Help with knee pain

garethjohn

Did the Cotswold Spring Classic yesterday (only the short route for now) and experienced knee pain for the first time. The pain started about 2/3 of the way into the 67mi distance, on the inside off my left knee. After the final climb the pain was much worse and had to stop after about half a mile for a couple of mins. I have ridden a similar distance before but nowhere near as difficult, plus it was chucking it down and quite windy. I haven't changed my setup and have been riding with mtb shoes and cleats for over a year. Have the day off today so my knee is on ice as i type. Any advice or pointing in the right direction would be appreciated

sungod

inside of the knee, can be one, some, or all of...

pushing too low a gear

cleat position, degree of float - foot too far out, toes-out/heel-in position

foot angle, if you overpronate, might need extra arch support and/or wedges

wrong saddle height/position

...and other things i'm sure

it's really worth making the effort to identify the cause and correct it, otherwise it'll just happen again and/or get worse

imho...

rest it, don't ride for a few days, and then only ride gently until you find out why and can fix it, for that, book an appointment with a good bike fitter

humpyg

Some good suggestions by sungod above.

Similar to you, I've been using the same set up for over a year and got knee pain on the top/inside of my knee cap, but after doing a 70m ride. Had a week off and my knee seemed fine but the pain kicked in after 30 mins. Another week off, and I'm still trying to work out what's causing it. All I can think of, is over-training the week before I did the 70m, and I'm coming back from a few months off the bike, so also wondering if the 70m was too much, too soon (had only been doing 30-35m for the month prior). Could you have been over-training the week prior? or was the sportive (distance, climbing) quite a bit above you training distance/climbing?

I self-diagnosed my injury with - http://en.wikipedia.org/wiki/Medial_collateral_ligament - might be worth checking out?

Kolraz

I've got this exact same pain and assumed I had overtrained. I went from having not been on the bike for 2 months to doing 300 miles in my first week back. It's improving all the time but I still can get out for more than 15 miles without the
pain coming back.

garethjohn

Thanks sg for replying. Will be driving to work for the rest of the week for sure, hopefully i'll be back on the bike next week. Since getting the edge 500 i've tried to increase my cadence lately, measured 73rpm ave yesterday. Was probably way too low before and maybe still is. Not sure about cleat positioning, pics attached. Could try pushing the cleat right out and see how i get on with that. Bike fitting seems expensive from what I can find so will try anything else first.

garethjohn

Have taken it easy lately to be honest. Altered my work commute to increase distance and difficulty a few weeks before and went for a 65 miler about four weeks ago with a few stops along the way, but rested the whole week prior. Didn't experience any niggles at all, just empty legs :oops:

Really hope this isn't a sign of things to come as i'm really getting into it now. Will get back on next week so will just have to wait and see. Also spoke with a friend who had a similar problem from football and has recommended a good physio but hopefully it's not that serious!

Rigged

73rpm sounds pretty low and means you'll be pushing a larger gear of you're still going usual speeds. The extra force needed will put a greater strain on your knees. Once you've had a little time off I'd suggest aiming for a cadence nearer 85-90 to see if that helps. Of course, if the fit of one/several aspects of your bike are off this may only slow the onset of stress related pains

joshr96

The night before a ride try getting a spare pillow and placing it under your knee joint when you are in bed. It rests your knee and usually leaves you ship shape by the morning.

alihisgreat

Probably just a cleat alignment issue.. and you need to get it sorted before you do some lasting damage (if you haven't done some already!?)

The easy way is to get a bike fit... as there can be issues with leg extension and knee over crank position too.

I'd been riding happily, not feeling that my cleats were dramatically wrong... but getting a little bit of discomfort... but after my bike fit the new alignment combined with correct leg extension and knee position makes everything feel much more natural and comfortable.


If course these are adjustments you can make yourself... but its going to need more trial and error.


A good place to start is to march on the spot for 10 seconds, then jump on the spot ~5 times and just stop and land normally.

