How to get rid of cycling related knee pain.
http://www.cycling-inform.com/articles/222/1/How-to-get-rid-of-cycling-related-knee-pain/Page1.html
David Heatley
David Heatley is the director
of Cycling-Inform and co-creator of the RaceRight Cycling Camp. He has
medalled at national and regional events in By David Heatley
Published on 03-Oct-08
I have suffered from knee pain
both on and off the bike. This article discusses my personal insight into cycling knee
pain and provides information about what worked for me.
I have suffered from knee pain
both on and off the bike. This article discusses my personal insight into cycling knee
pain and provides information about what worked for me.
NOTE: I’m not a qualified professional in this area. This is written from my personal experience and is not a substitute for professional medical advice. What worked for me is no guarantee that it will work for you. If you suffer knee pain I recommend that you seek help from qualified medical professionals.
In my mind there are two types of knee pain or injury.
The first type of knee pain is fairly straight forward and simple to resolve. This is the knee pain that results from some minor tendonitis as a result of increasing your kilometres too soon or from an accident that results in physical damage to the knee joint like a strain or a tendon tear. Most competent medical professionals can diagnose these problems quickly and have standard proven surgical and rehabilitation procedures to address them. These are generally problems that resulted from a singular event that triggers the pain; like a fall off the bike or a rapid increase in kilometres. This is the case where you have no history of knee pain prior to the event. When treated correctly your knees recover within the appropriate amount of time.
The second is a little more difficult to address. Your knees get sore and relate to no apparent singular event. You ride your bike normally and increase your kilometres in a steady fashion and slowly over time you knees get sore. You rest and the pain slowly goes away but lingers. You might find that you can cope with 150km a week and increasing your km’s over 150km results in pain that doesn’t go away. Your knees hurt at night. You wake in the morning, they still hurt. You go to work and while sitting at your desk you can feel your knees ache. Climbing stairs is painful. Professionals you see have their own opinion on what’s wrong but their treatment results in no or only minor relief. It’s frustrating. To solve this type of knee pain it's important to find a professional that is able to dive deep into and address the root cause of your knee pain and not the symptoms.
Professional Therapy
Firstly it's important to find an professional that understands cyclists. The sorts of problems that cyclists experience are sometimes different to other sports people.
I’ve found that taping knees with sports tape might be ok for other sports but didn’t work at all for me while on the bike. Strengthening exercises did however help but they needed to be functional like the ones that I have on the Matt Brindle Functional Strength DVD. Use free weights. Stay away from the gym machines as they usually only strengthen your joints in one plane of movement. In my opinion, gym machines are great for dysfunctional body builders to build muscle bulk but death to improving good functional movements required for sports people and general rehabilitation of movement.
Trigger Point Therapy - Excellent results. Large improvements within days of being treated. I read a book by Clair Davies called The Trigger Point Therapy Workbook. Made a lot of sense to me. I would recommend it anyone with on-going chronic pain. There are some very good Myotherapists out there. I found that the ones that could work on my hips to be the most successful. The theory behind is this: “Trigger points are manifested as small contraction knots in the muscles, that control the state of contraction and active ones may cause muscle spasm and referred pain”. Ref: http://www.naturaltherapypages.com.au/massage/Trigger_Point_Therapy. The muscle can’t function properly if it has a trigger point present. I personally don’t know all the facts on why it works but I’ve found it to be the singularly most effective way of sorting out my knees.
Bicycle Setup
Bike fit specialist – Good start. Yes, it’s very important if you have any knee pain to get the best bike fit that you can find. It’s really important to pay close attention to cleat placement and any shims, packers and other devices to help alight the foot correctly on the pedal. Seat height and forward/aft position is also important. Bike shops are usually good at getting you close to an ideal position but if you still have issues then you may have to see someone more specialised. I found that a good position was fundamental to resolving my knee pain.
Pedals - Pedal selection was very important. I have tried several pedal systems. The pedals that work best for me are the ones that don’t wear out after 6 months. By that I mean that they don’t start getting play in their bearings. One way to check is to grab the pedal and check for bearings play. When a pedal has play in it my foot will rock across the pedal in all directions while I’m pedalling the bike. It appears that my knees don’t like pedals with play in them. I’ve found that the Shimano SPD SL Pedals (ULTEGRA PD-6620 and DuraAce PD-7810) provide a great stable platform and their bearings seem to last a very long time before developing play.
Straight Seat – yes, check your seat to ensure that it’s straight! If you have an accident or an old seat take note that they do wear out and bend out of shape. One way to check that your seat is straight is to set your bike up in a home trainer. Then place a spirit level across the back of the seat at right angles to the top tube of your bike to check if it is level. If it has a lean then one of your bum checks is going to be sitting lower than the other. This effectively means that the leg on the higher side of the seat is going to have to reach further towards the pedal than the other leg. Click here for further information.
Nutritional supplements and pills
Anti-inflammatory pain medications and gels - Are great to help reduce the pain for a few weeks but are certainly not a long term solution. In the early season when I’m building up my km’s I suffer from a tendonitis in my knees. I find that anti-inflammatory pain medications help me cope with the pain until I have built enough strength in my knee joints. I usually find it takes around three weeks of 350km per week before my knees come good.
Glucosamine Joint Food – Good. Need to be on it for around three months for it to be effective. I usually add it to my recovery smoothes after a ride. I have found a great bulk packaged version of this products which can be purchased here.
Mobicosa – Excellent. This is a premium joint food similar to glucosamine but is a natural product made from New Zealand greenlip mussel extracts. I found this to be excellent even after only two weeks of taking it.to find out who sells it in Australia or New Zealand do a Google search on "Mobicosa".
