Knee Issue Question - boring I know

davbay

Hi, thought this the most approapriate place to ask this question so hope you guys can help with ideas. Cheers in advance.

Am suffering pain on the inner side of my right knee. Medial collateral ligament problems?

MRI showed no problems but every time I cycle to work - 12 mile it sets off my knee pain. Started 12 months ago. Never had pain while on bike but its definitely bike or spd's.

Did have a massive front chainring on singlespeed but replaced it with smaller original but still causes pain.

Bike is corret size, position seems ok. Do I change pedals and if so which ones? Currently using Shimano M540's.

Just wondered if anyone else had knee problems and what did you do to correct it?

Thanks.

furrag

I had terrible knee pain earlier this year. Terrible! Felt like I was being stabbed in the knee. Very sharp and sudden. The cause? The cleat.

The solution? Moving it about 1cm backwards and changing the angle slightly.

I'd highly suggest a fitting which involves correct cleat set-up, as well as saddle. Failing that, have a read; http://www.cptips.com/knee.htm

ride_whenever

Before you go wasting money on something that might not be the cause, fit a set of flat pedals and try it with that.

the knee is a very complex joint and muscle imbalances just about anywhere from the waist down can cause the trouble, i'd recommend a decent sports physio with some knowledge of cycling.

Toks

In my experience this sort of pain comes on because of some tiny new change to your pedalling action. You're gonna need to be a detective and check out all the possible reasons that have caused the change to your previous "pain free" action- right down to the last millimetre.

Have a look at what happening with your pedal/cleat set up
Check cleat alignment - generally the closer your foot is to the bottom bracket alieviates Medial Knee Pain (I use 'speed play pedals' and after a year the pedal housing wobbles slightly and thats enough to bring on MKP)
Check your seat hasn't slipped down or moved forward
Try not to push big gears for a while - spin more
Pedal smoothly - splaying knees or knees moving in a wobbly plane may cause pain
Use ICE if painful after rides
Get a professional bike fit
Stretching may help - although it didn't seem to help me!

ut_och_cykla

Ride-whenever's idea is a good one - eliminate pedal/cleat interface problems first. Could just be that your foot is too close to the bike, or that you are sitting twisted on the bike - check shorts/saddle wear patterns.
Also make sure you've not got mechanism too tight - if its set up right and your not MTBing it can actually be quite loose without it clicking out all the time!
A pro fitting session would help but on cyclingnews.com the experts there would prbably recommend that you be observed/filmed cycling hard on a turbo to see if you sit straight/drop hips to one side or other.
Cycling with old fashoined straps could be a solution - not perfect but stops feet slipping off pedal.

PaulS77

davbay wrote:

MRI showed no problems

Hope you don't mind me asking, did you get the MRI on the NHS? My GP wouldn't send me for one even though he said it may help diagnose my problem and I've been thinking about making a fuss.

rdt

davbay wrote:

Bike is corret size, position seems ok. Do I change pedals and if so which ones? Currently using Shimano M540's.

Just wondered if anyone else had knee problems and what did you do to correct it?

Have you always had this pain after cycling, or did it only begin to occur after something changed? That may give you a pointer to an obvious trigger.

When I started cycling again a few years ago, I frequently got a dull pain/ache in my right knee. This occurred after the ride, maybe the next day, never during. Shorter easy rides didn't cause much problem, but longer, hard rides could leave my knee aching for a few days. This limited how much I could ride, since I needed to rest the knee a fair amount. E.g. on a group cycling holiday in the Alps, I had to skip a day's riding because of it, and was forever loading up on Ibuprofen tabs and gel. Bummer. Varying cleat position seemed to help but not cure it. And I already used cleats which allowed for a lot of float (Crank Brothers).

When younger, I used to run a bit, but stopped because of the same knee pain, which was never fully diagnosed. So, when I had the same problem on the bike, I sort of accepted it as just one of those things to live with.

On these forums this year I began reading about leg length discrepancies, and suspected that applied to me, since I seemed to have to "reach" more on the right pedal down-stroke. So I used a shim to increase the stack height on my right shoe.

Very shortly afterwards, I went for a professional bike fitting which confirmed the shorter leg. My cleat position and general position on the bike were changed quite significantly, and a custom insole and varus wedge was fitted in my shoe.

