I am looking for web sites that discuss knee problems for bicyclists and some of the adjustments
that can be made in seat position and height. Anything on the general physiology/forces would also
be helpful.

I have a recurring knee pain, localized lower inside knee cap. Doctors have told me that it is basic
degeneration (arthritis?). It seems to come and go, but is definitely aggravated by certain
positions. I am about to start a series of position changes to study what is at work and what makes
things better. Rather than just start randomly moving things around, I'd like a good orientation to
the basic issues.

Thanks.

On Sun, 22 Feb 2004 17:16:44 -0800, Dan Daniel <ddandan.remove@pacbell.net>
wrote:

>I am looking for web sites that discuss knee problems for bicyclists and some of the adjustments
>that can be made in seat position and height. Anything on the general physiology/forces would also
>be helpful.
>
>I have a recurring knee pain, localized lower inside knee cap. Doctors have told me that it is
>basic degeneration (arthritis?). It seems to come and go, but is definitely aggravated by certain
>positions. I am about to start a series of position changes to study what is at work and what makes
>things better. Rather than just start randomly moving things around, I'd like a good orientation to
>the basic issues.

Your problem is likely having cycling as your only form of leg exercise.

You're either a)only using your knees through the upper portion of their range of motion, and the
resulting muscular imbalance is likely pulling your patella to the outside, or b) have really weak
hamstrings, because cycling for most people emphasizes quadricep development. The solution for a) is
deep back and front squats in good form to strengthen your vastus lateralus, and for b) some leg
curls, time on the glute-ham raise (with weight), and some romanian or stiff-legged deadlifts.

--

Scott Johnson "be a man ,stop looking for handouts , eat ,lift and shut your mouth" -John Carlo

On Mon, 23 Feb 2004 01:57:43 GMT, Top Sirloin
<scottjohnson@imacrackho.kc.rr.com> wrote:

>Your problem is likely having cycling as your only form of leg exercise.
>
>You're either a)only using your knees through the upper portion of their range of motion, and the
>resulting muscular imbalance is likely pulling your patella to the outside, or b) have really weak
>hamstrings, because cycling for most people emphasizes quadricep development. The solution for a)
>is deep back and front squats in good form to strengthen your vastus lateralus, and for b) some

But with the pink dumbells, right? You don't wanna get muscle-bound, or too toned?

>leg curls, time on the glute-ham raise (with weight), and some romanian or stiff-legged deadlifts.

Actually at the end of each ride, which is near a wooden bridge near my house, I do a bunch of BW
squats, calf raises, and holding onto the rail, stretch out to a full 'good morning' start position,
arms straight, and then a ham stretch. Makes good sense about the imbalance. This is in addition to
my workouts at the gym, by the way... ;-)

I'd suggest that this is not too common, b/c lots of ppl do mostly bike for their legs. But if you
have symptoms, good place to look. Most ppl immediately think the clips are torquing the lower leg
or overuse.

I might add...Do NOT believe the docs who say you have arthritis.

<rant> All orthopods are morons. Orthopedic surgeons only want to replace your joints or cut on you
to buy themselves big screen TVs and Benzes.

The diagnosis of arthritis is _meaningless_ from a simple x-ray. You need -at least- two xrays, one
from your younger, normal knee, and the one they take at diagnosis. And you need an MRI, and at
least 3-4 alternate/additional opinions, especially if you're young and normally active. See an
arthritis specialist, a sports med doc, and a physical therapist. Here, Scott gave you a valuable
opinion, and one that a good physical therapist might give. They actually see and work with people
and often know more 'real-world' advise than a guy who spends his days in the OR.

All it takes is a thinner than normal cartilage layer for them to pigeon-hole you and say it's
arthritis for them, that's the -definition- of arthritis.

In addition, they will only tell you -after- you get your joint replaced that such surgery doesn't
guarantee you relief, recovery, or any freaking thing at all. In fact if they make a mistake and
replace your hip, but the problem was a pinched nerve or some spondylosis in your spine, they just
say 'oh, well, too bad for you'. <\rant>

Thx Scott.

-B

PS, someone else will chip in with the glucosamine - chondroiton info. ;-)

> I have a recurring knee pain, localized lower inside knee cap. Doctors have told me that it is
> basic degeneration (arthritis?). It seems to come and go, but is definitely aggravated by certain
> positions. I am about to start a series of position changes to study what is at work and what
> makes things better. Rather than just start randomly moving things around, I'd like a good
> orientation to the basic issues.

First, try something really simple and free. Assuming you're using clipless pedals, move your cleats
*back* (towards the rear of the shoe). This reduces the leverage that can be exerted on your tendons
& ligaments and can sometimes yield miraculous results. Absolutely nothing to lose for trying, and
it's worked for a lot of our customers (as well as myself, many years ago).

