Mtb & knee problems: Solutions / Experiences…

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  • Mtb & knee problems: Solutions / Experiences…
  • Si

    Only 30, but I suffer a lot from sore knees (Biking / walking / kneeling), both just below the patella and down the tendons on the back… Been doing some research and trying to figure out some solutions so any advice on the options below….

    1. Strech daily, I stretch before I ride, but perhaps I need to do this more often on a daily basis

    2. Yoga??

    3. Supplements… Glucosamine and Chondrottin,

    4. A proper cleat fitting?? Comfortable with the rest of my bike setup but for £30 or so is this worth it??

    5. Gearing… Always push a ig gear and currently run 1×9 (32, 32-11) thinking about changing this on the new bike to 1×10 (30t, 36-11) to try and encourage spinning more…


    G and C helps mine. I know that from the consequences of running out far from home.

    Stop pushing big gears to start with

    Premier Icon mikewsmith

    Been doing some research and trying to figure out some solutions so any advice on the options below….

    Skip 1-5 and find out what is wrong then fix that. Can suggest someone in the midlands who might be able to help.


    💡 Stop being so gnaaaaar with your riding & find some nice smooth trails to ride 😉


    Should add i’ve been through the whole diagnosis process and got nowhere…. this included X-ray, MRI, Specialist, Physio. There was some suggestion of tendonitis but nothing firm…

    Having just moved to Scotland though considering going through this process again though….


    Si – on a more productive note: i went through similar in my early 30s when i was training for off road events by road riding, i found the more static position / road bike position gave me sore knees after 90mins or so. I got a referral from my GP who basically said it didn’t warrant further investigation as not life changing and his advice was to “stop riding”!!!. I paid to go private…. and got to see the same consultant who gave me the same answer…. great! I kept off the road, rode off road and all was well. Knees still get sore sometimes, particularly of late as i’m not riding much, live in valleys and am SS. I tried G&C but am terrible at remembering to take meds every day so they usually go out of date in the cupboard.

    I also tried various physios etc, but personally i found them all guess work & at £30-£40 a session i couldn’t afford it as often as needed, with no difinitive diagnosis or guarantee of effectice treatment.

    There is a physio/rehab guy in Ipswich that has cropped up on injury threads on STW that seems to have a great reputation, hopefully someone may come along on this thread with his details, or search the forum.

    Good luck.


    Also – maybe don’t focus purely on your knee, it may just be the weak link in the chain of your foot/ankle/knee/hip/pelvis/back, so a holistic posture / bike posture approach / assessment may be required.


    … and yoga is perfect for cyclists… as they get (ahem)… older!!!!!


    Skip 1-5 and find out what is wrong then fix that.

    Also – maybe don’t focus purely on your knee, it may just be the weak link in the chain of your foot/ankle/knee/hip/pelvis/back, so a holistic posture / bike posture approach / assessment may be required.

    I would persevere with a decent physio. Their experience and specialties are likely to be wide and varied but a decent physio prepared to spend the time with you getting things right is by far the best thing you can do. Then you have all the tools you need to properly inform a bike/ cleat fit, stretching/ exercise routine, etc. Even more so if X-ray/ MRI has given the all clear to anything obvious.

    After about 5 years of struggling to run 5 minutes or cycle 30 minutes gently, finally finding the right person (by chance going through NHS physio again) to help understand my body’s quirks and nuances has got me riding longer, further and faster than ever before.

    As a personal aside, I do *enjoy* foam rolling as a way to soothe the achey knees

    Premier Icon iainc

    Si, if you are near Edinburgh I know a very good bike specialist physio


    I started with similar problems at about the same age. Now, at 45, and 3 procedures later, I can barely walk, let alone ride my bikes.

    It would be worth seeing a bike fit expert (more like £200 than £30 for a comprehensive job by an expert). However, from your brief description, I think there may be underlying issues. ie. not caused by the cycling.

    You really need to get yourself in front of an expert who cares that you expect more from life than the ability to just do a “9 until 5”.

    I don’t think this is going to be available on the NHS or cheaply anywhere. Research well and be prepared to travel/spend :-/


    Cycling alone really should not be causing you pain in your knees. Though overuse and muscle weaknesses may combine to cause issues. I have personally suffered with knee pain for 4 years until I finally stopped getting frustrated, listened to my body and rested. I would do the following to start with….

    1. Get a QUALITY bike and shoe fit. (this will help eliminate problems with your current position)
    2. Strengthen your weaknesses, especially your hips/glutes. And maybe massage too. (see a physio for real advice and exercises, one associated with cycling would be better)
    3. Rest or reduce the mileage/ intensity. ( not just sitting infront of the TV but concentrating on something which does not aggravate your knee eg. swimming,)

    This is just my personal advice, it is what I have done after two less than successful surgeries. Hope this may help a little….Good luck!

    Premier Icon ahwiles

    Stop pushing big gears*.

    Or rather, learn how to spin an easy gear – there’s a time and place.

    (*Especially sitting down)


    Seat further forward, smaller cranks, and spinning.


    Knee pain is hard to diagnose, my own experience having had episodes of pain in either knee at different times, fortunately never both at the same time:-

    1. Too much cycling exclusively. In my younger days I rode 150-200 miles a week road and off road. Pain in one knee, had to stop riding for 3-4 months and follow a regime of straight leg exercises to address muscle inbalance. It worked and I also took up light running twice a week as a complimentary pursuit.

