Knee pain after 87 miles on bike


I am a regular cyclist and distance runner and last saturday (13TH) did an 87 mile sportive, cycling non stop for best part of 6 hours.  I had no pain while riding but the next day suddenly had pain in my left knee, around the inside of the patella (i think).  I rested for a day and then did some gym work including 10 mins on the exercise bike which was agony.  I ran too but this was ok with only mild pain.  I left it again and then the next day ran 8 miles with no probs.  Thinking it was ok i got on the turbo a day or so later but struggled with pain.  I haven't been back on the bike since but ran today and it felt 80% ok. 

I have no idea what it is but wonder if anyone has experienced this after a sudden long ride.  I normally ride max of about 50 miles so this was quite a jump in mileage.  If anyone can give a name or suggest what i might be experiencing that would be helpful.  Any advice gratefully recieved!

PS. It might be useful to note i have been visiting the physio for the last 2 months for a pelvis misalignment which has now been fixed.  Not sure if this has adjusted my riding style.

thanks, Laura


  • Has your bike been fitted and your cleat position been looked at? I would check that first and foremost!
  • Another useful comment from Davidm bleeding Aussies
  • i dont see any of his comments - keeps me sane 

    laura - look at how your knee moves at the top of the stroke, does it go in towards the frame, like Jamie said its probably cleat position


  • Thanks Jamie, yes i had it fitted a couple of years ago and have done hundreds of miles with no problems.  However i haven't had it looked at recently.  Cleats are just due for replacement actually but i was planning to put them in the same place.

    David - the distance shouldn't be the issue really as i am used to long rides, max before this was 70. 


  • Doner Kebab - my knee on the left is closer to the top tube on the up stroke than it is on the right. 

  • If your cleats are the same on both sides, it might be down to weak glutes and stabiliser muscles - I have a similar problem, which I only noticed after I had a Retul fit. Weak glutes allow your knee to drfit in, so its out of position as it were when you start to put force through it, causing pain.

    Strange it only showed up after a slightly longer ride - although may be a chronic condition that's been hiding in the background?

    Some youtube clips of exercises that were recommended for me here which may help.

  • Hi Laura, I'm having the same problem at the moment.  My right knee flared up after a 80 mile ride; like you I'm pretty used to riding long distances, though have been pushing a little harder of late.  I have my first ironman in 10 weeks so am starting to get very worried as the pain stops me training for 4 days after a big ride.  I saw a podiatrist yesterday who has recommended the glute strengthening stuff mentioned above.

    Does anyone else have any other advice?  To make matters worse I have an Achilles pull at the moment so can't run either!


  • popsiderpopsider ✭✭✭

    Don't change anything on the basis if one episode of knee pain after upping your miles would be my take on it.  Rest off the cycling for a bit.  

    If it returns and becomes a limiting factor then my choice would be find one of the few people that combine physio type knowledge with knowledge of bike fit / cycling.     That said if your knee on that side is obviously unstable or moving in an odd sort of plane then you could play about with shoe inserts and cleat position yourself.

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