With the impact-free nature of cycling, many people turn to the sport to spare potential knee injury. However, cycling can cause knee injuries for several reasons. The most common reasons for knee injuries related to cycling are improper training, overuse and improperly fitting equipment.
Iliotibial Band Friction Syndrome
The Australian Physiotherapy Association says that iliotibial band friction syndrome is the most common injury related to cycling. The iliotibial band is a fibrous tissue that originates at the hip, runs down the side of the leg and inserts just below the knee. The repetitive nature of cycling causes this band to rub, causing friction, against the bones around the knee causing pain. Pain from this type of injury commonly occurs just below the knee or to the outer side just above the knee. Proper training and equipment can prevent this injury.
Patellofemoral Pain Syndrome
Commonly referred to as PFPS, patellofemoral pain syndrome causes pain around or under the patella, or knee cap, that worsens with activity or prolonged sitting with knees flexed. An article by University of Washington Medical Center Dr. Mark S. Juhn in the Nov. 1, 1999 journal "American Family Physician" attributed the pain to the patella rubbing against the femoral, or thigh, bone. This can be due to foot problems, heavy lifting, inward curving legs, tight muscles of the back and lower legs or muscle weakness in the thighs. According to Dr. Michael Sparks of Dartmouth-Hitchcock Medical Center, causes include overuse, seat height or simply having a kneecap naturally out of alignment with the thigh bone. Treatment includes rest, strengthening of the quadriceps muscles, or thigh muscles, proper shoe fitting and ice as needed or after exercise.
Improper Training
Proper training is important for avoiding many cycling injuries, knees included. Build your time on the bike gradually, use a warm-up and cool-down period, stretch after riding the bike and add rest periods into your weekly riding schedule. Cadence is another training tool that will help avoid injuries. The APA advises an 85 revolution-per-minute cadence on flat terrain as optimal and adjust gears accordingly. They add for hill climbing, the gear that provides minimal strain on the knees is best.
Proper Fitting and Equipment
The Olin Health Center at Michigan State University recommends proper frame size, seat height, horizontal adjustment of the seat and stem height to avoid injuries. To avoid iliotibial friction, the APA recommends adjusting the seat so that while sitting on the bike with the pedal at six o'clock the heel is able to rest flat on the pedal. Ensure that foot placement on the pedal while riding allows the heel to remain in alignment with the lower leg as opposed to rotating outward or inward.
Considerations
When beginning a cycling routine, visit your local bike shop for proper fit and equipment. For seasoned cyclists experiencing knee pain, consult a physician. Treatments and therapies vary depending on the cause. Checking the seat adjustment on each ride can also help avoid injury as settings may shift during transport or from use.
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