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Q

With the good weather I have started cycling to work. Unfortunately, I am a fair weather rider so I haven't been on my bike since last October. I began noticing some sharp pain on the outside of my knee. It hurts me when I climb stairs and walk long distances and I have not had any twisting injuries to my knee so I don't think it is my cartilage. What is it?

 
A

A common problem with cyclists is tightness to the structures on the outside of the knee including a band of tissue called the iliotibial (IT) band. This structure attaches to the outside of the knee and is often irritated with cycling because of the repetitive nature of the sport/activity. An average light pace on a stationary bike might be between 60-100 rpms (revolutions per minute) which means when you are riding you are rubbing that tissue 60-100 times each minute you are on the bike. Additional irritation may be occurring with your long distance walking. In fact, long distance runners can have similar complaints of lateral knee pain from irritation of the IT band. My recommendation is to consult a physical therapist to complete a functional movement screen to check for muscle imbalances and a flexibility screen to see if you have adequate range of motion in your hip, knee and ankle joints. Additionally, you can consult someone to ensure your seat, crank and handle bar positions are appropriate for your size and body structure. You'll be amazed at how a subtle change in your position or flexibility can affect your pain.

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