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TRIA Orthopaedic Center Your Cycling Blog

Ask the TRIA Orthopaedic Surgeon

May 14, 2010

Depending on the stability of our joints, and the ligaments and cartilage enveloping said joints, noises might occur during a variety of exercises. Relatively impact-free, cycling can elicit some clicking or popping in the knee joints when harder efforts (read: gears) are performed, as well as when the knees are fully extended in the pedal stroke when standing up and out of the saddle to climb or bridge a gap. The real question is: should we be worried about that sound or sensation?

For the answer, we asked asked Dr. Fernando Pena, M.D., an orthopaedic surgeon with the TRIA Orthopaedic Center, whose specialties include foot and ankle issues, reconstruction, and sports medicine. Here’s what he thinks about the uncommon sounds and feelings of harder efforts or climbing out of the saddle:

For the most part, clicks, clonks and pops of any joint, as long as they are pain free, should not be a reason for concern. If the noises are associated with some pain or locking, then you should be evaluated by a physician or physical therapist. When it comes to the knee, you could have a torn meniscus (internal cartilage of the joint) that is getting caught or pinched when you bend the knee.  The definitive solution/answer to a problem like this would be to have an arthroscopic (small incisions and looking inside the joint with a little camera and instruments) intervention of the knee.

The only painful noises not to be concerned about are the ones coming from the front of the knee under the kneecap. Cycling, by design, is one of the healthiest sports for the knee cap joint. Appropriate seat height adjustment is critical to help eliminate knee noises and mild discomfort of the front of the knee.


Ask The TRIA Orthopaedic Surgeon

May 19, 2009

As the season progresses, so do our aches and pains. When we begin powering up our training volume, new pains tend to rear their ugly heads until they becomes unbearable. One of those that is typical of increased mileage is knee pain. No stranger to the cycling world, pain around the knees can subdue even the most experienced cyclist.

With the increase in pain comes the increase in blame. Many riders feel that it could be a variety of imperfections within the equipment, but the answer is usually within the riders themselves. This week’s answer comes from Cindy Schlafmann, PT, SCS, ATC, who just happens to be an Ironman triathlete in her spare time.

Typically, early in the season, cyclists start doing too much too soon and fail follow “The 10% Rule.” The recommended increase is no more than 10% per week. Often, the cause of knee pain is pushing too hard of gears and using more quadriceps (front of the leg) power rather than a more balance pedal stroke, which would use the pull of the hamstrings (back of the leg) and gluteal (butt) muscles.

Focus on a smooth circle during the entire pedal stroke rather than on just the push down. You can think of trying to scrape mud off the bottom of your shoe on the stroke between 9 o’clock and 3 o’clock if you think of the pedal stroke as a clock.

It would be recommended to keep the gearing lower and focus on higher cadence of >90 RPM(revolutions per minute), as well. Including hill repeats too quickly at the beginning of the season can also put increased strain on the knees if your strength is not yet there.

Another cause may be improper bike fit with the seat being possibly too low, which would cause more strain on the front part of your knee. I also recommend working on strengthening your core including lower abdominals, gluteal and hip muscles to help with balance throughout the trunk and legs.

We appreciate the help that Cindy has lent us in this week’s post. Stay tuned for more helpful information from the sports medicine specialists at TRIA Orthopaedic!