Runner's knee is a term used to describe a common syndrome that results from overuse of the knee. It affects people who flex their knees constantly such as runners and cyclists. Cycling with runner's knee requires rest, special exercises to strengthen your knee and possibly some changes to your bike fit.
Runner's knee is the nickname for a couple of conditions. Patellofemoral pain syndrome is when the patella, or knee cap, is misaligned on the groove in the femur, the bone in your thigh. Because the patella is no longer tracking properly, your femur is irritating the underside of the knee cap. The pain that results feels like it is coming from around or underneath your knee. It will start out as a gradual ache, eventually becoming so bad it will hurt all the time. Iliotibial Band Friction Syndrome manifests when the iliotibial band -- the tissue that connects the gluteal region to the outside of the tibia -- suffers from the friction of cycling with your knee bent at a 20 to 30 degree angle.
Initially you’ll have to take a break from cycling. See your doctor as soon as you can for an exact diagnosis. In the meantime, follow the R.I.C.E. method of rest, ice, compression and elevation. Wrap an elastic bandage around your knee and elevate it on pillows to rest it. Apply ice packs for 20 minutes at a time. Your doctor may also suggest that you take anti-inflammatory medicine to help with pain and swelling.
When your pain and swelling are reduced you can begin special exercises to rehabilitate your knee. This will require you to strengthen and stretch the muscles that support the knee. Most important are the quadriceps, hamstrings and iliotibial band. The quadriceps are in the front of your thigh and are responsible for stabilizing your knee cap and extending your leg. The hamstrings in the back of your thigh are responsible for bending your knee. When these muscles are strong they will absorb the pressure you place on your knee while cycling, which will reduce misalignment and also reduce pain.
Back in the Saddle
Once your knee is feeling better you can get back on your bike. However, you should consider making some changes when you cycle with runner's knee. First, look at your bike fit. A saddle that’s too low may be responsible for your condition. The saddle should be high enough so that your leg is still bent slightly at the bottom of a pedal stroke. When seated on your bike your toes should just touch the ground. The other change to make will be implementing a permanent routine of strengthening and stretching exercises three times a week to maintain your knee strength while cycling.