Second, you need to be aware that very few doctors have a clue about cycling. You need to find one
of the few that actually ride a bike... they *do* exist, ask around. Don't worry about finding a
"sports specialist." You want somebody who actually rides and understand what bikes are all about.
You ought to hear the stories some of our cycling Doctor customers tell... pretty amazing stuff.

--Mike-- Chain Reaction Bicycles http://www.ChainReactionBicycles.com

In article <0jki30tkkkim7ucmuseputnobrselglu76@4ax.com>, Dan Daniel
<ddandan.remove@pacbell.net> wrote:

> I am looking for web sites that discuss knee problems for bicyclists and some of the adjustments
> that can be made in seat position and height. Anything on the general physiology/forces would also
> be helpful.
>
> I have a recurring knee pain, localized lower inside knee cap. Doctors have told me that it is
> basic degeneration (arthritis?). It seems to come and go, but is definitely aggravated by certain
> positions. I am about to start a series of position changes to study what is at work and what
> makes things better. Rather than just start randomly moving things around, I'd like a good
> orientation to the basic issues.
>
> Thanks.

try the Knee guru- kneeguru.co.uk They discuss knee problems of all kinds and I found it to be very
informative.

On Sun, 22 Feb 2004 21:40:42 -0500, Badger_South <Badger@South.net> wrote:

>But with the pink dumbells, right? You don't wanna get muscle-bound, or too toned?

I like to bite chunks out of the pink dumbbells to scare away the thousand rep tricep extension
weenies. :-)

>Actually at the end of each ride, which is near a wooden bridge near my house, I do a bunch of BW
>squats, calf raises, and holding onto the rail, stretch out to a full 'good morning' start
>position, arms straight, and then a ham stretch. Makes good sense about the imbalance. This is in
>addition to my workouts at the gym, by the way... ;-)
>
>I'd suggest that this is not too common, b/c lots of ppl do mostly bike for their legs. But if you
>have symptoms, good place to look. Most ppl immediately think the clips are torquing the lower leg
>or overuse.

The muscular imbalance problem is more prevalent in people who push themselves to go faster,
because they're actually pushing down hard enough on the pedal to develop strength and
hypertrophyin their quads.

<snip excellent rant about medical professionals>

>PS, someone else will chip in with the glucosamine - chondroiton info. ;-)

Don't forget the fish oil - that did more for my joints than those two.

--
Scott Johnson "Always with the excuses for small legs. People like you are why they only open the
top half of caskets." -Tommy Bowen

On Mon, 23 Feb 2004 01:57:43 GMT, Top Sirloin
<scottjohnson@imacrackho.kc.rr.com> wrote:

>On Sun, 22 Feb 2004 17:16:44 -0800, Dan Daniel <ddandan.remove@pacbell.net> wrote:
>
>>I am looking for web sites that discuss knee problems for bicyclists and some of the adjustments
>>that can be made in seat position and height. Anything on the general physiology/forces would also
>>be helpful.
>>
>>I have a recurring knee pain, localized lower inside knee cap. Doctors have told me that it is
>>basic degeneration (arthritis?). It seems to come and go, but is definitely aggravated by certain
>>positions. I am about to start a series of position changes to study what is at work and what
>>makes things better. Rather than just start randomly moving things around, I'd like a good
>>orientation to the basic issues.
>
>Your problem is likely having cycling as your only form of leg exercise.
>
>You're either a)only using your knees through the upper portion of their range of motion, and the
>resulting muscular imbalance is likely pulling your patella to the outside, or b) have really weak
>hamstrings, because cycling for most people emphasizes quadricep development. The solution for a)
>is deep back and front squats in good form to strengthen your vastus lateralus, and for b) some leg
>curls, time on the glute-ham raise (with weight), and some romanian or stiff-legged deadlifts.

Ok, thanks. You're right. It's what the doctors have told me over the years- strengthen the
supporting muscles and the complete leg, and the stress on the joint will be less. Time to do these
exercises seriously.

On Sun, 22 Feb 2004 21:40:42 -0500, Badger_South <Badger@South.net>
wrote:

>On Mon, 23 Feb 2004 01:57:43 GMT, Top Sirloin <scottjohnson@imacrackho.kc.rr.com> wrote:
>

>
>I might add...Do NOT believe the docs who say you have arthritis.
>

Actually, I am not certain if that was the doctor's term. I might have heard her explain things in a
lot of words, gave a blank look, and mumble something like, 'Sort of like arthritis?" and she took
the easy way out.

><rant>

Luckily I haven't had any doctor push any surgical methods on me. The basic answers I have
gotten over the years haven't ever mentioned surgery- position, other leg exercises, rest, ice,
but no surgery.

