Did you know that a professional bike fitting will prevent cycling knee pain and back pain, and will help you to bike further and faster, without pain?
Causes of Cycling Knee Pain
Among all athletes, knee pain is the most common overuse injury. And among cyclists, knee pain is the most common leg overuse injury. Repetitive stress injuries are common in cyclists, no doubt due to the fact that cycling is just so addictive.
And cyclist knee pain is also common because the movement in cycling is very repetitive – when cycling for an hour, we average up to 5,000 pedal revolutions. Apart from that, high mileage, and the rapid increase in training intensity that many of us cannot resist in early spring, can both lead to cycling knee injuries. (Source: CPT Chad Asplund, MD, Knee Pain and Bicycling: Fitting Concepts for Clinicians; The Physician and Sports Medicine, 32.4)
But importantly, cycling knee injuries can be caused by ill-fitting bikes. As you can see from this table from a medical research report, there are all kinds of cycling knee injuries that can be caused simply by an ill-fitting bike.

How I Fixed my Cycling Knee Pain
A few months ago I bought a new bike (a really cool Specialized Tricross Sport). I was so happy with it that I went right out and rode hundreds of kilometers … and then suddenly found that I could not walk without pain. Naturally, I ignored the pain and continued cycling.
In fact, I reasoned that walking hurt more than cycling, so I should try to avoid walking, and actually cycle MORE.
But then it got to the point where I was having almost paralyzing pain in my knees while cycling, and I had to admit it was time to get help. I was having a serious attack of cycling knee pain. It was too late to prevent my cycling knee pain, and even my miraculous, cheap cure for cycling knee pain could not get me back in the saddle.
So I bit the bullet (hard) – I got a professional bike fitting done by Zenya Kasubuchi, a sports physiotherapist down at the Allan McGavin Sports Medicine Centre at the Plaza of Nations in downtown Vancouver. It was a hard bullet to bite because it was NOT CHEAP.

The professional bike fitting was worth every cent.

A Professional Bike Fitting includes Assessment, Diagnosis and Prescription
I got an in-depth assessment of my body, and the diagnosis that I had caused the problem by riding long distances on a bike that was not fitted to my body. The analogy Zenya used was running a train just slightly off the track for long distances – the constant friction had caused irritation, and stubborn ignoring of the irritation had led to quite serious inflammation.
After the assessment, Zenya measured and aligned every important part of my bike. This professional-bike-fitting included getting the saddle height right, and the distance between the saddle and the handlebars. It also meant lining up the saddle with the crank, so that the angle of my knees while pedaling was correct. And he showed me the right angle to have my knees at (apparently cycling like a duck is not recommended).
Good Shoes are Also Necessary to Prevent Cycling Pain
Also he pointed out that my sneakers were too floppy, and recommended that I get cycling shoes with really non-bendable soles, such as Five Tens.

Zenya fixed what he could right on the spot, and sent me away with a prescription for my local bike shop. The professional-bike-fitting prescription included getting a shorter stem, and changing the angle of said stem. It took the bike shop a while, but when I picked it up, it was like magic. I’ve never had a bike feel that good!
Also, Zenya pointed out that once my bike was perfect, I could make sure that my other bikes matched this one as closely as possible. This is really useful for people with several bikes, as these fittings are expensive, so you want to have as few as possible.
That said, I know that I will never again buy a bike and NOT get a professional bike fitting.
It Cost Me More to NOT Have a Professional Bike Fitting!
The cost of NOT having a professional bike fitting was really high:
- months of knee pain
- the depression caused by not being able to ride at all eventually
- about a dozen physiotherapy sessions
- hours of stretching exercises, and
- constant icing for about two months.
Wow! Compared to all that, a professional bike fitting is really good value for money.
I highly recommend that you get yourself a professional bike fitting the next time you get a new bike. Your knees will thank you! If you can’t afford one, then fit it yourself. Here is a book that shows you exactly how to do your own bike fitting: Bike Fit: Optimise your bike position for high performance and injury avoidance.
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Good post, Joe – I second that. I’ve had all of my bikes professionally fit by a physio and swear by it. One thing to consider on the cost…some plans cover the fitting if it is by a licensed physio and is in order to alleviate (or even avoid) injury. If you haven’t looked into it, you might want to.
Thanks Janine! That’s a good point – I will try my luck with my plan. To me it makes total sense for plans to cover it. I have had to claim my entire year’s worth of coverage for physio AND massage to deal with the injury. Using just a portion of the physio to PREVENT the injuries in the first place makes much more sense.
I got my bike fitted a couple months ago after intense knee pain and it was worth every penny! Then I got knee pain again a couple weeks ago and went to visit my physio and it turned out to be a tight IT band. I’ve been stretching it religiously and I’m going to see if the problem will stay away (so far it has)… otherwise I’ll be back to my bike shop to get my cleats adjusted again (which I think was what caused the knee pain in the first place).
Hi Katy. Yes, mine is mainly a tight IT band as well. I am doing a lot of rolling on this roller-thing. It was intensely painful at first, but is much better now, which shows progress. I have started cycling again, building up very, very slowly. It’s hard to do, because all I want to do is ride my bicycle like a maniac …
It is amazing what even a tiny adjustment can do. I have yet to get a professional fitting, but when I was in the middle of my first 40 km ride on my new bike last month, I was able to cure a tightness in my mid thighs instantly by raising the seat just 2-3 mm. It’s been 800 km since, and the tightness has not returned.
P.S. Nice bike. It was on my list, but I opted for a Rocky Mountain Solo CXR, mostly ’cause that’s the brand that my LBS sells. Aside from some factory quality control issues, I’ve had no regrets.
Hi Graeme, nice to hear from you. You’re right – just took 45 mm off a stem on another bike, and suddenly it’s not giving me elbow pain. These tiny changes make all the difference.
Thanks for comment about the bike. I have to say I love the Specialized Tricross – must do a review one of these days. Have never ridden a Rocky Mountain Solo CXR – if you ever want to post a review, I’d love to post it for you. People need good, unbiased reviews to help when making the all-important decision of which bike to buy!