Knee Discomfort

ibr17xvii

For the 1st time ever in as long as I've been cycling I'm getting some discomfort in my left knee & I don't really know where to start to try & solve it.

I'm getting like a dull ache in the front of one knee only that's there both on & off the bike. On the bike I can certainly notice it but I wouldn't say it's painful as such & not enough that I can't turn the pedals comfortably.

I got new saddles on both my bikes in around November last year & did have a play around with height & fore / aft when I got them but I'm pretty comfortable on the bike & I'm as sure as I can be that my saddle height is right & it's not too far forward. I'm pretty consistent in the time / mileage I ride & I've not increased that significantly over the period. I've never had a professional bike fit as I've never felt the need for one.

I've had the discomfort for about 9 months now (so before I got the saddles), it was hardly noticeable at first but it seems to be getting slightly worse. I've started doing some foam rollering / stretching in the last 6 months or so & that does seem to help a bit but doesn't get rid of it completely. When I put pressure on it I get a pain at the front & it's particularly sore going up & down stairs.

The only thing I can think of changing is my cleats. I use the black fixed Look Keo's & have done for about the last 3 years. The reality of these for me at least is there is a bit of float there which has always been enough. I did try the grey 4.5 degree cleats that came with the pedals initially but just didn't like them as there was far too much slopiness with the foot position & too much movement so I got the black ones & have used them ever since.

I still have the grey cleats so I could give them a try again or the only other thing I can think of is a good few days off the bike, rest it up & see if that helps. Apart from that I'm really stumped.

As I'm getting the pain both on & off the bike I was considering trying some physio & see if that helped or should I be going more down the bike fit route as I feel discomfort when I'm on the bike?

Any thoughts / recommendations gratefully received.

shirley_basso

Have you heard of IT band associated pain?

I had it and it was excruciating. Physio fixed then some good stretching kept it away for good.

ibr17xvii

shirley_basso said:

Have you heard of IT band associated pain?

I had it and it was excruciating. Physio fixed then some good stretching kept it away for good.

Yeah that's something I've heard of when I was getting into the foam rollering.

I do try & do some stretching & rollering on that area which as I say does seem to make a slight difference for a bit but never seems to clear it up completely.

I've foam rollered 5-6 times a week for 10-15 minutes at a time for a good few months now, it's painful but I don't really think I've seen much overall benefit.

shirley_basso

Hmmm. In that case I can only recommend you pony up for a good physio.

If you've been riding for a while and know even vaguely how to set up a bike, it's unlikely to be a bike fit issue.

MattFalle

go and see your doctor and get a referral to a physio

ibr17xvii

shirley_basso said:

Hmmm. In that case I can only recommend you pony up for a good physio.

If you've been riding for a while and know even vaguely how to set up a bike, it's unlikely to be a bike fit issue.

That's what I thought. I wouldn't say I'm an expert by any means but I know when I'm comfortable & I'm not really someone who tinkers with their position all the time.

ibr17xvii

MattFalle said:

go and see your doctor and get a referral to a physio

That's probably what I will end up doing although I'll cut out the middleman & just pay for the physio. In past experience it will take me months to get referred & I can't wait that long.

I was just wondering if there was anything else I could try beforehand.

MattFalle

It seems you have been very comprehensive so far so without disclosing your whole medical history on here (which would still be useless as we can't see, question or examine you) I'd say leave the internet sleuthing and go to a pro who can actually see you and your knee.

emanresu

I have a dodgy left knee that flares up from time to time.

I like foam rolling and stretching. It also tends to hurt when I sit for long periods so often have a potter around rather than just sit.

Cleat position is super important, a couple of degrees difference is the difference between comfort and pain.

Glucosamine, Chondroitin and MSM have worked wonders for me. They're often available under dosed, the evidence for their effectiveness isn't brillant and it might well be the placebo effect but I don't care they helped me and they're cheap

ibr17xvii

MattFalle said:

It seems you have been very comprehensive so far so without disclosing your whole medical history on here (which would still be useless as we can't see, question or examine you) I'd say leave the internet sleuthing and go to a pro who can actually see you and your knee.

My whole medical history isn't for the faint hearted so I left the gory bits out.

Never been to physio in my life so there's a 1st time for everything I guess. I've had it long enough now that it's not gonna go away by itself by the looks of it.

ibr17xvii

emanresu said:

I have a dodgy left knee that flares up from time to time.

I like foam rolling and stretching. It also tends to hurt when I sit for long periods so often have a potter around rather than just sit.

Cleat position is super important, a couple of degrees difference is the difference between comfort and pain.

