Patellofemoral pain syndrome is a type of anterior knee pain or pain that is a result of issues in and around the knee cap or patella. Fortunately, there are effective patellofemoral pain syndrome treatments such as physiotherapy, and a proper bike fit can reduce or eliminate symptoms.
“Patellofemoral pain syndrome or PFPS is a very common issue for cyclists,” says Tyler Dumont, a physiotherapist and HealthChoicesFirst.com partner. “It’s basically an overuse or irritation of the under surface of your kneecap.”
Bike Fitting and Patellofemoral Pain Syndrome
“There are many factors in the bike fit that can contribute to overloading that joint as well as technique errors that can contribute to that problem,” says Dumont. “When looking at bike fit in relation to patellofemoral pain, there are a few things we want to measure.
One is the knee angle. How much bend is at the knee when the foot is at the bottom of the pedal stroke. We use a basic tool called the goniometer. They just measure how much bend is at the knee: approximately 30 degrees is a safe window to be at. Another tool we use to measure with is a laser. We can look at the position of the knee from a side view relative to the pedal. That sort of helps guide us in moving a saddle forward or back and making sure that knee is in the correct position.”
A bike fitter can also use a laser to ensure that the knee is centered over the foot and during the pedal stroke. This allows the knee to keep a linear path during the pedaling motion.
Proper Cycling Footwear
“One of the key aspects when treating patellofemoral pain is to make sure that that shoe and the cleat are positioned properly,” says Dumont. “There are lots of changes you can do to the position. You want to make sure you have your natural toe in or toe out. If you’re naturally a toe out and you’re stuck toed in, that’s going to alter your biomechanics all the way up. We can tip the shoe side to side by using wedges underneath the cleat, or we can use wedges inside the shoe.”
Another option is to use custom or over-the-counter arch supports to correct your position. Learn more about orthotics for cycling shoes.
“If you're not in the right spot and the position is not natural for your body that will alter the biomechanics all the way up your lower extremity and can contribute to ankle problems, knee problems, hip problems, and even lower back pain,” says Dumont.
If you have questions about bike fit and patellofemoral pain treatment, see a certified bike fitter or a physiotherapist that does bike fits. They’ll help you position everything properly so you’re not at risk for developing patellofemoral pain syndrome.
Complementary Content to Patellofemoral Pain Syndrome Treatment
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If you're a cyclist, you may have experienced other conditions such as saddle sores, chafing, and iliotibial band syndrome. Seeing a physiotherapist can be very useful in treating and managing cycling injuries. Visit our physiotherapy video library for information on mobilization, heat therapy, rehabilitation exercises and more.