July 2017 | 47
Anterior knee pain
Anterior knee pain is pain experienced around the patella �kneecap� at the front of the knee . This is the most common overuse injury in cycling because of the way in which the quadriceps muscles are connected to the shin bone . Pressure on the pedals causes force to be repeatedly transmitted over the patello-femoral �oint , squashing it back against the femur .
Another cause of anterior knee pain is patellar tendonitis which occurs when the part of the tendon that attaches the patella to the bone below it becomes in�amed .
�hysiotherapy , anti-in�ammatory drugs and ice can help to relieve symptoms , and a knee support can also be used . With patellar compression syndrome , you need to work towards loosening tight lateral thigh muscles , but it is also worth considering a knee support to correct the position of the patella as overuse can cause it to track incorrectly . Anterior knee pain can be caused by poor positioning of the saddle and pedal cleats . A saddle that is too low or too far forward can increase pressure on the muscles and tendons and cause poor tracking of the patella . The pedal cleats being set too far forward will also have a similar effect .
A stabilising knee support will often help in rehabilitation following injury to the front of the knee and patellar supports are useful to improve tracking when pain is caused by patellofemoral syndrome or similar problems . Depending on the severity of the injury and the activity to be undertaken , there is a range of knee braces to help with stabilising the knee .
Posterior knee pain
Posterior knee pain is less common in cyclists than anterior pain . In most cases , it is caused by overextending the knee when using a saddle that is too far back or too high and can be relieved by adjusting your bicycle so that the knee is no longer overextended . If you have persistent posterior knee pain , you should see your doctor so that a Baker�s cyst can be eliminated . This is a collection of synovial �uids that gather in the space behind the knee that are harmless but uncomfortable . They usually disappear without treatment . the condition is known as iliotibial band syndrome or , strangely , Runner ’ s Knee . Iliotibial band syndrome can be caused by using cleats that cause the toes to be pointed inwards too far , but often occurs simply because of the repeated bending and straightening of the knee . This causes the iliotibial band to be moved backwards and forwards over the end of the femur just above the knee , resulting in in�ammation and pain .
As with any in�ammatory condition , immediate treatment includes ice , rest and anti-in�ammatory medication . The iliotibial band can tend to become tighter over time , and can pull your patella off centre if it is not counteracted by strong vastus medialis oblique muscles . Treatment for this condition involves physiotherapy , ice therapy and anti-in�ammatory drugs . �or those who want to continue to cycle whilst recovering , a stability knee brace with compression will help to reduce pain and in�ammation and support the knee .
Where ligaments have been damaged , a hinged brace with compression is likely to be what you need . The compression will help to reduce in�ammation and the straps give support like external ligaments . There are many different types of hinged braces , and your specific condition will determine which is most suitable .
For degenerative conditions , such as osteoarthritis , a different kind of support may be appropriate to manage the condition which will o�oad the pressure on the affected side of the knee to the less affected side , which can reduce pain and increase mobility . The condition itself is degenerative , therefore , in severe cases , knee replacement surgery is often the only treatment option available .
Paying attention to what your body is telling you , not overdoing your sport and protecting your joints from impact and rough treatment by wearing a knee support will help to ensure that you remain free from knee injuries . If you do experience an injury , getting a proper diagnosis , following the medical advice and obtaining the appropriate knee support will mean a shorter recovery period .
Medial / lateral knee pain
Pain at the sides of the knee , medial or lateral knee pain , is quite common and is felt in the collateral ligaments . Lateral and medial pain can be caused by problems with your pedal cleats . Lateral knee pain , or pain on the outside of the knee , is usually due to the pedal cleat being too close to the outside of the shoe or being positioned so that the foot is internally rotated . Medial pain , on the inside of the knee , occurs when the pedal cleat is too near the inside of the shoe or positioned so that the toes point outwards . Adjusting the position of the pedal cleats usually resolves the issue , but if it continues , any in�ammation can be reduced by using a compression knee support .
Iliotibial band syndrome
The iliotibial band is a strap of thick , fibrous tissue that extends down the outside of the thigh from the pelvis to under the knee . When this becomes in�amed ,