Glucosamine, Chondroitin and MSM have worked wonders for me. They're often available under dosed, the evidence for their effectiveness isn't brillant and it might well be the placebo effect but I don't care they helped me and they're cheap

Cleat & cleat position were something I've considered especially riding "fixed" (although they are far from that IMHO) cleats. I've had these shoes for well over 18 months though with the cleats in the same place so I can't see how it would anything to do with that.

Tempted to have a few rides on the grey cleats but I feel I'm clutching at straws TBH.

focuszing723

I would start by ruling things out, you know your knee hurts and are obviously concerned. Forget about the bike for a few weeks and go for light walks instead (rest from a forced fixed cleated biomechanical position).

When it recovers you will have the piece of mind your knee is OK and can start tinkering with setup from there. Change one thing at a time rather than lots so you know where you are.

N0bodyOfTheGoat

My left knee flared up just over a week ago, a few days after swapping saddles. I stupidly didn't check the saddle height of the replacement until after I got pain, turns out it had raised the seat by ~5mm (which is ~5 degrees less of knee bend at bottom dead centre).

I discovered in 2019 that I need a bit more knee bend than some at ~30 degrees.

I dropped the seat post to compensate, but then found I wasn't getting the desired extra comfort I hoped for and swapped back, so I've now got to ease off big efforts for a few weeks (going on 2019) while it hopefully repairs... A whole load of knee pain and further training setbacks for nothing.

ibr17xvii

N0bodyOfTheGoat said:

My left knee flared up just over a week ago, a few days after swapping saddles. I stupidly didn't check the saddle height of the replacement until after I got pain, turns out it had raised the seat by ~5mm (which is ~5 degrees less of knee bend at bottom dead centre).

I discovered in 2019 that I need a bit more knee bend than some at ~30 degrees.

I dropped the seat post to compensate, but then found I wasn't getting the desired extra comfort I hoped for and swapped back, so I've now got to ease off big efforts for a few weeks (going on 2019) while it hopefully repairs... A whole load of knee pain and further training setbacks for nothing.

Saddle height is probably the one thing I've messed about with most over the years, it's drove me mad at times. I'll just get dialled in to what I think is a nice comfortable position & then Selle Italia will bring a new saddle out & the process starts all again.......

I don't think I can put my pain down to that on this occasion though as I'd felt some discomfort before I changed & started messing about with the height.

ibr17xvii

focuszing723 said:

I would start by ruling things out, you know your knee hurts and are obviously concerned. Forget about the bike for a few weeks and go for light walks instead (rest from a forced fixed cleated biomechanical position).

When it recovers you will have the piece of mind your knee is OK and can start tinkering with setup from there. Change one thing at a time rather than lots so you know where you are.

This has 100% crossed my mind but the thought of not riding for a few weeks is doing my head in.

MattFalle

ibr17xvii said:

emanresu said:

I have a dodgy left knee that flares up from time to time.

I like foam rolling and stretching. It also tends to hurt when I sit for long periods so often have a potter around rather than just sit.

Cleat position is super important, a couple of degrees difference is the difference between comfort and pain.

Glucosamine, Chondroitin and MSM have worked wonders for me. They're often available under dosed, the evidence for their effectiveness isn't brillant and it might well be the placebo effect but I don't care they helped me and they're cheap

Cleat & cleat position were something I've considered especially riding "fixed" (although they are far from that IMHO) cleats. I've had these shoes for well over 18 months though with the cleats in the same place so I can't see how it would anything to do with that.

Tempted to have a few rides on the grey cleats but I feel I'm clutching at straws TBH.

my knees are mashed and i don't have a problem with black Keos - in fact the zero float fixed position works perfectly for my knees - red and grey allow too much movement and causes grief.

if the blacks are working for you prior to this latest gamut then carry on using them, otherwise you're just throwing another variable in.

have you booked an appt with a HCP yet?

ibr17xvii

my knees are mashed and i don't have a problem with black Keos - in fact the zero float fixed position works perfectly for my knees - red and grey allow too much movement and causes grief.

if the blacks are working for you prior to this latest gamut then carry on using them, otherwise you're just throwing another variable in.

have you booked an appt with a HCP yet?


That's pretty much my experience with the Keo cleats as well. I hated the float on the grey although to be fair I didn't give it much chance. Far too much movement in the foot for my liking. I was hesitant to use the fixed but I've never had an issue with them.

Currently Googling physios in my area to see who's recommended. I feel I'm opening a can of worms I won't be able to close if I start messing around too much with my position & I'm not convinced that's the issue anyway.

MattFalle

agree - you seem to have your position and equipt sorted so its most likely physioligical unless you're missing something, but hopefully one of your riding mates will have mentioned something if you look particularly weird in some respect.

no attached physios to and sports clubs in the area you can get recommendations on?

focuszing723

ibr17xvii said:

focuszing723 said:

I would start by ruling things out, you know your knee hurts and are obviously concerned. Forget about the bike for a few weeks and go for light walks instead (rest from a forced fixed cleated biomechanical position).

