Posts in cycling
Reducing Knee Pain In Cyclists

Cycling is one of the most popular outdoor activities in Boulder.  Cyclists we encounter in our Boulder Physical Therapy practice most commonly complain of pain on the front of their knee or anterior knee pain.  Research shows 1 in 2 competitive cyclists have experienced this knee pain resulting in lost training and competitions in over half of those affected (Clarsen et al. 2010).  A cyclists exposure to the impact of poor pedaling biomechanics is amplified by the volume of their training.  It is not uncommon for a competitive cyclist to flex and extend their knee over 5 million times per year during their training sessions and competitions (Callaghan et al. 2005).  In addition to training errors, bike biomechanics remain one of the key sources of an athlete's knee pain.

Athletes who have excessive movement in their lower bodies both reduce their cycling economy and performance, as well as, increase their injury risk.  In particular, the movement of the knee toward or away from the frame increases stress across the knee especially during the power portion of the pedal cycle.  The suboptimal mechanics change the alignment of the knee and the ability of the leg muscles to import forces on the foot and pedal.  Commonly, bike fitters use shoe orthotics or wedges to modify the relationship between the foot, shoe, and pedal.

Research has shown a rigid cycling shoe is the most economical and efficient interface with the pedal allowing cyclists to pedal at a lower % of their VO2 max for a given work load compared to a softer shoe.   Research regarding orthoses or wedges on cycling alignment and mechanics are fewer in number.  The limited research shows these orthoses or wedges 5-10 degrees can temporarily impact mechanics but their long term efficacy as a tool remains to be limited (Fitzgibbon et al. 2016).  They are most likely to benefit those athletes with true structural alignment impairments in the leg.  

Conversely, many of our patients's symptoms improve quickly with Physical Therapy interventions to correct impairments such as limited range of motion and muscle imbalances in the leg.  Once these are addressed an athlete is better able to use cuing and movement retraining to improve static and dynamic alignment of the knee while cycling.  In summary, athletes need the capacity to control the knee position through strengthening then the appropriate retraining to use that strength in an optimal cycling pedal cadence.  


Is my endurance training enough to build strength and muscle mass?

Triathletes have no shortage of aerobic exercise each week as they train for all 3 components of their sport, but often what they leave out is strength training.  Strength training has been shown to reduce injury risk and improve performance in swimming, cycling, and running.  The impact of this training is most noticeable in the athlete’s economy during each component of the event allowing them to sustain a higher power output, at a relatively lower level of aerobic capacity, compared to individuals who do not strength train.

In an older study authors examined the impact of strength training on muscle strength and muscle size among athletes who completed resistance training, running, or swimming for at least 10 years (Klitgaard et al. 1990).  The authors reported older athletes who completed resistance training had muscle cross section area and strength similar to younger sedentary individuals.  Surprisingly, the subjects who only competed running or swimming activities had similar muscle cross sectional area and strength to their sedentary peers.  The authors concluded that the regular performance of only endurance exercise was not able to prevent the loss of strength or muscle size associated with the aging process.

Endurance athletes are encouraged to perform regular strength training to slow the effects of aging and to improve their performance within their sports.  To learn more about how to incorporate strength training into your workouts contact a local Physical Therapist.



Strength Training Improves Cycling Performance

As we move towards the end of winter many Boulder cyclists are growing tired of the indoor hours on their bicycles.  One of the benefits of the winter months for cyclists is the opportunity to introduce strength training into their work out programs.  A 2 to 3 day a week, total body strengthening program not only reduces a cyclist's risk for injury, but has recently been shown to improve cycling performance.

As noted in a previous post on running economy, cycling economy is one of three factors shown to influence endurance sports performance.  Essentially how much of a cyclist's energy resources are used to produce a given speed and distance.  At a given speed or power intensity, a less economical or efficient cyclist will ride at a higher intensity of their max, burning more valuable fuel and oxygen, than a more economical or efficient cyclist.  These variations in efficiency are most visible during a cycling competition.

Sunde and colleagues recently examined the impact of an 8 week strengthening program on cycling performance and economy (J Strength Cond Res. 2016).  The cyclists continued their cycling training but also performed high intensity squat training (4 sets x 4 reps) 3 days per week to maximize their positive nervous and muscle system adaptations.  As expected the athletes demonstrated improved strength and power after the 8 weeks, but they also improved their efficiency and aerobic output.  These athletes extended their time to exhaustion at their maximum power output by close to 20%.  

Cyclists are advised to work with a local Physical Therapist to implement an individualized lower body strength training program to improve aerobic performance and reduce injury risk.