Fifty Plus (50+) - Knee's, Arthritis, Cadence

This comes up often and I have an interest in this subject. I did a simple test on me. The bike has been in use for at least 10,000 miles and is set up as well as I know how. I use the bike on trails, roads and hydraulic resistance trainer.
The test changed one variable only: Cadence.
Speed was held at 16.7 MPH.
Cadence of 78 RPM resulted in knee ache after 20 minutes and I stopped that after 30 minutes. HR 114 max. The word ("ache could be called pain")
Cadence of 88 RPM resulted in relief of the ache in both knee's after 5 minutes and no repeat of ache. HR 122 max. Every 15 minutes I got off the saddle and do one minute at 18 MPH. Duration of this test was one hour. Water consumption was one liter per 30 minutes. No food consumption.
I am pleasantly surprised that spinning at light load removed the discomfort.
The reason for this test:
I observed that some European bikers on the XC tour pedaled at low cadence. Lower cadence does result into lower HR. I thought that I should check this out.
Some of you know that I have Arthritis in both knee's but that has not prevented me from going XC or doing 6 hours on a hydraulic resistance trainer.
Perhaps this is of some interest for the 50+ bikers?

Your results make sense to me. Lower load per work cycle = lower stress and less pain. I've found that, escpecially in cold weather, I need to keep cadence above 90 RPM to avoid any knee problems. In fact, I've tried to set up my gearing so that I don't have to drop into the 70 RPM range on anything but the most extreme climbs. Even then, I use a great deal of out of seat climbing to avoid stress on the knees. Finally, I try to never equate my technique with what a professional cyclist does for two reasons. Most are elite and have genetic abilities I'll never have, and many wear themselves out during their career and really don't cycle all that much after retirement.

Will - was the "knee pain" the basic patellar tendonitis? (in front over the kneecap as when you try to push too big a gear?)

I have my left knee removed due to arthritis and am sitting here recovering from an operation on the other.
Oh..... the first operation, 1975

I am European and prefer the High Cadence, low gear method.

On 3 or 4 month tours it is the only way I am able to keep going every day.

Pushing a Low Cadence, High gear would cripple me forever.

george

Will, have you consulted an othopedic doctor yet? Your knees
will eventually take you to an ortho guy so it might not be
a bad idea to work with one now to "manage" your knees
to avoid a premature knee replacment.

To me this is where the the smart money is.

(I had both knees replaced in 2003/04. My doctor helped me get
5 more years out of them before the surgury)

Most of us when we start or started riding- used a high gear and low cadence. In my case It was not that low except going uphills where I ran out of gears on the high gearing I had. When I got my first respectable bike with the Compact MTB crankset of 42/32/22 and a rear 7 speed cassette of 12/28- I found that I could actually cycle up those hills that I used to walk. Still had a problem on the flat bits though and I should think my cadence never went above 75/80. Over the years though- my cadence has gone higher and Now I am on the road bike- I only ever use the 52 front ring on downhill sections.

We have a cadence meter on the Tandem and we find that we are comfortable at 90. when we get to 95 we change up a gear and when we drop to 85 we drop a gear. Then there are still those steep hills and when we run out of gears we grind away till we get to the top. Only thing is that if we drop below 60 we have to speed up to keep the legs working.

I have arthritic knees too. I could not begin to tell you what the RPM of the crank is when I ride, but I can testify that using a lower gear and pedaling faster is much much MUCH better on my knees than going the same speed in a lower gear and pedaling "harder".

I too have arthritis and a lack of cartlidge in one knee - thank you high scholl football. After numerous scopes and a tibial osteotomy I am wating until 60+ for a knee replacement. I have over 2100 miles totalled this year and I find that a high cadence works for me rather than trying to push to high a gear. Also with the cool weather I find that I need an extra layer than most to keep the knee joint warm - I usually wear leggings once the temp hits 60 wer and the cooler it gets the thicker the leggings.

Will - was the "knee pain" the basic patellar tendonitis? (in front over the kneecap as when you try to push too big a gear?)

I was pushing too high a gear as you say. I like to call it more of an ache than pain. Pain to me is stinging which this was not. It is a slowly building up of internal ache which gets worse as I continue. I am amazed that this ache disappeared with the higher cadence. I am not kidding because I do not want to give bad information.
My knee's are such that I cannot jog 6 miles on pavement without repercussions.
However, I can pedal all day long at higher cadence.

