Evening guys,

Finally got round to taking some pics, i’m still trying to diagnose my medial knee pain which started around 4 weeks ago.

Pain here…

I’m 6 foot 2″, ride a large Heckler, and never had any issues with my knees until now.

The pain isn’t there when I first get back on the bike, I can ride happily for over an hour without a hint of a problem. The first major climb in a ride tends to start it off, from that point it gets worse as the ride progresses. It manifests itself as a twinge in my left leg, where the quad joins the knee cap, on the inner side. Hurting most when I apply the downward pedal stroke. Hurting more if I climb again.

From pedal axle to seat is currently 37″. My inseam is 35″.

I did the hanging plum test and my knee is directly over the axle so fore/aft looks ok.

Here are some side on pics taken today (only had 5 seconds to hop on bike from timer on camera so footing may not be 100% lol), what to you think, saddle too high, low?

The side giving me a problem >>>

Cruciate ligament damage popped into my head – it’s a fairly common sporting thing isn’t it?

Seat looks to high so your leg is fully extended and when you put the extra effort in on the hills your doing the damage, try lowering the seat so when the pedal is at the bottom you still have some bend in the knee and not fully locked out.

The bike may be too small. Although you may be the right height, your legs are 1″ longer than mine depsite me being taller than you. I ride an XL. TBH my big problem with knee pain turned out to be cleat position. I had to try around for quite a while to get it right. If it’s medial knee pain then the cleats may be postitioned too far to the outside of your shoe. Try moving them around to see if it makes any difference.

The thing with getting the pedal behind the knee line is only applicable to a small number of riders. What’s more important is the angle at which the knee and leg sit at the top of the stroke as too much or too little will apply too much anterior or posterior force on the knee joint and affect your menisci.

Speedstar I ride superstar flats, how would that translate to flats? I tried an XL Heckler and the toptube was a bit close for comfort LOL

Jaggedblade thanks, my riding partner usually says my leg doesnt look straight enough so its good to get some outside perspective.

Yorlin wouldnt I be in pain all the time though? Once off the bike I can run, walk, stair climb without issue. When back on bike a few days later its fine, until I tackle the first hill and that sets it off.

That was going to be my first point, but to me it looks like you are running plain flats which should pretty much rule out all pedal/seat height (too high at least) causes…
Are you a spinner or a gurner?
Maybe try pushing lower gears at higher cadence and see if that helps…

I do have a pair of AM41’s which stick like glue to the Superstars, so my feet really don’t move much once in position, would this be akin to riding cleats with no float?

Haha gurner. Never heard that one before.

Yeah I think if your feet aren’t able to move a bit laterally then it will put extra pressure through your knees that will hurt unless you get it at an improbably perfect postion. I also think if you are not spinning in a low enough gear that will do the same thing as being in a poor position. what kind of pedalling do you do?

that bike is too small for you.

Also I can see on your left at least that your knee is actually in front of the pedal quite a bit. The middle of the pedal should bisect through the back of the knee, if you go by what I said might not be right a while ago. Although this is a rule of thumb, my feeling is the bike is a tad too small for you and even though you can elevate the seatpost to make the bottom of the pedal stroke an appropriate length, you are having to push forward through the top of the stroke instead of more of an arc, which as I said earlier, puts pressure on all the cushioning elements within the knee joint.

Bike is potentially too small for you. Try putting the saddle back on its rails, failing that try a layback seat post, so that you’re not having to bend your knee as much. The bend in your knee will be putting more pressure onto your femur via your knee cap and causing pain there. The medial knee pain might be related.

Can’t comment on the height of your saddle but I’ve had medial ligament trouble for a few months, however, i had no pain whilst cycling. Went to a Physio who recommended strengthening my quads. She also insisted that I stretch my quads, to hold the stretch for a minute and do them 3 times a days. After 2 weeks I had no pain.

Are you a spinner or a gurner?

What exactly are you referring to?! I would hazard a guess that i’m very much a gurner! Please explain and enlighten an old man…

Lerk/speedstar I was a gurner, particularly on sections where you can get some speed up, big chain ring grinding! but since this started i’ve been using high cadence, to try and take all pressure away from the knee caps.

nick i’ve had the bike since 2007, and never had a problem, so i’m stumped as to why its suddenly come on, and only aggravated by hills. Since i’ve never paid attention to saddle height though, thought that would be the best place to start.

“Also I can see on your left at least that your knee is actually in front of the pedal quite a bit. The middle of the pedal should bisect through the back of the knee, if you go by what I said might not be right a while ago. Although this is a rule of thumb,” when i did the plum on string check, it said to have cranks horizontal, when they are horizontal the knee is directly over the axle.

glupton, i like the idea of a layback seatpost, if they can take pressure off the knee, what are they usually used for?

Gazza, what kind of qaud stretches do you do, just the foot to ass, and hold whilst balancing on the other leg one?

Also I lowered the seatpost around 2 inches before, how does this look in comparison?

I wouldn’t have thought you’d get this kind of pain if your saddle is too high, I think you’d notice elsewhere first. Do your hips rock from side to side when you pedal? If they do then your saddle is too high.

