[Closed] Knee Pain, am I just breaking down?

Could be [url= http://en.wikipedia.org/wiki/Iliotibial_band_syndrome ]ITB[/url]. Common over-use injury. Need to do stretches and RICE treatment. Ditch the clips and ride flats until it's improved. (Just got off the phone to physio with similar issue). Actually, you can self-assess on this. Feel the knee cap, move fingers to outside of knee and you'll feel a hard ridge. Follow this up the leg (it becomes a larger band of tissue). IF it feels super-tight (you can compare to the other leg) - this is main culprit. Massage x2 per day. Ibuprofen may help.

Rest - And follow the above advice. I was off the bike for 2 months with my left ITB.

As well as cleat position, you maybe don't have enough float - I use eggbeater style pedals and used to use Time Atacs, and one reason was the amount of float.

At the time I read a lot of messages from people using SPDs and getting knee pain who then lost the knee pain when they changed to Times.
Plus that style of pedal clear mud better, as I read of people who got stuck in XTR SPDs after dabbing in mud.

Also, are you bandy legged? There is a possibility that you do do with some canting - the specialized BG shoes can address this somewhat I think but otherwise you would need a specialist - but that's probably unlikely and more float will sort you out.

Sounds just like ITB. The band rubs over the outside of the knee and becomes inflamed during extended use. Do you get a sore hip as well? If you lie on the bed and lift your leg up and down, is there a clunk? All common signs that I have.

Rolling was my solution. 60 times a day. I have The Grid roller from Trigger Point, and it is superb. Not cheap, but it makes for a great massage.

[url= http://www.tptherapy.com/shop/media/catalog/product/cache/1/image/420x/9df78eab33525d08d6e5fb8d27136e95/g/r/grid_stacked_1_1.jp g" target="_blank">http://www.tptherapy.com/shop/media/catalog/product/cache/1/image/420x/9df78eab33525d08d6e5fb8d27136e95/g/r/grid_stacked_1_1.jp g"/> [/img][/url]

Lowering the saddle helps too, as does cleat alignment - toe out. The direction of my feet aren't symmetric, and I suspect nor is leg length. Both of these contribute.

Andy Pruitt's Medical Guide for Cyclists

http://www.scribd.com/doc/61870541/28/Spring-Knee

I get similar pain if my setup isn't spot on, I reviewed the online articles / youtube and ended up moving my saddle forwards loads more than I have ever done before - no more knee pain.

For some reason I've always pushed my saddles right back on the rails, probably because it looked "right" in my head!

This was for my road bikes and mtn bike.

This view is what i went for:
[img] [/img]
[url= http://bikedynamics.co.uk/fit02.htm ]from here[/url]

I do have a knee click as well if my knee's are bent for more than a few minutes, there's a small, painless click when I straighten the leg...

Don't do a massive amount of riding, so rest isn't going to solve it. Might have to check in with the docs and see if they can advise a programme to sort it.

Will probably put my eggbeaters on and see if they help, just don't have any cleats at the moment.

i get this on my right knee.

i find if i ride either clips or flats extensively is ok. but swapping to one or the other will definately cause pain. (i guess the ligament settles down in different positions for differing pedalling technique) i ride 2x a week -a minimum 25odd miles (down from 4x - boo). so i guess periodic riding will be the same as me swapping pedal types. good excuse to ride more methinks!

I use candys so have float.

i have found position on the bike makes a differance but not much. too low a saddle hurts more though. too high and its bloody impossible to ride properly though so its a balancing game. i`ve scored a series of marks on my post i use for referance depending on pedals. also if you loweer the saddle for a fun bit you easily get it back to the same height again.

Same issue dogged me for a year, had the post up and down like a yo-yo and would have saved a small fortune in pedals if I'd followed advice like acjim's earlier.

hi, i'm a physio and keen mtber. i treat cyclists/runners with anterior knee pain like this all the time and i think all of the above info is pretty valid.

From the site/description of your pain its likely that your symptoms are from the patello-femoral joint (knee cap). pain occurs with exccesive loading of the joint surface which causes a bulid up of pressure in the bone under the cartilage. However, pain at this site can also be from many other tissues such as the soft tissue which attach the the side of the knee cap or even referred pain from your back or hip (the latter are pretty unlikely). Pain specifically from the ITB is normally more to the outside of the knee but thats not to say that a tight ITB is not an underlying cause of the problem.

To reduce the symptoms you should consider the following:
A period of relative rest - if it hurts dont do it.
Ice (2 hourly) and a course of anti-inflamatories (see a GP or pharamicist before taking medication)

to find the cause you should consider:
Training load - have you changed/increased training recently? this is the most common cause of the problem.
Bike fit/pedals
muscle tightness - typicaly cyclists have tight glutes/ITB/Quads/calves
Core strength - reduced strength in the lumbar spine and pelvis can lead to over load of the muscles in the peripheral limbs which can become tight and painful

The ITB roller above works really well as does a foam roller to use on tight muscles before stretches.

To get a quick resolution to the problem you really need to identify where the pain is coming from and the underlying causes. A DIY solution is possible but its best to get a professional assessment especially as these issues can return

Had something similar in my right knee and I found my seat was too high. Rested it for a few days, went out on the bike and the pain returned. Lowered the seat about 5mm and I've not had any problems since. 2 ACL reconstructions doesn't help either though.

if using the bike fit stuff, and angles etc, make sure you check on both left and right legs as they will likeley be different, in which case go somewhere in between

Hi
Yes I had a similar problem that started after I did the C2C with 8 hours of cycling each day - and persisted....

I read all the online stuff up too which seemed to indicate a front knee pain if your saddle is too low & back of knee if too high. I also use SPDs and like my saddle pushed back so I can stetch out.

I checked out my set up with 2 of the methods listed: 109% of your inseam (crotch to floor)from bottom of pedal axle to top of seat; and 88.3% of your inseam from cr of crank to top of seat.

My seat was a little above both measures (although it felt OK - no rolling / rocking pelvis) - but I dropped it about 1cm.

I have only ridden it once for about 3hrs so far - but the pain seems to have gone away.......

John

Are you sure that you're not overlooking something like this?

[img] [/img]

To the OP - do you ever get the pain off the bike?

If so it could be that the knee cap isn't tracking properly due to over development of the thigh muscle V under development of the muscle on the inner side on the thigh just above the knee, a fairly common problem with cyclists and one that can be overcome with certain exercises.

just be sure to avoid F1 driving whilst suffering symptoms of ITB.

No pain off the bike... I did 20-30k walk/jog/run on tarmac the other week with no issues...

I think I'll put some more effort into saddle height over the next few rides, see what happens. Should it be a recurring theme I'll get the docs to look at it.

Cheers all.

I find a good and easy way to investigate saddle position/height,cleat position is to unclip one foot and move it to the side slightly and then try to pedal smoothly with the other foot.

If I can't pedal smoothly it could be 'cos my saddle is too high and my pelvis is rocking (bad), or my saddle is too low - anyway fiddling with setup makes it obvious what is most smooth and most efficient at transferring power to the pedals when using one leg.

Slide back and forth on the saddle to see what a difference it makes to
the power delivery.

It is also easier to feel the difference of moving your cleats around when using one leg.

I also get some small pain behind the kneecaps, but mostly with running, due to some tight muscles/imbalance of tightness.

So before I go out I normally just kneel down for a minute or so and let my thighs stretch out, which is sometimes painful as they have gotten tight. Might be worth trying.

Also when cycling i try to keep my back somewhat straight so I am not tempted to mash on the pedals so much, but rather spin them. This reduces the stress on the knees.