I have OA in both knees, the left worse than the right, fortunately not so bad that I cannot ride but that is in large part to my maintenance routine that I (usually) follow. Consistency is the key here for this, which I myself need to get better at.
The good news is that, unless you’ve been told that your knee needs replacing, there are some things you can do that can help. Maybe you cannot do all of these, but if you can do some and you stick with it, this will get you started on the way to doing more to help your condition.
The text below started as a reply to a subscriber of my YT channel, and I’ve decided to post here sort of as a guide or explanation of what I do, with steps anyone that has less than severe OA can do to relieve pain and hopefully minimise further pain.
I plan to make a Youtube video on this soon, so stay tuned!
- Stretching the hip flexors, glutes and leg muscles is obviously important, especially the IT band, as with cycling this muscle can become very tight. I’d get on a roller foam for that and/or a massage gun. Can’t beat the pain of the roller tho! If this muscle is overly tight it can pull on the kneecap, exacerbating OA issues.
- A good physio helps to really work the legs and hips, once he/she has softened everything (3-5 weekly sessions) you can then maintain on your own.
- Once you’ve done that, I recommend getting to a gym, and doing very light leg work, not so heavy that it exacerbates any existing knee problems. I go 3 times a week or so, and I’ll use no more than 5-6kg and do 60 or so reps of hamstring curls, and seated leg extensions. For me traditional squats cause a little sharp pain so I use the seated squat machine and started off with no weights, just the weight of the foot plate, and do say 3 sets of 15-20 reps, then build it up in volume, I do 100 reps total now but again, very light, all the while paying attention to foot placement and the depth of the squat, to ensure there’s no pain. If there is, stop and get back at it another day, when it’s receded. If it continues, then squats of any kind aren’t a good idea. The bike does work these areas but these exercises ensure that the whole thigh/calf muscles are being used, which supports the knees better. Ice when you get home from the gym/rides.
- If you have no access to a gym, you can do light half-squats standing against a wall, using full water bottles as weights. Lunges are also possible, though again watch for the knee pain. I recommend single leg lunges, with one leg on a table this helps to isolate one leg at a time, stretches the hip flexors and improves balance. Build up to full lunges though. Going up and down shallow steps is another option, so at least you are working the thighs and glutes. Light ankle weights can be used too, for the leg extensions, simply sit on a chair and light one leg straight out, then do the other.
- Walk. The position we adopt whilst cycling is not one we were designed for (hence the need for stretching). A good, brisk 20-30 minute walk a few times a week, or even better daily, can help to re-align the body. If there’s a springy running track nearby, even better. This also helps with weight loss: being overweight exacerbates OA symptoms.
- Swim. Not for everyone I know, and wasn’t for me, but a bad back pushed me into the pool and I love it now. 20-30 mins 2-3 times a week, any stroke you prefer, works as a sort of ‘soft’ yoga and also as what you might call an ‘aqua-massage’. Also, no one can text you or call – bonus!
- Do some core stability work (swimming provides a bit of this too), this helps tilt the pelvis back which also helps the body’s posture. Planks are good and I will demo some of the other core work I do in the upcoming video.
- Drink lots of water, this hydrates the muscles.
- Find a 10 min pre- and post-ride stretch vid on Youtube for people with OA. I’m planning a video or two showing what I do to help my OA. Good luck!
- Riding position: Sit far back in the saddle, so the sit bones are totally on the area of the saddle designed to support you, rather than further ahead: this allows the hamstrings to be better utilised, and there’s less stress on the knee than when you sit further forward, as the bend angle is lessened. Also this helps with lower back movement, it minimises that and lets you have a smoother pedal stroke. Also helps with lower back issues such as bulging discs.
- Food: eat healthy! Here’s a list of good foods:
- Citrus fruits.
- Sweet potatoes.
Omega 3 Fatty Acids:
- Salmon and Tuna
- Ground flaxseed, Chia seeds
- Almonds, Walnuts & Pistachios contain healthy monosaturated fats and can fight against inflammation.
Extra Virgin Olive Oil:
- Contains a fatty acid called oleocanthal, which may inhibit inflammatory compounds in the body. Aim for one to two tablespoons daily in your diet.
Garlic & Onions:
- Contain diallyl disulfide that can in some cases improve the symptoms of osteoarthritis for many sufferers and help slow down the damage of cartilage. Great for first dates too!
- Can help lower the level of C-reactive protein (an inflammatory marker)
- Avoid trans- and saturated fats, added sugars, refined carbs, MSG, and alcohol!
Yes a lot to take in, and hard if not impossible (for me anyway) to be very strict about, but, adding some of these good foods to your diet, as often as possible, will help. For example, instead of pasta, I’ll often replace it with a lot of broccoli, which fills you up and absorbs sauce well. Instead of two cups of white rice with your salmon and veg, cut it in half and have some nuts on the side (and try wholegrain rice instead of white). Addicted to bread, as I am? Ditch white and go for multi-grain or rye.
As a basic rule, the more veg and fruit you can eat the better, and the less non-natural foods in general you can eat, the better. Beer? Well, we all need to feel human sometimes, however to appease the Cycling Gods, do make sure the beer is Belgian…
A word on chocolate. Chocolate is a gift to humanity from The Universe and should be respected as such. The rule tho is to go for dark chocolate rather than milk (less sugar), and eat 3 pieces instead of the whole bar. [Note to self]…
Good luck! Feel free to email me at email@example.com for coaching plans that can be built to incorporate issues such as OA, lower back pain, etc.