How should I set up a bike so it does not hurt my knees?

Setting the seat height

• 1. Stand beside the bike and set the seat roughly level with the top of your hip bone as a starting point
• 2. Sit on the bike and put your heel on the pedal at its lowest point; your leg should be almost straight
• 3. Now pedal with the ball of the foot; at the bottom the knee should be slightly bent, roughly 25 to 35 degrees
• 4. If your hips rock from side to side, the seat is too high; lower it a little
• 5. If the front of the knee aches, the seat is often too low; raise it in small steps

Other settings

• Seat forward and back: with the pedals level, the front of your knee should sit roughly above the pedal spindle
• Feet: keep them pointing straight ahead; if you use clip-in shoes, ask for the cleats to allow a little float
• Handlebars: high enough that you are not straining your back, especially on upright gym bikes
• Recumbent bikes: set the seat so the knee is nearly straight at full extension, as with an upright bike

Resistance and pace

Begin with light resistance at a steady cadence, roughly 70 to 90 turns per minute, for 10 to 20 minutes. Grinding heavy gears at low speed puts much more load on the kneecap. In spin classes, ignore cues to crank the resistance up when your knee is sore; stand out of the saddle sparingly.

After knee surgery, a stationary bike is often introduced once the knee bends to around 100 to 110 degrees. If a full turn is not yet possible, rock back and forth or pedal backwards until it is, following your physiotherapist's advice.

When to stop

Mild muscle burn is fine. Stop if you feel sharp pain, clicking with pain, or the knee swells afterwards. Pain on the outside of the knee in regular cyclists can be IT band irritation; pain inside the knee with catching needs a specialist assessment in Doha.