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Patellofemoral pain syndrome (PFPS) describes anterior (front) knee pain in the absence of other clinically diagnosed injury and is exacerbated by physical activity requiring deep knee flexion (bending). PFPS is a problem suffered by 37% of professional cyclists but PFPS can also occur in runners, walkers and when going up and down stairs.

Although there is less impact in cycling than other sports, the knee is asked to do many repetitions of the same movement. This may cause friction at the front of the knee which can be exacerbated by muscle imbalances around the hip and knee (poor biomechanics), as well as a less than ideal bike set up.

There is evidence that exercise therapy to correct these muscle imbalances can not only prevent and reduce pain but also improve a cyclist’s functional ability. Therapy involves loosening muscles that may be over tight through massage and stretching, as well as activating or strengthening other muscles, to improve any imbalances. Common imbalances are lower cross syndrome at the hip (see next article) or ITB syndrome and weak Vastus Medialis (thigh muscle near the inside of your knee) at the knee.

Here are three exercises that may help to get you started:

Glute Bridge (band)

ITB foam rolling

VMO Activation

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