“Cycling is a unique sport in that it fundamentally relies on power from the abdominals and lower back, but does virtually nothing to build or maintain it. In fact, cycling can sap your core strength and actually create problems, says Patty Tomlin, an exercise physiologist certified in Pilates at Colorado’s Boulder Center for Sports Medicine. Many of the cyclists she sees have overdeveloped quadriceps muscles and weak hamstrings, a classic problem that is a result of pedaling. Even off the bike, those powerful quads pull the hips forward and down, and the weaker hamstrings can’t pull back enough. This leads to poor posture and weak lower-back and abdominal muscles, says Tomlin.”
Muscles used in cycling. Artwork from the tenth volume (second period of 1892) of the French popular science weekly 'La Science Illustree'.
My physician gave me a massage therapy referral. I can’t just lay down and get a massage though, with a medical massage half the time is spent trying to figure out what is wrong. I am asked to rank how difficult the tasks of daily life are. This process fills me with guilt, making me feel like I am not qualified to be getting massage. I remember those times the arthritis in my lower back acted up, sending lightning bolts of pain through all corners of my body with every movement. I remember swollen throbbings of my wrists waking me up in the middle of the night; an immobilizing dull ache that dominated my hands for years after repetitive fishery work. I remember when the tension in my neck immobilized my entire jaw, rendering the simple act of eating a slice of bread physically impossible. The pain I am dealing with now doesn’t come close to comparing to those. I wish with longing I had the amazing insurance benefits then that I have now. I assume the pain I have is to be expected. I assume it’s the pain of being alive and working and commuting to work every day and not having a robust fitness routine to keep me balanced and limber. The pain wanders. One week, my knees take all the attention. The next week it’s my elbows, then the back, then the neck, and on in on in some sort of rotation.
However, I think the massage therapists might be on to something. I might have a legitimate issue that can be treated. It all started when a therapist pointed out that my quads are “ripped”. Another said they were “incredibly overdeveloped.” Before I could feel pride, however, they pointed out that the rest of me is “underdeveloped, especially by comparison. My health club recently offered a free fitness test. I knocked the squats out like nobody’s business. The personal trainer said I was a top performer. But, the rest of me performed at below average. How can any part of me be…below average? I bike every day! I belong to a health club! I should at least be average! But, it’s all coming together.
The massage therapists explained that, because muscles work in pairs, my knee is taking on significant pressures due to the severe unbalancing of my hamstrings and quadriceps. A brief web search gave it a name: patellofemoral pain.
“The pedaling movement puts more stress on the fronts of your thighs than the backs, which can lead to powerful quads and lesser developed hamstrings and glutes. If your quads overpower your hamstrings, they’ll drag your hips forward and down. Your hamstrings are unable to counteract that tug, resulting in compromised posture and weakened core muscles. You’ll tire more quickly on the bike as well as face an increased risk of back strain and injury.
In Brian Halpern’s book “The Knee Crisis Handbook,” a seasoned amateur cyclist complained of patellofemoral pain, or pain in the front of and around his kneecap. The pain stemmed from an imbalance in the strength of his inner thighs in comparison to his outer thighs. Although his quads were well developed, his outer thighs were overpowering his inner thighs and pulling his kneecaps toward the sides of his legs. The muscular imbalance between his abductors and adductors was planting the seeds for a knee-related injury.”
It is coming clear to me that I may soon be developing a medical reason to start the strengthening program I’ve been waiting to start for years. I have been trying to find something convenient, easy to commit to. The more the massage therapists treat me, the more I think that convenience may no longer be relevant.