Why does only one knee hurt ?

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  • Why does only one knee hurt ?
  • jerrys

    I took advantage of the good weather today for a couple of hour spin on the CdF. Right knee was aching slightly shortly after I set off, but I thought I could ‘ride it off’. At my furthest point from home (13 miles) I decided that that was a bad idea and limped home – if you can limp on a bike! It also played me up a couple of weeks ago when I took the CDF off road, but I thought I might have pulled it in one of my manic ‘get out of the clips before I topple over moments’. It’s a bit sore now, but by tomorrow I reckon I won’t feel it.

    Question is, is it somehow how I’m positioned on the bike – but if so, why is only one knee? Or is it more likely that i twisted it the other week and I only riding aggravates it? How much difference (if any) does moving the cleats slightly make. I’m using shimano mtb shoes and M324 pedals, but this is the first bike I’ve ever had where I have to clip in.

    For what it’s worth, I didn’t have much of a bike fit when I picked the bike up last year from the lbs (my fault, busy saturday – wrong day to buy a bike). Is it worth going back to the lbs for some help, or should I see if a couple of weeks rest sorts it out?

    Any help appreciated – chers !

    Premier Icon aazlad

    I’ve had a similar issue on and off over the past year on various bikes with various shoes. Doesn’t stop me riding but I do worry about future knee issues. Put it down to getting old.

    Is your saddle the right height? Maybe a tiny bit too low…

    Premier Icon dmorts

    Could be a muscle imbalance and you will not believe the miracles a few squats and stretches can do for that! Gets everything balanced up again. Feet parallel type squats, don’t know the proper name…

    Premier Icon davieg

    +1 dmorts

    I have had knee problems, possibly seat too high or not far enough back, but equally hammering the pedals has led me to develop it band syndrome. Strengthening my core and stretches has helped and using a foam roller helps keeps things loose.


    Have the same ..left leg/knee though.. Posted a thread about it here some time ago… They all call it a chocolate leg. ..in a long (ish) downhill section.. When both my feet is level.. I just cant stand long on the left leg…. gave up looking to fix it..nothing works 🙁

    *runs and cry*


    It’s possible that one of your legs is shorter than the other, so your saddle is too high for one of them (or too low). It takes a while to figure out the best compromise height for my saddle on new bikes due to this.

    Premier Icon JoeG

    Hurt some other part of your body worse. For instance, drop a big rock on your foot or hit your thumb real hard with a BFH. You’ll forget about the hurty knee in no time! 😉

    Edit vvv :mrgreen:


    When spds first came out I had a problem with one knee.
    It was on a week riding holiday of off road, some cold wet days. On the second to last day I could not ride any more due to the pain.
    All these years later I still get a twinge in the knee. (Just back on the bike after a 16 year lay off) now on flats.
    I put it down originally to the tension screw on the pedal being too tight and having to twist too hard to get my foot out, especially in cold weather.
    So make sure you find out what’s causing it, don’t end up having problems later.

    Premier Icon mtbmaff

    Go and get yourself checked out properly, my knee problem turned out to be my hip. The pains in my knee were actually caused by my hip being worn out.

    Premier Icon davieg

    Go and get yourself checked out properly, my knee problem turned out to be my hip

    I am not a physio, but my wife is. Like many ailments, where you experience the pain is not necessarily the cause. My knee pains was derived from tight hip flexors and IT Bands pulling on the various tendons that support the kness.

    Stretching may be a more productive and cheaper option before going for a bike fit.

    Premier Icon mikewsmith

    I am not a physio, but my wife is. Like many ailments, where you experience the pain is not necessarily the cause. My knee pains was derived from tight hip flexors and IT Bands pulling on the various tendons that support the kness.

    this + lots

    Turns out a lot of my issues are down to an inactive Glute on one side that is dragging a lot of stuff out of alignment. Probably due to some old injuries. It only really comes into play when I am too tired to correct the bad movement myself. Though the stock STW response was your saddle is too low. Got a mate in the midlands who can look at stuff like this. (does heaps with runners and other sports people and is a cyclist too)

    Herman Shake

    I had a recurring pain in my left knee which has come and gone over the years, but particularly associated with cleats (on a fixed, road and mtb). My feet are slightly different sizes like most people, since moving my left cleat forwards to be under the ball of my foot rather than matched to the right shoe (pretty much central) it’s balanced out.

