Contrary to appearances, I don't do all of my background reading at Wikipedia. With regard to my current knee troubles, I recently hobbled out to see if there are any books that might offer some useful advice.
There were two main things I wanted:
- Sound advice about cycling and knee injury
- Something a bit more substantial than 'just jump on a bike—it's low impact so it's good for your knees', because my own experience shows that's not necessarily the case
- Sound advice on how I can help my knee recover
- I'm thinking that maybe a sensible regime of exercise might be the go here
I found two titles: Knee Pain: The Self-Help Guide
Self-help guide
Never really a fanatic for self-help guides, I warily poked inside Garrett and Reznik's book for what they had to say about cycling. In the chapter on "How to prevent knee pain":
Another way to stay in shape is to bike, either outside or inside on a stationary bike. Because you are seated, you are removing the bone on bone impact caused by running.
The downside of biking, however, is the movement required typically involves a fuller range of motion than other sports.
And that's about the extent of it. Not altogether forthcoming about making sure the bike fits. But the point about the extra range of motion is well made: unless you're running up stairs, you'll generally put your knees through a greater angle of bend on a bike than on foot. And that's something I reckon cyclists don't often think about.
What about their recommended exercises? In the same chapter is a section on "Exercises that make the knee injury-resistant". Most of these seem to involve squats and otherwise loading the bent knee—and that's something that's no longer an option for this little black duck.
True, my knees are probably more pathological than normal at the moment, so how about the entire chapter on "Exercises to relieve knee pain"? That sounds more like my speed. Mostly these look good: plenty of unloaded knee extensions and flexions, leg lifts, ankle rotations, and muscle stretches. (And unlike with the more aggressive exercises in the other chapter, there is only a light-handed attempt to flog their SpοrtCοrd®—something that you could easily substitute with an old bike inner tube and a bit of ingenuity.)
Overall it seems like a pretty comprehensive book on its topic, but for me its coverage of cycling aspects is slender at best (which is odd, considering it includes no less than five photos of cyclists, making it the most illustrated sport in the book). I am also distinctly nervous about the "injury-resistant" exercises they recommend—my experience is that repeatedly loading the bent knee can actually cause injury.
Crisis? What crisis?
So to Halpern's book, where in the chapter "Play it safer: a activity-by-activity general knee health guide" I read:
Most cycling injuries are the result of overuse. Think about it—if you're cycling between 60 and 100 revolutions per minute, then your knee is performing the same task between 3,600 and 6,000 times an hour! That's a great deal of repetitve stress on the knee.
I seem to have heard that somewhere before, and I find it reassuring.
In terms of "protecting yourself", Dr Halpern makes a series of reasonably detailed recommendations under the following headings.
On proper equipment:
-
Make sure you bike is the right fit [yes! yes! yes!]
-
Use proper footwear
-
Correct leg-length differences
On training:
-
Don't do too much too soon
-
Don't build too fast
-
Don't ride in too low a gear
-
Maintain proper technique
-
Quit when you're tired
-
Strengthen your inner leg
When compared to the previous book, this is much better coverage of doing right thing by your knees while riding.
Halpern's recommended exercises are similar to those of Garrett and Reznik—I suppose there aren't too many different ways the knee can be bended and stretched—but Halpern definitely has fewer that involve loading the bent knee. He also gives a specific caution on squats:
It's true about all exercises, but especially of squats: proper mechanics lead to results, poor mechanics lead to injury. I'm here to tell you that a properly executed squat is one of the safest exercises out there, and if you can remember to [follow my technique], you'll be in good shape.
And I'm here to tell you that an improperly executed squat can lead to excruciating pain and debility. So, if you don't mind Doc, I'll just give them a miss altogether.
Other than the squats and a small selection of exercises with gymnasium equipment, his selection exercises is easy to perform and requires no equipment more exotic than a towel.
Conclusion
Although I favour Halpern's book, it's really unfair for me to "review" either because I only really dipped into them. The sections on knee anatomy and common maladies that affect the knee appear (on a quick skim) to be pretty comprehensive in both books. I must say that in Garrett and Reznik's book the anatomical illustrations are more generously-sized and lusciously detailed (including a wonderfully squirm-inducing diagram of an arthroscopy). This book also makes better use of photos and diagnostic imaging. And their self-diagnosis flow chart is more extensive than Halpern's too.
But for his sensible advice on cycling, his caution on squats, and his good selection of gentle exercises, it's mostly Halpern's advice that I'll be following.
Now if you don't mind, this old granny has to go and take some glucosamine (about which both books are cautiously positive).