Knee pain from sport

Sport is a key cause of knee pain. Learn more about specific injuries and how to treat them.

What is runner’s knee and how do I fix it?  

Runner’s knee refers to a condition which gives rise to a significant pain on the outside and/or front of the knee. As the name suggests, this condition is highly prevalent in recreational long distance runners. The pain itself arises from a combination of pain from the outer aspect of the patellofemoral joint or a friction syndrome related to the iliotibial band as this structure passes over the outer edge of the knee. The latter problem may be compounded by information to a fluid filled sac known as the iliotibial bursa.

The cause of runner’s knee is thought to lie in a biomechanical dysfunction in which a muscle imbalance develops between the hip flexor muscles and the iliotibial band itself. These muscles become overactive and inflexible and the development of weakness to the gluteal muscles which extend the hip and contribute to rotational control around the hip and knee. This dysfunction is thought to arise particularly in recreational runners due to the repetitive forward and backwards motion of the hip and knee without any lateral and rotational movements.

Treatment of the condition involves rectifying these faulty biomechanical patterns by changing training patterns as well as following a programme of gluteal strengthening exercises and appropriate flexibility regimes. In some cases, orthotics may be prescribed to help the alignment of the lower limb.

I get knee pain when cycling. How do I fix this?

Knee pain when cycling is particularly common problem and almost always arises from the patellofemoral joint, the connection between the thigh and hip. However, the cause of the patellofemoral pain may have a number of reasons and it is important to identify and treat the specific biomechanical cause of an individual’s pain.

The body position while cycling has the torso leaned forwards over the handlebars which places the hip in significant amounts of flexion. As a result, the hip flexor muscles and quadriceps muscles of the thigh work repetitively in a very shortened position. This can result in significant muscle tightness and associated tightness of the patellofemoral joint itself.

A further factor in determining the cause of patellofemoral pain among cyclists is to analyse whether there are any biomechanical problems due to over rotation of the knee during the pedalling action. 

Due to the significant relationship of cycling posture to cycling related knee pain, this problem is more often seen in road cyclists and triathletes who place their bodies in a more aggressive forward orientated position.

Treating cycling related knee pain involves physiotherapy to address hip joint and lower limb muscular inflexibility as well as muscular control and strengthening exercises to improve the ability of the hip and knee to resist rotational forces. Adjusting the height and position of the saddle, handlebars and the positioning and angle of the cleats (if being used) is highly recommended.

Staying active with knee pain

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