Since then, and so far, I've had no knee pain, and can now do back-to-back hard sessions over several consecutive days in a way I couldn't do before.

Because a few things (stack height, cleat position, bike position, insoles and wedges) changed at a similar time, it's difficult to know if there was a single fix, or if it was a combination of factors changing which cured the problem.

rock_hopper

Hi there, agree with some of the comments posted already, position can be very critical, especially in knee position, make sure that your knee is tracking straight up and down and your saddle height is right. Singlespeeding won't help at all! It just puts too much force through the joints.

Find it strange that no-one has suggested muscle imbalances, tight muscles or ligament damage which I would suggest is more likely the cause. Google search tendonitis for cyclists........very common. Also if your muscles aren't equally strong and flexible they can start pulling your knee out of alignment, which can cause pain. A lot of people get knee pain from a tight IT band. Maybe rest for a few days get a foam roller and do some stretching. Then you might want to look at strengthening the medial quad. Do you do any stretching? A lot of cyclists don't and it can cause so many problems. Hope this helps some.

Daver27

I've had chronic knee pain for most of this year since starting road riding (never had an issue in 23 years of MTBing)

so obviously the cause of my problems was the bike. it is nothing to do with the position in my case, it was (as mentioned above) muscle imbalances, specifically the fact that my outer quad had gotten a massive work out and my inner quad was as floppy as... !

some very light exercises from the physio has just about cured it (although not fully yet), along with months of rest (haven't been on the road bike in 5 months) as an added bonus, i am now super flexible whereas before i was as stiff as a board.

the problem with knee pain is that unless you stop what you are doing and address the cause of the pain, continued cycling will never allow it to heal and will probably make it worse. you mentioned a massive chainring on a single speed rig? do you ride sitting down a lot? is the pain just under the inside of the knee joint? bet you've done the same as me!

My advice, find a decent physio who specialises in cycling injuries (i can recommend one in sussex) and follow their advice.

hope that helps.

dave

Anonymous

davbay -

I had similar issue to you, went for a fit with Adrian Timmis at www.cadencesport.co.uk

He found I had one leg slightly longer than the other and my position was bobbins. My legs also tracked wonky.

He spends a sizable chunk of time with you chatting and getting you just right. First off are the moulded footbeds which are a revelation, they really are. Then he starts on your position, I had to have angled cleat shims to assist bringing my legs in line and also extra shims on my right leg as that was shorter.

Then the saddle/seatpost position gets dialled in using lasers and protractor thingies. Anything that uses lasers is freaking awesome and is worth any amount of money.

The result has been amazing. No pains. I got bad knee pain and lower back pain, now I get nowt! My power output has increased as well...

[/endshamelessplug]

ride_whenever

rock_hopper wrote:

Find it strange that no-one has suggested muscle imbalances, tight muscles or ligament damage which I would suggest is more likely the cause.

That is my first thought. Perhaps I should phrase these things well. I really need to get a professional bike fit to see what all the fuss is about because I really doubt it's much more than a bit of bodging. I fail to see how you can get someone into the right position in an afternoon or a couple of hours or whatever, particularly without a full core and flexibility assessment in which case you might as well get your sports physio to do it as they're going to be far more qualified than any professional fitter when it comes to individual ergonomics.

Casbar

Are you sure its actually knee pain you have. It could just be an inflamation of some sort where the VMO attaches to the knee. I'm saying that because the pain is on the inside of your knee. If its like a sharp pain and sore when you touch the end of the VMO it is more likely to be tendonitis or an inflamation

I agree in that case it is more likely to be muscle imbalance or a tight muscle or both

See a physio preferably one who is used to working with cyclist. A few good stretches and excersises should help.

Btw it never hurst to have your bike set up properly by a good fitter.

Seems I added nothing new here :roll:

davbay

Thank you all for your responses!

There's some good ideas I hadn't thought of so will try and borrow a turbo trainer off someone and film myself I think. I have been to physio a while back and have been working on building my quads too.

There's definitely alot more I need to look at though and I will certainly use the kind tips and ideas. Will post again if/when things improve and let you guys know how its going.

Dave.