What to Do About Knee Pain From the Stationary Bike

I got another great article for you today and it focuses on knee pain from the stationary bike.

It is from a friend, way in Australia.

I know, those crazy Ozzies.

Take it away Kristian.

Knee pain and riding a stationary or even a road bike are pretty synonymous.

Back in my personal training days, I had one client in particular- an ex rugby player who had numerous surgeries on both knees and pretty much all of his remaining cartilage scraped away. He couldn’t run for obvious reasons but he loved to cycle and didn’t want to give this up too.

The problem was, after 10 or so minutes on the stationary bike or any time under load- the pain would nearly be too much to bear. Not that he would say anything but I could see it written all over his face. So we spent a lot of time playing around with the limited positioning of the typical upright gym bikes and found some rules to adhere to when setting up either an upright gym bike or spin bike. Once we got his set up dialled in, and did something else of high importance which I’ll discuss below- my client’s knee pain all but disappeared.

Taking a step back- lots of fitness professionals use stationary bicycles in their clients’ programs.

There are many benefits to this such as:

  • increasing or re-establishing knee joint range of motion
  • improving knee joint stability
  • increasing strength of muscles around the knee

The features of the stationary bike, such as:

  • non weight bearing
  • low impact
  • controlled movement
  • variable resistance
  • range of motion similar to needed daily activities

Now as a triathlete and a high level triathlon coach, I understand the importance of correct bike set up for both on road bikes and your standard upright gym bike and spin bike (many of my athletes travel for work and have to use gym bikes).

Getting the set up dialed in to reduce knee pain or stop the likelihood of knee injuries occurring. The set up guide below is specifically for upright and spin bikes commonly found in gyms.

1. Get the Saddle Height Correct

The seat height has a direct influence on the amount of knee bend that occurs and thus provides opportunities for pain or injury to occur. When the saddle is too high, you’ll find your hips rock from side to side which can create problems around the hips and the over-reaching (toes pointed) coupled with the repetitive cycling motion can irritate the illiotibial band (ITB).

When the saddle is too low, you end up putting enormous stress through the patellofemoral joint. If you’re suffering from patellofemoral pain and considering cycling, ensure that your saddle is not too low.

To adjust the seat height correctly:

  1. Sit on a bike with your shoes on and make sure one pedal is in the 6 o’clock position (one crank arm point directly down and the other directly up).
  2. Place your heels on the pedal and slowly pedal backwards, your knee should fully extend without your hips rocking. If your hips rock, the saddle is too high.
  3. Now move the balls of your feet over the pedal and you should have a slight 5-10 degree bend in your knee. This will allow you to pedal comfortably without pointing your toes to reach full extension.

NOTE: If you’re coming off surgery and have limited range of motion (ROM) you’ll need to ‘slightly’ raise the seat to allow one full pedal revolution- as your ROM returns ensure you lower your seat height as advised above.

2. The Fore and Aft position

The correct position here is when your patellar tendon (knee in the forward position) is directly over the pedal axle.

3. Use the Pedal Straps

Nearly every stationary bike I have ever seen has pedal straps. These hold your feet in place and allow you to evenly push down and pull up on the pedals as they go through their circular motion helping you create a smooth and efficient pedal stroke.

Starting off with your muscle tissue in a better state

Above I mentioned another thing I did that was of high importance to rid my client of knee pain. This was using a foam roller for self myofascial release as pre-gen exercise tool.

A quick 10 minute session rolling through the calves, quadriceps and gluteals helps increase blood flow, and oxygen to the muscles, open up neurological pathways and break down any adhesions within the muscle tissue.

This prepped the muscles for exercise and started the warm up process but also reduced a lot of tension off the knees and created a better ROM from the get go.

I personally do not do any sessions now without some specific self myofascial release first and I highly recommend that all my athletes perform a pre session rolling ritual. The time investment is minimal but the eradication of pain and the performance gains are priceless.

Kristian Manietta of TriSpecific.com

It is Rick again.

Huge thanks to Kristian.

Excellent information.

If you have a question, make sure to leave it in the comment area.

If you have an opinion on the article, let me know.

Until next time.

Rick Kaselj, MS

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4 Comments

  1. Rick,
    Great article! As a indoor cycle instructor the most common mistake I see is the seat height. Also, I always tell my clients that it is important to focus on pedal stroke. For example, when you are on the upstroke of you should focus on using your hamstrings, which leads to taking stress off the knee. Anyway, just thought I would share for those that do a lot of cycling.

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