How old are you? My first guess (and it is just that) would be that you’re driving to high a gear and perhaps your knees just can’t take that kind of strain any more 🙂

My knees are OK but not great, I sometimes get pain when overgearing and it eases off when I spin a little more.

I’m not an expert, but the bike looks too small to me and your riding position appears cramped. I am 5’11” and ride a large Superlight – I know it’s not the same bike but I believe the sizing is similar/nearly the same, and I definitely wouldn’t want it any smaller.

EDIT – don’t know if this would be relevant to your problem, simply an observation (which may well be wrong!).

Hope you sort it out.

First thought from the photo of just the bike is that the seat is too high for the frame. The frame is too small for you or you have the seat too high. Your freakishly long legs may warrant the seat height but from the photos of you on the bike, it looks like two things to my eye. The frame is too small and the seat is way too high.

I just went out to the shed and measured my bike. I’m 6’4″ with a 33″ inside leg. My pedal to seat height measures 32″. For you to reach the pedals at 37″, even with you pointing your toes, your hips are rocking. To demonstrate how much your hips will rock, stand, raise one heal by 2″ and keep that leg straight, knee locked. Now put your weight on to the other leg that has the heal on the floor. See how much hips have rocked and almost instantly how the inside of your knee starts to hurt. Now the opposite. Raise one heal by 2″, put a decent bent in that knee. Now take your weight on the bent leg. There shouldn’t be any pain.

Another thing to think about is your foot position on the pedals. You say your feet don’t move due to the grippy shoes and pedals? This can as bad as incorrect cleat position on clipless pedals. Are you riding with your heals out to avoid heal rub on the chain stays? Try moving the balls of your feet out slightly and pulling your heals in.

First up drop that seat by 2″ to 3″.

Yeah fair enough re the cranks but I think as most folk are observing, you look a mite cramped in the cockpit. Thing is I also ride a Heckler and as I said above, you have longer legs than I do and therefore I can’t believe you need a smaller frame than me. It may be that you have been pushing hard on the ups to have some more fun on the down with it being more flickable etc but it may be taking a toll on your knees. Strengthening your quads is a great idea for knee pain and may help but I would also suggest trying a larger frame to see if it helps. The fact it’s only coming on after a while and on climbs suggests it is definitely a bike fit issue whatever it is.

Your knee makes an angle of about 20 degrees off the vertical when the pedal is at the lowest point. It should really be about 25-30 degrees, suggesting that your saddle is about an inch too high. It’s hard to get fore and aft from the photos because I like to see if kneecap is over the spindle with pedals horizontal. The reach looks a little small, but that really won’t affect the knee pain. Move the saddle down 2cm and foreward 0.5 cm at a time and see how that feels.

Cruzcampo: ye, but technique is important. I was told pull on my ankle and push the respective hip forward slightly (right leg and right hip). You can feel it stretching the muscle but obviously don’t go too far.

why not see a bike fit specialist who can take you through everything, also speak with a doctor/physio.

I wouldnt dream of trying to get a bad knee treated by internet forum

tonyd – when I climb and it gets steep it does feel more like a step machine than a smooth cadence. I’m in my early 30’s so hope the knees aren’t on the way out yet 😆

mokl – whats your leg measurement? I’ve always fancied a Superlight, although since Santa Cruz have brought so many new bikes out I don’t know where i’d begin to look for a new frame model.

bigblackshed – very helpful cheers!!! “your hips are rocking. To demonstrate how much your hips will rock, stand, raise one heal by 2″ and keep that leg straight, knee locked. Now put your weight on to the other leg that has the heal on the floor. See how much hips have rocked and almost instantly how the inside of your knee starts to hurt.” I’ve just felt a twinge in that spot doing this 😯 Think this confirms my saddle is drastically too high ❗ Doing the bent knee varient its fine.

“I’m 6’4″ with a 33″ inside leg. My pedal to seat height measures 32″” so that goes totally against all the 109% of inseam pedal to seat, and 88.3% of inseam bottom bracket to seat, saddle height advice, but makes more sense to avoid hip rock.

I ride with toes pointing out very slightly if I let my feet naturally sit.

glupton, i like the idea of a layback seatpost, if they can take pressure off the knee, what are they usually used for?

They are usually used to get your arse further away from the stem when you’ve bought a bike that’s too small for you and is giving you knee problems. 😉

speedstar – have you got a pic of you on the heckler, similar angle, so I can see what kind of space it gives?

Tired – thanks, more confirmation its too high, i’m definitely going to lower. moving it forward won’t that have the reverse effect of getting a layback seatpost as suggested above to take pressure off knee?

gazza – cheers for stretch tip!

Sancho – I have a lot of faith in the advice of STW’ers, more so than my doctor, thats for sure. Usual fob off, is “don’t so activity for x number of weeks and take these drugs” Physio, bike fitting will be my next step if I can’t fix it with simple saddle tweaks.

Moving further back to make a biek fit is a poor strategy. It also puts more strain on the outer ligaments if you don’t lower the saddle (been there have the injury). Knee over pedal is a good neutral starting point. But at the moment you are too high and are over-extending.

