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TRIA is a leader in orthopaedic treatment, providing comprehensive care from diagnosis, to treatment, to rehabilitation, even surgery at one convenient location in Bloomington, Minnesota.
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Ask the TRIA Orthopaedic Surgeon
June 4, 2010Most of the pain in cycling is located on the upper body. Wrists, hands, neck and back are the main culprits for bike-related pain, but the lower extremities are no strangers to pain, either. Knees are a touchy subject, as any slight biomechanical imperfection can cause major pain, as well as the four words that anger cyclists the most: stay off your bike. Michelle Gorman McNerney, M.D., CAQ Sports Medicine is going to address this week’s question: What should I do if the pain while cycling is behind my knees:
While cycling is a great exercise for cardiovascular fitness and large muscle strengthening, there are certain muscles that get neglected when we’re pounding out the hilly terrain. Cyclists, and triathletes for that matter, tend to target their straight ahead muscles, the hamstrings and the quadriceps, with their exercise programs. Many of the stabilizing muscles like the gluteus muscles get neglected with this training. That tends to limit the control you have in the thigh bone when you’re up out of the saddle and the knee cap tends to shift around (like a train off its tracks), causing pain and stiffness.
Pain and stiffness behind the knee can be noted during activities like cycling and running, but the activity can be pain-free with some athletes only noting symptoms after a ride. Interestingly, some of this pain may be detected even with day to day activities and on days where you didn’t even work out or are just sitting at your desk. It is actually common to have pain when sitting for a prolonged period of time with the knee in flexion. It is also common to note this with going up or down stairs.
A cyclist will always want to make sure they are having no swelling in or around the knee. The knee should not be catching or locking into place or feeling unstable (like giving way with walking). If none of those symptoms are occurring, it is safe to try and strengthen some of the stability muscles in the belly, back, and butt to help take some of the stress off your knees when you ride. Some target muscles to think about strengthening are the gluteus maximus and gluteus medius. Also, regularly using the transversus abdominis (not the beach muscles), a core stabilizer of the torso, will contribute to more stable lower extremities. Hip adductors are also a very important and often overlooked muscle group. A few visits with a good (sports) physical therapist is helpful to get on the right track and make sure you are activating the correct muscles and not wasting your time. It may be also worth a visit to your friendly sports physician to make sure there is nothing more significant going on!
