Knee pain

JoeLiam

Still the noob asking questions. I've tried the search function but I can't find any threads linked to my specific pain.

I'm getting pain just below the knee cap on my left leg, hurts more when going up hill. Right knee is fine, and pain stops not long after getting off bike.

Any ideas ? Seat too high/low ? to far forward/back ? MTFU ?

ai_1

JoeLiam wrote:

Still the noob asking questions. I've tried the search function but I can't find any threads linked to my specific pain.

I'm getting pain just below the knee cap on my left leg, hurts more when going up hill. Right knee is fine, and pain stops not long after getting off bike.

Any ideas ? Seat too high/low ? to far forward/back ? MTFU ?

Could be bike setup, could be unrelated knee weakness. Not everything is caused by cycling or the bike setup.
I've had some problems with my knees, sounds pretty similar to yours although in worse cases mine lasted quite a while afterwards. My problem was due to weekness of the muscles that stabilise the kneecap, resulting in patellar tracking problems.
If this is an ongoing issue my advice is always the same. Go to a physio.
I switched to Speedplay zero pedals which immediately improved knee comfort on the bike (no perceptable resistance to float allows your leg align itself without undue influence. I did some work to strengthen my knee stabilisers too and the problem has mostly disappeared. I suspect if I was more conscientious with the knee exercises it would have vanished completely much sooner.

stretchy

Ai_1 wrote:

Go to a physio..

+1. Had numerous problems with both knees caused by muscle imbalance. In my case physiotherapy has fixed the problems within a few weeks .

sungod

another possibility is simply pushing too high a gear, but as above could be any of umpteen reasons

see http://www.cptips.com/knee.htm for general info/ideas

check bikefit, cleat position etc., try gently investigating what provokes/eases it

if it persists/worsens go see a physio

eddiefiola

stretchy wrote:

Ai_1 wrote:

Go to a physio..

+1. Had numerous problems with both knees caused by muscle imbalance. In my case physiotherapy has fixed the problems within a few weeks .

Mind saying what the problem was and how they fixed it?

Self diagnosing myself at the moment with a knee tracking problem and think its muscle imbalance.

stretchy

eddiefiola wrote:

stretchy wrote:

Ai_1 wrote:

Go to a physio..

+1. Had numerous problems with both knees caused by muscle imbalance. In my case physiotherapy has fixed the problems within a few weeks .

Mind saying what the problem was and how they fixed it?

Self diagnosing myself at the moment with a knee tracking problem and think its muscle imbalance.

Sure, I've had patellar tracking problems in both knees. One was due to weak a weak hip and the other was a weak VMO. The VMO was weak after I had ACL surgery in that knee, took a few years for the problem to manifest. Should mention that a tight IT band didn't help in either case. It's difficult to self diagnose though so it's best to see a physio. If you're in the UK you can self refer to a NHS physio

ai_1

Assuming the cost for a physio is similar in the UK (approx €50 per visit in Ireland) and considering what we often pay for very minor comfort, performance or just appearance improvements via equipment and clothing, the physio is a cost well worth paying. I have sat on injuries in the past, either just waiting for them to resolve themselves or trying to diagnose and address them myself. It's not worth it.
I'm not saying it's impossible to resolve some issues yourself but it's hit and miss and the time wasted and the uncertainty about whether you're treating a root cause or a symptom is well worth the cost of a physio. One visit should be enough to get a diagnosis and there's nothing forcing you to return if you think you can treat it yourself after that. In my experience a good physio will generally not try to make cash on unnecessary return visits anyway.

You might get the right answer from doing some online research, asking friends who've had what sound like similar problems and polling other cyclists on BikeRadar but you're just as likely to lead yourself on a mad goose chase.

My advice is still: Go to the physio

faarn

I have had knee problems for a while mostly due to tight ITB and weak Glutes and Quads (according to Physio). He said the best thing for me was to cycle and as long as the pain was not severe to push through it a bit to build up my muscles. This was specific advice to me but has certainly helped and shows a trip to the Physio is probably the best idea.

On top of this I had knee pain on longer rides due to cleat position. I haven't had a bike fit but used this articel and trail and error to eliminate the ache.

http://www.bikeradar.com/gear/article/take-care-of-your-knees-part-2-17445/

bahzob

Both my knees are shot due to football injuries. I quite literally cannot run more than a few yards without them hurting.

Luckily there is no problem riding the bike even for 8+ hour rides.

Two things I found:
- Saddle height/position can make a huge difference. Just a bit too high or low and knees play up. For beginners the most frequent issue is setting it too low so you sit on it like a chair, with it bearing most of your weight. Your legs not your bum should take most of your weight while pedalling. This will put less strain on the the knee joints.
- Leg alignment. Viewed from the front the knees should, ideally, go up and down in a vertical line directly above the pedal. Many folk, especially those like me who have had knee problems, will have legs that are bent, so this doesn't happen. You can buy shims that fit under the cleat or insoles to help correct this problem. It may not be 100%, but will make a large difference.

A good bike fit should see to both these problems and other issues that may also cause problems. Pound for pound it is the single best investment you can make if you intend riding a bike for any length of time.

Also many bike fitters will also be qualified physios. If you shop around you should be able to find one who is both. Seeing someone like this is better than seeing a physio who may not have any actual practical experience of riding a bike.

sloppyschleckonds

There are so many variables that it will be a process of elimination, as others have said, start with the basics of saddle height, cleat position, iliotibial band stretches....etc etc etc

rafletcher

And for strengthening and stabilising the knee, try squats and heel lifts. Both easy enough to do at home.

Dodger747

This year and last, at around the same time in my training plan I've developed tendonitis in my knee [mainly my right knee[. I've found this to be a combination of lack of stretching/tightness caused by my training load and what I think is incorrect cleat alignment. Increased mileage may also be a factor.

I've just got an Ergon cleat tool which is a simple, but effective way of checking cleat alignment and noticed that my cleats were not symetrical and were quite a few degrees from the conventional centre line. I've realigned my cleats and it does feel better than the previous position. You can do this with squared paper, but the tool is a more robust way of setting up multiple shoes etc.

I'm hoping this prevents the tendonitis from coming back...

sgbman

Can you get this Ergon cleat tool for look delta, or can i make my own.

Dodger747

Doesn't look like it works with Deltas

http://www.wiggle.co.uk/ergon-pedal-cleat-tool/

However, some maths/squared paper will essentially replicate the cleat tool and it will give you a good point of reference rather than looking at the sole of your shoe.

JoeLiam

Have used a knee strap past week, no pain !! Think it must be a stability issue , maybe once leg get stronger it will sort itself.

eddiefiola

JoeLiam wrote:

Have used a knee strap past week, no pain !! Think it must be a stability issue , maybe once leg get stronger it will sort itself.

Nice!

I self diagnosed a weak VMO muscle as the possible problem of my kneecap issue (spent a long time thinking it was a bike fit issue).

Since last week I've been doing single leg squats (only dipping down 20-30 degrees) with my foot out at a 45 degree angle, also doing normal squats, and I can't believe how quickly my knee is getting stronger and the tracking issue has nearly gone.

86inch

Try Bulgarian Split Squats - sorted my ITB issues in 2 weeks.....

gmacz

Try adjusting cleat position to max gap between both feet.
It always seems to be a left leg problem, I think it is because the dominant right leg takes the straight position and the left leg is slightly angled.
Both legs straight on the pedals takes the strain of the knees, this worked for me.