Bicycling is an activity that can place significant stress on your legs, back and knees. In some cases, the repetitive actions of cycling can trigger pain at the front of your knee joint, which is formed by your femur, tibia and patella bones. This pain can have any one of several distinct underlying causes.
Patellar Tendinitis
If you have your bicycle seat set too low or too far forward, you can develop a painful condition called patellar tendinitis. This syndrome occurs when your patellar tendon, which runs between your patella -- or kneecap -- and your tibia, becomes inflamed. If this inflammation leads to degeneration of the patellar tendon, you have a related ailment called patellar tendinopathy. In addition, you can develop a disorder called patellofemoral pain syndrome, which causes pain either around or underneath your kneecap. You can also develop these problems if your bike's crankshafts are too long for you or if you have weakness in a thigh muscle called the vastus medialis.
Chondromalacia
Cycling-related pain at the front of your knee joint can also result from a condition called chondromalacia patella, which is characterized by breakdown in a layer of cartilage that covers the back of your kneecap. Normally, your kneecap rides smoothly over your tibia and femur when you bend your knee. In people with chondromalacia, this smooth tracking is disturbed, and the kneecap makes abnormal contact with the lowest portion of the femur. Potential factors in the development of this disorder include excessive, repetitive pressure on your kneecap and weakness or tightness in the muscles that form the front and rear of your thigh.
Additional Factors
In addition to the setup of your bicycle, factors in the onset of cycling-related knee pain include the internal alignment of your body, the health and combined function of your muscles and skeleton, your long-term cycling history, any recent changes in your cycling routine and stresses on your knee triggered by participation in specific events. Typically, a doctor or physical therapist who helps you deal with your pain must understand these factors and know how they contribute to the onset of your symptoms.
Prevention and Treatment
In some cases, bicyclists also develop painful inflammation in the quadriceps tendon, which runs between the thigh and kneecap. You can help avoid cycling-related knee pain by setting up your bike for your specific needs and body characteristics. Characteristics that factor into a proper setup include the relative length of your right and left legs, the way in which you align your feet on your pedals, the alignment between your thigh and tibia, and the position of your foot relative to your tibia. Methods used to treat cycling-related knee pain include rest, activity modification, nonprescription medication and strengthening of the muscles in your thigh. See your doctor for diagnosis and treatment that will fit your particular circumstances.
References
- Cycling Performance Tips: Leg, Knee and Hip Pain; May 1, 2010
- BrianMac Sports Coach: Cycling -- Importance of Bike Set-up; January 18, 2011
- UC San Diego Health System: Patellar Tendonitis or Tendinopathy
- FamilyDoctor.org: Patellofemoral Pain Syndrome; December 2010
- MedlinePlus: Chondromalacia Patella; June 13, 2010