Pedalling Style
A lot of people recommend spinning. That is pedalling the bike at high cadences to reduce the strain on your knees. You many find this helps. Especially when climbing hills. I have personally found that spinning actually makes my knees worst. My knees respond well to lower cadences. Like doing big gear hill repeats at a low cadence. It's important then to find out what works for you; spinning or grinding the gear.
NOTE: I’m not a qualified professional in this area. This is written from my personal experience and is not a substitute for professional medical advice. What worked for me is no guarantee that it will work for you. If you suffer knee pain I recommend that you seek help from qualified medical professionals.
In my mind there are two types of knee pain or injury.
The first type of knee pain is fairly straight forward and simple to resolve. This is the knee pain that results from some minor tendonitis as a result of increasing your kilometres too soon or from an accident that results in physical damage to the knee joint like a strain or a tendon tear. Most competent medical professionals can diagnose these problems quickly and have standard proven surgical and rehabilitation procedures to address them. These are generally problems that resulted from a singular event that triggers the pain; like a fall off the bike or a rapid increase in kilometres. This is the case where you have no history of knee pain prior to the event. When treated correctly your knees recover within the appropriate amount of time.
The second is a little more difficult to address. Your knees get sore and relate to no apparent singular event. You ride your bike normally and increase your kilometres in a steady fashion and slowly over time you knees get sore. You rest and the pain slowly goes away but lingers. You might find that you can cope with 150km a week and increasing your km’s over 150km results in pain that doesn’t go away. Your knees hurt at night. You wake in the morning, they still hurt. You go to work and while sitting at your desk you can feel your knees ache. Climbing stairs is painful. Professionals you see have their own opinion on what’s wrong but their treatment results in no or only minor relief. It’s frustrating. To solve this type of knee pain it's important to find a professional that is able to dive deep into and address the root cause of your knee pain and not the symptoms.
Professional Therapy
Firstly it's important to find an professional that understands cyclists. The sorts of problems that cyclists experience are sometimes different to other sports people.
I’ve found that taping knees with sports tape might be ok for other sports but didn’t work at all for me while on the bike. Strengthening exercises did however help but they needed to be functional like the ones that I have on the Matt Brindle Functional Strength DVD. Use free weights. Stay away from the gym machines as they usually only strengthen your joints in one plane of movement. In my opinion, gym machines are great for dysfunctional body builders to build muscle bulk but death to improving good functional movements required for sports people and general rehabilitation of movement.
Trigger Point Therapy - Excellent results. Large improvements within days of being treated. I read a book by Clair Davies called The Trigger Point Therapy Workbook. Made a lot of sense to me. I would recommend it anyone with on-going chronic pain. There are some very good Myotherapists out there. I found that the ones that could work on my hips to be the most successful. The theory behind is this: “Trigger points are manifested as small contraction knots in the muscles, that control the state of contraction and active ones may cause muscle spasm and referred pain”. Ref: http://www.naturaltherapypages.com.au/massage/Trigger_Point_Therapy. The muscle can’t function properly if it has a trigger point present. I personally don’t know all the facts on why it works but I’ve found it to be the singularly most effective way of sorting out my knees.
Bicycle Setup
Bike fit specialist – Good start. Yes, it’s very important if you have any knee pain to get the best bike fit that you can find. It’s really important to pay close attention to cleat placement and any shims, packers and other devices to help alight the foot correctly on the pedal. Seat height and forward/aft position is also important. Bike shops are usually good at getting you close to an ideal position but if you still have issues then you may have to see someone more specialised. I found that a good position was fundamental to resolving my knee pain.
Pedals - Pedal selection was very important. I have tried several pedal systems. The pedals that work best for me are the ones that don’t wear out after 6 months. By that I mean that they don’t start getting play in their bearings. One way to check is to grab the pedal and check for bearings play. When a pedal has play in it my foot will rock across the pedal in all directions while I’m pedalling the bike. It appears that my knees don’t like pedals with play in them. I’ve found that the Shimano SPD SL Pedals (ULTEGRA PD-6620 and DuraAce PD-7810) provide a great stable platform and their bearings seem to last a very long time before developing play.
Straight Seat – yes, check your seat to ensure that it’s straight! If you have an accident or an old seat take note that they do wear out and bend out of shape. One way to check that your seat is straight is to set your bike up in a home trainer. Then place a spirit level across the back of the seat at right angles to the top tube of your bike to check if it is level. If it has a lean then one of your bum checks is going to be sitting lower than the other. This effectively means that the leg on the higher side of the seat is going to have to reach further towards the pedal than the other leg. Click here for further information.
Nutritional supplements and pills
Anti-inflammatory pain medications and gels - Are great to help reduce the pain for a few weeks but are certainly not a long term solution. In the early season when I’m building up my km’s I suffer from a tendonitis in my knees. I find that anti-inflammatory pain medications help me cope with the pain until I have built enough strength in my knee joints. I usually find it takes around three weeks of 350km per week before my knees come good.
Glucosamine Joint Food – Good. Need to be on it for around three months for it to be effective. I usually add it to my recovery smoothes after a ride. I have found a great bulk packaged version of this products which can be purchased here.
Mobicosa – Excellent. This is a premium joint food similar to glucosamine but is a natural product made from New Zealand greenlip mussel extracts. I found this to be excellent even after only two weeks of taking it.to find out who sells it in Australia or New Zealand do a Google search on "Mobicosa".
Pedalling Style
A lot of people recommend spinning. That is pedalling the bike at high cadences to reduce the strain on your knees. You many find this helps. Especially when climbing hills. I have personally found that spinning actually makes my knees worst. My knees respond well to lower cadences. Like doing big gear hill repeats at a low cadence. It's important then to find out what works for you; spinning or grinding the gear.