Knee pain when you pedal
Knee pain on the bike is rarely an injury. It is almost always a position that has not been resolved. Where it hurts tells you what is wrong: pain at the front points to saddle height or setback, pain behind the knee to a saddle set too high, pain at the sides to cleat rotation. It is the complaint that disappears fastest once the position is properly measured.
- How common
- The number oneAlongside neck pain
- Usually solved in
- 1 sessionWith follow-up afterwards
- What we measure
- Knee angleAt bottom dead centre, with 3D kinematics
- Service
- €180Full bike fit
The area on the diagram
Which part of the fit this complaint belongs to
Every point links to its own complaint
Where it is decided
- Usual cause
- Saddle height, saddle setback or a rotated cleat.
- What we adjust
- Saddle height and setback, cleat rotation, wedges.
- Related measurements
- saddle heightsaddle setbackknee angle
Where it hurts tells you what is wrong
The knee is a hinge. It should flex and extend, and nothing else. When your position forces it to move in any other plane it complains, and it complains in a different place depending on the error.
| Where it hurts | Most common biomechanical cause | What we adjust |
|---|---|---|
| At the front, around the kneecap | Saddle too low or too far forward: the knee works in deep flexion and compresses the patellar tendon. | Saddle height and setback |
| Behind the knee | Saddle too high or too far back: the leg reaches full extension and pulls on the hamstring. | Saddle height, crank length |
| On the inside | Cleat rotated outwards, or a Q-factor that is too narrow. | Cleat rotation, spacers, wedges |
| On the outside | Iliotibial band under tension, usually from a cleat rotated inwards or a saddle set too high. | Cleat rotation, saddle height |
Why eyeballing it is not enough
The heel rule, the 109% method and a phone photo from the side will keep you in the right ballpark. But they all work from a still image of a leg that moves five thousand times an hour.
With 3D kinematic analysis from STT Systems we measure the real knee angle at bottom dead centre, the lateral deviation on every stroke and the symmetry between your two legs, while you pedal at your usual cadence. That is the difference between estimating and knowing.
Then we test the fixes one at a time and compare the numbers. If a change does not improve the figure, it does not stay on the bike.
You come with your own bike, your own shoes and the shorts you always ride in. We start with the interview, because when the pain appears and on which rides narrows things down fast, and then assess your mobility: a restriction at the hip is very often paid for at the knee. Cleats come before anything else. They are the contact point that causes the most trouble and the one almost nobody checks.
When it is not the bike
A bike fit is not a medical diagnosis. If the pain is also there when you walk or climb stairs, if there is visible swelling, if the knee gives way, or if it wakes you at night, start with a healthcare professional. We will tell you so plainly, and refer you if that is what you need.
And if the position turns out to be right and the pain stays, we say that too. A fit that changes very little is still information: it rules out the bike and points you somewhere more useful.
Questions about this complaint
How long does knee pain take to go once the fit is done?
Can it be the cleats rather than the saddle?
Only one knee hurts. What does that mean?
Should I stop riding until the fit?
Does this sound like your case?
Tell us when the pain shows up and on what kind of ride. We will tell you whether a fit solves it before you book anything.