Knee Pain

Discussion in 'Cycling Training' started by hoolies1, Jul 14, 2003.

  1. hoolies1

    hoolies1 New Member

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    I am very new to cycling and am having quite a bit of knee pain. I switched my pedals to clipless and that's when I noticed the pain. What are the typical things I should adjust to make the pain go away? I tried raising my seat and adjusted the cleats slightly, but didn't seem to help. Any guidlines out there anyone knows of? Good articles? Etc?
    thanks!
     
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  2. coolworx

    coolworx New Member

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    I had the same problem. What solved it for me was adjusting my cleats so that my toes were pointed a few degrees inward when clipped in.

    What sorta ped/cleats are you using? SPD's? Look's?
     
  3. hoolies1

    hoolies1 New Member

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    I'm using Looks. The pain was mostly on the outside of my knee. So, inward, huh? I'll give that a try. I thought that I tried it straight, then one extreme (inward) then the other (outward). But maybe I need to try it again slightly inward. After I heal, that is. Tough sitting and standing today!
    :(
     
  4. J-MAT

    J-MAT New Member

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    Hoolies1:

    All clipless pedal systems force your feet into unatural positions. Let your foot dangle naturally off the ground. You will probably find that the outside of your foot is lower than the inside.

    This is called forefoot tilt and experiencing pain on the outside of the knee is not uncommon when you have this condition (most do) and clip into the pedals. The pedals force your feet to be unaturally flat, and this puts stress on the outside of your knee.

    Get some "LeWedges." They used to be called "Big Meat" wedges. They help to restore your natural forefoot tilt when you are clipped in. They come 8 to a pack, 4 for each side. They are small plastic wedges that fit under your cleats, and help to restore the natural tilt of your feet. Get them here:

    http://www.lemondfitness.com/bf/bigmeat.htm


    They say to start with 2 wedges on each side, but you may not feel much difference with just 2. I use 4 on each side, and am going to throw more wedges in.

    I've used them for a long time, and you can feel a small, but noticeable difference.

    Good luck!!!
     
  5. KEEBLER

    KEEBLER New Member

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    In your post you stated you were new to cycling. Have you established a good enough base?? Maybe its just the fact that you are riding too hard. It is essential to have a good base before starting to work harder, so that your ligaments and your KNEES dont start to have problems. Its just a thought.

    Keebler
     
  6. bomber

    bomber New Member

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    Sometimes knee pain is caused irrespective of the fitness base if you push too big a gear... whatever you level of fitness dont go out there and MASH huge gears in an effort to go faster it puts too much strain on the joint itself... i would also go and have a professional set up on the bike as that will make the world of difference to your riding!!! Hope that helps..
     
  7. Insight Driver

    Insight Driver New Member

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    I subscribed to this forum for the main reason of learning all I can. This subject interests me. I'm 50 and only started riding on a paved trail about 6 months ago. I started with a recumbant bik. About a month ago I switched to a decent road bike.

    I notice knee pain after about 15 miles of riding. Depending on how I am spinning, it makes a difference which knee or both knees. I use SPD cleats.

    I was assuming my pain was due to my age.

    I'm currently at this fitness level: maintain upper heartrate for my age/weight while riding 20 miles at average speed of 15 mph. Mostly level paved trail along a river.
     
  8. MNJRC_Berko

    MNJRC_Berko New Member

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    Well, this is why we have Junior gearing.

    Youre probably pushing too big of a gear, gear down, high cadence.
     
  9. DurangoKid

    DurangoKid New Member

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    Here's a short list of knee related suggestions:
    * Get the bike refitted, attend a fitting clinic if you can find one
    * Pedals with some freedom of rotation (Look)
    * Smaller gears, bigger cadence
    * Existing knee damage
     
  10. Ssushi

    Ssushi New Member

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    I've had the knee pain thing a lot over the last few months and taken advice from peeps on this forum. It seems to be working and my knees are showing improvement. My advice would be:

    1) Spin fast and avoid the hard gears.
    2) Do not climb hills (until things are sorted)
    3) Set up your cleats correctly and use peddles with float (Look peddles are great as you can select your float angle).
    4) Train on an indoor trainer to get some good base miles in (no hills, no wind - you chose the conditions).

