After we’ve been out riding she gets a pain in the outside of her left knee, could be Medial but I doubt it?

She’s in pain for a good couple of hours after, struggles to straighten and bend her leg.

Anyone any advice on what it could be?

Go and see a physio, but sound possibly like it band issues?

Band issues?

Iliotibial band.

https://en.m.wikipedia.org/wiki/Iliotibial_band_syndrome

If she can’t straighten her knee, as though it feels like it’s locked and she has to push it straight she needs to go see her doc

Start with a physio, sounds like IT band is tight.

Cheers everyone. Would you tell her to stop cycling? She is a barista so on her feet all day too, as well as walking to and from work.

Not ideal is it?

Pre. Intra and post ride. Does she stretch?

touch toes. Foot to ass. Stood with feet crossed then lean forward feel stretch.

Last one especially really loosens that area back up. Riding tightens hamstrings which pull on these muscles around the knee.

Also the fact its only for a few hours post cycling then she stands up all day no problem, something on the bike to look at too. Saddle height. Flats or clipped in? Right size bike? Riding too hard when not warmed up? All year round or just summer problem?

See a physio before cycling, don’t want to aggravate anything

She doesn’t stretch, I’ll start getting her to.

Her Aunt is a physio and we’re out for a meal with her on Thursday so I’ll bring this up.

I would certainly book an appointment with a physio.

In the meantime, as above, it really does sound like a shortened IT band. One very common, and often very effective, way to sort this is by using a roller, such as this one: £21 from SportsDirect. There are cheaper ones but be mindful that they may be too soft.

To use the roller put it on the floor and lie with your leg on top so that the effected side (this is the ‘outside’ of your thigh, so the left hand side of your left thigh and the right hand side of your right thigh) is in contact with the roller. You now need to roll the length of your thigh, from hip to knee, along the roller. You do this by moving your whole body. This will be VERY!! painful at first, but this will subside within the first week. 5 minutes a day is the recommended amount, you may find this hard to achieve at first due to the pain, that is ok. Stick with it! 🙂

This video explains it better:

[video]https://m.youtube.com/watch?v=RoHBDim_fzk[/video]

Brilliant, thanks so much.

She doesn’t stretch, I’ll start getting her to.

The muscles associated with the IT band can be quite tricky to get to, hence the popularity of the foam roller. If you want to try to stretch them then the muscles you are targeting are

1.) Tensor fasciae lattae

2.) Gluteus maximus

3.) Vastus lateralis

A quick google search should show you some good stretches. Unfortunately, maybe because this is such a common injury, searching for ‘IT band stretch’ throws up an awful lot videos all claiming to have the perfect stretch so it can be a bit hard to sort out the wheat from the chaff.

Get someone to take a look at her on the bike. It’s causing the pain could be something really simple.

I build bikes regularly, size is bang on, as is leg position.

Not what I meant sorry, alignment of hips, legs, muscle imbalance etc. I have a muscle in my arse that doesn’t work properly that messes up the balance in one leg on the bike it I don’t do the right things. If the bike is agrivating it then the way to spot it could very likely be on the bike.

Can you get a copy of Andy Pruitts Medical Guide for Cyclists ?

Its great for isolating and fixing all sorts of troubles…

Try lowering her saddle a touch

Hmmm. Not sure how I could cure that mikewsmith? Would I have to watch her riding? See how shes got her feet/how shes sat on the bike?

jonnytheleyther – Member

I build bikes regularly, size is bang on, as is leg position.

crank length?

proportionally, my wife using 165’s is the same as me using 220’s, no wonder her knees hurt.

(she’s now got 140mm cranks, much better)

Hmmm. Get your point, but wouldn’t both knees be hurting?

possibly, if both legs are the same length/strength/dominance/etc.

Hmmm. Get your point, but wouldn’t both knees be hurting?

No, your body will protect one side; usually the right, according to SH. I still reckon the saddle’s too high; alot of people seem to run them too high.

When I first started riding I got this too. My left knee always used to ache after a couple of hours or so. Bike size was pretty much spot on and we tweeked the saddle height. I was riding flats so it wasn’t anything to do with shoes.

Best things that helped me: going to see a physio and getting advice on correct stretches for after riding and also wearing a good supportive knee pad (I found the pain to be much less when wearing my POC pads compared to when I didn’t so i thought it must offer some support as well as saving me knee). It turned out I had a really weak left knee and riding aggravated it, when I bend my left leg my knee goes outwards rather than down in a straight line. As others have said I needed to stretch my hamstrings and glutes.

Also at the time I was working on my feet all day too and only had the problem when riding, or hill walking on the descents.

You’re right, it is her left knee that’s bad and she rides flats too.

I’ll drop the saddle a little. Would you still leave off cycling for a few days though? Or stretch, drop saddle and give it a go?

