summit Cycle Coaching

 

 

3 parts

summit Cycle Coaching

3 Ways to Solve Knee Injuries in Cycling – Part 3

Introduction

Knee pain is one of the most common injuries in cycling, accounting for between 30-60% of all injuries, depending on what you read. In my experience, it is certainly the most common complaint I see and deal with.

In parts 1 and 2 we covered load management and strength/mobility. It’s certainly reasonable to try a few things before rushing off for advice. However, I would caution against ignoring injury for too long. It’s all too easy to stay in denial for months and dig. yourself a big hole.

So when should you seek advice? and where from?

3 – Seeking Professional Advice from Therapist or Bike Fitter

I’d probably split this down into 2 broad categories:

 

  1. Influencing the body
  2. Influencing the bike

 

Clearly, there’s a big overlap between these two, but to try and keep it simple, lets go with it.

Influencing the body can be anything from manual work on muscles, joints, neural mobility, balance, strength, coordination and many more. Again, you will see the overlap with our second strategy (Strength and Mobility)…a strong, skilful body with help you.

A lot of these gains are possible with exercise and the strategies outlined in part 2. However, sometimes more help is required and manual work from a physiotherapist can save a lot of time allowing you to progress the on bike and off bike exercises more quickly.

For example, we’ve all seen cyclists where one or both of their knees flare out at the top of the pedal stroke. This is most commonly due to stiffness in the hips, where hip flexion and/or hip internal rotation are limited meaning that to get the foot over the top of the pedal stroke the hip ‘buys’ some range using external rotation. This is what makes the knee flare out.

Now as we’ve said, this may not be optimal for the knee, but the knee can’t change it, it’s forced into this pattern by the hips. Manual therapy and exercise can really help increase hip range and change this pattern for the knee to a pattern of movement that no longer causes undue stress on the knee.

This is just one example, but similar could be seen all over the body. A little targeted help from a physio can allow self-help/maintenance to be far more rapid and sustained.

 

Influencing the bike is simply a way of influencing the body through the bike, but is no less effective. Changing the position on the bike is something we are all familiar with. I tinkered with my position for years, before I finally got a bike fit. I was totally blown away by how much more effective a bike fit was than my endless changes.

Since then of course I have extensively studied bike fitting and completed my qualifications to help my patients and clients directly. As well as the formal qualifications I have studied informally through Steve Hogg’s ebooks and blogs (which are incredibly detailed) and also I have spent a large amount of time researching bike fitting through my Clinical  Biomechanics MSc.

In the example above we looked at the knees flaring out due to stiff hips. If the pattern persists even after you have achieved as much range as you can from the hips/body, you need to look elsewhere for help. Here is where bike fitting can be so important. You can set the bike up so less hip flexion is required by making sure the saddle is at the right height, bar reach/height, altering the crank lengths, looking at pedal stack, pedal spacers and I’m sure many other options. This solution is never a generic 1+1=2 scenario. Everyone is an individual and comes with their own bike set up, their own movement patterns, their own injury history, their own set of beliefs. Everyone is an individual and the best results come from always treating my patients and clients with the highest level of individual attention.

The other advantage of influencing the bike is that the changes to the bike can be done instantly. Though this won’t necessarily solve all your pain instantly, you can buy some ROM so you can keep training while you work on the body. The bike fit can then evolve as the body improves, making for a quicker outcome that allows training to continue.

In Summary

Preventing injuries is the best-case scenario and having a good quality bike fit and a good movement regime off the bike are the best ways to achieve this.

If injuries do occur, don’t stay too long in denial! Look at the issue and its possible causes and try to address them. If it is beyond your knowledge or skill set then it is time to seek the advice from those who can help.

I’d caution against asking the internet…I see these posts all the time. You get a million answers all saying different things, each from an individual with a biased perspect. For example ‘raise your saddle 5-10mm, takes pressure off the knee…I’ve had no pain since I did it’ (I see that one a lot!). That’s great for that individual, but who. knows why they had knee pain? It may be for completely different reasons to you…your saddle may be the perfect height.

That is where the value of a trusted physio/bike fitter can really pay off.  If they are good, they minimise the bias, have an objective view and can look at you as an individual. This gives you a much better chance of understanding why you have knee pain and how you can solve it.

 

I really hope these posts are helpful, but if you have any questions at all leave them in the comments below or you can email me directly.

coach@summitcyclecoaching.co.uk

 

Neil Poulton

BSc. Physiotherapy

BSc. Sports Science

MSc. Clinical Biomechanics (ongoing)

ABCC Level 3 Cycling Coach

Bike Fitter


 

Any questions

If you have any questions or comments you can ask them in the comments section below or email:

coach@summitcyclecoaching.co.uk

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3 parts

Summit Cycle Coaching

3 Ways to Solve Knee Injuries in Cycling – Part 2

Introduction

In part 1 we discussed why knee injuries are so common in cycling and how one of the first steps you need to make is to get out of denial and acknowledge there’s an issue. Then we looked at our first strategy in solving the issue; Load Management.

In part 2 we will look at the next step in solving your knee pain, strength and mobility.

2 – Strength and Mobility

This may not be what you think it is…it’s not ‘strengthen the 

Cycling is a very limited sport when it comes to movement skill and movement competency. Considering the enormous range of movements and skills our bodies are capable of, cycling in no way pushes us in this way. As a result, it’s really important to push your movement when off the bike to maintain a strong, healthy body.

There’s no one simple answer, it’s for the long term and not just the occasional trip to the gym. You need to find something that is both interesting to you and convenient to do regularly enough.

