Tips from City Physiotherapy to treat your knee pain


Many people give up high impact sports or running in favor of cycling to help their painful joints. However this doesn’t mean that cycling doesn’t impact on your knees. Patello-femoral joint syndrome and patellar tendonitis are two of the most common bike riding-related injuries caused by overuse, weak muscles and incorrect bike fit. Both can make cycling painful.

Patello-femoral Pain Syndrome

The kneecap, or patella, is a floating bone that sits on the underside of the patella tendon. During knee movement, the patella tracks along a groove in the femur (thigh bone). When the undersurface of the kneecap tracks incorrectly, the cartilage on the patella and the femur can start to wear away, causing pain.

What causes this incorrect tracking of the kneecap?

Weakness in the VMO

The VMO, or vastus medialis oblique muscle, is part of the quadriceps muscle that runs along the inside of the thigh down towards the knee. When cycling, the vastus lateralis (quadriceps muscle on the outside of the thigh) often becomes overused and large, resulting in a muscular imbalance. The overpowering of the vastus lateralis can make the kneecap track too much towards the outside of the femur during pedaling, which leads to wearing of the cartilage and causes pain.

How do you fix this?

Stretch the lateral side of the leg with IT band and quadriceps stretches. Using a foam roller can assist here. Once you have gained flexibility, strengthen the VMO. Step-downs and short arc quadriceps exercises are two favorites.

Step Down: Stand sideways on a step. With one foot balancing on the step, lower your other leg toward the ground until your heel taps. Make sure to keep your hips level (concentrate on not dipping the hip on the lowering side, bending only at the knee) and your back straight. Start off with 10 repetitions on each leg and increase repetitions as your strength improves.

Short Arc Quad: Lying on your back, place a foam roller under your knee. Contract the quad so that your foot rises, making the leg straight. To isolate the VMO even more, rotate the foot slightly so that the toes point outward. Hold the contraction for 10 seconds and repeat 10 times. Once this exercise becomes easier, add ankle weights or hold the contraction for longer durations.

Remember that you shouldn’t feel pain with these exercises and performing them incorrectly can lead to further knee pain issues.  It is best to consult us at City Physiotherapy for an individual assessment of and tailored exercise and treatment plan suited to you specifically.  Give us a call on 8212 4886 to make an appointment with one of our friendly physio’s or remedial massage therapist today.