Knee pain

Eah_Dunno

Hello everyone

I know that there’s a wealth of information out there on this subject but I’m now at the stage of information overload and as such thought I would try and get opinions of people in the trench so to speak as opposed to numerous websites.

To be informative but as brief as possible.

• I recently started commuting to my work using my road bike.
• I cycle circa 60 miles a week.
• I am using Shimano spd pedals and shoes.

Last week was the first full week of commuting managed on my road bike in dry weather. If wet I use my MTB given it has mudguards and because I’m not that confident on my road bike in wet conditions.

The problem that I have is a sharp pain on the inside (Right hand side) of my left knee. In addition to this both knees were uncomfortable, but not sore, after the weeks commute which I have put down to fatigue.

After looking at various sites I’m fairly confident that the sharp pain is due to misaligned cleats on my left shoe. Again the consensus of opinion seems to be that I need to move my foot further away from the pedal.

My question is what do I do if I cannot physically move the cleat any more within the shoe recess? Can this distance even be increased? I’m a little reluctant to buy another pair of shoes given budgetary restrictions. Not ready to give up on spd’s yet but don’t want to be suffering either.

Can anyone help or advise?

Your time and answers much appreciated.

Brief update: After over two weeks of no bikes , numerous painkillers and a raised saddle height (by 1cm) I took the road bike out for a spin. I did not wear my spd shoes and everything felt fine. However the following day whilst not experiencing the sharp pain my right knee, as previously explained, I am in some discomfort from both knees similar to the fatigue pain as before. Whilst not in the same pain factor I only did a fraction of the miles involved in my weekly commute.

As before your time for reading this and any suggestions greatly appreciated.

Initialised

TBH a website with a sound scientific background will give you better advice than our "this worked for me" anecdotes.

But... What model shoes are you using?

A few things to test first:

Ride flats for a month while your legs adapt to the stresses of daily cycling set the cleats in a neutral position and try using them again.
Saddle height and position and is your knee directly above the pedal when the pedals are at 3:15?
Google "Bike Fit" for advice on getting this right.
Cleat angle, do your toes point in or out, have you compensated for this with cleat angle?
Cleat fore/aft position.
Are you just doing them up to tight?
Does slackening off the pedal help (more float with a looser grip on the cleat)?
Different insoles.
Finally there are pedal extenders that move the pedal out and cleat shims that can tilt your feet in or out.

Peddle Up!

If you need to move your foot (feet) out from the crank, consider SpeedPlay pedals with the extended axle. Lots of posts on this (search under my user name and SpeedPlay).

kajjal

You could try fitting flats which would give your feet more room to move to their natural position while your knees are recovering and it can give you a guide to a more comfortable foot position. Having my saddle too far back caused inner left knee pain for me.

Eah_Dunno

Thanks for the replies and suggestions guys.

It turns out that apparently I have tendonitis in both knees presumably from "Too much, too soon, too fast"

I have been advised to take a longer recover period and work up to a full week commute. As per suggestions and a bike fit website I'll go back to flats and tinker with the seat height & fore/aft position as those are free (in the monetary sense) fixes.

So frustrating but those be the breaks I suppose

As always any other suggestions still greatly received.

Cheers

nebz

Thought I would offer my knee pain experience.

The bad news (in my case at any rate) is that I had to take 4 months off the bike before my knee became pain free. I started cycling last year and gradually the knee pain built up to such an extent that I couldn't deal with it and sought help.

I tackled the problem a number of ways. Personally I didn't find a physio helpful but it is probably best to seek medical advice first! (I tried 3 different people, one of whom worked for a professional team). For me (I realise it might not work for everyone) the 3 best ways were:

1) Bike fit - go to someone who really knows what they're doing. I went to Cadence Sports with Adrian Timmis and it was a revelation. He didn't sort out the problem immediately but the pain became less intense. My saddle was too high, insoles were a revelation, and my cleats needed a minor adjustment. It's expensive but well worth it imho.
2) Stretch and roll your leg. Rolling had a huge impact, it was incredibly painful for the first month but gradually my muscles relaxed and consequently the knee pain lessened until it completely disappeared. I now roll and stretch for 15-20 mins before and after every ride and so far have suffered from little to no discomfort.
3) Rest, the hardest advice to follow. If you feel pain it's pointless to ride as you could cause long term injury. 4 months was a frustratingly long time but it was worth it in order to get the problem sorted. As i built up my miles again my knee pain returned (only slight twinges) I immediately took 1 week off with rolling and stretching and have felt no pain for the past 6 weeks.

I tried to mess around with my cleat positioning but for me getting a professional to look at it gave me piece of mind. For me I think I started cycling too hard, far and fast too quickly and my knees just couldn't keep up, which is why rest was so important. I am now cycling between 150-200 miles a week so once your knees are happy you'll be able to enjoy your bike for as much time as you can get away with!

I hope some of what I said is of help and best of luck

Eah_Dunno

Nebz (as with other posters) thanks for your time & comments.

To reply in no specific order:

A bike fit was in my mind although perhaps not at the forefront. I think the biggest drawback was the cost although you have echoed a number of comments that I have heard in this respect. Whilst tinkering is cheapest option given my relative inexperience on road bikes finding the solution may be more by luck than by method. Perhaps now is the time to seriously consider this option.

4 months rest :shock: I really hope that I'm not off the bike for that timescale although I now realise that I have to listen to my body.

Stretching and rolling exercises - I do stretch, albeit, only before starting. As previously stated I appreciate that everyone is different and that what works for you might not work for me but can you ellaborate on the stretches and rolling exercises that you undertake?

Thanks again

nebz

I read no end of threads, websites and watched youtube videos on bike fit. I tried tinkering but the pain remained so I felt a bike fit was justified (I don't think I'll ever have a career as a bike fitter!). Mine was expensive, even for a bike fit, but I felt that I'd rather pay the extra to be sure that I would receive a decent level of service from someone who really knew what they were doing. It's really worth researching the person/company offering the fit - I've had friends who weren't happy about the level of service from other places.

I know, the 4 months was an absolute killer, the only slight consolation was that I was out over winter so the weather wasn't particularly enticing!

In terms of stretching, it's essentially every leg stretch that you can think of - I pay particular attention to my quads. Rolling was/is for me the most important though. Use a foam roller (I actually ended up using a very large candle as I felt it gave the best resistance, very painful and I doubt it'd be recommended by a professional but it worked for me!) lie on your side so your problem knee is just below the roller and, essentially, very slowly roll the area from the top of your knee to your hip. Over time it becomes less pailful, you'll notice knotted areas and you'll need to spend more time gently rolling over them. Youtube "IT band foam roller" for any number of videos on how to use it.

I would caution though that this has worked for me but it might not work for you, so seek the advice of a doctor/physio first (though oddly none of the medical professionals I met mentioned using a roller). I'd hate to be the cause of more issues due to poor advice! I have been in your situation though so I know how frustrating it is but with perseverance you'll get it cracked