What is the relationship between cycling and knee health?

From the Guidelines

Cycling is generally beneficial for knee health when done properly, as it is a low-impact activity that can help lubricate the joint and build supporting muscles. To protect your knees while cycling, ensure your bike is properly fitted to your body—the seat height should allow for a slight bend in your knee (about 25-30 degrees) at the bottom of the pedal stroke 1. Maintain a cadence of 80-100 revolutions per minute to reduce strain on knee joints. Start with shorter, less intense rides and gradually increase duration and intensity. If you experience knee pain, consider taking a non-steroidal anti-inflammatory drug like ibuprofen (400-600mg every 6-8 hours with food) for short-term relief, but address the underlying cause. Strengthening the muscles around the knee—particularly quadriceps, hamstrings, and glutes—through exercises like squats and lunges can provide better support, as recommended by the 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee 1. Proper warm-up before rides and stretching afterward helps maintain flexibility.

Some key points to consider when cycling with knee issues include:

• Ensuring proper bike fit to reduce strain on the knee joint
• Maintaining a consistent cadence to reduce impact on the knee
• Gradually increasing ride duration and intensity to avoid overexertion
• Strengthening surrounding muscles to provide additional support
• Considering alternative exercises, such as tai chi or yoga, which may also be beneficial for knee health, as conditionally recommended by the 2019 American College of Rheumatology/Arthritis Foundation guideline 1.

It's essential to note that while cycling can be beneficial for knee health, it's crucial to prioritize individualized management plans, as recommended by the EULAR guidelines for the non-pharmacological core management of hip and knee osteoarthritis 1. This includes considering factors such as patient preferences, access, and affordability when recommending exercise programs. By taking a comprehensive approach to knee health, individuals can minimize the risk of injury and maximize the benefits of cycling.

From the Research

Relationship Between Cycling and Knee Health

• The relationship between cycling and knee health is complex, with various factors influencing the risk of knee problems 2, 3, 4, 5.
• A study found that the overall prevalence of knee pain among cyclists was 25.8%, with 27.6% of amateur cyclists and 15.9% of professional cyclists experiencing knee pain 2.
• The type of bicycle, goal of cycling, body mass index, and participation in other sports were found to be significant factors in the rate of knee pain among cyclists 2.
• Bike fitting was associated with increased odds of reporting a comfortable posture and not reporting pain while cycling, but no associations were found between bike fitting and injury within the last 12 months 3.
• Lateral shoe wedges were found to decrease the internal knee abduction moment during stationary cycling, but this finding was not accompanied by a decrease in knee adduction angle or subjective pain 4.
• Cycling with a low saddle height was found to be related to increased knee adduction moments in healthy recreational cyclists, which may lead to Patellofemoral Pain Syndrome 5.
• The relationship between the experience of knee pain and participation in physical activity is complex, with mixed results found in quantitative studies, highlighting the need for multi-component interventions to increase physical activity levels among individuals with knee pain 6.

Factors Influencing Knee Health in Cyclists

• Type of bicycle
• Goal of cycling
• Body mass index
• Participation in other sports
• Bike fitting
• Saddle height

Implications for Cyclists

• Proper bike fitting and saddle height adjustment can help reduce the risk of knee pain and injury 3, 5.
• Cyclists should be aware of the potential risks of knee problems and take steps to prevent them, such as adjusting their cycling technique and participating in regular exercise to strengthen their knee joints 2, 4.
• Further research is needed to fully understand the relationship between cycling and knee health, and to develop effective interventions to prevent knee problems in cyclists 6.