Knee pain from riding is a signal worth taking seriously, because a healthy riding position should not place significant stress on the knee joint. When the knee is sore after riding, it almost always means the joint is being asked to absorb forces or maintain positions that it was not designed to handle — and the source of that problem is usually found either above the knee in the hip and thigh, or below it in the stirrup length and foot position. Locating the source of the stress and addressing it directly is far more productive than simply trying to ride through the discomfort. The most common cause of rider knee pain is gripping with the knee. This is an extremely widespread habit, particularly among riders who learned to ride without a strong foundation in position or who ride horses that feel unpredictable or unsteady beneath them. When a rider grips with the knee to feel secure, two things happen simultaneously: the knee is pressed inward and upward against the saddle, which compresses the joint and restricts circulation, and the lower leg swings backward and away from the horse's side, which removes any meaningful leg contact and makes the position less secure rather than more. Gripping with the knee is one of those instinctive responses that achieves the opposite of its intended purpose. The security in riding comes from a long, weighted leg with a deep heel, not from a clamped knee — and releasing the grip, counterintuitive as it feels at first, actually produces a more stable and comfortable position for both rider and knee. Stirrup length is the second major contributor to knee pain and is one of the easiest things to adjust and evaluate. Stirrups that are too short force the knee into a more acutely bent angle through the entire ride, which concentrates stress on the joint and reduces blood flow to the surrounding tissue. Many riders, particularly those coming from an English background or those who have been told to ride with a deep bend in the knee for security, discover that lengthening their stirrup by even one or two holes significantly reduces or eliminates knee pain. The knee should be softly bent in the stirrup, not sharply angled, and you should be able to feel weight dropping through your heel without having to reach for the stirrup. Foot position in the stirrup interacts with knee comfort as well. A foot that is turned significantly outward — toes pointing well away from the horse — places the knee in a rotated position that stresses the medial structures of the joint with every stride. Bringing the foot to a more neutral position reduces that rotational stress. Conversely, a foot turned too far inward places stress on the lateral side of the knee. The goal is a foot angle that allows the knee to track in its natural plane of movement rather than being torqued to one side or the other throughout the ride. If positional corrections do not resolve the pain, it is worth considering saddle fit. A saddle with a twist that is too wide forces the rider's legs into an unnaturally splayed position, which puts persistent lateral stress on both knees. A qualified saddle fitter can assess whether your saddle is contributing to the problem. And if pain persists despite addressing all of these factors, a conversation with a sports medicine physician or physical therapist familiar with equestrian athletes is worthwhile — some knee issues in riders have underlying causes that benefit from targeted rehabilitation alongside the positional work.
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Watch: I Have Sore Knees From Riding — What Am I Doing Wrong

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Mary Wanless: Rider Biomechanics — Sore Knees From Riding: What Am I Doing Wrong
Mary Wanless Rider Biomechanics