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Bicycling May Reduce Knee Pain and Osteoarthritis

Pedal Through Pain - Study Links Cycling to Reduced Knee Osteoarthritis Risk

Medical News

bicycle through knee pain

A study published in April 2024, of 2,607 subjects with a mean age of 64.3 years, investigated the effect of bicycle riding on the development of knee osteoarthritis. 

They looked at three different endpoints, the prevalence of radiographic knee osteoarthritis, frequent knee pain, and symptomatic radiographic knee osteoarthritis.  51.6% of the subjects had a history of bike riding.  52.4%, 25.2%, 12.2%, and 10.2% identified bicycling in one, two, three, and four different time periods of their lives respectively.  The division of ages was 12–18, 19–34, 35–49, and greater than 50 years old.

Compared to non-bicyclers, bicyclers had 17% less risk for frequent knee pain, 9% less risk of radiographic osteoarthritis and 21% less risk of symptomatic radiographic osteoarthritis.  The reduction in symptomatic osteoarthritis was 17% for those that bicycled for only one period in their lives versus a 38% risk reduction for those that had bicycled in three periods of their lives and a 43% reduction for those that had bicycled in all four time frames in their lives. 


In this study people who bicycled had a lower prevalence of radiographic knee osteoarthritis, frequent knee pain, and symptomatic radiographic knee osteoarthritis, than non-bikers.  The more time one biked for, the higher the risk reduction.  A logical conclusion from this interesting study and the authors’ conclusion is that bicycling may be favorable to knee health, which may be true.  

However, there are some limitations in interpreting this data.  Another possibility to be considered is that people with knee problems may be less likely to continue bike riding while those with less knee pain or pathology are more likely to continue bike riding, rather than bike riding itself having a protective effect.  Finally, in the Osteoarthritis Initiative Database that was used for the study, 2,189 subjects were excluded for various reasons; not returning for a 96-month visit, not filling out the historical form, or not having x-rays of the knee to examine.  Eliminating subjects due to protocol violations is very common in medical research, but in this case almost 46% of the potential subjects were excluded.  There is no way of knowing, if those subjects had been included, whether the results would or would not have been the same. 

Lo GH  et al. Bicycling over a Lifetime Is Associated with Less Symptomatic Knee Osteoarthritis: Data from the Osteoarthritis Initiative. Medicine & Science in Sports & Exercise ():10.1249/MSS.0000000000003449, April 11, 2024. Retrieved from:


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