On Mon, 23 Feb 2004 03:06:05 GMT, "Mike Jacoubowsky"
<mikej1@ix.netcom.com> wrote:

>> I have a recurring knee pain, localized lower inside knee cap. Doctors have told me that it is
>> basic degeneration (arthritis?). It seems to come and go, but is definitely aggravated by certain
>> positions. I am about to start a series of position changes to study what is at work and what
>> makes things better. Rather than just start randomly moving things around, I'd like a good
>> orientation to the basic issues.
>
>First, try something really simple and free. Assuming you're using clipless pedals, move your
>cleats *back* (towards the rear of the shoe). This reduces the leverage that can be exerted on your
>tendons & ligaments and can sometimes yield miraculous results. Absolutely nothing to lose for
>trying, and it's worked for a lot of our customers (as well as myself, many years ago).
>

Sounds worth trying. Thanks.

>Second, you need to be aware that very few doctors have a clue about cycling. You need to find one
>of the few that actually ride a bike... they *do* exist, ask around. Don't worry about finding a
>"sports specialist." You want somebody who actually rides and understand what bikes are all about.
>You ought to hear the stories some of our cycling Doctor customers tell... pretty amazing stuff.
>
>--Mike-- Chain Reaction Bicycles http://www.ChainReactionBicycles.com
>

I am not looking to doctors for the knee pain. I've been lucky maybe, but the few doctors who have
looked at it over the years have all been pretty consistent and sane. I see it as some position
tweaks and some off-bike exercises to be done.

If a few months of exercises and position changes don't do much, I'll find a physical therapist or
other 'specialist' to get things evaluated. The problem is annoying but not debilitating.

On Sun, 22 Feb 2004 21:40:42 -0500, Badger_South <Badger@South.net>
wrote:
><\rant>

<pedant> That's supposed to be '/', not '\'. </pedant>
--
Rick Onanian

On Mon, 23 Feb 2004 23:12:07 -0800, Dan Daniel <ddandan.remove@pacbell.net>
wrote:

>>Second, you need to be aware that very few doctors have a clue about cycling. You need to find one
>>of the few that actually ride a bike... they *do* exist, ask around. Don't worry about finding a
>>"sports specialist." You want somebody who actually rides and understand what bikes are all about.
>>You ought to hear the stories some of our cycling Doctor customers tell... pretty amazing stuff.
>>
>>--Mike-- Chain Reaction Bicycles http://www.ChainReactionBicycles.com
>>
>
>I am not looking to doctors for the knee pain. I've been lucky maybe, but the few doctors who have
>looked at it over the years have all been pretty consistent and sane. I see it as some position
>tweaks and some off-bike exercises to be done.
>
>If a few months of exercises and position changes don't do much, I'll find a physical therapist or
>other 'specialist' to get things evaluated. The problem is annoying but not debilitating.

Dan, the important thing to realize is that if you have an overuse problem, it will only get worse.
You may be wearing away parts of the joint structure, and if that happens, buddy, you will be in a
world of hurt. I'm trying to look out for ya, man, not be pushing anything.

If you ride clips, then take the other advice. You do not want to fsk around with your knees hips or
ankles. You need to find the root cause and fix it, not go that route. Please be careful. I messed
up my hip, and didn't heed the signs and I'm payin' for it in my 50s. If it were not for this
injury, I'd be out skiing and running and going nuts, b/c I have the body of a 35 year old,
otherwise.

Fortunately the biking his helping as is the Glu-Chond. Two days ago for the first time, after the
biking I was actually able to run up the steps from my basement. Back in August, I was limping up
and holding on to the wall! (yay, me)

-B

On Mon, 23 Feb 2004 14:24:47 GMT, blanshay@total.net (Marlene
Blanshay) wrote:

>In article <0jki30tkkkim7ucmuseputnobrselglu76@4ax.com>, Dan Daniel
><ddandan.remove@pacbell.net> wrote:
>
>> I am looking for web sites that discuss knee problems for bicyclists and some of the adjustments
>> that can be made in seat position and height. Anything on the general physiology/forces would
>> also be helpful.
>>
>> I have a recurring knee pain, localized lower inside knee cap. Doctors have told me that it is
>> basic degeneration (arthritis?). It seems to come and go, but is definitely aggravated by certain
>> positions. I am about to start a series of position changes to study what is at work and what
>> makes things better. Rather than just start randomly moving things around, I'd like a good
>> orientation to the basic issues.
>>
>> Thanks.
>
>try the Knee guru- kneeguru.co.uk They discuss knee problems of all kinds and I found it to be very
>informative.

Great site! Thanks. Going to take awhile to dig trough it....

