Are you likely to get knee pain? What your pedal stroke can tell you.

A quick look at your pedal stroke will give you a rough indication whether you are likely to get a knee injury. With knee injuries presenting in the clinic, it is often the knee that drifts inwards towards the frame that is in trouble causing the knee pain.

In this short video here you can see the different strokes on the right versus left leg. The cyclists right knee dips towards the bike frame on each down stroke. Compare this to their left leg where the cyclists hip, knee and foot are in good alignment.

Why is this happening?

Most commonly the cause is due to weak hip abductors, specifically the gluteus medius and minimus. When these muscles are weak or not firing correctly they allow the knee to drift excessively over the arch of the foot. This can lead to an imbalance of the muscles around the kneecap with the muscles on the outside of the thigh tightening up. It can have an effect on how the knee cap moves up and down in its groove. Tight muscles can pull the kneecap to the outside of the groove leading to pain at the side of the knee. ITB issues can also arise. I have written a blog about kneecap pain, and also a blog on ITB pain here.

Why do the hip abductors weaken?

Hip abductors weaken or switch off when the body is held in a posture where these muscles are not used such as sitting for long periods (8hrs a day, 5 days a week, plus commute or couch time). Typically postures where your pelvis tilts forwards can lead to weakness here, and these weaknesses are often found with other muscular imbalances in around the hips and torso. If you want to check if your hip abductors and gluteals need strength visit my post on the topic here

What to do to fix it?

Long term resolution involves looking at the root cause of the problem – is there a problem with your posture, are other muscles weak or tight? And then correcting these issues along with targeting hip abductor strength. Prevention is better than cure so the exercise below is one that you could incorporate into your strength routine:

Side lying leg raises & circles

For the side lying exercises below it is really important that you lie with your hips stacked on top of each other, if your start to lean backwards you will not work the correct areas.

You should feel it work where the back pocket of your jeans would be. If you don’t move the top leg backwards until you feel the contraction in this area. If you feel the exercise in your back, roll the shoulders towards the floor and this should focus the exercise towards the gluteal area. No pain should be felt during this exercise. If you feel pain, cease the exercise and seek medical advice.

Start Position: Lie on your side with the muscle to be strengthened on top. Bend the lower leg slightly at the hip and knee for stability and bring the leg backwards as far as you can.

  1. Slowly raise the upper leg to just above hip height
  2. From this position slowly lower and raise the leg (1 repetition). Do up to 10 raises
  3. In the same position perform up to 10 small circles
  4. Over time build up to 3 sets of raises and circles 3 times a week

Side lying leg raise for gluteus medius and minimus strengthening, hip abductor strengthening, rehab knee pain, low back pain

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