We’re lucky to be in Colorado. We have access to trails and open space and can exercise while maintaining safe social distancing guidelines. If you like to ride your bike, you’ll have noticed that trails are busier than they used to be. Cycling is excellent cardiovascular exercise for these months when gyms are closed. 

However, maybe you don’t typically ride your bike. As with any form of cardiovascular exercise, repetitive motion can increase the risk of overuse injuries, such as tendinitis or tendinosis. It’s common for cyclists to have knee pain, especially with high mileage rides. The medial knee has multiple tendons that cross it (called “pes anserine”, or “goose foot”) and with constant movement, these tendons can get irritated as they glide over the bony surfaces that make up your knee joint. It’s also common for cyclists to have pain above or below the patella (kneecap).

With tendinosis injuries, the first step to relieving pain is rest. This doesn’t mean you can’t do other things! You can walk or jog if it’s pain free. The key is to vary your activity so inflammation can decrease. Strengthening muscles that support the knee joint can also decrease pain.

It’s important to have strong quadriceps, as they are muscles that do a lot of the work in the “down” movement on a bike pedal. Avid cyclists also have strong hamstrings in the back of the thigh to balance the work of the quadriceps. Gaining additional hip strength is also helpful, with attention to hip abductors and external rotators. This can help offload the stress of the inside of the knee, ideally decreasing pain. Further, getting pedals that allow you to push and pull can help to decrease pain. You can find straps that tie over the ball of the foot. Some pedals clip into the bottom of a cycling shoe, but don’t feel like you need to make a big investment in new shoes and pedals (unless you want to!)

Here are a few exercise suggestions for you to try to help alleviate the pain: 

Terminal knee extension: 


Do this standing or sitting.

Start with your knees slightly bent, then squeeze your quadriceps and straighten your knees.

Perform a lot of repetitions; up to 30 or until you feel fatigued.

image credit: hep2go.com 


Hamstring sets:

Place a towel under your ankle and push your heel down into the floor.

You should feel the back of your thigh activate.

Perform this to fatigue; up to 30 repetitions. 

image credit: hep2go.com 


Lateral band walks:

Place a resistance band around your ankles.

Bend your knees and hips, keeping your toes forward, and step to the side one way for several steps, then step the opposite direction.

If you don’t have a resistance band, that’s okay.

You can challenge yourself by keeping a deeper hip and knee bend; a slightly lower squat. 

image credit: hep2go.com 

Remember that in these uncertain times, Peak Form is still open to help you with aches and pains that you may not have had prior to stay-at-home orders. Stay active but stay safe and healthy! Please call our clinic to make an appointment at any time.

By Laura Vroman