    Good luck!

    Ssushi
     
  11. Brizza

    Brizza New Member

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    I experienced knee pain a few years ago and a physio told me that my ITB (down the outside of my leg, into the side of the knee connecting to the Patella) was too tight. I used massage and stretching to manage it.

    I have been doing some training for power recently as I get swamped when the pack 'surges' or during sprints.
    I had my ITB pain last night at the Velodrome doing standing starts. I also had the pain this afternoon while standing up from my desk.
    Can anyone tell me how they have managed their ITB problem?

    Thanks

    Brian
     
  12. bigmonkey

    bigmonkey New Member

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    VERY IMPORTANT EXERCISES / THEORY FOR THOSE WITH KNEE PAIN


    Most exercise like cycling/ runnnig uses quadriceps power with the knee bent at least 5-10 degrees. The majority of power comes from the outer side of the thigh. This power pulls on the knee cap from a few degrees off centre. This off centre / asymetric pull is counterbalanced by the medial thigh muscle( the rounded bulge of muscle above the kneecap on the inner side of the thigh. This short muscle pulls at quite an angle to the knee cap and serves to counteract the outward pull of the long, powerful outeraspect muscles.

    The problem is that the small counteracting muscle is much less effective when the leg is bent relative to a straight leg. ( we are designed to walk on our hind legs with pretty much straight legs) If the majority of exercise is undertaken with running or cycling then the small inner muscle can receive very little attention and will become relatively weak. it's counterbalancing function will quickly be overcome by the power of the rest of the quads group of muscles. This can lead to asymetric pull of the kneecap and PAIN. This can be from tendon strain or from exacerbation of chondromalacia or from the patela grinding on the surfaces underneath.

    Furthermore, strain of the short inner muscle can cause pain and strain whic can itself lead to loss of function/ relative nerve control loss in the muscle.

    Any problem with your foot/cleat postion will be magnified in this situation.

    THE ANSWER is that focused activity on this small inner muscle must be undertaken alongside standard training. This must be predominantly straight leg based involving a small degree of knee bend.

    You can see the effect of this if you use your indoor trainer. with your leg straight, contract your thigh muscles as tight as possible. you will see the bulge of the inner muscle above the knee cap on the inner aspect of the thigh. Feel how tight it is. Do the same with your pedal at the top of the stroke, with the leg bent, contract the thigh muscles (Without turning the pedals.) The inner muscle hardly does any thing.

    Now for a real test. Off the bike, sit on the floor with your back supported. Both legs outstreched in front of you. From completely relaxed, contract the thigh muscles as tight as possible. Notice how firm and tight the outer thigh becomes instantly. Also watch the direction of travel of the kneecap(Straigt up? or pulled outwards slightly?) Also watch to see how quickly the medial muscle contracts(any slight delay?) and how completely relative to the outer muscles.

    From this you should be able to appreciate the extent of the weakness and loss of nerve control in the medial muscle. You must train the inner muscle group to contract at the same instant as the outer group, and to pull on the knee cap for it to track straight up and down. Do this with the leg straight, on the floor. Contract the thighs as gradually as possible focusing on that inner group to match the outer. Also do intense leg straight, thigh contractions and hold for at least 10sec. Especially if there has been delay in the inner muscle contracting, any shorter and the inner muscle may not have reached it's peak contraction yet. Retrain the recruitment of the muscle. This should be incorporated into your daily routine. Once things are coming right, try and do the same exercises with slightly increasing knee bend. Then translate it to the pedal stroke. Appreciate that the inner muscles will have least power at the top of the stroke. So pushing over the top of the stroke to maintain power will exacerbate the knee pain in this situation.
     
  13. Aztec

    Aztec New Member

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    I ain't buyin' it. That's tooeasy of a solution to actually work. ;-)

    Could just as easily be tendonitis, no? Well, maybe not in David Spade's case since the pain is at extension rather than full flexion. Hmm.

