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Lanced Armprong

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Knees, knees, knees - PAIN!
« on: July 10, 2012, 21:52 »
I've been suffering for a couple of years or so with knee pain in one knee. I only get the pain when cycling. It usually comes on when I push a large gear, or do some climbing, but always comes on within 30-40mins. I had a cheap bike fit (cleat fit, bike position, stem adjustment etc) with Vankru, but that doesn't seem to have fixed it. I'm definitely more efficient when pedalling now, but was wondering if anyone else has had a similar issue?

I do get a bit of pain relief if I make sure I stretch my IT band 3 times a day, but it hasn't so far cleared the problem. I guess what I'm getting at, is if anyone has had the issue, have you managed to clear it through a regimen of stretching, or something different? I often forget to do the stretches, and often wonder if it will fix the issue. I understand the IT band can take a long time to sort as it's such tough tissue... I'm tempted to go for some physio/sports massage on my legs as I sometimes get a tight calf (opposite side to the knee pain).

I never get knee pain when walking or running, and I've tried all sorts of saddle positions etc. I spoke to one of the bike fitters in Hargroves Cycles who recommended their cleat fit, which I am tempted to do as he seemed to have some better ideas on the cause of the pain than Vankru did.

Been meaning to ask on BR/Cyclingnews forums for some time, but never got round to it :)

Cheers.
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    Re: Knees, knees, knees - PAIN!
    « Reply #1 on: July 10, 2012, 22:41 »
    First thing I think about with knee problems is cleats and shoes, and adjusting the float on the pedals. I would certainly recommend getting the pedal/cleat/float check done if its inexpensive.
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  • DinZ

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    Re: Knees, knees, knees - PAIN!
    « Reply #2 on: July 11, 2012, 00:00 »
    I've been suffering for a couple of years or so with knee pain in one knee. I only get the pain when cycling. It usually comes on when I push a large gear, or do some climbing, but always comes on within 30-40mins. I had a cheap bike fit (cleat fit, bike position, stem adjustment etc) with Vankru, but that doesn't seem to have fixed it. I'm definitely more efficient when pedalling now, but was wondering if anyone else has had a similar issue?

    I do get a bit of pain relief if I make sure I stretch my IT band 3 times a day, but it hasn't so far cleared the problem. I guess what I'm getting at, is if anyone has had the issue, have you managed to clear it through a regimen of stretching, or something different? I often forget to do the stretches, and often wonder if it will fix the issue. I understand the IT band can take a long time to sort as it's such tough tissue... I'm tempted to go for some physio/sports massage on my legs as I sometimes get a tight calf (opposite side to the knee pain).

    I never get knee pain when walking or running, and I've tried all sorts of saddle positions etc. I spoke to one of the bike fitters in Hargroves Cycles who recommended their cleat fit, which I am tempted to do as he seemed to have some better ideas on the cause of the pain than Vankru did.

    Been meaning to ask on BR/Cyclingnews forums for some time, but never got round to it :)

    Cheers.

    yes i have had loads of knee problems and am in the middle of fixing it

    as far as i can tell there are three things that can cause knee problems but all three are linked

    1. Bike fit
    2. your body
    3. the way you ride

    as you have had a basic bike fit and given your knee pain appears after a short time when pushing hard i would personally focus on number 2 first

    while your bike fit may not be ideal if you had a saddle fit and are confident that your saddle height is correct then my personal unqualified opinion is it is more likely to be 2 or 3 that is major cause of issue.

    with regards riding style, guess this depends on experience. you say it comes from pushing hard which in my mind removes number 3 as most likely cause. often knee pain can be caused by newbie / unfit riders pushing too high a gear for too long. if you are not that new and do not get it all the time then would ignore this

    right number 2. your body. riding is not a natural thing for us to do and your body needs to adapt to it. a lot of people spend ages tuning their bike position. why do they do this? because of the highly repetitive nature of riding. you spend hours doing the same thing over and over again many times a minute so the smallest issue can result in a big impact. well the same is true of your the other part of the machine, you. a small issue in your body can result in a big impact. i have been seeing physios about my issues and frankly i have about 4 things that are contributing to my knee pain. tight hamstrings, over worked abductors, dodgy back and a tight nerve.

    this is where it gets difficult. in general, lack of flexibility is a big issue and if it is a simple as that then Yoga is a very good idea. hamstrings in particular can cause knee pain and downward dog is your friend. if like me you are completely fliped then i would recommend finding a good physio. any good physio should be able to help you, i was lucky in that i found a physio that was also a cyclist so had a good understanding of the issues.