Do this a few times and you will get a good idea of the natural position of your feet.

garethjohn

Thanks all for the advice. Knee on the mend, much better today but staying off the bike 'til the weekend. Looked into local bike fittings with the actual bike, prices in excess of £100!!! :shock: That's just nuts! If anyone can recommend somewhere reasonable in the glos/stroud area please do. Got some measurements off bike fit calc and seems my bike may be on the smallish side, 185cm with a 56cm caad9. Does feel ok though to be honest. Will adust the seat height and position if need be ( http://www.youtube.com/watch?v=FAl_5e7bIHk ) and play with cleat positioning as advised then go from there. Will also try ramping up the rpm although 85-90 is quite a jump for me, can't hurt to try though.

Completely off subject, came across this while browsing. These guys are amazing!
http://www.cyclingtips.com.au/2012/03/g ... -analysis/

mgmidget1500

I hope things are on the mend. I have suffered from knee pain in the past when running (not much of a runner but do the Great South Run every couple of years) and finally this year thought I ought to do something about it. I saw my doctor who the referred me to our local NHS Physiotherapy clinic.

It seems that my control of my left leg isn't as good as my right, as consequence as I tire my left leg tries to go in directions other than straight ahead, while my knee cap tries to continue going forwards, this causes pain as my knee cap gets pulled to one side, this is called Patellar Subluxation http://orthopedics.about.com/cs/patella ... disloc.htm

This was spotted by my being filmed on a running machine and then the film being slowed down and you could see my left leg tending to swing out to the left in an arc before landing in front of my right leg (it certainly explained why my knee would hurt after a 10 mile run).

I had also noticed a bit of pain when out on my bike as my legs tire, having watched my legs as they spin I notice that if I don't concentrate on them, my left leg 'floats' and my inside of my knee can rub the top tube, while my right leg continues in a steadily with no 'floating'. I did my first 60 mile ride last night at around 40 miles I noticed my left knee starting to hurt a little, so I concentrated on ensuring that it didn't float right or left but was straight (as in pointing directly forward) and the pain stopped and I completed my ride, once I was conscious of my knee floating I was able to stop it (and the pain).

MY NHS physio has given me a number of simple exercises to help me regain control of my left leg and it is starting to make a difference. There is no harm in going to see the doctor and seeing if you can get a referral to an NHS Physio. Good luck and get it sorted before it becomes a big problem.

garethjohn

mgmidget1500 wrote:

I hope things are on the mend. I have suffered from knee pain in the past when running (not much of a runner but do the Great South Run every couple of years) and finally this year thought I ought to do something about it. I saw my doctor who the referred me to our local NHS Physiotherapy clinic.

It seems that my control of my left leg isn't as good as my right, as consequence as I tire my left leg tries to go in directions other than straight ahead, while my knee cap tries to continue going forwards, this causes pain as my knee cap gets pulled to one side, this is called Patellar Subluxation http://orthopedics.about.com/cs/patella ... disloc.htm

This was spotted by my being filmed on a running machine and then the film being slowed down and you could see my left leg tending to swing out to the left in an arc before landing in front of my right leg (it certainly explained why my knee would hurt after a 10 mile run).

I had also noticed a bit of pain when out on my bike as my legs tire, having watched my legs as they spin I notice that if I don't concentrate on them, my left leg 'floats' and my inside of my knee can rub the top tube, while my right leg continues in a steadily with no 'floating'. I did my first 60 mile ride last night at around 40 miles I noticed my left knee starting to hurt a little, so I concentrated on ensuring that it didn't float right or left but was straight (as in pointing directly forward) and the pain stopped and I completed my ride, once I was conscious of my knee floating I was able to stop it (and the pain).

MY NHS physio has given me a number of simple exercises to help me regain control of my left leg and it is starting to make a difference. There is no harm in going to see the doctor and seeing if you can get a referral to an NHS Physio. Good luck and get it sorted before it becomes a big problem.

Thanks for your post mgmidget, quite interesting. Although the knee is much better i've booked myself in to see the doc next friday just in case. Best to be over cautious i guess when comes to knees. Fingers crossed and i'll be on the bike sunday :P