knees again

Discussion in 'Recumbent bicycles' started by Dh, Dec 8, 2003.

  1. Dh

    Dh Guest

    Could someone, preferably someone with a medical background, please explain why riding a recumbent
    causes knee pain. What exactly is going on? When I feel pain or stiffness, I figure something is
    damaged or irritated. I just want to know if I could damage myself. Thanks, DH
     
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  2. Ian

    Ian Guest

    > From: "DH" <[email protected]> Organization: @Home Benelux Newsgroups: alt.rec.bicycles.recumbent
    > Date: Sun, 7 Dec 2003 23:53:15 +0100 Subject: knees again
    >
    > Could someone, preferably someone with a medical background, please explain why riding a recumbent
    > causes knee pain. What exactly is going on? When I feel pain or stiffness, I figure something is
    > damaged or irritated. I just want to know if I could damage myself. Thanks, DH
    >
    >
    I think you should see a doctor, one of the reasons I only ride recumbent is because my left knee
    has been reconstructed and riding recumbent is one of the few things that does not hurt it, if you
    are getting pain then it sounds like you have damaged something.

    --
    Ian

    http://www.catrike.co.uk
     
  3. No I'm not a medical person nor do I portray one, however I do know that if you push too hard too
    soon when you are riding a recumbent you probably will have knee problems. Go easy until you built
    up the miles. Spinning for several hundred miles should probably do it. Spinning is a good thing no
    matter what you ride. When you've been off the bike for a few weeks it maybe necessary to get
    reconditioned. Newbies often get on a bent and push too hard climbing even small hills. This puts
    lots of pressure on the knees, since you are pushing back in the seat. One of the advantages of a
    conventional bike, you naturally raise off the saddle, this relieves the knee pressure. Almost all
    of us have gone thru this learning curve. This being said if you are experiencing extreme knee pain
    time to take a rest and see a doc. Recumbents are a great riding experience, but there are new
    muscle groups that need to be conditioned. Go easy, learn to spin, get your bike adjusted to your
    riding style, and you'll probably do fine. Denny in Sayre, Pa "Bent but not Broken"

    "DH" <[email protected]> wrote in message news:[email protected]...
    > Could someone, preferably someone with a medical background, please explain why riding a recumbent
    > causes knee pain. What exactly is going on? When I feel pain or stiffness, I figure something is
    > damaged or irritated. I just want to know if I could damage myself. Thanks, DH
     
  4. Mike Rice

    Mike Rice Guest

    On Sun, 7 Dec 2003 23:53:15 +0100, "DH" <[email protected]> wrote:

    >Could someone, preferably someone with a medical background, please explain why riding a recumbent
    >causes knee pain. What exactly is going on? When I feel pain or stiffness, I figure something is
    >damaged or irritated. I just want to know if I could damage myself. Thanks, DH
    >

    No medical background here, but no knee pain either. I've only owned my Tour Easy a couple of
    months, and my rides are anywhere from 5 to 50 miles. I've been careful to stay in gears that allow
    me to spin around 85-90 rpm's without pushing hard. Early advice here told me to look out for
    developing knee pain if using a 'mash-y' pedaling style on a bent.

    I rode the Hilly Hundred here in Indiana with only three weeks experience and had no knee pain. I
    was very slow going up those hills, and walked up several of the worst ones (well, more than several
    on the second day). I do still have pain in the hand I sprained (or broke?) that weekend, but it's
    not riding related, and getting much better these days.

    Mike Rice
     
  5. Edward Ing

    Edward Ing Guest

    It is either force strain, or repetitive strain injury.

    If it is force strain, you are probably pushing too hard and need to spin.

    If it is repetitive strain injury, you are either overextending the joint or over compressing it and
    the repetitive motion strains the tendon.

    For the repetitive strain injury, you have to check two parameters on the recumbent. 1) Leg
    extension, neither too short nor too long and 2) the crank length -- too short is okay but you lose
    power. If the crank length is too long, even though your seat distance is correct, and your extended
    leg is in the proper position, your other leg, the compressed leg is too compressed.

    If the crank is too short, you won't have the repetitive strain injury problem, you will just not
    get an effective leverage as a longer crank.

