The short story of a grumbling knee

llamafarmer · March 2009

I've mentioned in a few threads about some minor pain I've been having in my right knee after riding and I thought it might help a few others with a similar issue to share my experience.

The pain has been occasional aching around the front of my knee (more discomfort than pain) that usually comes on the day after I've been riding and can last for a week or more. It's fairly intermittent, but I think it's mainly come on since I got my new bike at the start of Feb.

Went to a physio in Exeter today and she spent half an hour checking it over and bending my knee about and was very sure that it is just caused by my bike not being set up quite right. My right leg is very 'normal' - a nice straight line down my leg and through my knee to my feet. The left leg bows out at the knee slightly and the kneecap is rotated slightly out. This is not unusual, but explains why one knee can be ok and the other suffers. Basically my right leg is slightly misaligned in my cleats and with the endless repetition of pedaling, the large ITB muscle on the outside of my leg is getting tight (I have to try and give it some deep muscle massage to free it up).

She's given me a couple of stretching exercises to do, but has also suggested i adjust my chair and computer screen in the office to improve my seating posture. She's also taped my right knee cap over to the inside of my leg, which is really quite uncomfortable - I can't see me leaving it on for a couple of days as was suggested!

I was also put in touch with a local cycling coach who does some bike fitting in his free time and he's quoted me £30 to sit me on his turbo trainer (if my mtb will fit) and do a complete set up, so I'll be doing that tomorrow. That's quite a bit better than the £120 the local shop quoted me!

I'll update this tomorrow once I've got some feedback from the fitting, when hopefully he'll have sorted it for me!

pete236 · March 2009

Hi there.
I've had problems with my left knee for years, and starting a new job (apprentice car mechanic) has really made it bad. Tried lots of different exercises with the Physio and the latest thing is having the kneecap strapped over to the inside! It does seem to working. Give it the few days as suggested and just try to get used to the feeling of having your skin all stretched around! You'll notice if its working when you take the strapping off - after an hour or so my knee was aching like hell!
Next appointment in 2 weeks and I've got to keep the knee strapped - trying to do it yourself is a real struggle! Hopefully i'll get out on my bike this weekend (1st time this year!) but I'm thinking of going back to flat pedals, just in case my setup does have something to do with it!
Good luck!
Pete.

The Northern Monkey · March 2009

awesome, glad to see someone sorting their knee out!!
still suffering with mine atm... just sat here and I can feel it twitching

Already know my knees are at dodgy positions tho, mainly due to playing so much rugby when I was younger (I was playing 4 games a week one year!!). Really need to get to the docs

pete236 · March 2009

Tell you what, its sitting still that hurts the most! I had a brisk mile walk back from work today (got a lift in the morning) and it didn't hurt one bit! After sitting in front of the computer for a hours . . .
Just remembered that I'm entered in the London - Brighton ride in June, something to aim for at least!

I think some of my problems come from playing hockey. Played since I was about 6/7 and was in 3 of 5 school teams! 3 matches back to back . . . I must have been mad! I know a few guys who've had problems from rugby. Never enjoyed playing myself, but I know the body takes a battering!
It takes a lot of effort to go to the Doc's, but its worth it in the end. I wish I'd gone 5 years ago when the thing 1st started hurting! Ah well . . .
Take care!

mactrax · March 2009

Hi All,

I had similar problems with ITB and was receiving similar physio. I run as well and I was getting less pain cycling compared to running which I thought I'd have to give up. To cut a long story short I bought a pair of Skins compression tights and I can now run/cycle with very little limitation. For me the tights have been successful. I feel they keep the knee in place when I exercise. I also keep them on at times post recovery. May be worth a try. (Still doing my itb stretches, etc when I remember)

Paul.

Dr_Death · March 2009

TBH pain at the front of your knee coming on the day after cycling sounds more like a patella tendonitis. Difficult to be sure without seeing you though. Causes are much the same as for ITB syndrome only treatment is slightly different... Maybe worth mentioning to physio as an alternate possibility; make sure your cleats are properly lined up though as this causes all sorts of knee type problems.

llamafarmer · March 2009

Dr_Death wrote:

TBH pain at the front of your knee coming on the day after cycling sounds more like a patella tendonitis. Difficult to be sure without seeing you though. Causes are much the same as for ITB syndrome only treatment is slightly different... Maybe worth mentioning to physio as an alternate possibility; make sure your cleats are properly lined up though as this causes all sorts of knee type problems.

Cheers Steve, I hope not but I'll be careful! My physio certainly seemed very sure about her diagnosis, she said she was expecting that when I told her I was a cyclist with knee issues and that the exam confirmed it.

I went for the fitting on the Sunday, which was really useful, the guy's a very experienced French road bike coach, but hopefully his principles will apply to me too and I definitely learnt a thing or two. My setup wasn't far off, but he lowered my seat about 10mm (again this tied in with the pain at the front of the knee) and moved my seat and cleats forward slightly. I also ride with my toes down a lot which he seemed to think wasn't a problem, even if it was a bit odd

but I'm going to try and train myself out of that a bit too. He also reckoned really my cranks were too long, I have the standard 175s and it seems a bit odd that manufacturers don't scale the cranks down along with their frame sizes. I don't really want to spend £110 on a shorter one right now!

I also realised the other day that my shoes were interfering with the Time pedals, so have cut away a section of the tread and gained a bit of extra float.

I'm now going to concentrate on building up the strength around my knee and tidying up my pedaling technique and the decent weather this week has meant I could get out after work for an hour each day just on some local cycle paths or in the park. I'm probably going to stay away from the trails for another weekend and hope I can get good and fit for a trip to Afan the weekend after

If the problems persist then I'll have to rethink, but I'm hoping all this will sort me out now :?

geordiefreerider · March 2009

If its any consolation I shattered my kneecap 9 year ago after a big crash and its never been right and never will be I just put up with the pain coz I could never stop riding, and I cant run or play football on it anyway so it's the lesser of two evils to ride my bike otherwise I would be a vegetating slob in front of the box !!!

mudslinger · April 2009

llama - how's the knee now?

I have similar problems i.e. aching at the front of both my knees. I use SPDs & have considered Atacs or going to flatties. I like being clipped in though so how do you find the Time pedals?

paggnr · April 2009

but he lowered my seat about 10mm (again this tied in with the pain at the front of the knee)

This is odd. Pain in the front of the knee is a sign of a too low seat (as well as cleat issues). So lowering makes little sense. I too had knee problems that was fixed by moving to a 172.5mm crank.

AndyBike · April 2009

llamafarmer wrote:

I was also put in touch with a local cycling coach who does some bike fitting in his free time and he's quoted me £30 to sit me on his turbo trainer (if my mtb will fit) and do a complete set up, so I'll be doing that tomorrow.

Do you llamafarmer or anyone else know anyplace in the West Mids I can get this done. Ive been struggling with Shin pain, ITB soreness and rhs hip twinge for a couple of months. Ive eliminated the Pediatrist's now working throu the physios and sports massage etc.

Not being able to ride my new Anthem much is getting me down.

knackerknee · May 2009

Anyone with long term knee pain should see a specialist. I had knee pain and pains in the outside of my shins for months when training for a marathon, I went to see a specialst a couple of months after the marathon and was told that my knee caps were out of line and had worne the groove away that it tracks in on the femur. If had five operations on one knee in the last four months to try and sort it our, and told not to run again, so ive taken up cycling instead

The short story of a grumbling knee

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