and joints don’t have enough time to adapt, which can result in anterior knee pain (patellofemoral syndrome) or lateral knee pain (IT band syndrome).
3. Muscle Imbalance
Lack of strength or flexibility in certain muscles—quadriceps, hamstrings, glutes, or calves—can disrupt pedaling biomechanics, resulting in abnormal stress on the knee.
4. Previous Injuries
Past sprains, fractures, or knee surgeries can leave residual issues such as stiffness, weakness, or internal scarring, increasing the risk of pain while cycling.
How Physiotherapy Can Help Cyclists
Movement and Bike Analysis
In sports physiotherapy, we often start with an assessment of posture and pedaling mechanics. This allows us to identify imbalances and adjust the bike setup (saddle height, cleat alignment, handlebar position).
Targeted Muscle Work
Rehabilitation includes:
- Strengthening the quadriceps, glutes, and stabilizing muscles
- Stretching and mobility exercises to reduce tension
- Proprioception exercises to improve knee stability
Manual Therapy and Pain Relief
Manual therapy techniques, joint mobilizations, and sometimes soft tissue therapy (massage, myofascial release) can quickly relieve pain and improve mobility.
Prevention and Return to Cycling
Once pain is reduced, a personalized prevention program is implemented to avoid relapses and allow a gradual return to cycling under optimal conditions.
Practical Tips to Avoid Knee Pain While Cycling
- Have your bike professionally fitted by a bike-fitting specialist or physiotherapist familiar with cyclists
- Gradually increase training load, incorporating adequate rest phases
- Strengthen muscles complementary to cycling, particularly glutes and quadriceps
- Vary your pedaling positions to prevent repetitive overload
- Consult a physiotherapist promptly if pain persists for more than a few days
Conclusion: Enjoy Cycling Pain-Free
Knee pain is common among cyclists but should not be ignored. With a precise diagnosis and tailored physiotherapy, it is possible to relieve pain, correct underlying causes, and prevent recurrence.
If you are a cyclist in Basel experiencing knee pain, I would be happy to help you regain comfort, mobility, and enjoyment on your bike.
👉 Book your physiotherapy session in Basel today, specialized in sports rehabilitation.