Knee injuries are one of the most common overuse injuries in triathletes. While rarely caused by the swim portion of triathlon training, pain as a result of increased volume and intensity in cycling and running training can easily put an athlete at risk. If you're a triathlete, being aware of the common errors that can cause knee pain can help prevent a minor twinge of pain from developing into a debilitating sports injury that can sideline you for weeks.
Causes
Knee pain in cyclists and runners is usually caused by overload and biomechanical errors. Overload errors are common with runners and include exercising on hard surfaces like concrete, overdoing the intensity or duration and excessive uphill or downhill running. Biomechanical errors include leg-length difference, muscle imbalance and running style problems such as pronation.
Injuries
The most common cause of knee pain in triathletes is Illiotibial Band Syndrome. The illiotibial band is a thick band of tissue that passes down the outside of the thigh and inserts just below the knee. The band can become tight, pulling the knee joint out of alignment to rub against the outside of the knee, leading to inflammation and pain. Another common injury is Patella-Femoral Syndrome pain, located directly under the knee cap or patella resulting from irritation of the cartilage between the patella and the end of the thigh bone.
Treatment
Cyclists can easily correct imbalance issues by adjusting bike positioning. The American Medical Society for Sports Medicine recommends having your leg lengths evaluated for symmetry and corrected with cleat shims if necessary. Runners should avoid wearing over-worn shoes, and have their gait evaluated to ensure proper-fitting shoes in case of over- or under-pronation. For short-term relief, stretches for the IT band, piriformis muscle and hip flexors coupled with anti-inflammatory medications can be helpful. Icing the area of pain and easing off training also helps to speed recovery.
Recovery
Recovery time can range from three to six weeks for ITBS to several months for conditions such as Patella-Femoral Syndrome. Consult a sports medicine practitioner for a precise diagnosis of your injury and a recovery plan tailored to your needs.
Prevention
Dr. Thomas Miller, former medical director for the US Triathlon Team, suggests proactively building in set rest intervals into a training program. Proper warm-up before activity and stretching after exercise helps to prevent most leg injuries. In addition, strengthening exercises for the gluteus medius or hip abductor muscles improve endurance of the lower extremities for running and cycling.
