Do you suffer from Rider Knee Pain during and/or after time in the saddle? Or perhaps you suffer from knee pain every day and riding makes it worse? In this article, I am going to explain some reasons why you may be suffering and how you can determine the cause and manage the pain.

Causes of Knee Pain?

Causes of knee pain include arthritis, strained ligaments, tendonitis, and muscular tightness. You could have any of these that are more noticeable through riding but riding itself doesn’t cause knee pain.


There are 3 types of Arthritis:

Causes of Rider Knee Pain Image


This is the most common of the types. Osteoarthritis wears down the cartilage which is the cushioning between the bones in your knee joint. Without the cartilage, the bones rub together which causes pain, stiffness and restricts movement.

Post-Traumatic Arthritis

Following a trauma like a break or an impact. The cartilage starts to thin and the bones rub together and cause the same symptoms as Osteoarthritis. It may be years after the trauma before you notice.

Rheumatoid Arthritis

This is an autoimmune disease where your unhealthy immune system triggers inflammation in your joints even though there is no need for the body to do so. It believes there is an infection, an injury or a foreign invader when there is not.

When you believe you have arthritis you will visit the doctor who will check if the joint is swollen/inflamed, the range of movement and ask a number of questions. The one key point to remember is.

To diagnose arthritis of the knee officially, you will need an X-Ray and/or MRI.

You cannot diagnose without. It is an assumption.

Menisucs Tear in Knee Joint

Meniscus Tear

The meniscus is a piece of connective tissue that sits below the thigh bone (femur) in the knee joint. It acts as a shock absorber and enhances the stability of the joint. They are often caused by sharp sudden changes in direction such as in football or running. The cartlidge also thins as we age.

In a meniscus tear, you will often experience intermittent knee pain which can be sharp. This is because when you bend and straighten the leg the flap of the tear can get caught on the knee bone. Sometimes it will stay caught for a period of time which causes constant pain until the flap returns. Other times the flap just ‘flicks’ as the knee bends and straightens which causes the sharp shooting pain. Not always, but you may also experience swelling.

There are a number of movement tests that can be performed to assess if you have a meniscus tear although these are not reliable as the tests may not move the flap at that given time. Similar to arthritis. The only way to know for sure is to have an X-ray or MRI

Ligament Sprain

Similar to a meniscus tear, you can strain your knee ligaments by sudden changes in directions, twisting of the knee, or over-reaching. A sprain may also be caused by impact.

There are 4 ligaments within the knee joint.

  • Posterior cruciate Ligament (PCL) – Controls backward movement of the shin bone
  • Anterior Cruciate Ligament (ACL) – Controls rotation and forward movement of the shin bone
  • Medial Collateral Ligament (MCL) – Provides stability to the inner knee
  • Lateral Collateral Ligament (LCL) – Provides stability to the outer knee
Knee Anatomy Image


When a tendon becomes inflamed it causes swelling, pain, and discomfort. There are many causes of tendonitis such as strain, overuse, injury, or too much exercise. To determine if you have tendonitis a doctor will take a small amount of fluid from the joint to test. Tendonitis can occur anywhere in the body but for the knee to be affected it is normally associated with those that run or cycle long distances and those that play jumping sports such as basketball where the force of hitting the grounds strains the tendon.

Rider Leg Muscles

Muscular Tightness

The quadriceps tendon (front of thigh) sits over your kneecap and your hamstring (back of thigh) attaches to the back of the knee

When these muscles, either individually or separately, become tight. The muscle shortens pulling the tendon taut across the joint which applies pressure to the knee area. This pressure can make it feel like the issue is within the knee itself. Inflammation doesn’t usually occur from muscular tightness but it is possible. Especially if you have tight muscles and riding is aggravating those tight muscles.

Tightness in the quadriceps and hamstrings can occur in many ways. Such as being inactive, sitting for long periods of time. Repetitive exercises which target these areas but are never stretched/massaged.

Muscular tightness can be assessed formally by Soft Tissue Therapist.

How Do you Find out Why You Have Knee Pain?

As you can see from the possible causes above the knee pain symptoms you may be experiencing are all similar. If you are concerned that it is possibly anything other than muscular tightness then go to your doctor and ask for an X-ray or MRI. There are other methods but these are the most common. Such tests are the only way you will know for sure.

Assuming that the doctor has cleared you, muscular tightness may be the cause of your knee pain. A Sports or Soft Tissue therapist can identify which muscles may be causing you the issues.

Alleviating Knee Pain

In case you have tendonitis then you will need to reduce activities and reduce the inflammation by applying an ice compression. If it doesn’t improve your doctor may discuss steroid injections or surgery. Because of its nature, you will need to be guided by your doctor and work with them until the issue is resolved. Be strong and if you are not getting answers. Ask them to refer you to a specialist.

If the cause of your knee pain is arthritis or muscular tightness the best way to manage pain is to actually lengthen the muscles surrounding the knee joint through stretching and massage and improve the strength in your legs. The more you move, the better it will become. Having regular Sports massage or Soft Tissue therapy (not holistic massage) will also improve the tightness in the muscles as well as aid recovery in the muscle fibers.

You can of course take pain relievers and anti-inflammatories but on the understanding that this will simply mask the problems. It will not solve them.

Will Riding Make my Knee Pain Worse?

As mentioned above. Riding doesn’t cause knee pain but it will highlight that there is an underlying issue. Without knowing what that underlying issue is and then dealing with it then yes. Riding will make the knee pain worse.

The truth is many riders don’t know the real reason for their knee pain. It has not formally been diagnosed, rather just ‘labeled’. When you have tight leg muscles and/or arthritis of the knee then not exercising and having regular sports massage only makes it worse over time. Riding will become more and more uncomfortable.

Read our next article to learn how to Prevent Knee Pain when Riding

I was experiencing a lot of pain in my knee and it was beginning to stop me from doing the things I wanted.  The GP asked me about my symptoms and diagnosed arthritis without getting any scans.  This was worrying for me – my mum is disabled by arthritis in her knees.  I was recommended to speak to Clare at RiderCise. 

Clare designed a program of exercises to build my strength and put me in touch with a sports therapist for soft tissue massage.  The pain in the knee is a thing of the past.  I’m fitter now than I have been for years, and I’m no longer stopped from doing anything I want. 

Thank you, Clare.