    I've heard similar imbalance theories, usually centered around performing hamstring work like leg curls, or the hip abductor (I think that's the one -- where you bring your legs together).

    I'm suffering from a bit of pain now myself. Likely a combo of too big of gears too early and some belt squats done on top of knees already tender from the former. Stuuuupid.
     
  14. J-MAT

    J-MAT New Member

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    Brizza:

    Sorry to hear about your ITB problems. Standing starts are one of the hardest things you can do on a bike. They are very hard on the knees.

    You already have the answer to your problem, and that is a good stretching program. I've had all kind of knee problems (mostly from non-cycling)and ITB has hit me from time to time as well. I stretch daily, and it has by far been the most effective technique for keeping ITB away.

    Anyone who pushes hard will get some knee pain at some point. You have to know when to push, when to back off, and when it's ok to ride through an injury. I have actually found that the more time I take off the bike, the more pain sometimes creeps in. Riding tends to keep it away for me, even if I hurt my knee from riding. You just have to back off a little and let everything settle down.

    Dude, do your stretching and back off the intensity for several days. Get some of these wedges:

    http://www.lemondfitness.com/bf/bigmeat.htm

    I talk about these wedges whenever someone has knee pain. I've used them for a long time and swear by them. They make my knees a lot happier, and you might get a few extra rpm/watts from the improved stability in the knee joint. Hey Aztec, get some wedges also. If you are going to do heavy squats and time in the big ring, your knees need all the help they can get!!!

    Good luck!!!
     
  15. Aztec

    Aztec New Member

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    Man, that's some serious markup on cheap pieces of plastic and a few screws! I think they'd be easy to make using those tough plastic shims from Home Depot. Problem is that might not be the right angle...

    I'm going in for (another) pro fitting, this time on my actual frame, at UC Davis in August. Bringing a set of those along might be smart.

    I wonder if pointing your knees more inward achieves a similar effect. I think it does since it decreases the angle between the inside of you foot and your tibia. When I flatten my foot out, just sitting here, I get an uncomfortable feeling across the inside of my kneecap area.

    I bought some Carnac orthotics last week, which now that I think of it, might be doing something similar as well? I wonder... my knee pain stepped up a bit after using them my last two rides.
     
  16. Aztec

    Aztec New Member

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    Brizza -- What stretches did/do you do?
     
  17. J-MAT

    J-MAT New Member

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    Aztec:

    Yeah, those wedges have some markup on them, but I think it's worth it. For years, I made my own shims out of aluminum plate and plastic spatulas from Home Depot, but nothing really comes close to the Bigmeats/LeWedges. It is very hard to get the correct angles and that's what it's all about, correcting forefoot tilt.

    Your orthodics really can't do the job that the wedges do. You say you have noticed increased knee pain when your foot is flat. That's what happens when you clip in. Your feet are unaturally forced by the cleats to be flat, which placed undue stress on the whole knee.

    When you think of how many thousand pedal stokes you do on just an hour ride, it becomes critical to minimize correctable errors whenever you can. Even if you get fitted by experts, they still won't be able to correct your forefoot tilt. Only the wedges can do that.
     
  18. Aztec

    Aztec New Member

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    <<When you think of how many thousand pedal stokes you do on just an hour ride, it becomes critical to minimize correctable errors whenever you can. Even if you get fitted by experts, they still won't be able to correct your forefoot tilt. Only the wedges can do that. [/QUOTE]

    Hmm, good point. Makes a strong case for running HUGE gears for fewer revolutions! ;-)
     
  19. Brizza

    Brizza New Member

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    I did stretches for all the main leg muscles.

    Mainly Glut stretches, Vastus Intermedialis and Rectus Femouris stretches.

    I like the idea of building strength into the Varstus Medialis muscle to offset the pull by the ITB, but I'm not sure I would classify it as a small muscle.
    Leg Exentions at the gym hit that muscle specifically, I must get myself back into a gym.

    Brian
     
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