    "DH" <[email protected]> wrote in message news:<[email protected]>...
    > Could someone, preferably someone with a medical background, please explain why riding a recumbent
    > causes knee pain. What exactly is going on? When I feel pain or stiffness, I figure something is
    > damaged or irritated. I just want to know if I could damage myself. Thanks, DH
     
  6. Joe Keenan

    Joe Keenan Guest

    No medical advice here, but if the pain goes away after you've been off the bike, it might just be
    your "getting used to" period. Someone gave me that advice when I started on my recumbent and had
    some slight discomfort whereas I had none on my DF. In my case I was a "spinner" on both bikes. Pain
    went away after awhile.

    Good Luck

    Joe

    "DH" <[email protected]> wrote in message news:<[email protected]>...
    > Could someone, preferably someone with a medical background, please explain why riding a recumbent
    > causes knee pain. What exactly is going on? When I feel pain or stiffness, I figure something is
    > damaged or irritated. I just want to know if I could damage myself. Thanks, DH
     
  7. Skip

    Skip Guest

    "Ian" <[email protected]> wrote in message news:BBF96FC1.187BD%[email protected]...
    >
    > > From: "DH" <[email protected]> Organization: @Home Benelux Newsgroups: alt.rec.bicycles.recumbent
    > > Date: Sun, 7 Dec 2003 23:53:15 +0100 Subject: knees again
    > >
    > > Could someone, preferably someone with a medical background, please explain why riding a
    > > recumbent causes knee pain. What exactly is going on? When I feel pain or stiffness, I figure
    > > something is damaged or irritated. I just want to know if I could damage myself. Thanks, DH
    > >
    > >
    > I think you should see a doctor, one of the reasons I only ride recumbent
    is
    > because my left knee has been reconstructed and riding recumbent is one of the few things that
    > does not hurt it, if you are getting pain then it
    sounds
    > like you have damaged something.
    >
    > --
    > Ian
    >
    > http://www.catrike.co.uk
    >

    Are you sure the bike has been properly fitted to you? I get knee pain on both uprights and
    recumbents when my leg extension is too short. Even being off by a small amount causes pain after a
    certain point. It's the first thing I check and adding a tad more extension has always cured my knee
    pain. Other than that spin don't mash. See a physician with experienced in this area if the pain
    continues.

    skip
     
  8. Dh

    Dh Guest

    I appreciate all the responses, but am really interested in knowing (mechanically/biologically) what
    causes the pain when riding a bit too hard or a bit too long.

    I believe the bike fits me well. I have a slight to moderate break in my leg when biking and it
    feels natural.

    I really try to use the gears to keep things spinning, but sometimes you just need that extra burst
    of power and that's probably the wrong thing for me to do. I'll take you word for it that things
    will improve with time; _and_ if I have severe pain or chronic pain, I will see a doctor.
     
  9. Dh

    Dh Guest

    Edward, thanks for the info. Your answer was closest to the kind of info I was looking for.
     
  10. bentcruiser

    bentcruiser New Member

    Joined:
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    It is fairly easy to incur knee pain on a recumbent. It depends greatly on how you ride. A pedal masher may find it easy because there is no real stress on the body as on an upright bike. Thus the legs feel more confident to hammer the pedals. Some use their seat back to push off of giving the knees maybe too much confidence.

    I would however say that you should contact your primary care physician.
     
  11. Ian

    Ian Guest

    Edward Ing scribed with passion and wit:

    >
    > If the crank is too short, you won't have the repetitive strain injury problem, you will just not
    > get an effective leverage as a longer crank.
    >
    >
    >
    >
    > "DH" <[email protected]> wrote in message news:<[email protected]>...
    >> Could someone, preferably someone with a medical background, please explain why riding a
    >> recumbent causes knee pain. What exactly is going on? When I feel pain or stiffness, I figure
    >> something is damaged or irritated. I just want to know if I could damage myself. Thanks, DH

    Thinking more on this, there is also the question of "float" if you are using clipless pedals.

