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As a knee surgeon, I am often asked about pain in the knee, in the last we covered trauma and now we shall look at overuse injury. The weather is now good, and with intense enthusiasm you get out the road bike and start to shake off the winter cobwebs. Filled with keenness many start by doing the rides that they were doing at the end of last season – trying to do so at last summer’s pace.

I find that this sudden increase in activity, either by a rapid increase in load, mileage or intensity is the commonest cause of knee pain. This can be an effect of both the intensity and the duration. Both situations give rise to pain.Common examples of activity related pain include tendonopathy (pain in the tendons of the knee) caused by inflammation and irritation. In addition to too much or too hard, the set up of your bike in terms of ride position and cleat position can have a massive effect. It was a revelation to have a bike assessment myself – I used Tobina Wilson at Six Physio in the Fulham Road, and have never regretted it.Once this problem has been recognized, you need to do something about it. Cut back on riding radically until the situation is under control. Rest, Ice Compress and elevate the area. Apply Ice for 20 minutes (not directly to the skin) with a damp tea towel on the area to protect from ice burns. Stretch the muscle compartment.

I find it unusual that you see most sportsmen stretch both before and after the game – but rarely see cyclists doing so. One of my friends laughed as they saw me do my pre and post ride stretches.  I had to share the joke when they came to ask me for advice in relation to their quadriceps pain!To avoid getting into trouble, consider joining a weekly Pilates or Yoga class. Good for the mind as well as the body, and will prevent tendonopathies developing.

Our sports physicians are particularly expert in managing the resistant tendonopathy – you can read their biographies here – Sports Physicians

Safe cycling.