Finding the right saddle, getting a proper bike fit and wearing a good chamois can go a long way in preventing chafing, friction and other women's saddle pain issues that occur when you ride. The good news is that in almost all circumstances, saddle pain (and saddle sores) is completely preventable. Here's what you need to know, whether you're a new cyclist or you've been riding for years:
Don't wear underwear with your bike shorts. Not bikini cut, not thong, not g-string. Nothing. This deserves its own section because it's something that beginners are rarely told, and even if you do know, you may not know why. It's not about avoiding unsightly panty lines, or in any way about style. It's all about making your ride more comfortable by avoiding friction between skin, underwear and bike shorts. The pad in bike shorts is meant to trap bacteria and also alleviate friction by providing a single smooth surface from the top of your thighs across your nether regions. If you add an underwear layer, not only are you no longer getting any use out of the antimicrobial chamois pad, the two fabrics will rub against each other and your skin, which can lead to micro-tears in the skin, which can lead to saddle sores. So... just don't wear underwear with your shorts!
What Pains Me About Cycling: The Saddle
But think twice before you use that old, worn-out pair of bike shorts for your stationary training. The chamois (the padding inside the shorts) is probably worn thin and less effective, and you can guess what that means if you ride long enough: saddle sores.
One of the most important things to do is check that your ischial tuberosities (sitting bones) are in solid and well-maintained contact with the saddle. There are so many formulas for this, but without the use of saddle pressure mapping, the easiest way to test this is to sit onto some soft cardboard and find the indentations made with your ischial tuberosity (sit bones) and measure the distance between them. Your saddle should be about 10mm (at least) wider than this, to comfortably accommodate you.
If your knees hurt from cycling, there\u2019s no need to carry on suffering.\nWe\u2019re here to help you identify where the discomfort\u2019s coming from, what\u2019s causing it and how to stop it.\nIn this article, we look at the areas of the knee where pain might be felt when riding a bike, and the speci\ufb01c conditions that can lead to knee pain when cycling.\nLater we\u2019ll take a close look at the inner workings of the knee, and how cycling overuse injuries can lead to problems that stem from three broad categories.\nAll of them will have contributory factors from these three problem domains: changes in training intensity (cycling-speci\ufb01c); changes in equipment (bike-speci\ufb01c); and our intrinsic anatomical and biomechanical make-up (cyclist-speci\ufb01c).\nThe key is to identify which of these is most relevant to you and make a change.\nRead on to boost your knee knowledge and banish needling pain.\n\n \nRemember the golden rule for cycling knee pain\nWhile we can give you some basic strategies for getting out of trouble when plagued by knee pain, the old adage rings true:\u00a0stay out of trouble in the \ufb01rst place.\nMany problems with the knee can be avoided by not making sudden increases in your training regime or drastic changes in bike setup\nLook after your legs and they\u2019ll look after you: stretch all the big muscle groups after each ride and treat them to the odd massage\nDon\u2019t neglect core muscle strength \u2013 smaller core muscles can relieve much bigger limb muscles of surprisingly large loads\nThe scope of this article is limited to some of the more common overuse injuries, so if you\u2019ve sustained an acute injury or experience sudden pain, or if your symptoms don\u2019t improve with this very general advice, please seek appropriate qualified medical help.\n\n\n \n The four main areas of knee pain for cyclists\n\n Physio is not just for the pros and could be a sensible investment. Luc Claessen\/Getty Images\nThere are four areas of knee pain: anterior, posterior, medial\/lateral and iliotibial band syndrome. Let\u2019s look at each of those in turn.\nArea 1: Anterior knee pain\n\n Pain under the knee cap is known as runner\u2019s knee and can plague cyclists as well. Getty\nPain at the front of the knee \u2013 on and around the knee-cap (patella) \u2013 is the most common presentation of cycling overuse injuries, in part due to the anatomy of this area.\nThe large quadricep muscles attach to the shin bone via the patella, so the forces of pedalling are transmitted across the patello-femoral joint\u00a0whenever we bend our knees, essentially squashing it back against the thigh bone.