How to prevent knee pain when cycling {runner’s knee exercises}

Cycling is supposed to save your knees right?? People have been preaching that sermon to me since I started running: “you need to do something lower impact to save your knees”. Ahh if I had a dollar..

My pain is your gain because I’ve now learned about runner’s knee from a whole new perspective.

When my hips started to hurt {from being out of alignment} I could bike without pain, so as any distance runner would…I climbed aboard and went for LONG rides. Never once considering that a new workout might pin point some weakness in my body or cause other issues. 

My knee swelling up like a cantaloupe happened after my victory ride, yup the one where I celebrated riding the longest ever {not hard to do when you are a new rider}. Exercises to prevent knee pain from cyclingObviously I’m not saying that running will make everyone’s knees hurt, but there are more factors to consider than we might think if you are going to start spending hours on the bike.

And once I do some PT, I will be back to the bike to help improve my running.

It turns out, I just need to spend a little more time learning the right way to bike, including how to stay injury free, which may include things that running does not.
Causes of knee pain in cyclingGreat chart from Knee Clinic 

In my case {and many others} biking caused a flare up…called ironically runner’s knee.

Patellofemoral syndrome is simply the knee tracking incorrectly and often called runner’s knee because we tend to be the recipients of this due to weak muscles from only moving in a forward motion.

Runner’s may describe this pain as right below their knee cap, where cyclists may point more to the inside or outside of their knee cap. This is simply due to the difference in motion and where the friction is being created.

I’m going to really let you see deep inside me now…here is my knee.
Where the femur has two bumps your knee should easily slide through when moving. Pain occurs when due to poor movement patterns we repeatedly push the knee to one side and over one of those bumps, which as you might imagine creates inflammation in the tendons and wears the cartilage.IMG_7082Tight hips/glutes: as the leg goes near topstroke, the knee drifts to the side pulled by a tight hip

Tight IT Band/Weak Inner Thigh: A tight IT band will pull the knee out to the side as well and many runners have weak inner thighs from only forward movement, so they can’t counteract the pull. 

Weak glutes: The body will compensate with power from the quads, which again loads the knee

Toe pedaling: Places the knee in flexion throughout the stroke {err might be guilty here too}

Seat position: Both too low or too forward will cause issues for the knee {proper bike fitting resolves}. Should be a 25° to 30° flexion in the knee when the pedal is at the bottom-most point

As always consult your Physical Therapist before doing anything here, I’m speaking from my experience and from working with other runners over the last 12+ years.

My first recommendation is the lunge matrix to strengthen the IT Band. Issues with the ITB often cause runner’s knee. I started doing this after my injury in 2007 and have only has very short flare ups since then. {Click to see the lunge matrix}
IT Band Recovery Lunge MatrixSecond are a series of moves that focus on creating better hip stability, which in turn means your knee isn’t being pulled all over the place by weakness up the chain. {Click to see all the moves} HipStabilityVideoFinally here are the newest exercises that I am adding to my routine of stretching, foam rolling and the above exercises to help get my glutes and inner thigh muscles firing appropriately.

Squeeze with raise – Using a small ball or yoga block, squeeze knees together and simultaneously extend one leg. Repeat 10 times per leg to work the quad right near your knee. You have to stay focused on the squeeze. PT Exericise for Runners KneeClam shell with resistance: Admittedly I was doing this but without the band…that adds a whole new level. Laying on your side with knees together, focus on contracting your deep core muscles then with feet touching raise your top leg. This is going to work core and your outer hip. Repeat 10 times per leg.
Clam Shell with Resistance BandBridge March: The key to this exercise is not to let your hips sway at all while doing the movement. It requires focusing on your core, your glutes and well everything to keep it stable. The march is slow and only done for up to 1 minute. As soon as you start to see hip movement stop. DSC05524NOTE: I tried to keep this as non-medical as possible to get straight to the details, so please no pointing out that is the Vastus Medialis Oblique Muscle and not inner thigh, I get it, but wanted this to be helpful to everyone.

Are you consistent with PT type exercises?

Ever find a new workout highlights poor movements you’ve just gotten used to?

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