Force and repetition in cycling: possible implications for iliotibial band friction syndrome

Farrell, Kevin C.; Reisinger, Kim D.; Tillman, Mark D.

doi:10.1016/s0968-0160(02)00090-x

Cited by 77 publications

(50 citation statements)

References 10 publications

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“…One study examined the impact of saddle height on ITB syndrome and reported that a lower saddle height that increased minimum knee flexion angle to greater than 30° kept the ITB out of the impingement zone. 31 For cyclists at risk for ITB pain, a lower seat height may also be desirable by reducing compensatory lateral pelvic motion 31 that can increase stress to the ITB. Overall, more research is needed to better understand the effects of cycling on the medial and lateral regions of the knee.…”

Section: Discussionmentioning

confidence: 99%

“…34 In competitive cyclists, they found increased force effectiveness for road cyclists at optimal saddle height, and increased mean knee flexion angles at low and preferred compared to high and optimal saddle heights for road cyclists and triathletes. 29 Interestingly, Farrell et al 31 reported that while saddle height was set in the optimal position statically, knee flexion seen while cycling was greater due to lateral movement of the pelvis in recreational cyclists, which may decrease risk of ITB impingement. 31 Finally, Tamborindeguy and Bini 33 set saddle height based on cyclists' anthropometrics and found no differences in peak tibiofemoral compressive/anterior shear components across three slightly different saddle heights based on percentages of floor-greater trochanter heights of 97%, 100%, and 103%.…”

Section: Methodology and Outcomes Measuredmentioning

confidence: 99%

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The Influence of Extrinsic Factors on Knee Biomechanics During Cycling: A Systematic Review of the Literature

Johnston

Baskins

Koppel

et al. 2017

Intl J Sports Phys Ther

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Background:The knee is susceptible to injury during cycling due to the repetitive nature of the activity while generating torque on the pedal. Knee pain is the most common overuse related injury reported by cyclists, and intrinsic and extrinsic factors can contribute to the development of knee pain.Purpose: Due to the potential for various knee injuries, this purpose of this systematic review of the literature was to determine the association between biomechanical factors and knee injury risk in cyclists. Study Design: Systematic review of the literatureMethods: Literature searches were performed using CINAHL, Ovid, PubMed, Scopus and SPORTDiscus. Quality of studies was assessed using the Downs and Black Scale for non-randomized trials.Results: Fourteen papers were identified that met inclusion and exclusion criteria. Only four studies included cyclists with knee pain. Studies were small with sample sizes ranging from 9-24 participants, and were of low to moderate quality. Biomechanical factors that may impact knee pain include cadence, power output, crank length, saddle fore/ aft position, saddle height, and foot position. Changing these factors may lead to differing effects for cyclists who experience knee pain based on specific anatomical location. Conclusion:Changes in cycling parameters or positioning on the bicycle can impact movement, forces, and muscle activity around the knee. While studies show differences across some of the extrinsic factors included in this review, there is a lack of direct association between parameters/positioning on the cycle and knee injury risk due to the limited studies examining cyclists with and without pain or injury. The results of this review can provide guidance to professionals treating cyclists with knee pain, but more research is needed. Level of Evidence: 3a

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Section: Discussionmentioning

confidence: 99%

Section: Methodology and Outcomes Measuredmentioning

confidence: 99%

The Influence of Extrinsic Factors on Knee Biomechanics During Cycling: A Systematic Review of the Literature

Johnston

Baskins

Koppel

et al. 2017

Intl J Sports Phys Ther

View full text Add to dashboard Cite

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“…ITBS is common amongst the active population, and is especially prevalent in runners, cyclists, and military personnel (Ellis, Hing, and Reid 2007). ITBS has been speculated to be a Many speculate that this injury is a result of friction from the IT band shearing across the lateral femoral epicondyle (LFE) during the extension and flexion of the knee (Farrell, Reisinger, and Tillman 2003;Ellis, Hing, and Reid 2007;Orchard 2007;Hamill et al 2008). However, the counter arguments cite distal femoral and tibial attachment of the ITB as rendering the IT band unable to rub against the lateral femoral epicondyle in a forward and backward motion.…”

