Knee Pain

[wbmorrison]

Stimulated by a commitment to do an MS150 ride, I've been back on the bike (borrowed...a size or so too small) for about 6 weeks, logging approximately 75 miles a week. I have noticed on harder rides (cadence 90+ / speed 15mph) my right knee, directly behind the patella, hurts. Not huge pain like a cramp, but it's noticeable. I'm worried about logging bigger miles on the MS ride in one month with this knee thing. I've never injured the knee that I can recall. I've thought about "glucosamine doping" but I'm wondering if anyone has some ideas. Could it be the bike being too small, even if I'm in a decent riding position? Would knee pain be symptomatic of having the saddle too low or too high? I think if anything, I"m too low.

 

[redstorm]

Hi wbmorrison,

I do not know about your specific condition, but I had been having some pain mostly on the kneecap during the start of this season. The pain was due to a problem with my position on the bike and it turns out that raising the seat a little corrected the pain for me. I do know that taking some Advil/Motrin reduced the pain for me. I stopped cycling hard for about a week to give my knee a chance to recover and I have been knee pain free since then.

alp!

 

[wbmorrison]

Originally posted by redstorm
Hi wbmorrison,

I do not know about your specific condition, but I had been having some pain mostly on the kneecap during the start of this season. The pain was due to a problem with my position on the bike and it turns out that raising the seat a little corrected the pain for me. I do know that taking some Advil/Motrin reduced the pain for me. I stopped cycling hard for about a week to give my knee a chance to recover and I have been knee pain free since then.

alp!

Great, thanks for the feedback! I sense that I am a little low on the saddle, so maybe that will help. I did pop a couple o' Advil...we'll see how that helps. Could be inflamation. Thanks again for the post.

 

[sathomasga]

Originally posted by wbmorrison
[...] bike (borrowed...a size or so too small) [...]

That's almost certainly your problem. Knee problems with beginning cyclists are almost always due to

1) seat too low (which a too-small bike almost guarantees)

2) trying to push too high a gear

As much as I dislike telling someone they need to spend money, you really need to get a bike that fits you. The pain you feel now is only going to get worse.

 

[wbmorrison]

Originally posted by sathomasga
That's almost certainly your problem. Knee problems with beginning cyclists are almost always due to

1) seat too low (which a too-small bike almost guarantees)

2) trying to push too high a gear

As much as I dislike telling someone they need to spend money, you really need to get a bike that fits you. The pain you feel now is only going to get worse.

Thanks. My bike arrives tomorrow! : I went through the process of getting measured and I'm confident we'll be able to dial this into my dimensions pretty well.

Interestingly, I also read on another thread (Knee Pain Revisited) that a guy noticed that he was "rolling" his knees outward while peddaling and was suggested that he point his toes in a bit to help neutralize that rolling action. (He referred to a photo of Lance A. doing that.) He said once he began doing that, his knee pain went away.

So, between a properly fitted bike, maybe pointing my toes a bit and keeping Advil in reach, hopefully the pain will go away!!

 

[zaskar]

Originally posted by wbmorrison
Great, thanks for the feedback! I sense that I am a little low on the saddle, so maybe that will help. I did pop a couple o' Advil...we'll see how that helps. Could be inflamation. Thanks again for the post.

i read a few days ago in a cycling book (most)
times if knee pain is in the front part of knee
the seat is to low, if its behind the knee its to
high, after having my bike fit the fitting guy
raised my seat and my legs started hurting
on the back side of my legs (speacily) back of
kneess after reading that i lowerd seat
and pain went away.also i had knee pain before
from the shoe and clipless pedals. you will get
things dialed in on your new bike.

 

[redstorm]

Having a properly sized and fitted bike is realyl important! But it can be a slow process from getting the bike and then having the perfect fit. For myself it took 5 visits to the bike shop to get the fitting tuned a little more each time. I started having knee pain and then elbow pain and then neck pain and now no pain This is also why it is really important to purchase a bike from a shop that knows what they are doing and not getting your dream bike at WalMart

 

[wbmorrison]

Originally posted by redstorm
Having a properly sized and fitted bike is realyl important! But it can be a slow process from getting the bike and then having the perfect fit. For myself it took 5 visits to the bike shop to get the fitting tuned a little more each time. I started having knee pain and then elbow pain and then neck pain and now no pain This is also why it is really important to purchase a bike from a shop that knows what they are doing and not getting your dream bike at WalMart

Totally agree. Working with the Bicycle Sport Shop in Austin, TX. Really knowledgeable and patient folks. Took measurements on everything, wrote 'em down and will "dial you in to within 1mm" in all areas. I'm really hopeful my knee pain is mechanical and geometric (bike fit) and not physical (bum knee).

 

[sathomasga]

Originally posted by wbmorrison
[...] I'm really hopeful my knee pain is mechanical and geometric (bike fit) and not physical (bum knee).

Good news!

I doubt you have to worry about that. With a properly fitted bike and reasonable technique, cycling is fine, even for bum knees. There's a lot of medical studies that show it, but I can speak from experience. I messed up my knee rather badly playing racquetball right out of college. Even today (I'm 41), I can't do any impact exercises (e.g. running) at all because of knee pain. Cycling, however, is no problem. And my wife, at least, would call me a serious cyclist. (I average between 150 and 250 miles a week.)