    --
    Ian

    http://www.catrike.co.uk
     
  12. Gary Mc

    Gary Mc Guest

    "DH" <[email protected]> wrote in message news:<[email protected]>...
    > I appreciate all the responses, but am really interested in knowing (mechanically/biologically)
    > what causes the pain when riding a bit too hard or a bit too long.
    >
    > I believe the bike fits me well. I have a slight to moderate break in my leg when biking and it
    > feels natural.
    >
    Lawrence Preble, D.C. gave a great analysis on knee pain on this list in the past. Let me
    quote it here:

    >>Here are a few basic suggestions concerning cycling-related knee
    pain which you may find helpful. I posted something similar to this on this NG, some time ago;
    however, this might be a good time to review some basics in assessing and preventing knee injuries.
    Just a second while I take off my helmet and put on my lab coat...There, that's better. The
    following information should not be construed as a diagnosis or prescription for anyone's particular
    injury and is meant as informational, only. Also, this information did not originate with me but is
    widely available from multiple sources.

    The knee is the most commonly injured joint in cycling. As injury is generally a problem of overuse,
    it is often seen in the cyclist just beginning a training program or early in the training season
    when the temptation is to do too much too fast. The most common causes are:

    1.) For a wedgie rider, faulty saddle height or for recumbent rider, faulty seat distance.
    2.) Pushing excessively high gears
    3.) Slow cadence in cold weather
    4.) Too much leg work in the gym. (Yes, some of us cyclists do some cross-training, and some
    do way too much. I'm guessing this is not your main problem.)

    One way to classify knee pain (and identify possible solutions) is to look at the location
    of the pain.

    Anterior (i.e., front of knee.) Reasons patellar tendonitis patellofemoral syndrome Causes pushing
    BIG gears - cadence too low saddle too low or too far forward foot too far forward on the pedal
    crank arms too long leg length discrepancy with seat set for shorter leg Possible solutions ride at
    75 rpm or higher raise seat (in small increments of less than 5mm) or move seat back move cleat
    forward 1 to 2 mm shorten crank arms by 2.5 cm set seat for longer, not shorter, leg with correction
    for the shorter leg

    Posterior (back of knee) Reasons hamstring/gastrocnemius neurovascular bundle Causes saddle too high
    or recumbent seat too far back too much pedal float leg length discrepancy with no correction for
    shorter leg Possible solutions lower seat (in small increments) or move seat forward limit float to
    6 - 8 degrees set seat for longer, not shorter, leg with correction for the shorter leg

    Medial (inner side) Reasons medial collateral ligament pes anserenus Causes cleat position too wide
    - foot held internally rotated excessive knee frontal plane motion too little pedal float Possible
    solutions narrow foot position by moving cleat outwards orthotic or wedge to correct foot alignment
    pedal float should be 6 - 8 degrees

    Lateral (outside of knee) Reasons iliotibial band degenerative lateral meniscus Causes cleat
    position too narrow - foot held internally rotated too little pedal float excessive knee frontal
    plane motion Possible solutions widen foot position by moving cleat towards the bike pedal float
    should be 6 - 8 degrees orthotic or wedge to correct foot alignment

    Treatment General Issues

    These are usually conditions that develop slowly over a number of days and are not emergencies.
    Likewise immediate evaluation by an orthopedic specialist is overkill. Immediate care is always
    available at a walk in clinics, but it is more productive to see your primary care physician or a
    sports medicine physician as the first step.

    Dealing with yourself will be the biggest issue. Competitive athletes and overzealous newbies have a
    "fear of rest" - and rest is probably the single most effective treatment. Peer pressure to continue
    to ride doesn't help.

    First Aid Ice, elevation, and resting the knee are all helpful.

    Rehabilitation Take a few days off and then begin a limited riding program - cut back mileage by 20
    - 30 % and spin at a high rpm and in a low gear for a week or two. And the same goes for leg work
    in the gym. Remember, if you push too hard, you just get to start over again. Mild stretching
    before and after the ride keep the muscles loose, and icing the knee after the ride may be
    beneficial as well.

    Drugs Tylenol or NSAIDs such as motrin are a good start. Motrin can be taken up to 800 mg 3 times a
    day for a few days, but then drop back to the recommended dose on the bottle. If you have a history
    of ulcer problems or develop GI side effects, either switch to tylenol (it helps pain but is not as
    good an antiinflamatory) or see your physician for one of the newer Cox-2 medications (Vioxx,
    Celebrex) which are much easier on the stomach.

