For many Americans, myself included, cycling is only something we can do every so often.

I lived without a car for years, and I cycled 15 miles a day for commuting/chores. I developed pretty painful patellar tendonitis, and I went to physical therapy, which helped significantly (but didn't cure the issue).

I'm lucky if I can commute 3 days a week on my bike. I love it so much, I even do it when I'm in pain. But it's not possible to do it every day for me, without serious pain.

However, I'm currently converting my bike into an e-bike :) That will make it significantly easier on my poor old man joints.