Bespoke Blog
Let's Talk About... Knee Pain
The third of this mini-series of blog posts on cycling injuries with Bespoke's Head of Bike Fitting, Dan Pells and Resident Osteopath with New Body Osteopathy, Charlotte Mead focuses on knee pain; how you get it, how to fix it, and how to stop it coming back.
Dan and Charlotte both feel that with any pain arising from cycling, the body and the bike must be adjusted simultaneously to clear the injury and prevent its recurrence. Knee pain in cyclists is a common and debilitating injury which can be recurrent.
Although considered a "low impact" sport, cycling can lead too debilitating knee pain due to improper set-up, technique or physical/fitness limitations. Here we look at the most common issues for each area:
- Front of the knee - pain at the front of the knee, over the kneecap, is most commonly due to too much shear force across the knee joint created by the large powerful quads muscles. In cyclists this is commonly caused by poor bike fit as well as overwork such as sprinting and high gears without adequate fitness can all contribute to pain in this area.
- Back of the knee - pain at the back of the knee is much less common and usually attributed to one thing - over extending of the knee, stressing the hamstrings and tendons at the back of the knee. This is usually causes by a saddle that is too high or far back, or incorrect technique around the ankle joint ie. an excessive heel drop.
- Inside of the knee - This is almost always attributed to feet position, with the knee bearing the brunt of irregular foot position and movement. If the foot and ankle is not stabilised during the downward phase of the pedalling stroke, the knee can track inwards towards the bike frame, stressing the inner structures of the knee.
- Outside of the knee - Pain on the outside of the knee is usually caused by ilio-tibial band friction - ITB friction syndrome. This can be settled with a simultaneous change to your bike fit as well as osteopathic treatment and exercise prescription.
In Focus… Foam Roller for Knee Pain
The foam roller can be a hugely beneficial piece of kit for injury management and prevention at home, which can really complement your osteopathic treatment and speed along recovery. For today's In Focus, we give away the most effective foam roller stretches for cyclists with knee pain.
Otherwise known as self-myofascial release, the aims of foam rollering are:
- To increase blood flow
- To decrease pain
- To release "trigger points" to re-establish proper movement patterns within the muscle
The picture below indicates the positioning for foam rollering of all the main muscles of the legs. Where possible it is worthwhile to consult an expert such as an osteopath or physiotherapist before starting to use a foam roller for the first time, so they can check that this type of exercise is going to be safe and effective for you, and demonstrate how to use it.
As the picture shows, foam rollers are extremely versatile and can get to all areas on your legs that are uncomfortable.
The key pointers for effective foam rolling are:
- Speed - do this slowly! Foam rolling can be uncomfortable, minimise this and prevent risk of spasm by not shocking your muscles - slow, controlled, even pressure as you roll will give the most effective stretch.
- Pressure - the temptation to shy away from the most tender spots will be strong but these areas need the most attention - once you have found a tender spot you should hold still on this spot for 20-30 seconds until you feel it slowly releasing and becoming less painful.
- Breathing - to maximise the effectiveness ensure to breathe evenly and steadily to maximise your oxygen intake to support your muscles.
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