Cycling and patellar tendonitis often go hand in hand, especially for riders increasing their mileage or tackling more hills. Also known as patellar tendinopathy, this condition affects the tendon that connects your kneecap (patella) to your shinbone. The patellar tendon works with the thigh muscles to help you extend your knee, an essential movement with every pedal stroke.
Knee pain from cycling is a common complaint among both amateur and experienced cyclists. The repetitive nature of cycling, particularly when combined with muscle imbalances or a poor bike fit, can place excessive strain on the patellar tendon. Over time, this can lead to inflammation and irritation, resulting in persistent knee pain.
Physiotherapy can play a key role in reducing pain, improving muscle balance, and restoring efficient movement, helping cyclists return to riding comfortably and confidently.
What Is The Cause Of Patellar Tendonitis?
If you have ever felt kneecap pain after cycling, it could be patellar tendonitis. Patellar tenonitis can be caused by many things, and though it’s not exclusive to cyclists, the condition is most common in cyclists. This is because it’s easy to overuse or repeatedly stress the patellar tendon in the sport.
Putting your patellar under extreme stress through having sudden increases in training, such as starting to climb more hills or going for longer rides, can cause pain. It’s estimated that around 25% of cyclists have experienced this pain, and it’s recommended to get it checked out as soon as you feel it.
Patellar tendonitis is also primarily caused by poor load management. High loads may have either positive or negative effects on injury risks in athletes. In general, athletes respond significantly better to smaller increases and decreases in load than to big variations in loading. There is no “one size fits all” principle, and load should be prescribed or recommended on an individual and flexible basis, as there is a large variation in the time frame of response and adaptation to load.
Another common issue that causes the development of patellar tendonitis in cyclists is a poor bike fit. For instance, the saddle being too low or too far forward forces your knee to bend more than necessary during each pedal stroke. This increased knee flexion alters the natural movement pattern of the leg and places additional strain on the patellar tendon, especially in the power phase of pedalling.
Over time, this repetitive stress can cause inflammation and ultimately patellar tendonitis. Ensuring that your bike is properly fitted by a professional, along with physiotherapy, you can help prevent this issue and promote more efficient, pain-free riding.
Weak or imbalanced leg muscles, particularly the glutes and hamstrings, are significant factors in patellar tendonitis in cyclists. When these muscles are underdeveloped or not functioning properly, the quadriceps commonly overcompensate during pedalling. The increased reliance on the quads places added stress on the patellar tendon. Over time, the imbalance can lead to irritation and inflammation of the tendon and eventually, if left untreated, patellar tendonitis.
4 Ways Physiotherapy Can Help Cyclists Suffering With Patellar Tendonitis
1. Pain and inflammation management
In the early stages of patellar tendonitis, managing the pain and inflammation is a top priority to prevent the condition from worsening and to allow the tendon to begin healing.
There are a few ways that this can be done. Ice therapy can help reduce swelling and pain by constricting blood vessels and limiting the inflammatory response. This is typically applied for 15-20 minutes after the activity to calm down the tendon.
Manual therapy is a hands-on technique to mobilise the joints and can reduce joint stiffness and improve the tracking of the kneecap. Through the manual therapy techniques, it reduces the secondary tension around the tendon caused by joint misalignment or movement restriction.
Shockwave therapy is also a powerful treatment for pain and inflammation management. Many patients experience a noticeable improvement in their condition after just a few sessions, making it an ideal option for those looking to get back to their active lifestyle quickly.
The final pain and inflammation management option that sports injury physiotherapy can offer is soft tissue massage. This is used to relieve muscle tightness and decrease pulling forces on the patellar tendon, lowering irritation during movement.
These methods are typically combined with rest, load management, and the gradual reintroduction of activity to provide both immediate symptom relief and a solid foundation for long-term healing.
2. Muscle strengthening tips for cycling and patellar tendonitis
Strengthening the muscles around the knee is a core component of physiotherapy for patellar tendonitis.
A well-designed rehabilitation programme focuses on improving muscle, balance, control and endurance to reduce stress on the patellar tendon and promote long-term recovery.
Strengthening your muscles is important as weak or imbalanced muscles cause the tendons to absorb more load than they should, leading to overuse and irritation. By actively strengthening these muscles, they can support more efficient movements during cycling.
The process usually begins with low-load, high-control exercises and gradually progresses to higher resistance and functional movements. This should be done with a physiotherapist as they carefully monitor pain levels, movement quality and progression to avoid re-irritation of the tendon.
3. Flexibility and mobility work
Tight or restricted muscles and joints around the knee can significantly increase the strain placed on the patellar tendon, especially during repetitive activities like cycling.
This is where physiotherapy can help improve muscle flexibility and joint mobility to reduce this tension and promote more efficient, pain-free movement.
Flexibility and strengthening techniques are really important for the muscles to stay strong and not pull excessively.
Stretching techniques that you could implement into your daily life to avoid putting stress on your patellar include controlled leg swings, lunges, or body weight movements to prepare muscles and joints before activity. Holding gentle stretches for 20-30 seconds to lengthen tight muscles such as quads, hamstrings, calves and hip flexors all help avoid getting patellar tendonitis.
By improving muscle elasticity and coordination, you reduce the risk of getting patellar tendonitis and other common injuries that come from cycling.
4. Movement and posture correction
Correcting movement and posture is a crucial part of physiotherapy for cyclists dealing with patellar tendonitis. Physiotherapists perform a thorough assessment of your biomechanics, which includes observing your cycling posture and even your walking pattern.
When you are on the bike, subtle issues like a forward tilted pelvis, knee collapsing inwards, or poor core engagement can all increase stress placed patellar tendon with every pedal stroke. Over time, these small mechanical faults contribute to repetitive strain and inflammation. Off the bike, dysfunctional movement patterns can further aggravate the tendon.
A physiotherapist will work closely with you to identify these imbalances and use tailored interventions, such as targeted mobility work and technique drills, to correct them. By improving alignment and teaching your body to move more efficiently, you help offload the patellar tendon, allowing it to heal properly and reducing the risk of recurrence.
For cyclists in particular, this may also involve adjustments to cleat positions, saddle height and pedalling technique, ensuring that both on your bike and off your bike movements support recovery and long-term joint health.
Let Us Help
Patellar tendonitis does not need to hamper your cycling performance or goals. With the right physiotherapy expertise, training plan, and rehabilitation, you will be better prepared to take on more challenges and achieve more milestones.
We want to be a part of your cycling journey and be the ones to help you reach your goals. With 9 clinics around the UK, our physiotherapists are trained and qualified to assess, diagnose, and treat any of your injuries.
Whether it is easing pain in your knee or creating a treatment plan, physiotherapy is highly effective and is a long-term treatment option. We also provide a wide range of treatment options such as repetitive strain wrist treatment, sports therapy, lower back physiotherapy, RSI injury treatment, treatment for joint pain and stiffness, and more.
Let us kickstart your journey to stronger knees today by booking an appointment with us. If you’re already ready to commit to treatment, take a look at our Sports Pass, a treatment bundle that is designed for active people ready to recover from injury.