\nAlthough more common in explosive sports, the part of the tendon attaching the patella to the bony prominence below the kneecap can become in\ufb02amed (patellar tendonitis). If this area is persistently sore to the touch it\u2019s definitely worth seeking medical help. It should respond to ice, anti-in\ufb02ammatories and physiotherapy, with or without strapping.\nHowever, if you\u2019re reading this and you have anterior knee pain from cycling, chances are you\u2019ve got what\u2019s known as a \u2018patellar compression syndrome\u2019.\nThe scourge of cyclists and runners alike, it can completely \ufb02oor you, causing pain when off the bike and ride-stopping agony when on it.\n\n Even at the lowest point in the pedal stroke, the leg doesn\u2019t lock out. Felix Smith \/ Our Media\nDuring the push phase of pedalling, we seldom complete the last 35 degrees of knee extension \u2013 a movement which is largely under the control of the vastus medialis oblique (VMO) muscle.\nThis means that over a long period of time, and often in spite of outward appearances, the muscles down the outside of the thigh become much stronger and tighter than these less-used medial muscles.\nThe patella is pulled subtly off-kilter and forces through the patello-femoral joint increase, causing diffuse pain anywhere around the kneecap. The soft tissues around the lateral aspect of the patella slowly shorten over time, and make strengthening exercises of the VMO muscle alone largely ineffectual.\nFour ways you can treat anterior knee pain when cycling\n\n Extending the knee can stop surrounding muscles becoming tight. Tim de Waele\/Getty Images\nThe key to treating such a condition is to loosen off the lateral structures before attempting to redress the balance and concentrating on building medial muscle bulk.\nThere are various methods for doing this, all of which aim to reduce the forces through the patello-femoral joint:\nTry to keep your leg out straight, if you\u2019re troubled with anterior knee pain of this type, whenever you have the choice.\nBe aware of bike-speci\ufb01c problems. Make sure your saddle is set to the right height. Pushing too big a gear or using excessively long cranks can also be a problem.\nBuilding up the vastus medialis oblique muscle can also help. After a week or so of regular stretching and self-massage, work on building up the vastus medialis oblique muscle to balance out the stabilising forces on the patella. It\u2019s slow and can feel pointless initially, but persist with loosening the lateral side then strengthening the medial side, and in a couple of weeks you\u2019ll feel a difference.\nThere\u2019s not much point in taping up the patella because the forces generated when cycling are too great and the taping just won\u2019t hold. Particularly resistant cases can be tackled by a sports physio, who can work speci\ufb01cally on mobilising the tight lateral tissues around the patella.\nIt\u2019s also worth pointing out that cycling isn\u2019t the only time we bend our knees and stress the patello-femoral joint.\nCrouching down to pick something up and tackling stairs are more obvious activities, but sitting at a desk with feet underneath the chair (or in a cinema seat) for prolonged periods will produce the same effect.\nArea 2: Posterior knee pain\n\n Posterior knee pain is likely to be felt in the posterior cruciate ligament at the back of the knee. Getty\nPain behind the knee is far less common, and much more straightforward. It\u2019s almost always due to over-extending the knee.\nBike-speci\ufb01c problems to look for: a saddle that\u2019s too high or too far back, although these are just as likely to cause pain further up the hamstrings.\nPersistent pain behind the knee should be looked at medically to exclude a Baker\u2019s Cyst.\nNamed after the person who originally described them and nothing to do with making bread, they\u2019re a harmless bulging of synovial \ufb02uid into the space behind the knee. Your doctor can discuss treatment options with you.\nArea 3: Medial and lateral knee pain\n\n The medial and lateral collateral ligaments cause pain on the side of the knee. Getty\nPain at the sides of the knees is fairly common and the culprits here are almost always the feet, or more specifically, incorrectly fitted pedal cleats.\nTo this end, such pain is often noticed during or after the \ufb01rst ride with cleats, or with a new pair of shoes or replacement cleats.\nThe structures causing the pain are most often the collateral ligaments, which sit on the outsides of the knee joints, stopping them from bending the wrong way.