Another 100 miler but BAD knee pain this time?????

Stephen Mccluney

Hi ,
My normal training is 2 week-day 35 mile hilly rides and 1 sunday 65 mile ride, all are over hilly and windy terrain at an average of 16 mph.I have NEVER had any knee pain.
Completed a hilly and very windy 100mile charity ride yesterday and could barely walk when i got off the bike.
To be honest it was only pride that kept me going the last 25 miles.The pain is at the outside of my knee ( which i think are the collaterall ligaments) rather than the knee cap/joint.
The only thing i have changed in the last few weeks is the saddle( to a brooks champion), but i was VERY careful to get the height correct, and i replaced my worn out cleats, but again i was very careful to re-position these in the same place as the old ones.
My question is would the slightly different Q-factor between my training bike and my commuter cause this sort of pain or could it be a combination of saddle/cleat positions???
Any ideas

timestar

There are so many factors that you include here, any or all of which might contribute to your knee problem. The knee is a diagnostic minefileld and should only be done by a qualified medical person. I would strongly advise biting the financial bullet and visiting your local physio who has sports expertise.

SteveR_100Milers

Big jump from 35 miles to 100. I rode the Dragon 200Kms and I thought my knees would never work properly again. Did a 100TT 3 weeks ago, felt fine the next day. If you increase the distances it will get easier (to a point)

ut_och_cykla

Timestar & Steve R are right - there are so many things that could be at issue - see someone with knee expertise (probabaly not your GP!) soon if it doesn't clear up.
HAving said that I would guess your cleats may not be entirely innocent. Why did you change them - were the others very 'loose' - and are the new ones nice and 'tight'. If so I suggest they are not correctly aligned for your knee and /or there is no longer enough float for your knee. The saddle may have contributed as may differences in Q factor but I think the cleats are guilty. When you've seen the physio you might consider moving the cleat outwards a bit ... mebbe
Get well soon.

Shadescp

I've had many knee problems. One was very serious that cost me 2 years of quality cycling.

If the pain is on the outside of the knee then it could be caused by a tight ITB band, brought on by your big jump in mileage.
If there is inflammation then some ultra-sound would be beneficial as it could be patellar tendonitis.
Whatever the exact diagnosis it could drag on and become chronic if you don't take care.
My advice:
* Have 4 days rest then start low "active recovery" cycling, gradually increase your mileage.
* Buy some strong ani-inflammatories and take them for two weeks.
* Massage your knee and stretch the quads and hamstrings and calves. Google an ITB band stretch and do that everyday without fail.
* Changing the cleats could of done it. You might think you replaced the old with new at the correct angle but if it's out just a little it can cause problems.
* I know many people, who have had serious knee problems, found switching to Speedplay pedals to be greatly beneficial.
* I found that there are some poor physios out there. Ensure you see a good Sports physio who is familiar with knee injuries.

With a sensible, patient approach it will soon clear up.

Blonde

Use the CSP to find a registered sports physio - dont just go to any old Tom Dick or Harry.
http://www.csp.org.uk/ - Use the 'Physio 2 U' link on the right.

I agree with all said - the fact that 100 miles is a big mark up on 35 or even 65 means that it could simply be an overuse injury which is common. You're bending your knee and doing the exact same movement 1 000 000s of times. It's bound to get sore if your musecle arent used to it. Joints can be painful during or afterward if the surrounding muscles are providing isufficient support and IT band tightness is definitely present if it's the outside of the knee that is sore. I cant tell you to stretch it as I have tried and tried but cant feel a thing and mine are still tight! The only thing I have found useful for this is a good, deep sports massage and some manipulation of the knee cap with your fingers. The sports physio I saw showed me how to do this and it does help, because the knee cap gets gradually pulled over to the outside of the knee, by the tight IT band, which leads to poor tracking and soreness right inside the joint as well, so maniplutaing the knee cap helps to free it and eases pain. Brooks saddles are quite a high/deep saddle. I had B17s and noticed I had to put them lower than flatter saddles. It depends where you actually sit on the saddle as well - if you're measured the height from the nose, this may not be the best indicator as it's not where you sit on the saddle and Brooks saddles have a very definite tilt and shape to them as well (nose up and middle area dipped) which will effect positioning and whereabouts you sit on them.