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Why so many middle-aged cyclists suffer unbearable knee pain

If you’re looking for a new exercise to get your teeth into, cycling may seem the obvious choice – especially if you’ve counted out running because you’re worried about your knees.

It requires no pricey gym membership and, if your commute isn’t too long, you can squeeze it in on the way to and from work.

No wonder more than two million Britons cycle every single day – and for many, it’s a new-found hobby, often taken up well into adulthood. After all, there’s all that expensive gear to buy – this isn’t just a pastime for kids!

More than two million Britons cycle every single day ¿ and for many, it¿s a new-found hobby, often taken up well into adulthood. But many middle-aged cyclists suffer unbearable knee pain

More than two million Britons cycle every single day – and for many, it’s a new-found hobby, often taken up well into adulthood. But many middle-aged cyclists suffer unbearable knee pain

But as a personal trainer, I see the following scenario all too often: it’s all happy riding until about six months into a cycling regime.

Then knee pain strikes.

In severe cases, I’ve had men and women come to me struggling to walk long distances.

Many are reliant on strong painkillers to get them through their next bike ride.

They want to know, why has this happened to them? After all, unlike running, cycling is supposed to be ‘low-impact’ exercise, and ideal if joint pain is a problem.

The truth is, they are all suffering from a common but little-known condition called cyclist’s knee.

It is an agonising condition that affects about 65 per cent of keen cyclists.

As anyone who’s ever got on a bike will no doubt know, the motion of pedalling while cycling uses the thigh muscle – or quadriceps – more than any other.

In reality the quadriceps, also known as the quads, aren’t a single muscle but a group of four. Cyclist’s knee occurs when one of them, the vastus lateralis, becomes overworked and enlarged.

This large muscle sits on the outside of the upper thigh.

Ever noticed the huge bulging muscle on the outer thigh of elite cyclists? That’s an over-developed vastus lateralis.

And along with the rectus femoris, and the vastus intermedius, which runs down the front of the thigh, it is responsible for almost half of your pedalling power.

These muscles are pushed to their limit every time you press down the pedal – particularly when cycling uphill.

The problem is, the fourth – and equally important – quad muscle, the vastus medialis oblique (VMO), doesn’t get worked during pedalling. So while the others grow, this stays disproportionately small, becoming weak and sensitive.

This imbalance can start to pull the kneecap out of place, ultimately causing cartilage inside the joint to wear away – otherwise known as arthritis.

A step-up is a great exercise to ease the pain. You can use equipment (shown), the stairs in your house, front door step, or even the kerb

A step-up is a great exercise to ease the pain. You can use equipment (shown), the stairs in your house, front door step, or even the kerb 

The result? Searing pain in the knee which can also affect the lower back, hips and ankles.

I often use a visualisation to help my clients realise the extent of the damage.

I say: ‘Imagine four people walking in single file, carrying a heavy log on their shoulders.

‘Each person represents one of the four quadriceps. If one person is much weaker than the rest, the workload is not distributed equally between all four people, creating an imbalance. Eventually, they might drop the log.’ 

Other highly important muscles can also become neglected if cycling is chosen above all other exercise, including the hamstrings, which run down the back of the thigh, and the gluteus maximus, or buttock muscles.

The walk sit knee squeeze: Standing, lean your back against a wall and bend your knees at 90 degrees as if you¿re sitting on an invisible chair and hold for as long as you can

The walk sit knee squeeze: Standing, lean your back against a wall and bend your knees at 90 degrees as if you’re sitting on an invisible chair and hold for as long as you can

Thankfully, these common problems can be easily remedied with a handful of simple exercises. London-based physiotherapist Dimcho Bachev, who works with Olympic athletes, says: ‘By keeping the VMO muscle activated with leg exercises and stretching, many knee problems are solved the majority of the time without any interventions.’

Above are three key exercises that will help to spread the load and free your poor, tired knees. Practise them at least once daily if you’re suffering from knee pain, and you’ll be back on your bike in no time.

Always see a medical professional, though, before embarking on any plan.

For best results, these should be incorporated into a full-body exercise regime, as part of an active lifestyle.

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