Knee Health Pathway

Let’s Make Happy Knees.

Knee health is critical and often overlooked among endurance athletes–until there is a problem. In this guide, we explore knee health, anatomy, and how to prevent knee injuries through strength training and key exercises that support long-term knee health.

The knee is often considered to be “the victim” within the lower body, caught between the hip and the foot. Your individual biomechanics and movement patterns, along with your bike fit, influence how the knee responds to the forces being generated at that joint.

This Pathway contains content from many of our experts including Dr. Andy Pruitt, Trevor Connor, Menachem Brodie, and Jess Elliott, to name a few. Follow this Pathway to start with the basics of knee health and progress to specific exercises to improve lower body strength and promote knee stability and health.

Diagnosing knee pain

In this video, Dr. Andy Pruitt presents the science and symptoms of one of the most common knee ailments as well as many other knee issues that crop up throughout the season.

Knee issues used to be the most common over-use injury among cyclists. While they are no longer atop that list, it is still nearly impossible for most cyclists to go through their careers without one.

One of the most common knee issues is something called “spring knee” caused by adding too much volume too early in the season, adding too much volume with too much work in the weight room, or through poor clothing choices.

Start here to learn from more than 40 years of Dr. Andy Pruitt’s experience in cycling medicine and ergonomics. Click below for this Workshop.

The knee as a victim

The knee is often considered to be “the victim” within the lower body, caught between the hip and the foot. An athlete’s biomechanics and movement patterns, along with his or her bike fit, influence how the knee responds to the forces being generated at that joint. Dr. Andy Pruitt, our Director of Sports Medicine, explains why this can often lead to injury.

Preventing injuries

In the Fast Talk episode “Preventing Cycling’s Most Common Injuries with Dr. Andy Pruitt”, we discuss some of the most common cycling injuries and how to address them. Listen to the first 25 minutes to learn about knee health and bike fit from Dr. Andy Pruitt.

The remainder of this episode reviews other cycling injuries including back pain, saddle sores, numbness, pressure, and hand pain. This information is crucial to understanding how bike fit coordinates your position across all planes of movement. It’s not just saddle height or stem length.

If you are dealing with knee pain or other discomfort on the bike, or want to learn how to promote long-term knee health for an enjoyable cycling career, get your notepad ready and listen in! Click below to listen.

Tendonitis

Tendonitis is the result of asking your body to do something it was not strong enough to do. As you are planning your season, think about where you want to be for your goal event(s) and work back from there to determine how to prepare the body for the real training to come. Coach Trevor and Dr. Andy Pruitt give you some key considerations for planning your base season, from establishing how to dress for your rides and approaching your long steady training, to methods for improving tendon durability in the weight room. Read this Article below.

Functional training

The Fast Talk episode “Functional Training with Menachem Brodie” takes a deep dive with Menachem Brodie, who is a Strength & Conditioning Specialist and USA Cycling Level 1 Coach. Learn not only the “what” and the “why” behind functional training off the bike, but also take away keys on breathing and six key exercises for cyclists. Listen to Brodie.

Four common overuse and imbalance injuries

So, you have taken on strength training to support your endurance training. Next, listen to this Fast Talk episode “Preventing Injuries Through Strength and Conditioning” with Strength & Conditioning Specialist, Jess Elliott, to learn about her view on four of the most common overuse and imbalance injuries for cyclists. 

We will take this back to the bike with Specialized Master Bike Fitter and Biomechanist, Charles Van Atta, to bring both viewpoints together to address how to use your bike fit and strength exercises to address these common overuse or imbalance injuries. Listen to Elliott.

More exercises

Are you looking for additional exercises to support knee health or strategies to relieve knee pain? Check out “How to Keep Your Knees Happy” for a detailed review of treatment strategies from Dr. Andy Pruitt.

Finally, bring the “Keep My Knees Happy” Routine into your program to loosen and build strength and stability in your glutes and quads with this seven-movement routine that will complement any training program. See more exercises below.

Full-body strength and stability

In this series of full-body movements, Strength & Conditioning Specialist, Jess Elliott of TAG Performance, walks you through a multi-planar approach to strengthening some common weaknesses. The goals of this routine are to build stability, efficiency, and resilience, so she prioritizes overall movement quality, force generation and absorption, muscle sequencing and activation, muscle balance, and core/postural integrity. This is not about pushing a ton of weight around; this is about learning how to move well for life. See key movements below.

Leg curls

Learn how to perform leg curls properly to activate and strengthen the posterior chain and those important hamstring and gluteal muscles. Variations are shown to highlight progressions so you can track improvement and continue challenging yourself.  

Reverse slide lunge

The reverse slide lunge is great for pushing and pulling movements like the pedal stroke. It also allows you to work on your lower body strength and balance through a unilateral approach. Learn how to incorporate this movement into your strength routine with simple at-home tools.  

Single-leg Romanian deadlift

The single-leg RDL (Romanian deadlift) once again focuses heavily on the posterior chain coordination and muscle recruitment. This one requires some good balance, so watch the video to learn how you can perform this movement effectively to develop your strength, stability, and resilience.  

STILL NEED HELP?

Some knee pain and injuries are stubborn enough to require personal intervention. If you still need help, schedule a free consultation with us and we will develop a path forward that is individualized for you.