Section: Iliotibial Band Pain Syndromementioning

confidence: 99%

“…Joint kinematics do contribute to ITBS development, but it is not evident that joint metrics, such as the knee flexion "Impingement Zone" (Farrell, Reisinger, and Tillman 2003), are effective in real-time assessment of injury risk. While the scientific community tends to agree on a compression-based injury mechanism for ITBS, more research is needed on identifying the mechanism(s) of ITBS.…”

Section: Iliotibial Band Pain Syndromementioning

confidence: 99%

“…From these results, it is indicated that the ankle control has a significant effect on pedal control in the Fatigue group, while Non-Fatigue subject performance hints that other adjustments up the kinematic chain counteract ankle plantar flexion changes and maintain relative pedal orientation through the ride section. Knee extension is considered a significant metric for ITBS injury risk exposure, as implemented in the "impingement zone" (IZ, knee extension > -30°) of knee ROM (Farrell, Reisinger, and Tillman 2003), where the ITB is said to be inducing shear friction loads on the lateral knee. Using the current definition of IZ indicated that the Fatigue group may experience significantly greater duration of LFE contact (p<0.01) than Non-Fatigue subjects.…”

Section: Rpm Profilesmentioning

confidence: 99%

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An Investigation of Fatigue in Stationary Biking with Application to Iliotibial Band Syndrome Development

Sathyanarayan

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Cycling, or spinning (stationary biking), is a sport that has a low incidence of acute injury and is considered a safe, low impact, cardio workout. However, the repetitive behavior of cycling makes the rider especially prone to the development of long-term injury. In literature, the cause of these injuries has been theorized to have multiple contributors, such as improper riding technique, poor compensation strategies, and overall muscle fatigue. The primary aim of this thesis is to advance the current understanding of human performance and fatigue processes by combining kinematic, kinetic, and muscle activation data from an experimental stationary bike test to identify performance metric trends, analyze EMG-based regression models of performance loss, and develop subject-specific musculoskeletal models to estimate iliotibial band syndrome (ITBS) risk factors, lateral femoral epicondyle (LFE) compression force and impingement duration. Highdimensional data was collected from sEMG-fitted volunteers as they were guided through a 1-hour stationary biking endurance routine. Motion capture and novel bike instrumentation were utilized to collect detailed kinematic and kinetic data with minimal influence on cycling performance. Following a warm-up period, pedaling resistance was manually incremented to maintain a selfreported high resistance level and reflect group stationary biking training. Volunteer fatigue levels were categorized by the extent of cadence reduction under constant cycling difficulty. Fatigued and non-fatigued performance groups exhibited significant differences, with the Fatigued group showing: greater peak hip adduction, greater lumbar flexion, greater torso and pelvic center-ofmass motion, and greater reductions in muscle activation amplitude. EMG signal shape parameters from the fatigue group were used to develop linear regression models of performance reduction. Correlation analysis and model fitting revealed a strong significance of distal motor control loss (foot plantar-/dorsi-flexion muscles), not power generation muscles, in triggering system-level performance change. OpenSim muscle path biofidelity was improved to match literature cadaveric muscle data, and estimation of ITBS risk factors was implemented. Model predictions indicate fatigued individuals have increased LFE compression duration, but decreased compression force due to kinematic changes. While osteokinematic and muscle activation compensation mechanisms were observed to maintain cadence among the non-fatigue group, increased LFE compression force was predicted with continued cycling. The investigation highlights the degradation of technique and elevated injury risk associated with fatigue and compensation processes, respectively. The identified performance-critical muscle parameters and fatigue-induced kinematic changes that can be used to inform overuse injury prevention in clinical rehabilitation, athletic training, and military applications.

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Knee

Miller

Pedowitz

Dalal

et al.

Magnetic Resonance Imaging in Orthopedic Sports Medicine

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Force and repetition in cycling: possible implications for iliotibial band friction syndrome

Cited by 77 publications

References 10 publications

The Influence of Extrinsic Factors on Knee Biomechanics During Cycling: A Systematic Review of the Literature

The Influence of Extrinsic Factors on Knee Biomechanics During Cycling: A Systematic Review of the Literature

An Investigation of Fatigue in Stationary Biking with Application to Iliotibial Band Syndrome Development

Knee

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