Knee Injuries

Do you struggle with niggly knee pain? Do you frequently develop pain towards the end of a longer run or bike ride? Are you stiff and sore when getting up from a chair or from bed in the morning? Then we have some useful information for you.

Knee injuries are one of the most common complaints across all sports, particularly triathlons due the repetitive nature of the activities involved and the high volume of training required.

Overuse injuries frequently result from a combination of training errors and poor biomechanics.

Unlike ligament and cartilage injuries which are common in team sports like rugby and soccer, the most common sources of knee pain in triathletes stem from the patellofemoral joint (kneecap) and the iliotibial band (ITB).

These injuries often result from an imbalance in muscle strength and flexibility between the inner quadriceps muscles compared to the outer quadriceps and ITB.

Additionally, inactive or weak gluteal muscles cause the knee to drift inwards during the gait/pedal cycle (see photos 1 & 2).

This places significant load on the patella altering alignment.

Abnormal compression and grinding forces occur underneath the patella which becomes inflamed.

With ITB friction syndrome the lower portion of the ITB rubs over the bony prominence at the outside of the knee causing “friction” and inflammation.

A key feature of knee injuries is that in the presence of pain, muscle inhibition occurs particularly within the inner quads muscle which in turn affects the ability of the knee joint to absorb shock and function optimally.

The result is often a downward spiral of ongoing pain and discomfort which prevents recovery with rest alone.

Although common muscle imbalances exist with these injuries, treatment and rehabilitation may vary dependent on each athlete’s particular presentation and demands.

Therefore, an accurate diagnosis from an experienced physiotherapist is important.

Thorough clinical assessment incorporating functional movement patterns, video analysis of running and cycling technique as well as assessment of foot function are essential to fully identify all the risk factors contributing to injury.

Habit Physiotherapy strives for a Technical Excellence assessment approach, utilising Gait Scan technology with Silicon Coach and Kinesiocapture video analysis as well as incorporating the Functional Movement Screen (see photo 3).

Typically, rehabilitation programmes will involve exercises to lengthen the ITB and outer quadriceps muscles using a foam roller (photo 4).

In addition to injury management, these biomechanical & muscle imbalance deficits can be targeted in an attempt to improve efficiency and economy of motion therefore having a significant influence on performance.

Developing an optimal conditioning plan will ensure that you are able to enhance the effects of training, improve recovery and perform better when racing.

If you have struggled with knee pain either recently or over the last few seasons, contact the team at Habit Physiotherapy for a consultation.