Neverending knee pain/quitting cycling

Hi all,

Has anyone got over long term (18 months+) knee pain?

I’ve been to 3 physios, had two new bike fits, seen an orthopaedic specialist. Nothing is working. I could detail this further but i’ll keep things simple. I have done every exercise 10000 times, massage, rolling daily, stretching daily, icing etc. Taping, new insoles, taping foot. I must have the strongest glute med on the planet now after all the exercises on it.

Generally hurts more riding outside. Generally fine on trainer.

I do also have the sensation that my right(bad) doesn’t feel as natural/strong/planted as my good leg.

If anyone can offer some help, let me know. Seriously considering stopping cycling. I’ve been riding 8 years, was 4.5 w/kg/cat2 uk. Used to be able to ride 450 tss per week no problem. Now I’m so inconsistent and patchy its like 200 for the last 6 weeks, so naturally my fitness has tanked.

Any stories to give me hope would be hugely appreciated.

Thanks all

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I felt with knee pain for quite a while, did whole bike fit, mri on knee, dr, etc. none of that helped. What worked for me physical therapy, they discovered my ankles were really week so exercises and switching from Speedplay to Shimano SPD-SL . I think most of my problems were from foot movement allowing knee movement and this pain. voltaren Gel is also amazing for knee pain for me, if I start to feel even a twinge if pain that makes it go away very quick

What kind of work did they prescribe you?

Currently doing…

1 leg bridge. Monster walk with band. Bosu ball single leg squats. Short arc ankle raises with ankle weights. Clamshells with band. Balance for 1 min on bosu one legged.

Typically 3 X 15 reps every day. With foam rolling on all leg muscles and stretches. Weekly massage also.

Just in case you haven’t seen this thread: [FAQ] How to Fix Knee Injuries for Cyclists (Knee Pain)

Thanks…I’ve read that a few dozen times already to no avail I’m afraid.


Have you been off the bike entirely while doing these exercises? You need to be off the bike for a few months to recover.


Same here. So many theories that it’s hard to know what to try. I won’t hijack your thread, but I have an issue that doesn’t keep me off the bike, but is annoyingly painful and prevents me from holding long hard intervals (like a ramp test), so I literally feel your pain and was hoping you could find help there.

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Where on the knee is the pain and when does it start? Hard efforts? Long saddle time?

If I do a recovery ride easy outside…no problem. Long and/or hard, I expect to happen.

wheres the pain?

Kind of diffuse over the knee cap, but if I had to try and pinpoint it, I’d say it’s just to the inside of the patella tendon if I have to localise it.

This seems pretty consistent with what I was prescribed. I’ve seen you say that if you keep it easy that you don’t have a problem. If you are determined try to get to the volume you want to be at at the intensity that works for you. Once you can do the volume add in small doses of slightly more intensity. Expect it to take months, not weeks, to build up tolerance. If you go too hard be willing to back off and restart.

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What’s your current situation?

My knees started causing me issues at the start of 2019. Just about completely quit cycling. Hooked up with a PT and listened to my coach and started building back onto the bike octobetish of 19. Back to setting PRs in 2020. Coming off my first ‘good’ offseason now. Still do hip and leg strength work before pretty much every ride.

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I feel your pain and frustration - long term (40 years) knee sufferer.

Simple exercise check: can you stand on just your weak knee for 1+ minutes with your other leg raised into a right angle (thigh parallel to the ground, lower leg vertical)? The key is if you can do this without shaking, especially at the ankle. If not, then this indicates you need to work on strengthening the hip & ankle on the weak leg.

The other thing to check is to do a ramp effort, and check how well your weak leg tracks. Is there a power level at which your weak leg starts to wobble through the pedal stroke? If so, then this is another sign of weakness and/or hip tightness. Stay below this power level as you work on doing 1 leg exercises. For 1 legged exercises, I would doing lying straight leg raises in all four directions. As you do these and strengthen the muscles, work up to being able to do these with ankle weights - this was one of the exercise sets I was prescribed when I was rehabbing after knee surgery.

Good luck

I don’t know the nature of your isssue, but just in case it’s related to osteoarthritis my brother gets these injections every 6-9 months. Works for him very well, placebo or not.

What do you think of the one leg work? I couldn’t do the bosu ball one legged. FWIW what seemed to work for me (n=1) was focusing on goblet squats, kettlebell deadlift & swings, and weighted step-ups. For warmup and activation I do 7 way hips and monster walks. Good luck!

I don’t want to stand up after 7 way hips, never mind getting on a bike.

Feel good activation for me, so funny how n=1 works.