Updated: Dec 2, 2022
There are many forms of knee injury and this is not an exhaustive list. If you have knee concerns and this article still leaves you with questions. You can book a no-strings call with me to discuss solutions and if I can't help you, I'll point you in the right direction.
90 revolutions per minute for just 60 minutes is 5,400 pedal strokes. Add that up over a week or even a year and it's a mind-blowing amount of repetitions. Now, I'm a Strength & Conditioning Coach. They're not, but If Pedal strokes were reps in a gym I'd have a problem with them. They just don't utilize the intended full ROM (range of motion) of the knee joint, hip or ankle while we're at it. We're basically short cycling our hamstrings and quads while our foot is locked onto a rigid platform.
No wonder knee pain is so common among cyclists. Today I'm only going to focus on knee function and the ways in which your knee function can manifest pain in the knee. I know the hip and ankle as well as your bike fit will influence knee health. But for today we're keeping the scope of the conversation intentionally narrow. We'll get to the hips next week.
I'm a fan of treating problems with the simplest or most obvious solution first. So if you're getting knee pain and you're an avid or new cyclist we can reasonably assume that its cycling that's causing the pain. It'll likely present in one of the following ways.
Pain under the knee cap - Patellofemoral pain syndrome (PFPS),or Patellar Bursitis
Pain to the left or right of the knee - Iliotibial band syndrome (ITBS/ITBS)
Pain on the surface or just above/below the knee cap - Patellar tendinopathy
Whichever you are suffering from, the recommended course of action will be.
Relative rest - remove the offending stimulus (eg. Cycling).
Restore Healthy, full movement to the joint
Strengthen the healthy, full range of motion in order to solidify recovery
We're going to take number 1. off the table for this audience, although it may become necessary if we exhaust our other options. And I would suggest this is why taking quick and decisive action is important here. I you are getting "niggles" deal with them before they become more insidious..
Now it's possible you don't have knee pain. In which case, I'd recommend trying this test just to make sure you're not at any immediate risk and that your knee has healthy active ROM as well as well-balanced Quads and Hamstrings.
If you ARE suffering from any of the above or you just failed the above test, here's the drill....
Lengthen the hamstrings in a straight leg, hips flexed position.
Jefferson curl - start off with about 10% bodyweight in each hand. When you can complete 5 sets of 5 with 20 seconds rest between sets, you can add another 5lbs per hand. If you're interested in getting really strong at this movement, I've had clients progress safely and gradually up to 25% of body weight in each hand.
*NB if you have underlying back concerns, this exercise may well work for you, but you should drop me a line first if you want to make sure it is suitable.
Lengthen the quads in a hips-extended position.
This is an infinitely scalable exercise. Hike your heels up higher, to begin with in order to decrease the load at the end ROM. When you can complete 5 sets of 5 with 30 seconds rest, decrease the height of your platform by ~4 inches.
the beauty of these two drills is that they both offer the leverage and stability to allow a stretch, increasing mobility. We're also loading through eccentric and concentric movement phases which will encourage the body to 1. remodel tendon tissue and 2. promote a long lasting neural pattern allowing you to keep your greater mobility without having to stretch every day. In short, we're improving mobility and strength at the same time.
Now Tibial Rotation -
You probably haven't heard of tibial rotation, but it's a necessary movement of the knee and it enables us to articulate our foot in different positions ( you can see why it would suffer from cycling). Without tibial rotation, the articular surfaces of our knees will incur greater wear in certain spots and this might lead to a shorter healthy life of our cartilage and meniscus.
It's another use it or lose it facility, so let's get to using it..
Tibial rotation drill
Use this drill after long rides for recovery. Or if you really struggle with knee pain in peidgeon pose or during seated windshield wipers , you should make this a daily drill. I've seen it help many a client.
As I mentioned at the start of the article. There are many forms of knee injury and this is not an exhaustive list. If you have knee concerns and this article still leaves you with questions. You can book a no-strings call with me to discuss solutions.
Next week, we'll look at the hips. As well as seeing how hip dysfunction can cause even more knee pain, we'll be looking up-chain to the back. Hit the subscribe button if you don't want to miss it :)