Cycling pain behind the knees is the classic symptom of a common overuse condition referred to as patellofemoral pain syndrome. Once you take steps to rest your knee and relieve your pain, you can begin to treat the condition with physical therapy to get you back on your bike.
Patellofemoral Pain Syndrome
Patellofemoral pain syndrome is caused when the patella or knee cap is no longer tracking properly on the femur, the bone in your thigh. The syndrome is common among cyclists. It results from the frequent flexing of the knee, which is required for pushing the pedals in rotation after rotation. The pain from the misalignment of the patella feels like it is originating from behind or around you knees. This is because your femur is rubbing against the underside of the knee cap causing irritation.
Initial Treatment
Initial treatment for patellofemoral pain syndrome is rest and pain reduction. Follow the R.I.C.E. method, which stands for rest, ice, compression and elevation. Wrap you knee in a flexible brace or an elastic bandage to help reduce soreness and swelling. Elevate your knee on a few pillows and apply ice to your knee 20 minutes at a time. Your doctor may also advise you to take anti-inflammatory drugs such as ibuprofen.
Physical Therapy
Once the pain subsides your doctor will prescribe physical therapy to strengthen and stretch the muscles that support your knee, namely the quadriceps, hamstrings and gluteal muscles. The quadriceps are a group of four muscles in the front of your thigh that stabilize your knee cap and allow you to extend your leg. The hamstrings are a group of three muscles in the back of your thigh that allow you to bend your knee. The gluteal muscles are a group of three muscles in your buttocks that allow you to move your thigh. The stronger these muscles are, the better they will be able to absorb the pressure you place on your knees during cycling.
Adjust Your Bike Fit
It's possible that you are suffering patellofemoral pain syndrome because of a poor bike fit that is placing too much pressure on your knees. You may need to readjust your saddle position. The saddle should be parallel to the ground. The saddle height should be high enough so that your leg is only slightly bent at the bottom of a pedal stroke. This means you should just be able to touch your toes to the ground when seated on your bicycle.
