Leon E. Popovitz, MD
Top-Rated Orthopedic Surgeon
Specializing in Arthroscopic Surgery of the Shoulder & Knee.
For appointments 212.759.4553

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NYC Bike Rider

Avoid Knee Injuries On Your Bike Commute

Citi Bike, New York City’s bike-sharing system has been growing in popularity since its inception last Memorial Day. For 7.7 million local commuters, the bike-program offers a new mode of transportation. But with it, comes a new host of potential injuries. While run-ins with cars and pedestrians may be the first danger to come to mind, cycling poses some unique threats to the knees, one of the body’s most fragile joints. The stress of pedal repetitions and the bike’s awkward seating position both have the potential to result in some painful injuries. But don’t let that deter you from your active commute! Here I provide some simple, yet effective ways to ward off knee injuries commonly brought on from cycling.

Warm Up

While you may not think of your morning bicycle commute as an intense workout, you still need to warm up. Before jumping on the saddle, spend five to ten minutes doing dynamic stretches. An active warm up will improve your range of motion, enhance stability, and ward off muscle tears, knee strain, and injuries. No time for a full-fledged warm up? Start your commute riding in a low gear and pedal at a fast cadence until your body temperature and heart rate are elevated. If you can avoid using high gears your entire ride, even better! Peddling in a low gear is easier on the quadriceps, which helps ward off tendinitis in the knee.

Start Slow

Cycling newbies often develop knee pain because they’re too ambitious, trying to ride too far, too soon. While it’s great you’re riding to work, you may not want to pedal the entire way if your commute is more than 15 minutes. Instead, ride part of the way and then walk the rest of the distance. Doing a variety of low-impact activities — such as walking and biking, prevents overuse injuries (like patellar tendinitis or patellofemoral pain syndrome) by allowing the body to use different muscle groups. Over time, as you build up endurance and fitness, you’ll be able to ride longer without the risk of injury.

Fine-Tune Your Fit

Many cyclists under-extend their pedal stroke which leads to pain in the front of the knees (anterior knee pain) and overuse injuries like patellar tendinitis. Keep pain at bay by adjusting your saddle. Ideally, you should have a slight bend in your knee at the bottom of each pedal stroke (80% to 90% of full leg extension). A proper fit recruits the hamstring and glutes to take on the brunt of the work, taking the strain off of the quadriceps and the patellar tendon.

Find the Right Footing

Placing your feet in the proper position on the pedals may help ward off patellofemoral syndrome, anterior knee pain, and ligament injuries. The angle of your shoe should mirror the natural angle of your heel. To get a good visual of this, sit on the edge of a table and let your legs relax at a 90 degree angle. Look down: Whatever angle your feet naturally hang should be replicated while you’re on your bike. If you start to feel pain on the outside of your knee (lateral pain) your foot is likely internally rotated. Rotate your toe outward a bit to reduce the pain. If you experience pain on the inside of your knee (medial pain), rotate your toe inward.

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  1. thanks Leon! This was very helpful!

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