Common problem, patellofemoral syndrome. Fancy name for wear and tear of articular cartilage behind knee cap. Often can be chronic, but helped. Bike fit should ensure proper leg extension at dead bottom center. The angle should be between 25-30 degrees, measured by skilled bike fitter with goniometer. Medical treatment short course of anti-inflammatories, stretching quads, hamstrings, iliotibial band, and glutes. Ice after exercise. Important to do short arc quad exercises with only slight knee bend, to strengthen VMO, strengthen glute abductors, extensors. Try to pedal with good technique, circles. Capsaicin topical can help block pain signals, but needs to be used regularly to be helpful. You can also try glucosamine/chondroitin but needs to be taken for a couple of months, to see if it helps. PRP injections, are not proven, or covered by insurance, but there has been evidence that it might help some patients.
Also, bicycling foot orthotics, cleat adjusted so ball of first toe at center of spindle of bike pedal, you can also try moving cleat behind from this position. Hope this advice is helpful, but find skilled sports medicine physician, physical therapist, bike fitter, to implement treatment. Let me know how you do. Avoid any deep knee bend strengthening exercises, squats, lunges, which put tremendous force on patellofemoral joint.
This is my experience as a bicyclist, who has an arthritic knee affecting my
medial compartment, and patellofemoral joint.
Often can be chronic, but helped. Bike fit should ensure proper leg extension at dead bottom center. The angle should be between 25-30 degrees, measured by skilled bike fitter with goniometer. Medical treatment short course of anti-inflammatories, stretching quads, hamstrings, iliotibial band, and glutes. Ice after exercise. Important to do short arc quad exercises with only slight knee bend, to strengthen VMO, strengthen glute abductors, extensors. Try to pedal with good technique, circles. Capsaicin topical can help block pain signals, but needs to be used regularly to be helpful. You can also try glucosamine/chondroitin but needs to be taken for a couple of months, to see if it helps. PRP injections, are not proven, or covered by insurance, but there has been evidence that it might help some patients.
Also, bicycling foot orthotics, cleat adjusted so ball of first toe at center of spindle of bike pedal, you can also try moving cleat behind from this position. Hope this advice is helpful, but find skilled sports medicine physician, physical therapist, bike fitter, to implement treatment. Let me know how you do. Avoid any deep knee bend strengthening exercises, squats, lunges, which put tremendous force on patellofemoral joint. Sit on table high enough so feet do not touch floor. Observe your natural alignment of foot and ankle. This is usually heel in, this is the same position you should be in when you snap into your pedals.
I’m going to build off this. Strengthening the posterior chain has been so beneficial to me. I do deadlifts with a trap bar, puts less force on the knee. But usually our quads are so strong compared to your Glutes and hamstrings. It made such a difference. Also I stretch for 20 minutes everyday. Really good long holds for hips, hamstrings, and quads. I know there is all kinds of people who say you stretch that much but I think it’s crap. As much as we sit at work and on a bike you need to stretch. I have grade 3 chondromalacia patella due to a poor bike fit for years And right It bands and inactive Glutes and hamstrings. Got that rectified and started everything else and about 4 months later I feel pretty dang good. This is my experience.
Mike