ITB & Knee Pain After Cycling
Is le Tour de France motivating you to roll out your bike and warmest cycling kit – even in the depths of the Australian Winter?
Either now or as the weather warms up, many cyclists get back into training or increase training intensity in preparation to ride more or race. A common question remains on many cyclists’ minds:
“Why do my knees always hurt when I ride?”
What Causes Knee Pain When Cycling
Patellofemoral joint pain syndrome is one of the most prevalent complaints of cyclists of all disciplines - from road cyclists to mountain bikers. It can be defined as any knee pain experienced at the front of the knee. This pain can be experienced in the kneecap which can also refer slightly up the thigh and down into the shin.
This front of knee joint pain is caused generally by incorrect tracking of the kneecap (patella) on the groove in the front of the femur bone. In most individuals it is found that this incorrect tracking pulls the kneecap towards the outside of the knee, resulting in a knee pain which is more on the outside of the knee rather than the inside.
Common Knee Pain Causes for Cyclists:
Maltracking of the patella can be caused by many things. There are four main factors which can be pinpointed in most individuals with patellofemoral joint pain:
- Cycling position
- Muscle tightness
- Muscle weakness
- Joint malalignment
In this article we will tackle the most common form of knee pain in cyclists, caused by muscle tightness, as explained below. In future articles we will address cycling position and muscle weakness as an overall view of how to improve joint alignment of the lower limb, and reduce knee pain.
ITB Pain From Muscle Tightness
Muscle tightness, especially of the iliotibial band (ITB), is a common cause of knee pain in cyclists. Luckily, it can be easily resolved to reduce knee pain while cycling.
The ITB is a fibrous sheath which originates from two muscles, your gluteus maximus, and the tensor fascia latae (TFL).
Both of these muscles play a very important role during different phases of the pedal stroke when cycling. Your gluteus maximus is most active at the top of your pedal stroke and the first 25% thereafter. Your TFL is most active from the bottom of your downward stroke, back to the top of the stroke.
If either of these muscles becomes over or under active during your pedal stroke, it is very easy for the ITB to become tight and inflamed, resulting in knee or hip pain.
Treating ITB Knee Pain
The best ways to stay on top of ITB pain is a using a foam roller and undertaking regular stretching.
Rolling out every day, post training, releases the tissues in the band and pinpoints any tight spots where you may favour your leg through the pedal stroke.
Foam Rolling ITB
How to: Starting at the hip joint roll the roller down towards the knee supporting as much as needed by flexing the other leg forwards and pushing through the foot. Place as much body weight through the leg on the roller as possible.
You can also perform the following stretches, as demonstrated below, pre and post ride:
Pretzel Stretch
How to: Lying on your side, grab the ankle of your top leg and extend the hip like you would if you were stretching your quads. Then, flex the hip of the bottom leg and bring the bottom heel up and hook it onto the outside of the knee of the top leg and push knee down towards the floor to place tension on the ITB.
Standing ITB Stretch
How to: When standing, step across the body and reaching down to the ankle of the leg behind allows full lengthening of the ITB out of the hip joint.
Glute Stretch
How to: Laying flat on the floor, cross one ankle over the knee of the other leg, then lift the leg up behind the knee and pull towards the chest. This allows lengthening of the ITB and the gluteus maximus.
Your Action Plan
Perform simple stretches regularly and making use of a foam roller will alleviate any persistent tightness in your muscles causing ITP knee pain. This in turn will keep you performing at your maximum potential when cycling.
Remember, if any pain persists don’t hesitate to contact your Back In Motion physiotherapist for a Free Initial Assessment. Find your local practice to book a consult now.
Lyndsey Edmunds - Physiotherapist, Back In Motion Mount Barker
Lyndsey studied a Bachelor of Physiotherapy at the University of South Australia. She particularly loves treating sports related musculoskeletal injuries and being involved in long term chronic condition management, helping people achieve their goals, both in sport, and in their everyday life. In her spare time she loves cycling, racing regularly, having raced national level in her high school years and currently racing with Norwood Cycling Club, long distance running and netball.