Touring - Tips for Knee Pain?

On my most recent tour about three weeks ago, I discovered that at the end of the first 70-mile day my right knee was bothering me a bit. I didn't think much about it until midway through the next day, when I was in so much pain that I nearly couldn't continue. I fought through it for the remainder of the tour, thinking I would heal later. Sure enough, after a few days of rest at home, the knee was fine. Through several shorter rides over the past few weeks, I have not been bothered by it. But last night on an admittedly too-fast 40-mile ride, I was in great pain again. I assume this is tendonitis; the pain is on the outside of the right knee. Has anyone had similar experience with knee pain? What did you do to address it?

Outside your knee, right where you can feel the top of your Fibula? Once it begins it hurts on every pedal stroke but is ok when you are just standing around? If this is the case then I'd say you are have ITBS.

Iliotibial Band Syndrome

Give some stretching a try and see if that helps.

What you might need to do (http://www.rice.edu/~jenky/sports/itband.html)

More reading to help you deterimine if I've got this right and what to do. (http://www.csuchico.edu/phed/atc/Projects/ITband/ITBFS.html)

Also, if you cant touch your toes while keeping your legs straight then work on that too.



Best regards,

Ron
Wasatch Mountain Range, Utah

I'm no physician or sports med specialist, but I do have somewhere over 100,000 miles of touring experience and have met lots of folks over the years. What I've noticed about knees in the last few years is that more and more people - young people - are have serious problems. I believe that there's a connection between clipless pedals and knee strain. My experience has been that few people touring with the old toeclips have knee problems - while many much younger people touring clipless do have problems. My guess is that - one - toeclips allow you to move your foot position slightly so that stress through the knee is never focused on the same exact spot and - two - that clipless pedals allow you to put too much stress on the upstroke. Anybody else have more info on this?? Best - J

Clipless pedals are far from new being technology. I was racing back in the eighties when Look hit the market with the first ones and it was something that just about all the racers and racer want-a-bees welcomed. I never had a problem with knee pain with either the ones that lock your foot in place or allow lateral rotation.

Improper saddle position is probably a greater source of knee pain than clippless pedals are. Yes, improperly possitoned cleats *can* cause pain but a saddle that's too high or too low almost always will.

It also depends on the individual and with record numbers of people coming to cycling, you'll have an increase in just about all the old issues. There were 1,400 viewers on this site when I looked earlier. I'll be interested to see how many of these new cyclist will still be at it Post Lance. There could be a flood of slightly used bicycles hitting ebay next summer, and a drop in the reported cases of knee pain.

Cheers

Just posted this to a similar ? over in the road racing forum, but it's easier to stick it here again than to send you over there:

http://www.cptips.com/knee.htm

Some good basic advice here. It's quick and easy to check your bike fit vs. the problem you are having--at least check before you shell out some serious $$$ for a doc.

Raise your saddle? Too low and you put strain on your knees. Does the bike even fit right? Is it set up right? Spin at 90 rpm (80-100). If you're grinding along at 60 rpm (pedal cadence) you are putting extra strain on our knees. Make sure your pedals give you enough "flat" so that your FEET and KNEES determine where you foot sit on the pedals not the cleats determining the angle. Ice your knee, then apply heat (warm/hot water from a bath tub faucet works MUCH better than a heating pad). Use this ice/heat cycle as part of your healing therapy; it helps flush out the cell fragments that are part of the inflammation. Take an anti-inflammatory AFTER you exercise (you want to know if you're making it hurt, not mask it). The anti-inflammatory AFTER exercise helps healing (along with ice/heat)(at least some of the pain is probably inflammation -- reducing inflammation can help speed recovery). You may have some muscular issues that are causing problems, things that specific exercised can remedy. Depending on the actual cause, a patellar strap (Cho-Pat and Pro-Tec make some) can help your patella track better. (But, that may not be your problem.) You might need a diagnostic with a professional someone (not just the opinionated folks, here) to figure out exactly what is happening and why. Then you can work on specific fixes in addition to healing the injury.

I have 58 year old knees that have seen a LOT of hiking, backpacking, and biking miles. The stronger my legs are the better my knees feel and function.

I agree... I have had the same bike for over 10 years... did a lot of Single Track riding so the Saddle was lower then normal... Now I have made a commuter bike out of it... it took me forever to do the following:
Saddle Height
Saddle adjust forward/back
Saddle Tilt
Cleat adjustments on the shoes (forward/back/angle etc.)

I had the "sore knee" syndrome for a while, but a lot of "tweaking" did the trick.

Good Luck to ya


(oh yeah... you should see all the Marks on my seat post.. from trying 1/4 inch increments, Not to mention the marks on my shoes/cleats...it helps to have a starting point to reference)

Saddle height and handle bar to seat distance. Fool with both until it stops hurting. I just went through this exorcise on a new bike, the seat was about 1/2" too high, took about a week to figure out. Too low can be a problem as well.

With me the seat to high makes the top of the knee just above the knee cap to ache, with the seat too low I have problems in the mussel on top of my legs.

Joe

my second day on tour, I started to notice a bit of knee pain... on the third day, I raised my seat a quarter of an inch and it went away for the rest of the trip. Give it a try perhaps, analyze your posture and tweak from there. "Great Pain" should be nowhere in your vocabulary if you plan on doing a tour.

good luck
~Steve

If you haven't done your low gear spining intro for the year, and you get a burn like feeling under the kneecap, often nothing more complicated than working on the hamstring will solve your problem. Just stand in front of a heavy object you can hook your heel under, and lift. A couch works, or a partner. That trick has pulled my knees into form over the year, and you don't have to do it much to have an effect.