\nBike-speci\ufb01c problems are usually to blame here: badly placed cleats will either affect the Q angle (how far apart your feet are positioned) or cause excessive rotation of the knee joint, stressing one or other of the collaterals. The cleat position and knee pain diagram (below) describes the usual culprits and what to do with them.\nTwo\u00a0 ways to avoid and treat medial and lateral knee pain when cycling\n\n Cleat position and knee pain explained. BikeRadar\nCheck cleats for excessive wear regularly. Always make sure you draw round cleats with a felt tip pen to mark your position before replacing them. Experiment with different cleat types until you \ufb01nd one with the right amount of \ufb02oat for you (too much or too little can both cause problems).\nGet off on the right foot. If you\u2019re new to cleats, one tip for getting a good starting position is to sit on the edge of a table with hips, knees and ankles relaxed at 90 degrees. Look down: whatever angle your feet naturally dangle at should be replicated by the cleats.\nArea 4: Iliotibial band syndrome\n\n Running down the outside of the leg, the iliotibial band is prone to become tight and knotty. Getty\nAnother painful condition that\u2019s very closely related to patellar compression syndrome is called \u2018iliotibial band syndrome\u2019.\nThe iliotibial band is a thick \ufb01brous strap of tissue that runs all the way down the lateral thigh, from the pelvis to just below the knee. It\u2019s a structure that has a habit of tightening up over time and pulling the patella off centre if your vastus medialis oblique muscles aren\u2019t strong enough to counteract.\nBecause of where it sits, as the knee is repeatedly bent and straightened, it moves back and forth over the knobbly end of the thigh bone just above the knee, cushioned by a \ufb02uid-\ufb01lled bursa. It\u2019s at this point that inflammation can occur, which is then irritated each time the knee is bent.\nMost commonly seen in runners, it\u2019s an unpleasant condition thought to be exacerbated by weakness of the gluteus medius muscle \u2013 another essential core muscle that gets neglected by cycling \u2013 and also by wearing cleats that point the toes too far inwards.\nHow to manage iliotibial band syndrome\n\n This stretch targets hard-to-reach muscles down the side of the leg. Robertus Pudyanto\/Getty Images\nIn the acute phase of the injury, the mainstay of its treatment is the same as any for an in\ufb02ammatory condition: rest, ice and regular anti-in\ufb02ammatory medications such as Ibuprofen, if tolerated.\nRehabilitation after this is very similar to that described above for patellar compression syndrome, but with a focus on building up the gluteus medius muscle instead of (or as well as) the vastus medialis oblique.\nNear-religious stretching, especially of the iliotibial band, should precede strengthening exercises. A return to normal activities should be phased in gradually, being guided by (a lack of) pain. Incredibly resistant cases can be operated on, but it\u2019s rarely required if the above regime is followed.\nGluteus medius strengthening exercises for cyclists\n\n The gluteus medius is located to the side of the buttock. Getty\nThe following exercises are all designed to strengthen the gluteus medius muscle \u2013 an important core abductor of the hip, often neglected by cycling.\nIt\u2019s a smallish muscle which, when contracting, can be felt as a lump at the top of the \u2018scoops\u2019 of your buttocks \u2013 it\u2019s a good idea to place a hand on this area when doing the exercises, to make sure you\u2019re exercising it.\n1. Side-lying leg lifts\n\n Leg lifts are a useful exercise for strengthening the gluteus medius.\nAn exercise performed by lying on your good side, with lowermost leg bent for balance.\nKeeping the uppermost leg straight, and with the foot rotated out to 45 degrees, raise it up and slightly backwards, holding just for a couple of seconds. Lower the leg and repeat, feeling for the contraction of the muscle with your uppermost hand.\n2. Rotating dip\nStand sideways on to a wall, balancing on the affected leg, with the unaffected leg lifted just off the ground and pressed against the wall for support. Now slightly bend the standing knee, dip down by a few inches and hold this position.\nKeeping your weight on the outside of your foot, now try to twist the knee outwards, stabilising yourself against the wall with your other (raised) leg.\nThis is an excellent way to build the gluteus medius, has the added advantage of also indirectly stretching the fibres of the ITB and what\u2019s more can be done while cleaning your teeth!