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Cycling related Knee injury

Apr 3rd, 2014

Brian asked for the following advice:
On Sunday 02 March I was out training on my bike doing sprint intervals for
summer sportives. I’m a keen road cyclist who has put in a strong base over
the winter months (1,000 km / month). I am early 30s, male and never had
problems with my knees.

While on the bike I never noticed any pain. The pain started on Sunday
evening. The pain is in the front-upper part of my knee and only occurs when
bending under pressure (Squatting, down stairs and cycling). There is no pain
walking, and even no pain running (But I’ve obviously put that on hold for
now). The pain is very bad if I put any sort of power into the pedals (+ 120
W).

Do you have any advice on possible exercises, treatments or a diagnosis? Do
you think this is something serious?

Thank you.

The Guru Responded:

Hi Brian

Sounds like an issue with the way for kneecap tracks or moves on the front of your thigh.

It should sit in a groove and helped to stay in this groove by tissue at the edge of your kneecap, but also is massively influenced by what you do with your hip and what you do with your feet.

Any deviation from this groove causes the pressure in the underlying bone (kneecap) to build up due to small amount of swelling between the bone structure itself – causing pain. Commonly worse doing the things you describe.

What to do? Key things are improve your gluteal stability especially on a bike at distance and high wattage as you start to loose your endurance. Use a foam roller (on your ITB) post ride. Have a decent bike set up where the bike fits to you and not you fitting to the bike – most common issue is handlebars too far away.

Work on small single knee squats, work on alignment on your bike, don’t ride through pain (pre/during/post) and if needs be go an see someone who can help – should be fairly standard stuff.

….really sorry for the delay

The Guru
Six Physio

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