    2. Ill fitting cleats and SPD’s with no float. Once I changed to SPD’s with float and set my cleats right (followed instructions and observed how feet hang when sitting etc.).

    3. Recent episode – and I ride flats now anyway – new shoes on ling rides. Got some 5.10 Danny Macs and on long rides (20+ miles) I was getting pain in one knee. Took a while to work out but stopped using those shoes and within 2 weeks all OK for the last 3 months. I need a flat shoe with a firm sole and good support.

    Those are examples but more generally as soon as I experience pain, rest then a change of exercise is the best thing.

    some good advice on this thread. so to sum it up
    check crank length
    move seat forward
    get some gears and spin instead of pushing high gears
    correct seat hight(dropper is ace)
    set cleats correctly or try some flats
    a bit of suspension helps
    i have made these changes and can ride for a couple of hours pain free doesnt sound alot but in pain after walking less than 1/2 a mile.


    Ian… Il bob you an email thanks….

    Also then curious anyone recommend a decent bike fitter Edinburgh / Stirling / Fife way??

    Those I’ve looked at seem to follow either the Trek method or the Retul way any pro’s cons with either…. This is all solely for the mountain bike.

    Retul seem to be all 3D data capture whereas the Trek way is more so old school measuring….


    The method is irrelevant if the person fitting you know naff all about biomechanics. A monkey can be trained to use the “old school rules” or a fancy bit of IR based kit (like Retul) but all will get you in a rough ball park and chances are the changes you need to make are far more subtle. Fitting to numbers is for an “average” fit yet few of us will be bang on average but sit one side or another of various measures. If you don’t understand how everything links together and how it relates to the underlying anatomy then this is where bike fits start to get a bad reputation.

    Basically, see someone with the best experience not necessarily the fanciest bit of kit. A biomechanist or cycling physio with a Retul type system is perhaps the best but there are few genuinely decent and experienced fittiers around and you have to be patient and not expect instant solutions or results.

    My 2 cents 😀

    Premier Icon mikewsmith

    Yep, methods are a tool for the average….

    One of my mates back home does bio mechanical assessments and treatment plans based on that.

    Over here in Oz after a good bit of searching my knee issue can be put down to the fact one of my Glutes isn’t working correctly (missing really)


    I had weak knee problems a few years ago after I effectively put XC racing/training to bed after 10 years of it.

    I took up Nitro model racing which involved, along with racing, marshalling other races i.e running around like a loon to collect overturned cars etc on uneven ground (off-road) and basically ignored my bike for about 3 years.

    My knees were constantly giving me problems and I couldnt figure out what was going on until I started just going out for one decent ride per week.

    No problems since!

    Basically put it down there being nothing “knitting” my knees together since all my muscles had dissapeared.

    Resigned myself to a life of cycling to avoid the same . bugger!! 🙂

    No doubt there are many forms of knee ailments but just my experience if any help at all …..

    Oh …… big believer in Time pedals too ….. loads of float and a completely different mechanism to standard spd’s.


    I had significant knee pain a couple of years ago. After 2 hours of riding I would get shooting paint through the back of my knee-cap.

    Luckily I get a free physio through work, his suggestion was more “conditioning” of the knee muscles. Basically that came down to 100+ 1/2 squats (low enough for the knees to be in line with the toes), leg raises with a rubber band around the knees, leg equipment in the gym etc etc etc. Essentially, I was using the legs/knees lots without doing any work to build the opposing muscles which don’t get built up during normal cycling.


    @mikewsmith it sounds like I have a similar problem you, my glutes do not work properly at all, add that to have a collapsed arch and my knees aren’t very happy.

    I have far less knee pain when I use flats.

    Still giving you grief then?
    Have you looked into Orthopedic insoles which can adjust your stance minutely/gently over an extended period without you really noticing it.

    Give you a catch up call at some point 🙂

    Premier Icon Wally

    Buy some new shoes and play around with cleat position. I had a terrible right knee problem – after 2 hours it always played up. Bought some new shoes and it went away – put on old waterproof shoes – reappeared…it was the cleat position. Old waterproof shoes now also used. Soo pleased I got this sorted, it was getting really serious. Now just the legs to sort out!

    For me it was

    a) a lot of rest, find something else to do for 3 months other than ride, I took up swimming. Gave it chance to rest properly and whatevers inflamed to go away properly

    b) build up the riding slowly, mine always comes back if i try and do too much too soon (i.e. trying to do 100 miles with no training after a winter off the bike), but with a gradual buildup 100+ mile rides are no problem.

    c) anything other than biking, go swimming, a run, or the gym rather than riding for exercise (commute by car and go to the gym on the way home). Keep the riding for ‘fun’. Keeps the -ve’s of riding to a minimum (repetitive range of motion) and helps keep all the other muscles balanced.

    I used to suffer terribly from knee pain with SPD pedals. On advice I moved over to Time ATAC and hey presto no more knee problems.


    I got knee pain last year which I put down to having my saddle too high.

    Premier Icon iainc

    Si, never got an email ? Look up SpaceClinics, Stephen Mutch. Well known expert who I have seen a few times. He has worked with Olympic track riders

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