On day 4 (ie. fairly exhausted) of a mountain bike trip to Colorado, I injured my knee. I was stopped, dropper seat in lowest position, I thought I was in the easiest gear but I was in a middle gear. When I started pedaling, there was immediate pain above the knee cap. The pain was mild enough to get back to trail head.

Researching this, seems like it could be tendonitis in either the quad or patella tendons. It only hurts when biking, not walking, getting up from seated position, etc.

After 2 weeks, I went on a leisurely ride on flat streets and in a few minutes the pain began with every pedal stroke. Waited another 1.5 weeks (today) and pain started within a few minutes.

Anyone else experience this or have tips to speed up recovery? I've been icing and using a knee sleeve/compress.


  • 3
    Voted to close as medical advice is off topic. However I can say it took me months to recover from tendonitis just above the knee. Go see a physio and get advice on a rehab routine.
    – Andy P
    Commented Aug 9, 2022 at 22:35
  • Unfortunately tendon and ligament issues can take weeks and months to fully heal :( A massage roller can help somewhat. I’ve had knee issues because of instability in my ankle joint and feet, it’s not always only a matter of bike fit.
    – Michael
    Commented Aug 10, 2022 at 5:35
  • I spent at least a year getting rid of ITBS. Even then I am still susceptible for it coming back early in the season. Fortunately, now it does not stay for too long (a week or two, not many weeks) if I do develop the pain but it has never been solved completely. And one can find many conflicting recommendations out there even from qualified professionals. There are voices that are strongly against rollers because they further irritate the tissue even if they make you not to feel the pain that much for some time. Usually one should look for muscle imbalances and places to strengthen. Commented Aug 10, 2022 at 12:10
  • Similarly, I am now susceptible for repeated Achilles tendinopathy from classical cross country skiing. No clear way of solving it other than getting the right muscle groups used to hard work before the season starts. Commented Aug 10, 2022 at 12:14

1 Answer 1


Knee pain is a complex issue, because the body is very complex and not completely understood. This is a caveat for what I am about to say. Another caveat is that even if I were a clinician (which I am not), the following is not medical advice because I am not examining you in person.

In my experience, improper bike fit, and in particular improper saddle height, can cause knee pain. Performance-oriented cyclists can push their saddles up too high. The remedy is finding a bike fitter. However, finding a good fitter can be tricky, because bike fit is complex and not completely understood. Nevertheless, you could start there. Good bike fitters may also have a sense of physiology, at least enough to give you appropriate stretching and strengthening routines.

If you see a physiotherapist, that can also work well. However, your average physical therapist won’t be aware of bike fit issues. They can’t be expected to, as it is a bit more of a niche sport in many countries, and there are many sports. Your average physiotherapist would still be able to assess for muscular imbalances that might cause knee pain. However, your position can be the cause of those imbalances, and they would not generally be able to assess that.

If you see a physician, in my experience, most may not have the expertise to get to the root cause of the issue, and they might prescribe medication and refer you to a physical therapist.

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