To use the roller put it on the floor and lie with your leg on top so that the effected side (this is the ‘outside’ of your thigh, so the left hand side of your left thigh and the right hand side of your right thigh) is in contact with the roller. You now need to roll the length of your thigh, from hip to knee, along the roller. You do this by moving your whole body. This will be VERY!! painful at first, but this will subside within the first week. 5 minutes a day is the recommended amount, you may find this hard to achieve at first due to the pain, that is ok. Stick with it!

I get the same thing. Painful with flats, even worse with SPDs. Walking down steep hills makes it really bad too (I was in tears coming down Ben Nevis last time).

Foam rolling helps massively but it is agonisingly painful to do so I have to admit I don’t do it every day. Really should try and put in the effort, I know.

Walking down steep hills makes it really bad too (I was in tears coming down Ben Nevis last time).

There is a chance that you may also have some instability issues with your knee here, as well as a shortened IT band. Your knee joint is held on place by the muscles surrounding it and sometimes they need a little strengthening up. You feel it when you are walking down hill because this is one of the few times that you use this much range of motion in your knee joint whilst putting it under load.

This is very common and easy to sort out, book an appointment with a physio, they will tell you what to do. You may have to wait a few weeks for an appointment but I’m sure you’ll agree that it’ll be worth it for your peace of mind! 🙂

In the meantime don’t give up on the foam roller- I promise the pain will drop off after a few days if you keep at it!! 🙂

Oh Fionap I was just the same coming down Ben Nevis, excruciating! I’ve never actually used a foam roller to fix it, just done lots of stretching which has helped and I don’t have issues on the bike anymore (even though I ride more than ever – 10 hours+ a week). But I still get it hill walking. Will look into the foam roller though for when I go hill walking. Anything to help!

Johnny I’m not sure how often your mrs rides, when I got this I was only riding once or twice a week tops and I had a couple of weeks off but noticed it didn’t help. The physio worked a treat though. I did cut my rides shorter so that once the pain came I knew I could stop and go home. Get her some good knee pads or one of the muscle supports you can get in Boots, it should help too. I had an MRI scan and all sorts to find the cause but it was just a muscle imbalance that stretching would sort.

Also, if you are finding it too painful, try moving your body slightly so that the roller is pressing on the sides of the effected area (as in towards the front or the back of the thigh) whilst still going up and down from hip to knee. This will still do you a lot of good (in fact you should really be doing it anyway).

Cheers everyone, you’ve been brilliant as ever.

There is a fair bit of info that suggests using foam rollers on IT Band issues is not helpful and can cause more problems.

I have IT Band pain every now and again, a physio visit is in order.

Thanks Shermer (and sorry for thread hijack Jonny but hopefully it’s relevant) – what would a physio do if I saw one? Massage/alignment stuff or teach me some exercises/stretches?

jonnytheleyther – Member
Hmmm. Not sure how I could cure that mikewsmith? Would I have to watch her riding? See how shes got her feet/how shes sat on the bike?

Some of it can be really subtle, just staying with a mate (no plug) who does this sort of stuff, there are always plenty of symptoms to treat but root cause is the way to fix it. The ex went through loads of stuff to sort issues with back/hip/knee was a long process but worked.

To be really honest I wouldn’t take advice from anyone who hadn’t spoken to or seen your missus moving, just a personal preference. The internet is a dangerous diagnostic tool. If you want the name of someone I would trust midlands based (cyclist/runner/fixing bloke) drop me an email

My knees have been giving me grief for a while. Cycling hurts my knees after so many miles but walking down a steep hill is worse I think it depends on how much pressure is going through the knee. Lots of pressure – more sore the knee. Squats do it in as well. Unweighted at that. Hurts to just sit down with my legs bent 90 degrees for long (ish) periods. Last week I had MRI scan on each knee. Now just awaiting to hear the results from CATS. Until then it is guesswork as to what is wrong. That is my advice on knee pain – get the MRI or else its really hard to work out (guess) whats wrong.

I get knee pain on most bikes it for me is always sorted by moving the seat forward.

As others have said, it’s ITB inflammation that will reveal itself as a sharp pain on the outside of the knee. The band is over-extended and rubbing on a boney prominence.

Usual cure is saddle position. Lower the saddle by 0.5 to 1.0 cm and move it forward on the rails 0.5cm as well. Sometimes setting saddle height based on previous bikes will still put the rider in an over-extended position if the seat tube angle is shallower. That happened to me and I suffered for some time.

A foam roller always helps symptoms, but it’s saddle position that is the cause. Once correct, expect the pain to go away.

That is my advice on knee pain – get the MRI or else its really hard to work out (guess) whats wrong.

Previous knee pain was caused by having flat feet, no amount of scanning the knee would tell you that, physio spotted it easily. Scans etc are just part of a diagnostic tool kit, probably won’t tell you why cycling causes the pain either.