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Knee pain while cycling

The causes of knee pain vary, but are usually related to the position on the bike and the position of the foot. If the foot or the pedal are not aligned correctly, this has a direct effect on the load on the knee joint. In addition to the correct adjustment of the cleats, SQlab insoles support the foot for optimal pressure distribution and better power transmission. We offer our pedals in different axle lengths for a natural foot position.

Knee pain due to an unnatural foot position

Cause: one-sided strain

SQlab knee pain

SQlab solution: different axle lengths

SQlab knee pain

Cause: Pedals with a short axle usually only allow a parallel foot position, which often does not correspond to the natural foot position.

SQlab solution: pedals with different axle lengths for a natural foot position. The extended axis of the SQlab pedals allows a more physiological, natural foot position. This prevents one-sided strain – especially in the case of fibula head syndrome.

The different axle lengths

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These pedals are rarely used, but they still have their place. The short axle is suitable for cyclists with small shoe sizes who can ride with their feet parallel. The so-called Q-factor is thus smaller. In particular, in combination with a narrow sit bone distance and narrow hip width, it makes sense to stand with your feet as close together as possible.

The standard size, for those who honestly get by with the pedals of the market leaders in this area.

This is important for people whose feet form a V shape when viewed from above. If you place your feet on the pedals parallel to each other, this no longer corresponds to the natural position and can cause discomfort in the knees. So if you experience discomfort, especially on the outside of the knee at the fibula head, you should place your feet on the pedal in their natural position. With clipless pedals, the cleat can usually be adjusted without any problems. But since it is then usually too narrow for the heel and it rubs against the crank or the frame, the longer axle of the SQlab pedals quite simply provides more space for this foot position. Even from shoe size 45 upwards, it often gets cramped and you see smoothly polished cranks.

When pedaling, the foot tends to rotate slightly. That's why we recommend clipless pedals, which allow for this movement. Normal platform pedals should therefore have a surface that is not too grippy, even though slipping off them can be somewhat dangerous. Pedals with a large and grippy surface that often bite into the shoe sole via pins can cause the knee to twist when riding, but also when dismounting.

The contact surface of SQlab bike pedals is always horizontal. For millions of years, humans have been accustomed to walking on flat ground. Even though the pedaling movement is still quite new for the biomechanical development of humans, the foot angle is a very individual value. The best way to align the feet is in the shoe and first with insoles.

It is best to have a bike fitting expert adjust the foot using V-wedges, for example, in the case of a large forefoot angle and a non-axial knee elevation curve.

Knee pain due to a misalignment of the leg axis

Cause: Malposition of the knee

SQlab knee pain

SQlab solution: Insoles that supports the weak points

SQlab knee pain

Leg Axis


Due to instability or muscular imbalances, the knee can move inward or outward from the leg axis while standing or pedaling (also called O-leg or X-leg). The resulting one-sided strain can cause knee pain. 

Especially with more pronounced leg axes and foot arches, the musculature around the knee joint and ankle joint is strongly overstrained without support and is permanently brought into an unnatural position (knee tilts inward or outward). Due to the resulting muscular tension and instability, the longitudinal arch is permanently overstrained and promotes knee pain. Depending on the foot type (based on the SQlab foot type determination), SQlab insoles support the arch of the foot to varying degrees in order to compensate for misalignments in the leg axes. This can reduce symptoms of fatigue and knee pain.Therefore, it is clear that in addition to the foot type the leg axis is also important for the selection of the correct support level.

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Knee pain due to restricted joint movement

Studies to date have shown that allowing 10° of axial rotation in clipless pedals can reduce the potential for stress injuries to the knees. SQlab has used these findings to become the first company on the market to develop an active pedal for a knee-friendly, ergonomic pedalling motion. While float of up to 10° is already common with clipless pedals, the foot is static on a city pedal with grip. The SQlab 502 active pedal is the first city pedal with lateral float and good grip at the same time.

The adantages of freedom of movement

+ natural movement of the foot
+ foot position is determined by the knee
+ knee joint is protected

The position of the foot on the pedal has a direct influence on the axis of rotation in the knee joint. An unnaturally twisted position of the feet on the pedal also causes a rotation of the lower leg and changes the usual joint movement in the knee. The one-sided strain can lead to pain and increased wear and tear of the joint.