Cycling can be a great way to help rebuild strength into your legs if you have knee pain but it must be used in combination with other methods. Cycling is in fact a key part of the early stages of an ACL rehabilitation program after surgery and many elite cyclists like former Australian professional Simon Gerrans who started cycling after a serious knee injury. However, it is not the real solution to your problem and in some cases cycling can even be the reason you have knee pain! In this article, I will discuss the value of using cycling for treating knee pain and how it can be a great tool if used wisely.
How Cycling Helps To Strengthen The Quadriceps
The reason cycling feels good for most knee pain sufferers is that it builds strength into their legs without the need for stability, excessive compression or impact that you will get from running and to some extent walking. It can be a simple way to build quadriceps strength when there is pain present which is why it is often one of the first things you can do after knee surgery.
Cycling is one of the easiest ways to build some muscle into the quadriceps for the pedaling action mechanically favors these muscles which can be a good thing especially for the often weak vastus medialis oblique muscle (VMO). The VMO muscle is very important for knee stability and gets a lot of attention with rehabilitation and physical therapists. If you set up your bike correctly and adopt good pedaling action where you push with the heel and not the toes you can develop some strength with this muscle.
A stronger VMO enables better alignment and support of the knee.
However, just like my previous article about swimming for back pain it has several major problems associated with using this solely to “fix” your problem. While it may definitely help the person with knee pain, cycling will do little to address the reason for knee pain.
Why Cycling Does Not Address The Root Cause Of Knee Pain
With any injury it is very important to address the underlying root cause or trigger of the pain and not fall into the trap of treating symptoms. While cycling can help it is not going to address the real problem for it ignores or has no influence over these key factors.
•Instability & poor alignment of the lower limb in movements completed standing up.
•Demand stability and strength at the foot or the hip
•Change faulty movement patterns in particular with gait, squat, and lunge.
The video below gives you a good visual of this.
When we perform the simple action of walking these things are essential for healthy alignment of the knee and cycling will not have any influence over this.
Knees are exposed to tremendous pain and problems whenever they are forced into a twisting action or bend sideways, (eg ACL tear) known as valgus or varus, and lastly if they hyper-extend. This means you need exercises that teach the body how to resist these movements and be able to withstand them. You cannot do that on the bike.
Too Much Cycling Can Create Knee Pain!
While we definitely need to improve quad strength, too much cycling can lead to overuse and stiffness at the knee joint.
This is where you can begin to see problems like:
•Inhibition of the glutes which are essential for abduction of the hip and alignment of the knee.
•Gradual increase with internal rotation and adduction of the hip leading to poor alignment of the knee standing up.
•Gradual loss of knee flexion that will pull the patella upwards.
It is difficult to build strength into the glutes and hamstrings as they are at a mechanical disadvantage with cycling and many keen cyclists have very weak glutes as a result. Hamstring weakness is also a problem and has been proven to be a massive weakness with ACL injuries.
The bigger the difference between the quads and hamstrings increases anterior shear force at the knee flexion angles that occur during single leg landing and pivoting movements.
Even if you are able to maintain good quad to hamstring/glute ratio, prevent stiffness and loss of knee flexion, you still may not be moving correctly and favoring quad dominance with certain movements.
This can only be effectively corrected with strength training done in standing positions.
Romanian deadlifts, single leg deadlifts and various lunge movements are all great examples of exercises that enhance alignment of the lower limb with a focus on hip loaded exercises. Stability is an essential component of knee injury rehabilitation in order to maintain optimal knee alignment and integrity.
What Exercises Should You Use?
It is impossible for me to give a one size fits all approach. You must use a comprehensive assessment that finds your weaknesses and put a plan in place to correct them.
In our article How To Strengthen A Weak VMO & Reduce Knee Pain In 5 Simple Steps I give you stacks of ideas on how to do this. We have also have two detailed programs with all of the assessments and exercise instructions that you can download below by clicking on the image.
I also suggest to get a copy of our online program below that includes all the detailed assessments and programs.
Summary
There is no doubt that cycling can be helpful in the early stages of knee pain rehabilitation but it must be used wisely. If it is used in combination with a strength program that addresses muscle imbalances and stability deficits it can be a great addition. If it is over-used or used as the only method you are not likely to succeed in treating your problem at the source.
About The Author
Nick Jack is owner of No Regrets Personal Training and has over 20 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specializes in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise.
References
Movement – By Gray Cook
Corrective Exercise Solutions – by Evan Osar
Athletes Acceleration Speed Training & Game Like Speed – by Lee Taft
Diagnosis & Treatment Of Movement Impairment Syndromes – By Shirley Sahrman
Knee Injuries In Athletes – by Sports Injury Bulletin
The ACL Solution – by Robert G Marx
Understanding & Preventing Non-Contact ACL Injuries – American Orthopaedic Society For Sports Medicine
Anatomy Trains – by Thomas Meyers
Motor Learning and Performance – By Richard A Schmidt and Timothy D Lee
Assessment & Treatment Of Muscle Imbalance – By Vladimir Janda
How To Eat, Move & Be Healthy by Paul Chek
Scientific Core Conditioning Correspondence Course – By Paul Chek
Advanced Program Design – By Paul Chek
Twist Conditioning Sports Strength – By Peter Twist