Will, have you consulted an othopedic doctor yet? Your knees
will eventually take you to an ortho guy so it might not be
a bad idea to work with one now to "manage" your knees
to avoid a premature knee replacment.

To me this is where the the smart money is.

(I had both knees replaced in 2003/04. My doctor helped me get
5 more years out of them before the surgury)

Yes, I have consulted two such MD's. I was on crutches following a rock climbing accident. X-ray's and MRI showed nothing broken. The lineaments were stretched which causes the bones to grind. The MD said that nothing can be done except give me Vioxx. Would you believe that? Lucky that I am afraid of any pills and got off them ASAP thanks to many many hours of no load spinning.
I am pretty happy now. I can do 12 mile fast walk and bike all day long as long as I do nothing dumb like use a big gear. I am 65 and accept that I will get the typical problems most of us get.

We have a cadence meter on the Tandem and we find that we are comfortable at 90. when we get to 95 we change up a gear and when we drop to 85 we drop a gear. Then there are still those steep hills and when we run out of gears we grind away till we get to the top. Only thing is that if we drop below 60 we have to speed up to keep the legs working.

Yes, this is why I just got this new CF bike with triple crank. It is featherlight compared to my tandem.
Good thing my wife does not read these post's.:rolleyes:

Also with the cool weather I find that I need an extra layer than most to keep the knee joint warm - I usually wear leggings once the temp hits 60 wer and the cooler it gets the thicker the leggings.

Thanks for the tip. I did go in cold weather today and could feel it in my knee's. No big deal but it was not like on a warm day.

I'll chime in as a counter point to everyone else. My bike is set up with much longer gears. My small chain ring is a 52. I try to maintain a steady cadence, but it is much lower what is considered average. I do try to run in a combination that feels most efficient, and, so, by nature, I guess I minimize mashing as much as possible.

I ride 2200 - 2500 miles per year.

So far, no knee pain.

Doesn't make me right - just make me me.

For those of you with arthritic knees, I give you a lot of credit for keeping yourselves fit and continuing to ride. I'm no doctor, but, it seems natural to me that if you keep using those joints, they will do better than if you didn't use them.

I suppose my time is coming - so, I'll keep all this advice stored away for that day.

Caruso

A bit off topic but here goes anyway. I'm getting cortisone injections in both knees today. I'll ask the Doctor if I need to do anything different re: cycling, but does anyone here have experience or advice regarding this subject. I've not had any injections since starting riding early this spring (which is good, they used to be needed more frequently) so I really don't know. Thanks for any advice.

Hmm. I've been getting some knee twinges lately - that grow worse as the ride progresses. The pain is in the front kneecap but towards the inside of half. Now that you've reminded me I think I'll try a higher cadence - especially if I feel the first twinge. My goal has been 90 and I do tend to hit it; I haven't been monitoring lately so maybe it dropped.

My knees are Ok,but it's my hands,wrist,and elbows that give me trouble,sometimes my shoulder.That's why I'm so apprehensive on getting a new bike.It feels better for the most part when I get done riding but right now my hands a hurting a bit and when I get back they wont feel to bad.I guess just getting limbered up.Sometimes I cant do what I like,like a distance ride, but it still feels good just to get out.As far as a new bike, I'm going today and see what turns up.George

For those of you with arthritic knees, I give you a lot of credit for keeping yourselves fit and continuing to ride. I'm no doctor, but, it seems natural to me that if you keep using those joints, they will do better than if you didn't use them.

I suppose my time is coming - so, I'll keep all this advice stored away for that day.

Caruso,

In 1975 I had a bicycle accident at work. A large chemical plant. Chain came off the sprocket. Ended up with a torn ACL and meniscus in my left knee. Repaired in 1977. By 1990 the soft tissue had gone degenerative. Cleaned out in 1992.

The orthopedic specialist told me to get back on a bike. I could no longer enjoy hiking without the knee becoming inflamed.

Pedaling a bicycle helps to lubricate a knee joint. There is no circulation within the joint proper. Oxygen and food reach the soft tissue by passing through the membrane around the joint. Walking produces impact on the soft tissue in the joint. Pedaling gives the benefits of "feeding" the joint without the damaging repetitive impact on the soft tissue. It becomes a way of prolonging the usefull life of the soft tissue within the joint.

With the bike I can cover territory I would not have considered in just walking or hiking. Even with the degenerative left knee it is possible to cover 40 or 50 miles on a bike ride without irritating the damaged knee.