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  • Martin318is

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    Re: Knees, knees, knees - PAIN!
    « Reply #3 on: July 11, 2012, 03:58 »
    2 quick observations:

    Foot issues such as pronation and things like functional leg length differences are generally not spotted by basic bike fits.

    Its entirely possible that your issue may require orthotic footbeds or other non standard adjustments.

    One other thing- stop riding and fix it now.  I have been dealing with horrendous ITB issues for 3 years becuase I spent a few konths being tough and riding through the pain
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    Re: Knees, knees, knees - PAIN!
    « Reply #4 on: July 11, 2012, 04:08 »
    Oh should have said that the best thing you can do is bite the bullet and get a full bike fit by someone who has physio experience as well. They will check 1 and 2 for you.

    Here it costs a good $400 to get this done but should fix you and in some cases (i know i was able to) you can claim back of health insurance
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  • Lanced Armprong

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    Re: Knees, knees, knees - PAIN!
    « Reply #5 on: July 11, 2012, 21:41 »
    Thanks for the replies so far, much appreciated.

    I guess I should have given a little more info since you've touched on it. Firstly, I would say my hams are quite tight, I do try to stretch them as much as I can (quite busy at work so tends to slip my mind). Maybe this is where I should focus on/get physio.

    Secondly, from 1994 to 2008, I played football (soccer) twice a week, and in the last 2 years of playing, I would be in agony around my heel for the following 2 days after a match (even after a 5-a-side match). I got checked out by a foot specialist (the NHS couldn't help after 6 months, including physio), and he made me some custom orthotics as I was heavily over-pronating. Within 2 weeks I had no more heel pain! During those 2 weeks though, I got a clicky knee and hip - obviously where things were aligning etc as it settled down. That was 5 years ago, and I only really took up serious cycling in 2009.

    I ALSO have a slight leg length difference in the leg with pain, but it's above the knee where the difference is. My foot specialist isn't familiar enough with bike fitting and cycling, so recommended I maybe go for another bike fit. Vankru advised me that I should not be using my orthotics for cycling (I had been using them on every ride till that point - Christmas 2011), as they were made for walking/running, so again, who do I believe? Maybe a different bike fitter will have a different opinion...

    Even typing this out, I realise that it is going to be back to the stretching regularly and plenty of physio - I was just hoping maybe someone had some extra advice on something that I was maybe missing.

    Thanks again!
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  • just some guy

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    Re: Knees, knees, knees - PAIN!
    « Reply #6 on: July 11, 2012, 21:48 »
    I've been suffering for a couple of years or so with knee pain in one knee. I only get the pain when cycling. It usually comes on when I push a large gear, or do some climbing, but always comes on within 30-40mins. I had a cheap bike fit (cleat fit, bike position, stem adjustment etc) with Vankru, but that doesn't seem to have fixed it. I'm definitely more efficient when pedalling now, but was wondering if anyone else has had a similar issue?

    I do get a bit of pain relief if I make sure I stretch my IT band 3 times a day, but it hasn't so far cleared the problem. I guess what I'm getting at, is if anyone has had the issue, have you managed to clear it through a regimen of stretching, or something different? I often forget to do the stretches, and often wonder if it will fix the issue. I understand the IT band can take a long time to sort as it's such tough tissue... I'm tempted to go for some physio/sports massage on my legs as I sometimes get a tight calf (opposite side to the knee pain).

