Bicycling participation has grown steadily over the past 10 years and continues to grow with the popularity of cyclists like Lance Armstrong and the broadcasting of the Tour de France. Cycling is a good low-impact exercise for people who need an alternative to running or other high-impact exercises. The most common injuries in cyclists include anterior knee pain and patellofemoral pain syndrome.
Symptoms
The symptoms experienced by cyclists vary depending on the type of knee injury and the areas and tissues affected. Most symptoms of knee injuries include pain and swelling, but some injuries like patellofemoral pain, can cause pain and swelling directly under the kneecap which may result in a locking of the knee during cycling or walking. Cartilage breakdown in the knee can put extra pressure on the bones that meet in the knee joint, which can produce bone pain and swelling and may lead to an irritation of the synovial membrane of the knee which can cause discomfort and synovitis.
Types of Knee Pain
Anterior knee pain is one of the most frequently reported types of knee pain from cyclists, and may be related to repetitive stress or inflammation in the knee. Anterior knee pain may result from patellofemoral pain syndrome, chondromalacia, quadriceps tendinosis, patellar tendinosis and sometimes prepatellar bursitis. Medial knee pain can result from anatomic abnormalities such as genu varus or overpronation or from problems like pes anserine bursitis or mediopatellar plica syndrome. The normal pedaling motion causes the tibia to rotate internally when the knee is extended, leading to medial pain in the knee. Lateral knee pain is usually caused by Iliotibial band syndrome which causes the band of fascia along the outside of the leg to tighten, causing instability in the knee. Posterior knee pain is rare in cyclists, but may result from biceps tendinosis or medial hamstring tendinosis.
Causes
Some knee pain in cyclists is caused by the athlete's anatomy. Having one leg longer than the other, high arches, flat feet, tightness in the lower limbs or being out of shape, bow-legged or knock-kneed can all lead to knee pain when riding. Knee pain can also result from riding a bike with an improper fit. Improper saddle height, saddle position or tilt, and cleat position can all increase the rotation of the tibia, which can lead to medial knee pain. Riding in gears that are too high or climbing very steep hills can also increase stress in the knees, exacerbating any existing injuries.
Treatment
Manage an overuse injury by controlling inflammation and protecting the injury, resting the lower limb, compressing and putting ice on the knee, elevating the knee and taking NSAIDs to help relieve swelling and pain. Visit a doctor if the pain and swelling gets worse or does not subside after about four days. Once the inflammation of the knee is alleviated, your doctor may prescribe rehabilitation exercises to restore your range of motion and strengthen your knee before returning to cycling. If the cause of your pain is due to a problem with your anatomy, you may need to wear a knee brace to help stabilize your knee while riding. If the problem lies in your bike, you should take your bicycle to a bike shop for an adjustment. Most shops can fit your bike to your body for a minimal charge.
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