    Stand with your back and heals against a wall, are the balls of your feet in the same place?

    Saddle height may vary based on your pedalling style; lower for heel droppers, middle for level footed pedalling and a tad higher for toes down. A saddle too high will make you pedal toes down so experiment, it will also make your hips rock as you try to reach the bottom of the pedal stroke; lower back pain being the give away.

    In terms of saddle fore/aft, use the top of your shin rather than your knee cap as the reference to be over the spindle (again, a starting point not a rule).

    If you get lateral pressure from the pedal when pedalling you may need to tweak the angle rather than position of the cleat as you should be in the middle of the float.

    When tired my knees widen when pedalling as my form gets sloppy. Consciously pedalling with knees above ankles seems odd but again maintains alignment.

    Finally stretching regularly to loosen/strengthen glutes, hamstrings, core and back provide your body with more support for itself.

    Finally part 2; as you can pull up on the pedals when clipped in doesn’t necessarily mean you should. Use it to initiate your pedal stroke earlier at 12-1 and hold longer to about 7-8, studies show trying to pull a full circle can fight the opposite foot, waste energy and increase knee injury potential.

    Premier Icon singletrackfred

    +1 dmorts and davieg
    Currently having physio for exactly that. Now onto my third session and the pain is easing up.
    I would recommend getting physio and fixing it.

    My Mrs is also a sports and remedial masseuse and has done a lot of work with the GB mtb team and when my knee or back causes problems it’s almost always –

    Like many ailments, where you experience the pain is not necessarily the cause. My knee pains was derived from tight hip flexors and IT Bands pulling on the various tendons that support the kness.

    Premier Icon jambalaya

    Yes of course it’s possible for only one knee to have an issue. As above many possible explanations. Most important is to listen to your body (ie stop/slow down) and get some advice.


    +1 IT band. Currently really enjoying physio for it, honest.


    Thanks for the replies folks, most appreciated.

    On reflection, at the age of 53,doing no exercise then going for a 25 mile cycle, then doing nothing and then going for another 25+ mile cycle a fortnight later is probably not the best technique for getting bike fit! I’ve obviously been spurred on by all the tales of epic 70 mile plus efforts on here :). What actually is a realistic mileage for someone with job/family commitments who hasn’t ridden a drop bar bike for years?

    Seriously, I think it was a cleat/panic moment which caused the original injury and I’m just aggravating it at the moment. I might try swopping back to flat pedals and toe clips and take things easy for a bit, as well as trying stretches etc mentioned in other posts.


    What about gout? The doctor thinks I get it in my knees, sometimes both sometimes one at a time

    Premier Icon billyboy

    My initial knee issues (I thought) were down to my sitting too far back from the cranks. The more directly above the crank I ride, the more my knees will behave themselves.
    Then I had a knee lock up and an arthroscopy to clear it. Since then I get occassional pain in both knees, so I’m seeing the local knee man tomorrow for peace of mind…or to discuss intervention if nescessary.

    Could be worth looking into custom insoles (or at least buying some with enough arch support) and shims wedges if you need them. A podiatrist(?) should be able to help


    I used to get exactly the same thing after consistant and high effort pedalling ie a long climb. Making sure saddle height is right helped loads for me and I have to say a dropper is good for that. I always used to leave myself in a middle-ish position because I couldn’t be bothered to stop and frig about with my saddle height. Now it’s nice and easy to get in a better position.

    Also check out different crank sizes. Either too long a crank or too short a crank will give you aching knees. I changed over to 170mm cranks which seems to have also helped.

    Premier Icon adsh

    1. You need to get fitted – google Adrian Timmis http://www.cadencesport.co.uk/bike-fitting/ no-one has a bad word to say about him. I did it and it was money very well spent.

    2. Stretch, then stretch some more

    3. Ride shorter distances more often and build up. Takes a year or so for tendons and ligaments to catch up with muscle development.

    4. When riding change to a gear spinnier than you can actualy push.

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