    I never get knee pain when walking or running, and I've tried all sorts of saddle positions etc. I spoke to one of the bike fitters in Hargroves Cycles who recommended their cleat fit, which I am tempted to do as he seemed to have some better ideas on the cause of the pain than Vankru did.

    Been meaning to ask on BR/Cyclingnews forums for some time, but never got round to it :)

    Cheers.

    Ok free advice time

    I work in this area

    you never said where the pain is -

    some general bits and pieces of what others have mentioned

    if it is ITB related the issue is compression of a fat pad on the outside of the knee, and that irritates nerves endings.

    ITB issues come from proximal ( higher up ) issues in running and walking and sometimes in cycling.

    LLD - leg length discrepancy comes in 2 forms Functional - ie the body makes one leg act shorter and structural one leg is shorter.

    do you rock side to side when you are tired and climbing ?

    I may be able to help maybe not internet advice is bad at the best of times

    1st get an diagnosis

    get a really good bike fit done.

    ice your knee, rest and stretch , look at your core stability and get someone to look at muscle balance on the leg for you.

    generally treatment is simple but pushing boundaries will not help   
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    Anthony Moan

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    Re: Knees, knees, knees - PAIN!
    « Reply #7 on: July 11, 2012, 22:15 »
    Lance there is no such pain which a fistful per day of Voltaren rapid can not handle. So go for it, and ask help then. If you have it more ;D
    Call brother Tony 8)
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    Lanced Armprong

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    Re: Knees, knees, knees - PAIN!
    « Reply #8 on: July 11, 2012, 22:19 »
    Ok free advice time

    I work in this area

    you never said where the pain is - looking at the right knee from the front, it would be lower left, on the front of the knee - best I can describe.

    some general bits and pieces of what others have mentioned

    if it is ITB related the issue is compression of a fat pad on the outside of the knee, and that irritates nerves endings.

    ITB issues come from proximal ( higher up ) issues in running and walking and sometimes in cycling.

    LLD - leg length discrepancy comes in 2 forms Functional - ie the body makes one leg act shorter and structural one leg is shorter.

    do you rock side to side when you are tired and climbing ? no, I tend to be pretty smooth when pedalling. when I get tired (quickly on climbs, I'm over 6' and weigh 13st), I just sit and grind out the 28t :)

    I may be able to help maybe not internet advice is bad at the best of times

    1st get an diagnosis

    get a really good bike fit done.

    ice your knee, rest and stretch , look at your core stability and get someone to look at muscle balance on the leg for you.

    generally treatment is simple but pushing boundaries will not help   

    I can answer two of those in red.

    thanks for the advice, I think I'll back to Hargroves for the cleat fit/BG fit and see what they say. At the same time, I'm going to contact a physio that was recommended to me recently.

    Tony, cheers, put up with it for 3 years now - bored with the pain. It holds me back from doing bigger mileage rides. Want to achieve some cycling ambitions in my life (Marmotte, L2P etc) so need to get it sorted once and for all. Just don't have bottom-less pockets of cash...
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  • DinZ

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    Re: Knees, knees, knees - PAIN!
    « Reply #9 on: July 12, 2012, 00:04 »
    I will leave it to the resident expert but tight hamstrings is the main cause of my knee issues as it causes unnecessary strain on the knee. you should a lot like me basically. got some issues caused by earlier sport, for tight hamstrings, know you should stretch them, forget to do exercises.

    i am happy to share some of the exercises i do to see if they help but nothing will be better than going to see physio and getting hands on expertise. just remember not all physios are equal, physio only works if you do the exercises (my big issue) and in general yoga, boring as it is, is actually really good. sign up for classes, commit to going twice a week and do the stretching in the company of lots of attractive women.

    my final 2 cents is from what you have said i would spend my time and money initially on a decent physio and take some time off to fix it (if you have waited this long maybe consider putting up with it for the summer then fixing it in the winter when it is easier to stay off your bike). You can do endless bike fits but if the guy does not fix your body issues (the muscles ones not the body issues bought on by looking at pictures in mens health and wishing you ahd bigger guns) then the bike fit is not going to fix it.

    now i am going to have to go into a meeting room at work and do my physio exercises cause i feel guilty
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  • just some guy

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    Re: Knees, knees, knees - PAIN!
    « Reply #10 on: July 12, 2012, 08:49 »
    I can answer two of those in red.

    thanks for the advice, I think I'll back to Hargroves for the cleat fit/BG fit and see what they say. At the same time, I'm going to contact a physio that was recommended to me recently.

