5 Reasons Driving Stick Shift can Cause Knee Pain

I learned how to drive stick shift at the age of 16 and I was absolutely horrible. However, 3 out of 4 family vehicles at the time were manual transmission so I had to learn fast. I now own a 5-speed manual Toyota Rav4. Over the years of driving and thousands of clutch presses, I have experienced my fair share of knee pain and found ways to avoid it.

What & How:

There are a few muscles that are mainly used when depressing the clutch. The glutes, which extend the upper leg, the quadriceps and hamstring, which are for lower leg extension and curling, and the gastrocnemigreat-demonstration-of-why-the-kneecap-is-a-useful-thing-imgurus, soleus, and anterior tibialis, all of which work together to act on the ankle and allow the pumping motion of the foot. The main way the clutch is usually pressed is by knee extension.

The knee is extended, or straightened out, by way of the quad tendon pulling on the tibia through the patella, or knee cap. The knee cap give the quadriceps a mechanical advantage and helps use to perform knee extension much more efficiently.


Compression and overuse. The knee joint has a thin cushion that sits between the femur and the tibia, called the meniscus, which absorbs the compressive force from the knee. Compared to the shock force during a standing and walking position, the shock force is not evenly distributed in a seated position–most of the force stays at the knee. During leg movement, the kneecap glides in a groove at the end of the femur, called the patellofemoral groove. Irritation between the patella and femur may occur from high repetitions of rubbing between the two surfaces. In some people, the patella does not track perfectly in the groove, causing quicker and more painful irritation.

Knee sleeves  are a good way to distribute compression and congruently guide the patella in the patellofemoral groove to reduce pain. Another source of pain may begin when an enormous amount of force is put through the quad tendon during extension against a resistant force, like a clutch. Highly repetitive tension put through a small tendon over an hour commute in stop-and-go traffic is of concern for pain and fatigue.

knee-2  knee-1

Reasons & Fixes:

1.Stop and Go Traffic – Traffic is where most damage is done from driving manual. Reduce the use of the clutch by properly gauging the distance between yourself and the car ahead of you. Slowly crawl in 1st or 2nd gear during traffic to decrease the number of times you use the clutch.

2. Seat Distance – The more the knee is bent, the more force is put through it. When the leg is bent, the quad tendon is stretched and pressed into the patellofemoral groove. Set your knee distance so that you knee is slightly bent and relaxed.

3. Leg Weakness – If your lower extremities are stronger, it will require less energy to perform the action and experience less fatigue.

4. Butt Weakness – The butt muscles, called the glutes, are a group of muscles that extend the thigh bone, called the femur, and can assist with straightening out the knee when seated. If the glute muscles are weak, the quads are will be overworked  when depressing the clutch, causing knee pain.

5. Use your Foot – If possible, press the pedal by only using your calves and by pressing down the clutch with your foot to give your knee a break.

*Bonus* – Don’t forget about your right knee! Move it around to allow the natural fluid of the knee to lubricate the joint and avoid stiffness.


Without a doubt, seeing a Physical Therapist is the best way to prevent and END knee pain. Having a hands-on experience with a Physical Therapist means dedicated attention and care to relax tight muscles, lubricate stiff joints, and strengthen your body so you can get back to doing what you love.

  • Give the manual vehicle a rest when possible.
  • Ice , compress, & elevate the knee if severely irritated
  • have a stiff or tight clutch fixed
  • Keep the knee joint moving. Hours of driving stick shift keeps the joint in limited positions. joint motion restores nutrients and reduces swelling and pain
  • A knee compression sleeve may also help the reduce pain by helping the kneecap glide in the femoral groove correctly.

Combine this knowledge with a visit to a physical therapist and you will see a dramatic drop in your pain and a dynamic increase in the activities you love to do.

Thank You for Your Attention.  

*Free Content!!  Pre-registration Smart Success PT    Mentoring Monday Facebook Group    Keys to PT Marketing     5 things to know before your PT interview    Free Clinical application for PT’s & 20% off complete anatomy app

Click to listen & Download on iTunes        The Hunt for Greatness
* To learn how Physical Therapy can serve you, see GetPT1st ,  Greg Todd , Renewal Rehab  Paul Gough Physio RoomsFunctional Patterns  ,  Aaron LeBauer , Kelly Starrett,  The Movement Fix, Anatomy Trains,  The Prehab Guys,  Modern Manual Therapy,   Dr. Ben Fung ,   Andrews University Doctor of Physical Therapy

Edited: Ffrancesca Famorcan

Featured Image: http://flexogenix.com/regenerative-medicine/

View More: http://joellearner.pass.us/casey


2 thoughts on “5 Reasons Driving Stick Shift can Cause Knee Pain

  1. bumper to bumper traffic, i cannot leave a centi, the cars in left right lanes might take a km….
    seat back, so knee is not very bent need to try.
    leg and butt strengthening, lol. no help there.

    Foot on pedal, yes!. have been tryin it on and off. will definitely focus on that. it helps

    or i think i need to modify and get a clutch presser that my left hand hand could do.
    expat in UAE where its right hand driving side.
    getting the coordination of hand press+shift will take some time.

    and living in one emirate, working in the next.
    5 days a week, SHARJAH to DUBAI return @ 1.30 to 5 hours depending on traffic coz of the number of major/minor accidents,any dust/rain storms, holidays and of course the time of departure.

    driving a stick shift/manual, any and every bit helps.

    Liked by 1 person

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s