Training & Nutrition - lots of knee pain when cycling; can't ride anymore

I gave up cycling a while ago because I was going bored with it, but also because I was having a lot of knee pain for up to several days afterwards. I even get knee pain when riding the stadionary bikes at the gym. Specifically, the pain is behind the lower part of my kneecap on my right leg (I'm right-handed BTW). I don't get this pain when I'm running or squatting or doing leg extensions, only when cycling. Is there anything I can do? Seat height? Toe position/angle? I use Look pedals w/ float on my bike and straps at the gym.

Pain behind the kneecap (I assume you mean the back of the knee) is usually caused by saddle height being set too high.

Pain behind the knee is from a saddle too high. But pain behind the knee cap but still on the front of the knee is due to a saddle too low. A too low saddle is the most common mistake I see people making. A good 80% of the recreational cyclists I see have their saddle way too low...we are talking inches here.

Your knee should be almost completely straight on the full downstroke. Do not set the saddle height so that you can touch the ground from a seated position! This is what most people do and will set the saddle too low. If you need to touch the ground, at an interesection for example, you just step forward and straddle the top tube.

Since this is only with your right leg, you may have a leg length discrepency which would require the use of a spacer under your cleat on the left leg or orthotics. You would set the saddle height for your longest leg(right) and put the spacer under your short leg. Since you get this pain on both the clips and clipless pedals I doubt that pedals are the issue.

Basic advise: get a bike fitting from a well-regarded bike fitting specialist.

Your riding position needs change over time, and it's good to have a pro get you into the proper position. It may involve tweaking saddle height, cleat position, crank arm length, saddle ramp angle, stem length and height, etc. - there are plenty of variables to consider.

But by all means, invest a little and get the pro fitting. Like a helmet, it's cheap insurance against a lot of future pain.

I think the fact that you are right handed makes the problem obvious - quit spanking the monkey while riding the bike! or set you saddle a bit lower. :p

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

Try a lower gear/higher cadence.

I wont give you any advice, just check with a physician. I had the same symptom and I was diagnosed with chondromalatia, nothing that a good stretch cant solve.

Ricardo

I wont give you any advice, just check with a physician. I had the same symptom and I was diagnosed with chondromalatia, nothing that a good stretch cant solve.

Ricardo

re chrondomacia . . . try spinning in low gears instad of pushing high gears. I doubt if any cyclist can avoid chrondo if they don't use it as feedback to change their riding style and try to transition to a lower gear with a higher cadence to go the desired speed. So, I recommend a computer with cadence which you also can use when the bike is on a trainer. :)

Not to dismiss the importance of appropriate (I hesitate to say "correct") seat and cleat positioning, but knee pain can result from other things, too...including simple overuse.

I'd certainly look into a "professional" bike fit, but let's hear about your training program or habits...maybe you are just biting off more than you (your knees) can chew.

My seat is high enough. I can't sit on the saddle and touch the ground at the same time, rather I straddle the toptube, clip in one foot, then stand on it to sit down.

I rode my trainer again yesterday for an hour (with the seat high enough and at 80+ rpm) and still had the knee pain.

I checked the link above and one of the recommendations is "move cleat forward 1 to 2 mm." I noticed that I have my cleat all the way back. So I'll try that for the next time I'm on my trainer.

My seat is high enough. I can't sit on the saddle and touch the ground at the same time, rather I straddle the toptube, clip in one foot, then stand on it to sit down.
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An easy way to check proper seat height is to clip out, and try and pedal with your heel. If your seat is high enough, your heel should just barely touch the pedal at the lowest point.

Also, adjusting your cleats may work. I was having the same problem, but with pai at the top of my kneecap on my right knee. Turns out the cleat wasn't back far enough. Slid it back, after about 2 weeks, the pain went away, and I was good as new.

Jeff

[QUOTE=mac]

I rode my trainer again yesterday for an hour (with the seat high enough and at 80+ rpm) and still had the knee pain.
QUOTE]

I use my hydraulic resistance trainer daily unless I find time and weather conditions to go biking.
I do 17 MPH on a trainer at 90 RPM. My knees hurt at 17 MPH and 80 RPM.
I do not have this problem road biking at >18 MPH.

An easy way to check proper seat height is to clip out, and try and pedal with your heel. If your seat is high enough, your heel should just barely touch the pedal at the lowest point. Yeah, this is a good easy test because it takes into account crankarm-length as well. It's also the minimum height of your saddle. Many road-racers use about 1/4" higher than that and track-riders can be up to 1/2" higher than the pedal.

ALso having the saddle too far back will also cause similar problems with pain under the knee-cap. The KOPS position is a good starting point. Remember to re-check your saddle height after sliding the saddle fore or aft.

I'd suggest riding without clipless pedals, get some platform pedals and try those with tennis-shoes for a while. This will give you the maximum amount of float in case you've got some sort of rotation thing going one that's being held tight by the clipless pedals.

I've had a patella racking problem for years. I have a similar pain that's just behind my kneecap. This never happened when I was a runner, and I'm pretty sure my saddle's at the right height.

I've been to physical therapy, tried lots of stretching, and blew money on an orthopedic quack. The only time I've felt no pain for any extended period was when I quit my desk job. I spent a few months working while stretched out on the couch, with my knees straight. Not a very helpful suggestion, I know, but if you work in a seated position you could try to change your position, stretch your quads more, and get up more often.

I hope you find a solution to your problem.

This is sort of interesting, about the patella: http://www.arthroscopy.com/sp05032.htm

Well, I moved my cleats forward and the pain greatly diminished when I rode my trainer for an hour on Sunday. :) So I rode my bike for the first time in a couple of months yesterday and had very little pain except when I was mashing up a mountain. So I think that was it. I used to always have my cleats forward, but when I got new shoes and/or my old cleats wore out, I just slapped on the new ones without much consideration.