    Tony, cheers, put up with it for 3 years now - bored with the pain. It holds me back from doing bigger mileage rides. Want to achieve some cycling ambitions in my life (Marmotte, L2P etc) so need to get it sorted once and for all. Just don't have bottom-less pockets of cash...

    sound like it up around your hips and core area, the ITB inserts on the right hand side of the right knee ie the outside , it begins as a muscle on the outside of the hip and if stretching that helps then I would say the hips and core are the problem

    Physio get a to

    1 diagnosis the  problem

    2. work out why it is getting stressed

    3 build a treatment program to 1 - reduce pain

                                                       2- stop it from coming back

    good luck
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  • Lanced Armprong

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    Re: Knees, knees, knees - PAIN!
    « Reply #11 on: July 12, 2012, 20:13 »
    Thanks all, good solid advice which I'll be following!  :tu
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  • L'arri

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    Re: Knees, knees, knees - PAIN!
    « Reply #12 on: March 14, 2013, 08:57 »
    Just starting to get a bit of knee pain (lateral collateral ligament?) on the left leg only now that I have restarted on the pride and joy for turbo only.

    Having done all winter so far on the CX bike, I suppose these transitional niggles are inevitable, but it's not helped by the fact that I have different shoes and pedal systems on each.

    A shop near me does Cyfac fits but I'm a bit concerned about how much it will cost as we're not as flush these days with Mrs L'arri not working.

    Apparently, the machine spits out an optimal fit but when you do these fits, do they go ahead and apply the settings in the shop or do you have to do them yourself?
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    Re: Knees, knees, knees - PAIN!
    « Reply #13 on: March 14, 2013, 09:08 »
    Just starting to get a bit of knee pain (lateral collateral ligament?) on the left leg only now that I have restarted on the pride and joy for turbo only.

    Having done all winter so far on the CX bike, I suppose these transitional niggles are inevitable, but it's not helped by the fact that I have different shoes and pedal systems on each.

    A shop near me does Cyfac fits but I'm a bit concerned about how much it will cost as we're not as flush these days with Mrs L'arri not working.

    Apparently, the machine spits out an optimal fit but when you do these fits, do they go ahead and apply the settings in the shop or do you have to do them yourself?

    Larri take some photos show me where it hurts and write down when it hurts etc

    see what I can do over the interwebs
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  • L'arri

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    Re: Knees, knees, knees - PAIN!
    « Reply #14 on: March 14, 2013, 10:21 »
    Larri take some photos show me where it hurts and write down when it hurts etc

    see what I can do over the interwebs



    Not my legs obviously but #1 is the main source of pain and a little bit #2.

    #2 subsides quite quickly but #1 stays around a little longer. It's odd because it's not your "classic" knee pain.

    I get it after about a half hour on the turbo, typically when riding against a lot of resistance. It doesn't happen before two hours out on the road but it's noticeable after that.
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  • just some guy

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    Re: Knees, knees, knees - PAIN!
    « Reply #15 on: March 14, 2013, 10:23 »
    feel it a little when walking on stairs ?
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    Re: Knees, knees, knees - PAIN!
    « Reply #16 on: March 14, 2013, 10:32 »
    feel it a little when walking on stairs ?

