INTRODUCTION: A Physiotherapy-led Bike Fitting (PBF) intervention including a bike fit, education, and exercise prescription can be helpful among cyclists with knee pain. OBJECTIVE: To describe the PBF intervention and to assess knee-related pain and disability change among recreational cyclists exposed to the PBF intervention. METHODS: This is a single group prospective observational longitudinal study on a cohort of recreational road cyclists who consulted for cycling-related knee pain at a physiotherapy clinic specialized in cycling. The PBF included a comprehensive bike fit focusing on key measurements such as knee flexion and knee alignment relative to the pedal axis while cycling. Additionally, tailored education was provided on cycling cadence and training progression, along with exercise prescriptions. The primary outcome was the knee pain during cycling measured with the numerical pain rating scale (NPRS
0-10). Linear models were used to assess within-group changes across time points at 4 and 12 weeks. RESULTS: Seventy-six recreational road cyclists with knee pain while cycling were included and all received the PBF intervention. In terms of evolution over time following the intervention, there were significant improvements over time in worst, least, and average knee pain while cycling ( CONCLUSIONS: Based on this single group observational study, recreational road cyclist exposed to a PBF intervention, including a bike fit, tailored education, and exercises prescriptions reported a reduction in cycling-related knee pain and disability.