Cycling Knee Pain: The #1 Issue for Newcastle Riders

If you cycle in Newcastle, chances are you’ve felt knee pain at some point. It’s the number one problem we treat in local cyclists and triathletes. Whether you’re climbing Mt Sugarloaf, training for Ironman Port Macquarie, or cruising along the Fernleigh Track, knee pain can quickly take the joy out of riding.

The good news? Most cycling knee pain is preventable — and fixable — with the right combination of bike fit and physiotherapy.

Why Cyclists Get Knee Pain

Cycling may be low impact, but it’s highly repetitive. On a two-hour ride, you can rack up more than 10,000 pedal strokes. Even tiny imbalances are amplified.

The most common causes we see in Newcastle cyclists are:

• Bike fit issues – saddle too high/low, cleat misalignment, or crank length mismatch.

• Weak glutes and quads – poor muscle balance shifts stress to the knee.

• Sudden training spikes – jumping from 50 km weeks to 100 km+ without a gradual build.

• Poor recovery – fatigue alters biomechanics and overloads the joint.

The Different Types of Cycling Knee Pain

Not all knee pain is the same. Where you feel pain often points to the cause:

• Front of the knee (patellofemoral pain) – usually linked to saddle height, weak quads or under-utilised glutes.

• Outside of the knee (ITB irritation) – often linked to cleat angle or hip weakness.

• Inside of the knee – less common but often linked to poor tracking or excessive inward collapse.

Why Ignoring Knee Pain Doesn’t Work

Many riders try to “push through” knee pain, but this usually makes things worse. Without addressing the underlying cause, pain tends to:

• Recur every time you increase distance or intensity.

• Spread to the hips or back due to compensation.

• Limit performance and enjoyment.

How We Treat Cycling Knee Pain in Newcastle

At Up N Adam Performance Training & Physiotherapy, we combine bike fit expertise and physiotherapy testing to address both the bike and the body.

Step 1: Assessment

• Detailed cycling and pain history.

• VALD strength testing for glutes, quads, and hamstrings.

• Professional BikeFit with Physiotherapist Dean Waterman (located at Up N Adam) if deemed appropriate ( www.cyclefitphysio.com ).

Step 2: Relieve Pain

• Hands-on physio (soft tissue release, dry needling if indicated).

• Glute activation work.

• Training load modification to reduce irritation while staying active.

Step 3: Strength & Retraining

• Bike Specific Glute and quad activation drills.

• Hip and core stability exercises for smoother pedal strokes.

• Progressive strengthening from rehab to performance.

Step 4: Return to Full Training

• Gradual load build-up.

• Re-testing with VALD to confirm strength restored.

• Bike fit fine-tuning for comfort and efficiency.

Book your Cycling Knee Pain Physio Appointment today

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Case Study: Right Medial Knee Pain – Cyclist

A competitive cyclist presented with right medial knee pain of six weeks’ duration after increasing training load in preparation for a Victorian Alps Event. Symptoms included a “pulling” sensation and quad fatigue during hill climbs.

Initial Assessment:

• Medial knee pain reproduced on concentric phase of squatting.

• Reduced right hip internal rotation at 90°, tight glutes, and difficulty recruiting the right glute on single-leg press (5 plates). Pain reduced with glute activation.

• Marked tenderness in the right VMO.

Intervention:

Soft tissue release to right quadriceps, gluteal stretches, activation drills, and glute engagement on both bike and leg press.

Progress:

At 6 weeks, knee pain had fully resolved. Hip internal rotation normalised, glute strength improved (6 plates SL press), and flexibility increased.

Outcome:

Patient reported complete symptom resolution and returned to racing without recurrence of knee pain. Discharged after self-managing a maintenance program of glute, ITB, and hip strength / mobility drills.

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FAQs – Cycling Knee Pain

Do I need a new bike to fix knee pain?

Not usually. Most issues are solved with small fit changes and strengthening.

Can physio actually make me faster?

Yes. By optimising muscle balance and bike fit, many cyclists find they ride with more power and efficiency.

How long until I can cycle pain-free again?

Most riders see improvement in 4–6 weeks with the right plan.

Is knee pain just part of cycling?

No. Pain is a sign something needs adjusting — whether it’s your body, your bike, or both.

Final Word

Knee pain doesn’t have to be part of cycling. With the right assessment, bike fit, and strength program, you can ride longer, stronger, and without discomfort.

You can book an appointment with Darren or Newcastle Knights Physiotherapists Katie or Hayd'n at www.upnadamptphysio.com .

Bookings also available on our website for the following services at Up N Adam Performance Training & Physiotherapy:

• Dietitian - Sweat testing, weight-loss or to optimise your training nutrition / fuelling www.nutrientnation.com.au

• VO2 Max testing with Lucas McBeath - to discover more effective ways to train efficiently www.flowitri.com.au

• Strength & Conditioning Programs with Adam Clarke - contact us or book via the website or email us at upnadamptphysio@gmail.com

• Remedial Massage with Katheryn Rodgers - to relieve accumulative muscle tension & keep you training well.

• CycleFit by Physiotherapist Dean Waterman - At Up N Adam, for all your bike fitting solutions www.cyclefitphysio.com