When it recovers you will have the piece of mind your knee is OK and can start tinkering with setup from there. Change one thing at a time rather than lots so you know where you are.

This has 100% crossed my mind but the thought of not riding for a few weeks is doing my head in.

I've had knee pain various times from cycling and I could put it down to various things. Seat position, cleats, inactivity then expecting too much, riding too much...What always stops it though is resting and having walk instead. Also strained my kneed whilst hill walking resulting in pain whilst even standing (put it down to overstretching steep down hills).

I know what you mean, but it's important and reassuring to rule out any complications.

ibr17xvii

MattFalle said:

agree - you seem to have your position and equipt sorted so its most likely physioligical unless you're missing something, but hopefully one of your riding mates will have mentioned something if you look particularly weird in some respect.

no attached physios to and sports clubs in the area you can get recommendations on?

No not really. There a sports injury clinic locally that's got a good reputation so I think I might try them. I'm not waiting for the NHS & they're not as a pricey as I thought TBH.

I've not got time to ride today & tomorrow anyway cos of work so that should give it a little rest & I'll see how I go from there.

MattFalle

sound as a pound my son.

keep us updated.

ibr17xvii

MattFalle said:

sound as a pound my son.

keep us updated.

Will do, thanks for your help everyone.

redvision

Before making any changes to your set up I would fully stretch out the glutes.

Cycling tends to cause lazy glutes and often leads to knee pain, similar to what you describe. A good stretch before and after your ride (or any workout) may help and if the pain continues then look at your set up.

photonic69

Are you near any Universities that have sporting prowess e.g. Loughborough or Bath etc? They often have excellent physios that look after their elite sports stars and do offer public treatment to subsidise their operation. I'm booked in to see one in a few weeks for shoulder pain along with lumbar pain and plantar fasciitis. Initial assesment consultation is around £55 and follow up sessions £45. I figure to get the ball rolling whilst waiting for my GP to arrange their physio to see me which might take 4-6 weeks.

ibr17xvii

redvision said:

Before making any changes to your set up I would fully stretch out the glutes.

Cycling tends to cause lazy glutes and often leads to knee pain, similar to what you describe. A good stretch before and after your ride (or any workout) may help and if the pain continues then look at your set up.

I do try & do some stretching pre ride if I have time & certainly post ride but I always get the feeling I'm not doing it right. I am massively inflexible & always have been so it's certainly something I should be doing.

Something else for me to Google.

ibr17xvii

photonic69 said:

Are you near any Universities that have sporting prowess e.g. Loughborough or Bath etc? They often have excellent physios that look after their elite sports stars and do offer public treatment to subsidise their operation. I'm booked in to see one in a few weeks for shoulder pain along with lumbar pain and plantar fasciitis. Initial assesment consultation is around £55 and follow up sessions £45. I figure to get the ball rolling whilst waiting for my GP to arrange their physio to see me which might take 4-6 weeks.

I am quite near a big Uni actually. Never thought of that, cheers.

I've completely ruled out the NHS. I took me literally months to get referred for another non related (& non bike related) issue.

Obviously I appreciate the way of the world at the minute but I'm not waiting that long for this.

webboo

emanresu said:

I have a dodgy left knee that flares up from time to time.

I like foam rolling and stretching. It also tends to hurt when I sit for long periods so often have a potter around rather than just sit.

Cleat position is super important, a couple of degrees difference is the difference between comfort and pain.

Glucosamine, Chondroitin and MSM have worked wonders for me. They're often available under dosed, the evidence for their effectiveness isn't brillant and it might well be the placebo effect but I don't care they helped me and they're cheap

The evidence is non existent however there is some evidence that they may cause more harm the good with tendon conditions such as Dupuytrens contracture.

MattFalle

aaaah yes, Dupuytrens contracture.

that one.

webboo

Yes that one. Just hope your great, great grandad wasn’t a Viking.

MattFalle

not to be confused with bi-lateral peri optical ekimosis.

sniper68

I started with knee niggles about 18 months ago.I finally made an appointment to see my GP who sent me for X-rays.Osteoarthritis in both knees.Been to see a physio and stretches/supplements/creams not having any effect so waiting on a consultation.Injections probably next on the agenda.
You don’t say your age.I’m 52 but ride with a lass who had to have both knees replaced at 45 due to Osteoarthritis.
My advice is get it looked at ASAP.
I’ve recently changed from Look Keo to Speedplay Zero and have found a sweet spot for the cleats that makes riding painless again.