What is cyclist’s knee and how do you treat it?

Pain around the kneecap can be easily caused by repetitive cycling. Here's physio and cycling specialist Stephen Garvey with some advice on prevention and treatment

Illustration by Daniel Seex

How does cyclist’s knee happen?

Patellofemoral pain is an umbrella term for a variety of anatomical abnormalities that lead to knee pain. This can be described as pain under and/or around the patella (kneecap) as a result of physical overuse (the patella can be subjected to load up to 1.5 times your body weight when cycling), muscular imbalances and/or biomechanical changes in the patellofemoral joint. The lateral structures of the thigh, which connect to the patella, are stronger than the medial structures, so any imbalance in these forces can cause the patella to tilt/rotate, which can lead to dysfunction.


How will you know if you have cyclist’s knee?

In a repetitive sport such as cycling, if your average cadence is approximately 90rpm, you can expect to complete 5,400 revolutions per hour. So it’s easy to understand why and how dysfunctions, and subsequently pain, through your patella can easily arise. But there are many structures in the front of the knee that might cause pain and may not always be related to the patellofemoral joint. A good physio is likely to determine the source, the contributing factors and provide a rehab programme.

How do you avoid cyclists knee?

A good bike fit and adjustments to your training habits will help reduce the risks of pain.

How do you rehab it if you already have cyclist’s knee?

A rehab programme will be drawn up from a screening process that will look at biomechanical imbalances that may have contributed to your pain. This might consist of a strengthening programme: increasing power output, reducing muscle imbalances to alleviate tension in muscles that are being over worked and strengthening ones that aren’t used a lot.

Stephen Garvey is a physiotherapist with Six Physio

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