YMMV, but one thing I've found to be a real blessing is Speedplay X series clipless pedals. You can search the Web and this forum to find out more, but what's unique about Speedplay Xs is they have unlimited float. Float is the ability of the foot to rotate around the ball in the horizontal plane. So, with Speedplay Xs you can swing your heel to any angle whatsoever. (Think of grinding a bug after you've stepped on it.) Lots of folks with knee pain swear by them because they allow your foot to rotate to its natural angle instead of forcing you into an unnatural one.

One this topic, I wouldn't necessarily try to point your toes in. That may be a natural position for you, or it may not. (In my case, my feet naturally point out!) If you go with Speedplay Xs, then your feet will find their natural angle automatically.

Good luck with the new ride!

Stephen

 

[brandonbrown]

Sing on Brother(s)!

I've torn both ACLs in doing other impact sports and my doctor recommended cycling to me. I had one knee's ACL fixed and after all of the problems I've had with it I decided not to do the other (right) knee.

I have had some pains behind the patella as others have mentioned and the doc went in to scope it out, and basically said I had arthritis in the left knee (the one I had operated on).

Pretty sad for someone 36 to have arthritis already.

I can speak from experience though, if you keep up cycling and building slowly on your distances, you will be relieved to know that your knees will get *STRONGER* or at least the helper muscles around the knee that support it get stronger.

I used to take VIOXX, then Celebrex, and whatever medicine of the day was promising pain relief. After two years of riding I take *NO* medicines and feel great.

One other thing of note; does anyone have any experience with the Glucosamine/Chondritin? I've been taking it for over 4 years now and I haven't noticed any difference. I've experimented removing it for months and simply don't see anything that it is helping. Thoughts?

Good luck and keep cycling,

Brandon

 

[kokopuffs]

Either the dose of glucosamine is insufficient or it just doesn't plain work for you. Or, you knees are too far gone. Sorry.

Please keep in mind that the term arthritis is a general, non specific term. There are at least 10 - 20 different types of arthritides.

 

[brandonbrown]

Personally I'm taking 1500mg Glucosamine and 1200mg Chontritin and some amount of MSM.

Whatever arthritis I have/had is the type that hurts when performing physical activity!

 

[jgugelm]

I can certainly relate to the 'behind the knee' pain. I've been having a love/hate relationship with the local medical community for the past 5 months to figure out what is wrong with my knee. My symptoms are as you describe. The worst pain is what they call 'movie goers' knee. That is where sitting with you knee at a 90 degree angle for a couple of hours is very uncomfortable. I haven't been able to trace it to a specific cause although I had a couple of spectacular yard sales on my MTB this spring.

So, I went to my regular doctor who said I may have bursitis (fluid on the knee) or PFS (patella femoral syndrome). Got put on Celebrex for a month to no avail. Went back and got some PT prescribed. Tried that for 4 weeks to repair the PFS. BTW, PFS is when your knee cap does not track correctly in the groove with you leg bones and starts to eat up cartilage. PT helped a little but not enough. Finally got a referral to an orthopedic surgeon (OS). He took some x-rays and came to this conclusion: The good news is I don't need surgery. The bad news is I don't need surgery. Although the PFS seemed to be gone, there seemed to be some roughed up cartilage under my knee cap that will wear itself down in a few months with repetitive, low impact exercise ... biking! Which may be what got me in this mess in the first place.

If you think PFS may be the culprit, do some exercises that will strengthen you inner quads: leg lifts, low-angle leg extensions, etc. Google search on patellar femoral syndrome will give lots of leads. Otherwise, the OS said stretch the hammies lots, and keep working the quads. Also a steady diet of ibuprofen and ice to help inflammation. I also got a pro bike fit and put some wedges under my pedal cleats to correct a pretty good pronation problem I have (like most people).

The reason I drag on about this is the OS said he figures most of the non-trauma induced injuries he sees are repetetive motion types, of which PFS is a large part.

Good luck with it!

BTW, my 'injury' helped me convince my wife I needed a new road bike: 1) to keep me from hurting myself again on my MTB 2) to fix the problem biking caused in the first place!

 

[Brizza]

I have front of knee pain. I've never heard of PFS (patella femoral syndrome), but have been told by a Physio that my ITB is too tight. Massage, warm baths and stretching does make a difference and I have learnt to manage the pain.

Is this the same condition as PFS?

Brian

 

[jgugelm]

As far as I know, PFS and ITB are two different things. My basic understanding of difference in symptoms is as follows: ITB hurts along the front of the knee (below the knee cap). PFS hurts underneath the knee cap. Meaning it feels like the the back side of your knee cap is hurting.

 

[kokopuffs]

The ITB runs along the lateral thigh, as I recall.

 

[white_bison]

took me 6 weeks off the bike for my knee to recover. was not torn, as per the doctor, the cause was riding into the wind after a long winter. not good because i feel better now and summer is over. good luck, and remember when you start a season you are not superman.