Body weight is important with damaged knees. Gaining weight increases the knee discomfort. Bicycling is a good way to loose weight.

Damaged knee caps do present a problem with pedaling. Changing the position of the foot on the pedals helps sometimes. Other times simply changing the angle of the foot during pedaling helps.
With bicycles you strengthen the muscles that support and guide the kneecap as it moves over the grooves in the bones of the joint. Strengthening and stabilizing the knee helps to prevent the common problem of repeated falls towards the side with the damaged knee.

Yes, I have consulted two such MD's. I was on crutches following a rock climbing accident. X-ray's and MRI showed nothing broken. The lineaments were stretched which causes the bones to grind. The MD said that nothing can be done except give me Vioxx. Would you believe that? Lucky that I am afraid of any pills and got off them ASAP thanks to many many hours of no load spinning.
I am pretty happy now. I can do 12 mile fast walk and bike all day long as long as I do nothing dumb like use a big gear. I am 65 and accept that I will get the typical problems most of us get.

Don't be to down on your doctor mate as he was following good accepted methods of "managing" your
pain. I understand why Vioxx didn't get it for you 'cause all that junk did for me was cripple me up
so bad in three days on it I could barely walk!:mad: (same for my wife). My doctor then put me on an
older well proven med called "ARTHROTEC" that really managed the pain very well with no side effects
at all. (my wife still takes it for her arthritis)

As long as you are mindful of the mechanics of joint loading you should do fine. I'm very glad to hear
that you did consult a doctor just be aware that no honest doctor will recommend a joint replacment
until there is NO other choice. It's a one way trip for them. all the best, mate.

A bit off topic but here goes anyway. I'm getting cortisone injections in both knees today. I'll ask the Doctor if I need to do anything different re: cycling, but does anyone here have experience or advice regarding this subject. I've not had any injections since starting riding early this spring (which is good, they used to be needed more frequently) so I really don't know. Thanks for any advice.

My rock climbing accident resulted into a bloody shoulder also. I could not lift a glass of water for one year after the accident. Nothing was broken. Just stretched lineaments and inflammation.
The fix?
Cortisone shots with repetitive LIGHT exercise using rubber bands and 3 pound weights. We are now two years later and I am about 90% of before the accident. I am continuing with the exercise because it seems the proper thing to do. Two times 15 minutes per day.
I do not know why the other MD's did not use cortisone on my knee. I am speculating that the Arthritis scared them off and did not want to give me a false sense of security which is what the cortisone would do.

I understand why Vioxx didn't get it for you 'cause all that junk did for me was cripple me up
so bad in three days on it I could barely walk!:mad: (same for my wife). My doctor then put me on an
older well proven med called "ARTHROTEC" that really managed the pain very well with no side effects
at all. (my wife still takes it for her arthritis)

I loved Vioxx and would go back on it in a heartbeat. I will have to look into "ARTHROTEC". I have not found anything that works very well for me that my gastroenterologist approves of since Vioxx and Bextra were taken off the market.



As long as you are mindful of the mechanics of joint loading you should do fine. I'm very glad to hear
that you did consult a doctor just be aware that no honest doctor will recommend a joint replacment
until there is NO other choice. It's a one way trip for them. all the best, mate.

Generally agree except there is never "NO other choice" for any surgery. It is just a matter of how bad the other choices are. If the alternative is death it is a no brainer, anything else is judgement call. Individuals may draw the line in different places regarding the level of pain they will or will not tolerate.

Pete

Hmm. I've been getting some knee twinges lately - that grow worse as the ride progresses. The pain is in the front kneecap but towards the inside of half. Now that you've reminded me I think I'll try a higher cadence - especially if I feel the first twinge. My goal has been 90 and I do tend to hit it; I haven't been monitoring lately so maybe it dropped.

I would do that ----AND-----study if the saddle is in the right position. Your leg should be almost straight in pedal down position and the knee more or less over the crank center on average. There are a lot of threads on this BF which claim that saddle position and proper bike size are very important.
I found the comfort of a size 58 bike to be dramatic better than a size 60 bike (for my size). I could not believe it. It is only 2 cm. That makes a big difference in ability to spin and keep even pressure on your knee.
I would avoid jerky push pull if I were you.
Suggestion: See if you can get your hands on a good loaner bike. Perhaps in a bike club? Or an accommodating LBS?