Good options are:

 

  • Yoga
  • A varied gym/home-based strength training routine
  • A varied stretching and mobility routine
  • Other endurance sport like running, cross country skiing or swimming can help
  • Another sport that does challenge your movement boundaries (tennis, badminton, football, rock climbing, etc)

 

These are by no means the only options and you don’t have to choose just one. Mix it up, challenge your body in multiple directions and a variety of ways and you will be rewarded with a body that is more robust and more resistant to injury.

Like any type of training, the benefits will be varied. The main benefits as I see it are:

 

  • strengthening of muscles you don’t stimulate adequately in cycling
  • Maintaining bone density
  • strengthening and stiffening of ligaments and tendons
  • Increased neuromuscular control
  • stimulation of joints through a greater range than achieved through cycling
  • Strength and stability of joints through a greater range of motion

 

Like your cycling training, you don’t do the same thing all year round (If you do get in touch I can make you a lot faster!). So you can vary what you do and how much through the year. No harm in having periods of more cycling focused time and then other periods of more off-bike work.

I think strength training is important for almost everyone. But you could argue it is even more important for females and gets increasingly important with age for everyone. It’s beyond the scope to go into detail about strength and conditioning here, but I would suggest getting help with strength and conditioning as it pays off in avoiding mistakes and injury.

If you have questions, leave a comment or feel free to email – coach@summitcyclecoaching.co.uk

In Summary

Like most things in life and training, there is no one solution. Also like most things in life and training, finding a way to do things that are consistent and sustainable is the best way to achieve success.

Find something that works for you, that pushes your body in a different way to cycling and varies the loads and ranges that are imposed. Find something you enjoy, otherwise, the likelihood of it being maintained is greatly reduced!


HOw does online cycle coaching work?

Communication is key. Our coaching is set up to make sure both coach and athlete can understand each other and communicate easily. The cornerstone of this is establishing  clear goals and your time available. 

Communication will be done in a way that suits the individual, but will primarily be through the coaching calls and through the online training diary with both session plans, session reviews and feedback.

Progress will be monitored through the calls, the diary and scheduled testing sessions that will let us know we are on the right track.

Neil Poulton

Head Coach

Summit Cycle Coaching

National Para road race champion 2019

 

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national Masters Track champion 2019

M40-44 Time Trial

 

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3 parts

  • Part 1 – Load Management
  • Part 2 – Strength and Mobility
  • Part 3 – When/Why to Seek Advice

Summit Cycle Coaching

3 Ways to Solve Knee Injuries in Cycling – Part 1

Introduction

Knee pain is one of the most common injuries in cycling, accounting for between 30-60% of all injuries, depending on what you read. In my experience, it is certainly the most common complaint I see and deal with.

 

Why is Knee Pain so common in cyclists?

The knees are a common site of injury in many sports, but are certainly commonly injured in cycling, but why? It is combination of factors, as with most injuries. However, the knee in cycling has 2 distinct disadvantages:

 

  1. High Loads: It’s charged with transmitting the very repetitive and powerful muscular forces generated above in the glutes, quads and hamstrings.
  2. Movement Patterns: It doesn’t get to choose it’s own range of movement or movement pattern.

 

The powerful forces clearly have the ability to stress the various tissues of the knee, however, compared to weight bearing activities, these are actually relatively low. However, they are very repetitive, and it is this combination that really brings out the problems.

The second issue is where we can have more influence and is where a large portion of your knee pain solution can be found. What I mean by this is that your position on the bike forces the knee to transmit the forces in a given position, pattern and range of motion (ROM). Your knee can’t choose. Even if the forces are placing stress on tissues that are injured or sensitive, there is not much the knee can do, which is why it runs into these chronic pain problems so often in cycling. On a more positive note, this is something we can influence to help you knee pain.

1 – Load Management

The most underestimated tool in dealing with injuries. Chronic injuries are a loss of homeostasis in the tissues, or the sensitivity of the tissues. Restoring the homeostasis is the goal and this requires some honesty in managing load relative to the perception of pain.

In some cases there is tissue loading that is mechanically driven resulting in an injury. Overloading the tissues causes a downward spiral of tissue damage, incomplete recovery, more loading, more incomplete recovery and so on.

Appropriate load management means that you progressively load the tissues allowing positive adaptation and recovery from the injury.

This seems obvious, but it is all too common to see people who have ignored early warning signals resulting in them digging a pretty deep hole to climb out of by the time they seek help.

This is strategy is an attempt to influence the ‘high loads’ issue discussed above. It is really important, but will work best when combined with the other strategies mentioned below.

Though this ‘mechanical model’ seems fairly easy to understand and logical, this scenario is less common than you might think. More common in chronic pain is what I would call a ‘sensitivity model’.

I think most of us would assume our injury falls under the mechanical model and the part it may. However it is more common to see what I would describe as the sensitivity model.

Repetative irritation can cause a tissue to become ‘sensitised’. Once the tissue is sensitised it takes less irritation for the tissue to output a signal. In an a chronic injury that output is commonly interpreted by the brain as pain. This is the reason why when some injuries are investived with scans nothing is found.

In a similar way to mechanical loading, helping to desensitise a tissue requires appropriate and progressive loading. Other ways to desensitise a tissue include the use of heat/ice, gentle movement, gentle massage, in fact, it can be anything that causes an ‘input’ that the brain perceives as different to the painful input.

It’s beyond the scope of this blog to fully explain this, but it’s important to think beyond mechanical injury. If you have questions, leave a comment or feel free to email – coach@summitcyclecoaching.co.uk

In Summary

Being honest with yourself and the presence of pain/injury will likely limit the severity of the injury and speed up the overall recovery. In most cases, stopping riding altogether is not necessary. Though load management will be a part of the recovery, if you find yourself in a hole you want to get out of, stop digging!

This is not the whole solution and in parts 2 and 3 we will look at the other key components that will need to be considered alongside load management.


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