It's not all about that bass... it's all about the knees

More and more patients are coming to me with knee problems. If you can criticise any part of the body - the knee is at the forefront. Its design for mobility over stability leaves it vulnerable to injuries because any unexpected force from either side of the knee or a twist in the ankle can damage the inside structures.

Anterior Knee pain is one of the most common cycling injuries and this can be down to a few factors: bike position, changes in hours/intensity on the bike and the cyclists level of ability to compensate and adapt to these changes. Research has shown that cycling injuries are often the result of overuse repetitive pedal motion coupled with biomechanical malalignment. The motion of the lower extremity during exercise constitute a complex kinetic chain of events and highlight any abnormality present. Therefore, any disruption to this chain may cause dysfunction, injury and impaired performance.

Pain at the front of your knee can be down to a number of things but the most common cause is patella-femoral syndrome. The Quadricep muscle which is made up of four different muscles attaches from the hip to the front of the knee. It is used when walking, running, going up and down stairs and predominately in the downward phase of the cycling pedal stroke. When this group of muscles become too tight they can cause the patella (kneecap) to rub against the undersurface of the knee causing pain during and after activity.

It is very easy to have an imbalance between the four muscles so strengthening them equally and making sure that the patella sits centrally will take the load of the knee joint reducing and often eliminating the pain. This can be done with one legged lunges focusing on taking the knee cap over the first two toes keeping the patella straight and inline on the forward and backward phase. Stretching and massage really helps with removing the muscle tightness and lactic acid build up after a hard cycling session.

It is also very important to look at bike position and to note any changes you have recently made especially in regards to saddle height or your cleats. Fundamentally, a biomechanical assessment to look at how the structures within the knee work, how your hip and ankle are function are key to treat and as a preventative measure in the future. Sometimes it is apparent that there is a leg length discrepancy which is contributing to the knee pain and this is something that can be addressed during the biomechanical assessments.

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