Risk of patella femoral joint injury can be reduced with wedged foot orthoses in cycling shoesGregersen, CS., et.al. (2006). How changing the inversion/eversion foot angle affects the non-driving intersegmental knee moments and the relative activation of the vastii muscles in cycling. Journal of Biomechanical Engineering.
It has been commonly believed that common overuse knee injuries (such as patella femoral syndrome) in cycling are largely due to muscle imbalances. This study aimed to quantify the relationship between knee moments (varus/valgus and internal/external axial moments) and muscle activity. Data gathered from 15 subjects included pedal loads, surface EMG and kinematic measures under five randomly assigned inversion/eversion foot angles. The outcome of this study showed that eversion of the foot during cycling reduced knee moments, and changed muscle activation that could potentially reduce lateral patellar tracking and decrease the risk of injury to the patellofemoral joint.