The bike looks too small, but a longer stem, not a setback seatpost is the correct option. Whether handling is adversely affected, only you can decide. But get the saddle position right first.

Evening guys,

A new frame isn’t going to be in the budget for a while, so going to start off by trying a setback/layback seatpost, any thoughts on the Thomson elite setback?

http://www.wiggle.co.uk/thomson-elite-setback-seat-post/

Got to say I agree with the others, frame way to small, the saddle height didn’t look to bad, but its going to be hard for you to make a frame too small fit. I made the same mistake with my first santa cruz…. 🙁

Where would an XL Heckler give extra length, on the top tube? hence putting me further away from the handle bars (if I kept my other components for example)

You will not solve this problem online. Sancho is right unfortunately. Too many variables, too many likely causes and too many possible solutions. A few static photos gives some rough data but is nothing compared to how your joints behave dynamically for a start.

See someone who can spend time with you getting this right. I hasten to use the term bike fit as it seems to be a bit of a dirty word around here. But a bike fit is your best bet as already mentioned.

That said, there are some obvious things that look off in the photos. Biggest problem is the top tube length on your current frame looks way too short= far too small frame. You are pretty much sat upright which is never going to be an efficient riding position. That doesn’t necessarily directly relate to the knee pain but without changing the frame all seatpost faffing will most likely be in vein. A compromised saddle to crank/ pedal relationship just to balance out other factors is not a substitute for a correctly fitting frame.

My only other advice besides don’t put your faith in an internet solution and most likely get a bigger frame, would be to pretty much disregard all “rules of thumb” you might have read about getting correct saddle height/ fore and aft/ using plumb lines/ etc. These are rough guidelines based upon what is statistically most likely to fit an “average” rider. If you ever see the data that goes in to creating such things you will see very few (if any) people actually fit this “average” profile. Ride magazine in Oz did an interesting feature too which took detailed measurements of various roadie Pros and their bikes and the variation in bike fits against these so called “rules” of fitting was staggering. That isn’t to say all have optimised positions but they certainly aren’t struggling either. As I said, they are guidelines to give a starting point from where more detailed and meaningful adjustments can be made.

Long and short of it- get a bike fit from someone with a good reputation who can take the proper time to explore the bike/ knee issues you have. Knee pain is never fun but it will get sorted and it will feel like a revelation when it is sorted 😀 Stick at it! 😀

Agree with all others – frame too small (I’m 5’11” on a large)
Also agree with cleat position issue – I have one pair of shoes I never get knee problems with and 2 others I always do and very painful after 2 hours or so – despite matching the cleat positions – I can never solve with the other shoes.

Are you sure your legs are actually exactly the same length?

if ever a man needed a 29er

Biggest problem is the top tube length on your current frame looks way too short= far too small frame. You are pretty much sat upright which is never going to be an efficient riding position.

Serious question: Why is sitting almost upright an inefficient riding position?

Are you sure your legs are actually exactly the same length?

that was my first thought – left leg looks edit – shorter!

But go & see someone that can really help.

Serious question: Why is sitting almost upright an inefficient riding

Afaik it isn’t.

Interesting to read that you’ve gone from a slow cadence to a faster one up hills. Why did you change?

I had pain in exactly the same place, diagnosed as a torn medial meniscus, which i was told can either repair itelf or may if physio did not work, require a small op.

I was given a series of knee strengthening and stretching exercises and thankfully after a month (and just riding road bike for which i’ve had a fitting) it went.

Personally i feel that riding with your saddle low would make it worse as you tend to splay your legs outwards then and put stress on that side of the knee.

I don’t think the way forwards is to “spend” your way out, with new frame etc, you would be better spening the money on a good physio that understands cyclists and who can cure the actual physical injury, not buy a new bike and hope your knee gets better.

I’ve been having similar issues.

In the first set of pics your saddle height looks about right, maybe slightly too low. In the second pics the saddle is way too low.

As suggested above, moving the saddle back on the rails would be a good move for general bike fit. But I don’t think you need a new bike.

Other things that have helped me:
-Peddling from the glutes, i.e. engaging bum muscles when peddling
-Keeping heel down when at the bottom of the pedal stroke
-Specialized Bodyfit footbeds that “fill out” my slightly flat foot.
-Stretching quads.

There was an excellent article I read a few years ago about seat height and how the professionals did it. The bottom line is that you want top of saddle to top of pedal to be around 107% of inside leg measurement.

The easiest way to achieve this is to sit on the saddle and put your heel on the pedal, keeping your hips level. At the bottom of the stroke your leg should be just about locked out.

I agree with the comments about the frame being too small for you, so if the budget does not stretch to a change, a layback seatpost would help. A vertical line from the pedal axle when the crank is horizontal should be just on the front of the kneecap, not the back as someone said

I am very careful about my whole riding position as I have serious ligament damage in my right knee so need to protect it as much as I can

A vertical line from the pedal axle when the crank is horizontal should be just on the front of the kneecap, not the back as someone said

It can be wherever works for you.