    Prevention

    a.. Correct biomechanics - follow suggestions above
    b.. Consider a complete bike fit
    c.. Choose gears that allow a cadence of at least 75 - 80 RPM
    d.. Don't make big changes in your training program - increasing mileage by more than 10% a week
    is a risk factor for injury as is over zealous interval training.
    e.. Keep your legs covered in cold temperatures
     
  13. Dh

    Dh Guest

    > Thinking more on this, there is also the question of "float" if you are using clipless pedals.

    Ian, I am using clipless pedals.
     
  14. Dh

    Dh Guest

    Gary, thank you so much for that post! I will copy that and study it.

    Thank you, Dave Horne
     
  15. Dan Schaper

    Dan Schaper Guest

    Anyone have experience with the various gizmos (HostelShoppe has 2 types) that let one experiment
    with different pedal positions to simulate shorter crank lengths. I'm not sure I'm ready to shell
    out for a new shorter crank, but have been thinking about getting a set of these adapters to see if
    it's an improvement.

    Edward Ing wrote:
    > 2)the crank length -- too short is okay but you lose power. If the crank length is too long, even
    > though your seat distance is correct, and your extended leg is in the proper position, your
    > other leg, the compressed leg is too compressed.
    >
    > If the crank is too short, you won't have the repetitive strain injury problem, you will just not
    > get an effective leverage as a longer crank.
     
  16. Ian

    Ian Guest

    DH scribed with passion and wit:

    >> Thinking more on this, there is also the question of "float" if you are using clipless pedals.
    >
    > Ian, I am using clipless pedals.
    >
    >
    >
    Which pedals are they? How much float do they give?

    --
    Ian

    http://www.catrike.co.uk
     
  17. Dh

    Dh Guest

    These are just regular pedals with a large surface area, no clips. I don't understand your use of
    the word 'float' in this context. What does that mean?
     
  18. Gary posted below a good summary of some advice on knee pain from an earlier posting by Lawrence
    Preble. Much of this and more is available in a book that was recently mentioned in Bicycling called
    "The Knee Crisis Handbook" by Brian Halpern.

    I've read a lot on this subject, and while I didn't learn much new, the book did cover just about
    everything I've seen. In particular it mentioned the problem of knee cap alignment from muscle
    imbalance that is frequently overlooked (its not mentioned below for example.)

    For anyone new to the subject this book would provide a great review on this painful subject.