    Yes, I do, but only #1. And my stairs are very steep. ;)
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    Re: Knees, knees, knees - PAIN!
    « Reply #17 on: March 14, 2013, 10:48 »
    Yes, I do, but only #1. And my stairs are very steep. ;)

    Sounds like an ITB issue

    Illiotibial band - don´t google it the information you will read is wrong

    when the fascia is tight due to muscles in the hip it compresses a fat pad and nerves which gives you the pain, and this pain and tightness changes the biomechanics of the knee in cycling - saddle height is an issue here as well if too high , but so is a weak core and that rocking you get when tired.

    here is your treatment plan

    Core training - lots

    Ice 20 min after cycling

    reduced cycling Km for a while

    Lower your saddle height a little, stop rocking on the bike from the hips.

    Stretching 3 times a day 3 times per leg 25 sec per stretch







    do this one standing with the bent/front leg on a desk



    4-5 min massgae use a tennis ball if you do not have a roll

    let me know how you go
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  • L'arri

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    Re: Knees, knees, knees - PAIN!
    « Reply #18 on: March 14, 2013, 10:50 »
    Gotta love the in-house support! Thanks so much, jsg! :hug
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  • esafosfina

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    Re: Knees, knees, knees - PAIN!
    « Reply #19 on: March 24, 2013, 14:10 »
    Some good stuff in this thread... I've always suffered from niggling issues with my right knee, until this year when I started to use a 'varus shim' in my new shoes. Helped me a great deal. As mentioned tight ITBs are often a cause, as are tight hip-flexors. Perhaps also get a physio or osteo to check out your spine... I ruptured a disc years ago and it threw my hips out, which in turn threw my left knee out. Once the spine was stable my knee followed suit!
    This may be stating the bleeding obvious, but it's always worth checking simple things - are your pedal axles bent? Is your saddle bent? Cleat wear? Seat height etc etc...
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    Re: Knees, knees, knees - PAIN!
    « Reply #20 on: February 07, 2014, 19:17 »
    I have dead bone in my left knee and arthritis in my right. I tried riding this summer. ended up with more pain from the left knee. Turns out in order for me to ride a bicycle the seat has to be higher so I don't bend the knee as much. Hope to try this, this summer.
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    Re: Knees, knees, knees - PAIN!
    « Reply #21 on: February 07, 2014, 19:51 »
    Hope that works for you :)
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    Re: Knees, knees, knees - PAIN!
    « Reply #22 on: February 07, 2014, 22:35 »
    Sounds like an ITB issue

    Illiotibial band - don´t google it the information you will read is wrong

    when the fascia is tight due to muscles in the hip it compresses a fat pad and nerves which gives you the pain, and this pain and tightness changes the biomechanics of the knee in cycling - saddle height is an issue here as well if too high , but so is a weak core and that rocking you get when tired.

    here is your treatment plan

    Core training - lots

    Ice 20 min after cycling

    reduced cycling Km for a while

    Lower your saddle height a little, stop rocking on the bike from the hips.

    Stretching 3 times a day 3 times per leg 25 sec per stretch







    do this one standing with the bent/front leg on a desk



    4-5 min massgae use a tennis ball if you do not have a roll

    let me know how you go

    excellent :D
    I do this stuff and if I get lazy and don't use the foam roller I get punished with little niggles….
    also when cycling concentrate on an even stroke and don't get in the habit of 'smashing' the pedals down…..should be a nice smooth all-round movement.
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  • 42x16ss

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    Re: Knees, knees, knees - PAIN!
    « Reply #23 on: February 11, 2014, 03:44 »
    I can only back up what JSG said about the physio. I have been lucky enough to know some superb physios from my time at QAS when I was younger and they've helped me out hugely over the years.

    The OP should get an assessment and bike fit done to see how they fit the bike and how the bike fits them. You would be amazed at the little things that they can pick up.

    The stretches and exercises recommended above are great - I do them all at least 1-3 times a week - but if you are having ITB issues I would also recommend a "Spiky Ball" :D

    http://thumbs4.ebaystatic.com/d/l225/m/m9Mful5RB8EFZDx1Lgz8j1g.jpg

    These are great for releasing ITB's and Glutes ;)
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