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Ready to Ride Pain Free?

by Blake Tucker-Jones, PTA

As the warmer weather beckons us to spend more time on our bikes, overuse injuries become more prevalent. The most common injury reported is anterior knee pain. This can be caused by limited hamstring flexibility, tight IT band, low cadence while pedaling, or poor cleat alignment to name a few.

Let’s focus on the flexibility of the muscles and how that can play a role. If the hip rotators are tight, then as you are at the bottom of your pedal stroke your knee can fall inward towards midline putting stress on the knee and affecting how the patella (kneecap) glides.

A tight IT Band (the iliotibial band is a tendon along the lateral side of your leg) can also cause the patella to not track properly in the femoral groove causing knee pain. Many factors can cause tightness here including muscle tightness in the hips and legs as well as body mechanics both off and on the bike. A physical therapist can help you assess what causes are specific to your body but here are just a couple of stretches to help you address possible problem areas.

As already mentioned, low cadence while pedaling can be another cause of knee pain. What this really means is that if you are pedaling with a lot of force through your pedals instead of shifting to an easier gear, you’re putting undue pressure on your knees. If you’re riding up an incline or a hill don’t be afraid to use that easier gear to lighten the load on your knees. If you have a bike computer that can tell you your cadence, a good suggestion would be to try to keep it around 70-90 RPMs. This will train your muscles to have a more efficient pedal spin and you will have to use less power which translates to happier knees.

The position of the saddle (both height and fore/aft position) can affect your knees as well. For every person the optimal position of the saddle will be affected by muscle flexibility, the anatomy of that person’s body, experience on the bike and if that person prefers to be more upright vs in a more aero position. (Tip: When your pedal is horizontal to the ground and in the most forward position your knee should be in the same plane as the pedal spindle.) If you have pain while on the bike or you ride your bike on a regular basis, then having a bike fit is a good start to avoid any overuse injuries that can sometimes take months to show signs of pain.

Eight percent of Portland residents are reported to use their bicycle as their primary source of transportation (CNN/Travel June 2017). Our city has started implementing it’s Vision Zero (a move to have zero traffic related deaths or serious injuries) and plans to achieve this by 2025. Here are some safety tips to help you stay safe on the bike and help our Vision Zero become reality:

Be Visible: Wear reflective clothing and use lights both on the front and rear of your bike. Bright colors are a good way to have drivers notice you during daytime hours but remember that they won’t be seen when it’s dark, so have those lights ready.
Be alert. Look and listen to your surroundings. That means don’t try being on your phone or have headphones on when riding on the road.
Wear a helmet. Concussions and head injuries can impact you for a lifetime, so don’t take any chances. Wear that helmet.
Be predictable. Bike according to the rules of the road. Don’t zip in between cars just because you can fit. Signal if you need to get into another lane and for all turns. Bike in the same direction as traffic and go with the flow if you can.
Watch out for doors opening from parked cars. Don’t assume they will see you coming. It’s a good idea to leave some room between yourself and a line of parked cars.
Use designated bike lanes/routes when possible. Refer to PBOT’s bike map or purchase a Portland bike friendly map at your neighborhood bike shop.