    Steve Christensen Midland, MI

    >The knee is the most commonly injured joint in cycling. As injury is generally a problem of
    >overuse, it is often seen in the cyclist just beginning a training program or early in the training
    >season when the temptation is to do too much too fast. The most common causes are:
    >
    > 1.) For a wedgie rider, faulty saddle height or for recumbent rider, faulty seat distance.
    > 2.) Pushing excessively high gears
    > 3.) Slow cadence in cold weather
    > 4.) Too much leg work in the gym. (Yes, some of us cyclists do some cross-training, and
    > some do way too much. I'm guessing this is not your main problem.)
    >
    >
    >One way to classify knee pain (and identify possible solutions) is to look at the location of
    >the pain.
    >
    >Anterior (i.e., front of knee.) Reasons patellar tendonitis patellofemoral syndrome Causes pushing
    >BIG gears - cadence too low saddle too low or too far forward foot too far forward on the pedal
    >crank arms too long leg length discrepancy with seat set for shorter leg Possible solutions ride at
    >75 rpm or higher raise seat (in small increments of less than 5mm) or move seat back move cleat
    >forward 1 to 2 mm shorten crank arms by 2.5 cm set seat for longer, not shorter, leg with
    >correction for the shorter leg
    >
    >Posterior (back of knee) Reasons hamstring/gastrocnemius neurovascular bundle Causes saddle too
    >high or recumbent seat too far back too much pedal float leg length discrepancy with no correction
    >for shorter leg Possible solutions lower seat (in small increments) or move seat forward limit
    >float to 6 - 8 degrees set seat for longer, not shorter, leg with correction for the shorter leg
    >
    >Medial (inner side) Reasons medial collateral ligament pes anserenus Causes cleat position too wide
    >- foot held internally rotated excessive knee frontal plane motion too little pedal float Possible
    >solutions narrow foot position by moving cleat outwards orthotic or wedge to correct foot alignment
    >pedal float should be 6 - 8 degrees
    >
    >Lateral (outside of knee) Reasons iliotibial band degenerative lateral meniscus Causes cleat
    >position too narrow - foot held internally rotated too little pedal float excessive knee frontal
    >plane motion Possible solutions widen foot position by moving cleat towards the bike pedal float
    >should be 6 - 8 degrees orthotic or wedge to correct foot alignment
    >
    >Treatment General Issues
    >
    >These are usually conditions that develop slowly over a number of days and are not emergencies.
    >Likewise immediate evaluation by an orthopedic specialist is overkill. Immediate care is always
    >available at a walk in clinics, but it is more productive to see your primary care physician or a
    >sports medicine physician as the first step.
    >
    >Dealing with yourself will be the biggest issue. Competitive athletes and overzealous newbies have
    >a "fear of rest" - and rest is probably the single most effective treatment. Peer pressure to
    >continue to ride doesn't help.
    >
    >First Aid Ice, elevation, and resting the knee are all helpful.
    >
    >Rehabilitation Take a few days off and then begin a limited riding program - cut back mileage by 20
    >- 30 % and spin at a high rpm and in a low gear for a week or two. And the same goes for leg work
    >in the gym. Remember, if you push too hard, you just get to start over again. Mild stretching
    >before and after the ride keep the muscles loose, and icing the knee after the ride may be
    >beneficial as well.
    >
    >Drugs Tylenol or NSAIDs such as motrin are a good start. Motrin can be taken up to 800 mg 3 times a
    >day for a few days, but then drop back to the recommended dose on the bottle. If you have a history
    >of ulcer problems or develop GI side effects, either switch to tylenol (it helps pain but is not as
    >good an antiinflamatory) or see your physician for one of the newer Cox-2 medications (Vioxx,
    >Celebrex) which are much easier on the stomach.
    >
    >
    >Prevention
    >
    > a.. Correct biomechanics - follow suggestions above
    > b.. Consider a complete bike fit
    > c.. Choose gears that allow a cadence of at least 75 - 80 RPM
    > d.. Don't make big changes in your training program - increasing mileage by more than 10% a week
    > is a risk factor for injury as is over zealous interval training.
    > e.. Keep your legs covered in cold temperatures
     
  19. Ian

    Ian Guest

    DH scribed with passion and wit:

    > These are just regular pedals with a large surface area, no clips. I don't understand your use of
    > the word 'float' in this context. What does that mean?
    >
    >
    Clipless refers to pedals that have cleats to attach to the shoes, float is the ability for the feet
    to move in the cleats while you are pedaling to mirror the natural movement of the joints, if your
    feet are rigid on the pedals then extra stress is placed on the knees, but I'm not sure how this
    works with platform pedals, which are what you have, comments anyone?

    --
    Ian

    http://www.catrike.co.uk
     
  20. "Edward Ing" <[email protected]> wrote in message
    news:[email protected]...
    > It is either force strain, or repetitive strain injury.
    >
    > If it is force strain, you are probably pushing too hard and need to spin.
    >
    > If it is repetitive strain injury, you are either overextending the joint or over compressing it
    > and the repetitive motion strains the tendon.
    >
    > For the repetitive strain injury, you have to check two parameters on the recumbent. 1) Leg
    > extension, neither too short nor too long and 2) the crank length -- too short is okay but you
    > lose power. If the crank length is too long, even though your seat distance is correct, and your
    > extended leg is in the proper position, your other leg, the compressed leg is too compressed.
    >
    > If the crank is too short, you won't have the repetitive strain injury problem, you will just not
    > get an effective leverage as a longer crank.

    I'm 5.7" on a Trice Micro and have recently switched from 170 to 152m cranks. I should have done
    this long ago, it only took a short while to adapt to, and cost me only $30 to try. Worth it to find
    out if it helps, IMHO.

    SteveC
     
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