I will have to look into "ARTHROTEC".

Just checked and it has the same problems as ibuprofen and other NSAIDs (which work great for me, but I can't take them without aggravating gastric problems). So I guess arthrotec isn't the answer for me.

I currently use Celebrex, but it isn't as effective for me as Vioxx, Bextra, or any number of NSAIDs like ibuprofen.

My knees are Ok,but it's my hands,wrist,and elbows that give me trouble,sometimes my shoulder.That's why I'm so apprehensive on getting a new bike.It feels better for the most part when I get done riding but right now my hands a hurting a bit and when I get back they wont feel to bad.I guess just getting limbered up.Sometimes I cant do what I like,like a distance ride, but it still feels good just to get out.As far as a new bike, I'm going today and see what turns up.George

George, here is what I would do based on the information you provide.
1) Every morning I go through an exercise routine for 15 minutes to strengthen my joints. I use light rubber bands and very light weights.
2) Every night, if I do not go biking, I go on a trainer at a set speed and RPM. Every 15 minutes go off the saddle for a minute and pedal hard. Do it for one hour.
3) Before going to bed repeat #1.
Regarding a new bike: The new CF bikes are very much nicer to ride than older bikes. You may fall in love again.:)

I tried Celebrex and it did nothing for me at all.A buddy of mine couldn't walk at times and Celebrex did nothing for him as well.I asked what worked for him and it works for me too,Naproxen. When I really flare up I add Tramadol. You may not want the Tramadol, sometimes it really slows you down.Naproxen is like a strong Aleve.
I also just got back from a different Giant dealing and he did have bikes to fit.He seemed to think a large would work fine for me.There wasn't much difference between the two.The OCR 1 was $1100 marked down to $ 1000. I saw one on Ebay for $650. I'm not an Ebay fan but I just may try to get that one.It's a large and last years model with about 2 hundred miles on it.

Anyone experiencing stiffness, pain, and swelling in multiple joints would do well to check with a Rheumatologist.

Most of the posts in this thread have described pain in just one or two joints, and problems which can often be attributed to a particular injury. That is typical of Osteoarthritis, a condition often caused by mechanical wear and tear on the joints.

Stiffness, pain, and swelling in multiple joints, including hands, shoulders, and knees, are symptoms of Rheumatoid Arthritis. RA is a serious, chronic, autoimmune disease, and proper treatment involves more than exercise, heat rubs, and cortizone shots. It takes powerful meds and ongoing medical attention to minimize the damage it does. While there is no cure for RA, early treatment can reduce joint deformation and ameliorate some of the other bad effects of the disease.

I tried Celebrex and it did nothing for me at all.A buddy of mine couldn't walk at times and Celebrex did nothing for him as well.I asked what worked for him and it works for me too,Naproxen. When I really flare up I add Tramadol. You may not want the Tramadol, sometimes it really slows you down.Naproxen is like a strong Aleve.

About meds ... I have RA and was a real mess in the late 90s ... could barely walk ... needed help getting dressed in the morning. I was on a lot of Prednisone, but it was just not working for me. A change in meds turned everything around.

I'm off the Prednisone now and take Methotrexate, Arava, Plaquenil, and 20 regular aspirin a day. There are blood tests every month to make sure that stuff isn't killing me, but my quality of life is a *lot* better ... I can even ride a bike now! :D

I have RA and I'm on Methotrexate as well.

It's a ***** that the med's that help with OA make your stomach bleed unless you're really careful. Too bad Vioxx tended to make some people drop dead, it seems to work really well on OA at least for me. Now I only take aspirin and some Ibuprofen, both of which fit the bleeding stomash profile. My doc has me on Prilosec daily he says forever. So far so good. Honestly though, the cycling has made more difference in overall quality of life, especially the knees than any of the meds ever did.

It's clear this is NOT a dog board, otherwise the female dog word would not be starred out!

My doc has me on Prilosec daily he says forever.

I know it's easier said than done, but GERD symptoms can decrease or go away entirely for some if there is significant weight loss.

Besides the arthritis meds, the prilosec scrip is related to gastric and colon health. I had a colonoscopy done three years ago, they removed five (YIKES!) polyps. I had an upper gastric endoscopy done the same day. Three ulcers too. Doc says the stomach acid contributes to the risk for more polyps as well as the ulcers, so he says it's from here on out. I do not have any symptoms like heartburn or gastric reflux, just blessed with really good digestive juices I guess.