The Knee Scene

by Robbie

Cycling is often prescribed as an alternative to other athletic ventures, such as running. The reason for this is that cycling is a low impact sport. However, the repetitive motions of cycling amplify stress to the body that would normally be negligible.

For example, let's say you go on a ride that lasts two hours, and your average cadence is 90 revolutions per minute. That means you did 10,800 pedal strokes... A four-hour ride at an average cadence of 90 rpm's would mean that you initiated 21,600 pedal strokes. Now imagine that for some reason you didn't quite put the cleat of your pedal onto your right shoe correctly; let's say that it is off of zero by 5 degrees. You might not notice this mistake instantly because we are hardly ever in perfect anatomical position. We move every-which-way on a daily basis and our bodies seem to take it just fine. But when we force a series of joints into an awkward, immovable position and load it with stress repeatedly, about 11,000 "reps," cartilage, tendons, ligaments, and muscles may become irritated.

Yes, we can adapt to unusual positions, that’s the nature of the beast for cyclists—for competitive cyclists it's all about adapting to the most aerodynamic position without sacrificing power or causing injury. There is a difference; with a screwy cleat the joint is being stressed, and with the cycling position muscle is being used in a new way. Soft-tissue does a much better job of adapting to new stress because it has a much greater range of motion and is generally unaffected by slight abnormalities in movement. When muscle doesn't adapt, we are usually informed quickly in the form of a strain or a tear of the muscle. These injuries are extremely rare in cycling, but are possible.

So who cares if a knee or a hip gets a little irritated? The knee and hip might only care for a few days, or however long it takes to recover. The real trouble begins when the damaged tissue is not given time to mend before it is stressed again. An injury of this sort is usually referred to as a "chronic injury," and will continue to be a pain until it is given some undivided attention.

These nagging injuries should be given priority if they ever flare up. If they are not treated promptly, they can become more severe and more difficult to cure. More pain from a nagging injury usually means that it is being damaged even more, which causes it to swell. Generally speaking, the longer a chronic injury causes pain, the longer it will take to remedy the problem. Vice versa, the sooner you address a problem, the sooner it will be remedied.

So how can you avoid a cycling-induced chronic knee injury? Listed below are some things that you should take into consideration if you plan to increase your weekly hours and would like to avoid knee injury:

1. If it hurts, stop. This is the most obvious rule in the book. If you feel any sort of nagging in your knee, take it easy. You might not have to stop entirely, but you should definitely lower your intensity and increase your rpm's. Nine times out of 10 the problem is tendonitis, which can easily be treated.

2. Make sure your bike fits properly. Adjust the fore-aft position of your seat if necessary. Triple check the height of your seat; make sure your knees are given enough room to extend as well as not too much. Make sure your seat isn’t tilted forward or backward. Generally speaking, if the front of your knee hurts, your seat is too low, your seat is too far forward, or your cleats are too close to your toe; if the back of your knee hurts, your seat is too high, your seat is too far back, or your cleats are placed too far away from your toes. If your knees hurt medially or laterally, try positioning your cleat to one side or the other. Etc... Read all you can about bike fitting, it seems to be endlessly fascinating.

3. Check your cleats, make sure they are centered and line up with the inside ball of your foot. I recommend Speedplay pedals because they offer tons of low-resistance float.

4. Be smart about your approach to riding/training. You can get away with riding for three hours once a week with your friends, but most people can’t get away with getting off the couch or from behind the desk and expect to ride 15 to 20 hours per week without encountering problems. In the “off season,” do your best to stay active; commute via bicycle if possible, go to the gym, run, if you must. Build your weekly hours slowly and wait to build your intensity until you’re sure you have fully adapted to the demands of cycling.

5. Flexibility. We all probably have room for more flexibility. I know that it’s hard to be consistent with this one but it is highly beneficial. Signing up for a yoga class can help, but what it really comes down to is being consistent. You won’t gain flexibility by stretching a certain muscle group for one minute every Monday and Wednesday in your yoga class. Beyond helping to prevent injury, stretching will also help your performance on the bike. It’s said that being inflexible can sometimes help with sprinting, but at the same time, flexibility will save you energy in the long term because you won’t be fighting your own biomechanics. I’m willing to bet that the best time trialists in the world also have very flexible hamstrings.

6. Spinning versus pushing. Pedals are meant to be spun, not pushed. Especially in the early season, do your best to focus on a high cadence, this should help prevent any early season strains, and it will also make your heart stronger. Generally speaking, physical therapists will suggest spinning on the flats to help cure tendonitis. Climbing or sprinting too early in the season can be problematic because your tendons might not be prepared. Spinning can be helpful and hurtful, but mostly helpful. It can be harmful if you aren’t used to it; I’ve been guilty of focusing more on spinning than going fast and then wonder why I can’t keep up. Vice versa, it’s easier to match the accelerations of the pack when you’re spinning, and I promise you that you can sprint much faster when you aren’t in your 53-11.