\nFour strategies for loosening tight lateral muscles of the thigh\nAs well as the usual stretches for quads and hamstrings \u2013 always a good idea \u2013 there are two stretches that target the lateral structures, in particular the iliotibial band.\nContrary to popular belief, it is possible to stretch the lower end of the iliotibial band.\n1. Lower iliotibial band stretch\n\n This stretch is ideal for lengthening tight soft tissues around the lateral aspect of the patella. BikeRadar\nLie on your good side, in a straight line along the edge of a bed so you\u2019re looking across the bed.\nHold on to the end of the bed with your lower arm for support.\nReach behind you with your upper arm and pull your foot to your bottom, as if you were doing a regular quads stretch. Keeping your foot against your bottom, gently increase the quads stretch by pulling your leg backwards. You\u2019ll feel it along the front of your thigh \u2013 let yourself relax into this stretch.\nStill holding this stretch, and making sure you don\u2019t tilt your hips backwards, now very gently push your knee down towards the floor.\nAt a certain point you should feel quite a sharp stretch down near the knee \u2013 perfect for lengthening those tight soft tissues around the lateral aspect of the patella. It\u2019s important to keep your whole body in line and perpendicular to the bed during the stretch.\nIf you\u2019re lucky enough to be able to enlist the help of a patient friend, ask them to place one hand on your hips (to stop them from rocking backwards) and push down \u2013 very gently \u2013 on your knee with the other. This produces a better stretch, since you can completely relax the leg as it\u2019s being pushed down.\n2. Upper iliotibial band stretch\nStanding upright, cross your bad leg behind your good one, making sure you keep it locked straight.\nThen, without bending forwards, gently lean sideways from the waist over to the good side.\nYou can support yourself against a wall by leaning away from it. You should feel this stretch over the outside of the hip and upper thigh.\n3. Massage\n\n Loosen the quadriceps with regular massage or foam rolling. Tim De Waele\/Corbis via Getty Images\nYou can do this yourself, after a ride or a hot bath. With the leg locked out straight, rub with firm pressure all along the outside of the thigh. This is most easily achieved by using the palm of your hand to rub a squash ball in a circular motion over the muscles.\nAlternatively, use a little oil and the flats of your fingers or thumb. If you\u2019re really lucky, you\u2019ll have a willing helper to do it for you.\n4. Trigger points\n\n A foam roller effectively targets the lateral thigh. Getty\nThis doesn\u2019t work for everyone, but applying deep, sustained pressure (for up to 30 seconds) with a thumb or foam roller over particularly tight or painful areas along the lateral thigh can sometimes work wonders. Sit down, lock your leg out straight to relax all the quads and find problem areas by massaging.\nPressing hard can cause your eyes to water if you\u2019re feeling particularly tender, but persist with it and you\u2019ll often feel tight spots twitching in submission and relaxing under the pressure.\nAn indirect and effective way of pinpointing these trigger points is to lie on your side and gently lower the weight of your leg on to a tennis ball. Be warned though, it\u2019s not for the faint-hearted.","image":"@type":"ImageObject","url":"https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/21\/2021\/04\/kneepain3-e7fd138.jpg?quality=90&resize=768,574","width":768,"height":574,"headline":"Why do my knees hurt? Cycling knee pain explained and how to manage it","author":["@type":"Person","name":"BikeRadar"],"publisher":"@type":"Organization","name":"BikeRadar","url":"https:\/\/www.bikeradar.com","logo":"@type":"ImageObject","url":"https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/21\/2019\/03\/cropped-White-Orange-da60b0b-04d8ff9.png?quality=90&resize=265,53","width":182,"height":60,"speakable":"@type":"SpeakableSpecification","xpath":["\/html\/head\/title","\/html\/head\/meta[@name='description']\/@content"],"url":"https:\/\/www.bikeradar.com\/advice\/fitness-and-training\/cycling-knee-pain-the-problem-areas\/","datePublished":"2022-07-16T16:00:00+00:00","dateModified":"2022-07-16T16:00:21+00:00"}] Why do my knees hurt? Cycling knee pain explained and how to manage it How to identify and treat specific overuse knee conditions for cyclists 2ff7e9595c
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