On Tue, 24 Feb 2004 09:50:27 -0500, Badger_South <Badger@South.net>
wrote:

>On Mon, 23 Feb 2004 23:12:07 -0800, Dan Daniel <ddandan.remove@pacbell.net> wrote:
>
>>>Second, you need to be aware that very few doctors have a clue about cycling. You need to find
>>>one of the few that actually ride a bike... they *do* exist, ask around. Don't worry about
>>>finding a "sports specialist." You want somebody who actually rides and understand what bikes are
>>>all about. You ought to hear the stories some of our cycling Doctor customers tell... pretty
>>>amazing stuff.
>>>
>>>--Mike-- Chain Reaction Bicycles http://www.ChainReactionBicycles.com
>>>
>>
>>I am not looking to doctors for the knee pain. I've been lucky maybe, but the few doctors who have
>>looked at it over the years have all been pretty consistent and sane. I see it as some position
>>tweaks and some off-bike exercises to be done.
>>
>>If a few months of exercises and position changes don't do much, I'll find a physical therapist or
>>other 'specialist' to get things evaluated. The problem is annoying but not debilitating.
>
>Dan, the important thing to realize is that if you have an overuse problem, it will only get worse.
>You may be wearing away parts of the joint structure, and if that happens, buddy, you will be in a
>world of hurt. I'm trying to look out for ya, man, not be pushing anything.
>

I get you. I'm listening and thinking about all you (and others) have said.

>If you ride clips, then take the other advice. You do not want to fsk around with your knees hips
>or ankles. You need to find the root cause and fix it, not go that route. Please be careful. I
>messed up my hip, and didn't heed the signs and I'm payin' for it in my 50s. If it were not for
>this injury, I'd be out skiing and running and going nuts, b/c I have the body of a 35 year old,
>otherwise.
>

Yep, hitting 45 I am more and more aware of permanent damage. If I don't take it seriously now, it
won't give me any choice later.

>Fortunately the biking his helping as is the Glu-Chond. Two days ago for the first time, after the
>biking I was actually able to run up the steps from my basement. Back in August, I was limping up
>and holding on to the wall! (yay, me)
>
>-B
>

Definitely YAY you. Congratulations. Thanks for taking the time and hopefully save me and others
some of the pain you have gone through. Glad to know that the biking has helped your hip
problems so well!

"Dan Daniel" <ddandan.remove@pacbell.net> wrote in message
news:0jki30tkkkim7ucmuseputnobrselglu76@4ax.com...
> I am looking for web sites that discuss knee problems for bicyclists and some of the adjustments
> that can be made in seat position and height. Anything on the general physiology/forces would also
> be helpful.
>
> I have a recurring knee pain, localized lower inside knee cap. Doctors have told me that it is
> basic degeneration (arthritis?). It seems to come and go, but is definitely aggravated by certain
> positions. I am about to start a series of position changes to study what is at work and what
> makes things better. Rather than just start randomly moving things around, I'd like a good
> orientation to the basic issues.

I do a lot of long distance riding and I'm over 50. I've found that my knees (fortunately pretty
injury free) are extremely sensitive to toe-in(out) settings on my cleats. I've also found they're
somewhat less sensitive to cleat forward/back (like cleat back) and saddle height (that more affects
lower back). Occasionally, I get the classic "under the kneecap" twinges. When that happens, I do
the straight leg lifts that the sports med doc suggested 20+ years ago (patella tracking problem -->
tendonitis) when I had similar pains from running (which he suggested I stop, & I did). Although I
use pedals with relatively little float (SPD, ~4 deg), if I keep the cleats back (last position) and
toe in the maximum amount, my knees remain happy, even though I put a substantial (~2,500 mi/yr)
amount of riding on a fixed gear. Another thing to be careful about is to keep your knees warm, I
did a double century not long ago with bare knees and temps in the 40's, and my knees got very
unhappy. I'm also a believer in "vitamin I" (Ibuprofen), I think it's useful to prevent
inflammation, I take some before most long rides.

On Tue, 24 Feb 2004 07:44:02 -0800, Dan Daniel <ddandan.remove@pacbell.net>
wrote:

>
>Yep, hitting 45 I am more and more aware of permanent damage. If I don't take it seriously now, it
>won't give me any choice later.
>
>>Fortunately the biking his helping as is the Glu-Chond. Two days ago for the first time, after the
>>biking I was actually able to run up the steps from my basement. Back in August, I was limping up
>>and holding on to the wall! (yay, me)
>>
>>-B
>>
>
>Definitely YAY you. Congratulations. Thanks for taking the time and hopefully save me and others
>some of the pain you have gone through. Glad to know that the biking has helped your hip
>problems so well!

Well, let me moderate my response, b/c it's most likely that you have an easy problem to fix. Just
investigate and try to fix it is all I'm saying. Don't just be satisfied with 'it's minor, I'll live
with it'. <smile>

Just for you, mind you, one near geezer to another...here's a pix of me in late 2002 over 50! <bg>

http://www.pbase.com/image/18847396/medium

Thanks for the 'yay'. ;-)

-B