Years ago, a friend of mine laid some wisdom on me that I hold dear
to this day; little ring until spring. No matter how enthusiastic we
are, no matter what early events we have, we need to give our
connective tissue some time to adjust from indoor rides to longer,
harder outdoor training. Diving head-long into the big gears can lead
to the dreaded “Spring Knee,” which forces one back to little
Spring Knee is the name given to a specific tendinitis
that strikes the tendons across the front of the knee. It’s usually a
result of overusage and too much strain on the tissue that might be
relatively weak after the winter hibernation. As the name implies, it
tends to occur in the early part of the riding season. While it is an
indictor that the tissue could use some TLC, it’s also typical of
those of us who can’t wait to get out and hammer.
Before I go on
much more, let me suggest the book Andy Pruitt’s Complete Medical
Guide for Cyclists. Pruitt holds a doctorate in education and is the
Director of the Boulder Center for Sports Medicine. This is the first
resource I consult when I have some new, weird pain after riding. It
is full of descriptions and, more importantly, treatments for ailments
typical of cyclists.
So Spring Knee is marked by a sharp pain
along the top of the kneecap. It’s usually on one of the top corners
of the kneecap. Occasionally, the pain shows up where the tendon and
muscles come together, about two or three inches above the
Treatment of this looks a lot like prevention. Go easy on
gearing. Spin light gears for a few weeks. If the pain persists after
a week, consider taking some time off. I know this is difficult just
as the thermometer begins its upward journey, but it is better to take
care of it now them have to see a doctor in June.
I’m not an
advocate of either ice or nonsteroidal anti-inflammatory drugs for
reasons I will explain, but I have no medical background beyond my own
collection of injuries. Ice and ibuprofen are exactly what Pruitt
Again, I am not a doctor and if you have knee pain
that persists, talk to a real doctor. That said, recent studies have
shown that even moderate use of NSAID can cause liver damage. They are
real drugs and should be respected as such. Again, talk to a real
doctor, which I am not.
Second, inflammation is part of your
body’s healing process. When we apply ice, we interrupt our ownhealing. Two recent articles in medical journals address this. Go find “The Use of Cryotherapy in Sports Injury” found in Sports Medicine Vol.3, pages 398-414. Another place to look is the Journal of EmergencyMedicine, Feb. 25, 2008. “Is Ice Right? Does Cryotherapy Improve
Outcome for Acute Soft Tissue Injury?”
The first article states
that ice can actually cause our lymphatic system to work in the wrong
direction, adding to swelling. The second article states that they
found no evidence that ice helps in recovery. This flies in the face
of everything we have been told for years, but it is something worth
The alternative to these is compression. Some sort of
compression sleeve over the injured area can help control swelling
and, hopefully, speed recovery.
Spring is also a time for new
equipment. A new bike is possibly as sure an indicator of spring, and
in my opinion, more beautiful than new blooms. The things to remember
are fit and form. Make sure your fit is spot-on. Again, let me guide
you toward the Boulder Center for Sports Medicine. They perform a
variety of professional bike fits that will assure that you are in the
best position to power that new steed.
Second comes form. No
matter how long you have ridden, you can always work on for. The most
common problem is in back position. We should have a pretty straight
and flat back when on the bike. The forward lean should come from the
hip joints, not the back. We should be supported by core muscles and
the forward lean should be supported by the muscles of the gluteuls.
We should feel tension on the high, outside muscles, like we would in
a deadlift. They are, after all, the same big muscles. The more you
are able to flatten your back and drive with the glutes, the more
efficient your efforts. You will be using not just the muscles across
the front of the leg, the quads, but the high hamstrings and glutes as
well. Spreding the same effort across three muscle groups, instead of
just one, results in more power for longer periods.
Keep it all
in mind next time you get out.
By the way, We are now 12 weeks out from Ride the Rockies. According to their own training chart, this coming week, which they start on Saturday, March 16, we should do 20 miles in a single ride this weekend, and another 40 miles split up over three rides over next week. As the above blog points out, we should still be spinning small gears. If you have even a hint of Spring Knee, wear knee warmers or embrocation (a warming oil or IcieHot sort of thing).
Oh, and this shot has nothing to do with the column, I just like it because Ivan was being shy the day I took this.
Have fun, be safe. I’m going