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Bike Safely

and Avoid the Pain

It’s no coincidence that we have

seen a surge in people taking up

cycling as a hobby and/or sport

when last year Great Britain won

more cycling gold medals than ever

before.Add to this GB’s recent

success in this year’sTour de France,

with BradleyWiggins finishing 4th in

the general classification, and Mark

Cavendish winning a record 6 stages,

including the final stage on the

Champs Elysees, and perhaps we

will see even more people getting

on their bikes.

It’s simple – cycling is tremendous fun and

one of the best ways to keep fit – if you

are sensible about it. And we are not just

talking about the rules of the road!

Cycling is one of the most enjoyable and

satisfying of sports which, after years

of being classed as a somewhat odd

minority pastime undertaken by the sad

and masochistic, is now mainstream and

recognised as a fabulous way of getting

the body to work as it was intended. But

unfortunately, this resurgence in the sport

is also being marked with more and more

injuries needing specialist help.

Nicole Oh, a senior physiotherapist at

the London Bridge Hospital Sports Injury

Clinic, is also a keen cyclist and sees the

results of over enthusiastic exercise every

day.“Most of the injuries we see are as a

result of people trying to do too much too

soon,” she said.

Nicole goes on to say,“Cycling in itself

shouldn’t generally cause injuries (unless

you fall off!). It’s people trying to increase

the amount they do far too quickly, or by

doing such a repetitive action the wrong

way, that causes the problem.”

But injuries do happen; Anterior Knee

Pain – pain through the front of the knee

due to irritation of the cartilage behind

the kneecap – is one of the most common

cycling-related injuries. Here are a few

things your patients can consider to avoid

sore stiff knees:

• Check seat height and position – with

the crank vertical, the knee should be

at an angle of 25-30°.With the crank

horizontal, a line dropped from the

front of the kneecap should bisect the

pedal axis.Too low or forward can

increase the compression through the

kneecap.Too high or back can stress the

structures at the back of the knee and

make it hard to stabilise the pelvis.

• Gearing and Cadence – pushing hard

gears at low revolutions puts a lot of

load through the kneecap.They should

try to ‘spin’ lower gears at a high

cadence – at least 80rpm.

• Pedal technique – watch for inside

drifting of the knee, especially during the

push down phase (and when they are

tired).This could be due to weakness of

the inside quads muscle (VMO) or gluts.

Also, try to imagine drawing smooth

circles with both the pedals, rather than

an up and down sledgehammer-type


• Increased load and volume – in short,

too much distance/hills/resistance, too

quickly. Like all things, this needs to

build up gradually.

As Nicole says, this particular injury is “just

the tip of the iceberg!”

If you think one of your patients could have any of the above problems, refer them to see a Physiotherapist to keep

those pedals turning smoothly.The number to call to see Nicole or one of her colleagues is

020 7234 2500




The GP Liaison team arrange and manage consultant, GP and physiotherapist meeting opportunities

throughout the year.These free educational seminars are run both locally to you and here at the

hospital or neighbouring venues.To view a list of previous and upcoming seminars, please visit .

Educational Seminars

For further information, please contact one of our GP Liaison Officers:

Hannah Hughes Tel.

020 7234 2557


[email protected]

Louise Kemp


020 7234 2051


[email protected]