Bike Fit Emergency: what to do when knee pain strikes
You get off the bike and notice a nagging ache or "warm" sensation at the front of your kneecap....what should you do? Cycling knee pain is no fun and can be tricky to get rid of. Here's a video on what to do next:https://youtu.be/vykGOfAIyc0Abridged version:
- Keep it moving -- range of motion (don't sit in a car) and some light massage. Later in the day if it tightens up you might consider warming it up slightly before moving. You can do some stretching or yoga but keep the stresses on the knee low -- you don't want to stretch it aggressively. Really more about just keeping it moving.
- Ice is okay the first couple days, but after a week or two I would give equal weight to warming modalities like warm baths.
- Anti-inflammatories? Research is showing that not only might these substances not help the tendons heal, they might be actively preventing it.
Continue these precautions for a few days.Should you rest and do nothing?
- No. Under no circumstances should you do this. A day off is fine -- maybe two if the onset was particularly violent -- but injuries in general heal better with exercise.
- Modify your riding schedule slightly
- Cross-train if necessary
Most imporant step: Figure out the root cause(s)
- post-mortem: have to figure out why it happened.
- traumatic bursitis/tendinits?
- increase in mileage?
- increase in climbing?
- changes to position? (new parts?)
Is there an "out of the blue" scenario?
- No, it's just that it'a more difficult to determine the root cause.
- Often it's multiple factors -- instead of 1 big thing it's 2+ very small things.
- Example: a rider has been putting in good mileage, and even some climbing. On a particularly warm spring day they do a very familiar climb towards the end of a ride that's 30 minutes longer than usual, and knee pain develops. Why?
- Since the climb was done later in a ride than usual and it was warmer than they were acclimated to at the time, overall level of fatigue was greater.
- This leads to the rider shortening their reach to the bars, especially while climbing, in order to take some strain off the latissimus muscles of the upper body (to pull more effectively on the bars for leverage) and decrease the strain on the low back.
- Most times riders will shorten this reach by splitting the difference -- by moving hands back to the flats on the bar (which is noticeable) and slightly scooting hips forward on the saddle (which is uch less noticeable).
- Now the hip position relative to the feet is such that at the 12 o'clock position the knee flexes to 122° versus the 118° it normally does when on the hoods and not fatigued.
- Finally, this position can also make it difficult to activate the glutes and hip extensors and so the pedal stroke becomes 5% more quadricep dominant further increasing the strain across the tissues surrounding the knee cap.
Distance ridden didn't increase much. No excessive climbing. No parts were changed. No changes to the fit were done. But still knee pain developed. This is how it can "come out of nowhere".Any questions or comments about this topic? Have any topic suggestions? Start a conversation below with a comment, or reach out to me via email Research article on ibuprofen & tendon healing