How can I stop cycling hurting my knees?

A physio told me to ride less often and less far, but I'm an addict and I can't cut back. Do you have any tips to reduce pain?

I've suffered with knee pain since I was 20, and it's been getting steadily worse. Most would assume it stems from football or jogging, both known knee-killers, but I've no interest in either. Cycling is the culprit.

Although it's a low-impact exercise I cover a few thousand miles a year (according to my slightly anal mileage spreadsheet) and that seems to have taken its toll. I've been to the GP a few times – invariably I was told to rest it, but the pain remained. I just never got around to doing anything more.

Last month I finally did and was given a referral to a physiotherapist, but their news wasn't good. Apparently the back of my kneecaps are being ground away and roughened. This causes the pain and also the clicks, squeaks and grinding that I hear when I bend my leg.

It happens to us all as we age – I'm just speeding up the process by turning the pedals millions of times a year. Ride less often, and less far, I was told. But for me cycling is transportation, relaxation, enjoyment and meditation. I'm an addict, and I can't cut back.

So I decided to look at my options. First I called a private physiotherapist. Michael Crebbin works at Complete Physio and is himself a keen cyclist. He said pain at the back of the knee is the most common complaint and that much of it can be avoided by building up to longer rides gradually, warming up properly and avoiding grinding along in high gears.

"Cycling is a low-impact and linear exercise which requires good knee range of movement and many people cycle well into their mature years," he said. "I always recommend a cycle-specific warm-up to prepare the body for exercise – gentle riding at high cadence until body temperature and heart rate have risen sufficiently is ideal."

Grinding noises from knees could be down to aging-related wear, as I'd been told, but may also be poor joint alignment or muscle tightness – and therefore correctable.

Earlier in the year I'd also booked myself in for a professional bike fit with Scherrit Knoesen from the Bike Whisperer, which had made a big difference. I asked him if there was anything else I should be doing.

He said the main causes of knee pain were having the saddle too low, the cleats set up wrong or simply by attempting too much too soon.

As my bike was already set up his main advice to me was: "Warm up, especially when you get older. Bodies don't respond well to hard work when they're cold. Good lifetime habits of exercise including non-cycling stuff probably helps. If you are determined, there's no reason why most of us shouldn't ride into our 80s at least."

So, I think I'll book a session with a private physio for a second opinion, treat my knees more carefully with proper warm-ups and maybe scale back on the longest rides.

I also found some exercises and stretches which lots of people seem to swear by and, despite less-than-solid scientific proof that it works, I'll start taking Glucosamine tablets and cod liver oil.

Hopefully these will let me keep cycling into my old age. I'm only 28 and these knees have got to last me...

Are there any other tips that have worked for you?

source: http://www.guardian.co.uk/environment/bike-blog/2010/dec/03/cycling-fitness