Training & Nutrition - Knee Problems and Bike Cleats

I'm not sure if those goes here or not, but I'll give it a try ...

The last few months I've been having knee problems while biking, and we've been having a really hard time diagnosing what's causing the pain. (MRIs and Knee Docs have no answers) I ended up seeing a physical therapist who noticed that I have really "loose" ankles (meaning they are really flexible due to a lot of sprains) which cause me to tweak my knees ever so slightly when I walk. He didn't think that it would really cause that much of a concern while walking, but it may possibly add up over time.

After he said that, I mentioned how I use the "red" moveable cleats while road biking, which allows more movement on the pedal than the fixed "black" cleat, and if what he was saying is true, my pedaling movements might be aggrivating my knees. He said he didn't know much about cycling, so he couldn't provide an definitive answer, but it was his thinking that the black cleats would be better for me because they would prevent me from torquing my knees around while pedaling on my "loose ankles".

Now it was always my understanding that the "red" cleats were the better ones to get if you had bad knees, BECAUSE they allowed you that free movement. My PT is saying the exact opposite for my case, but is the first to admit he doesn't know a whole lot about cycling. What he's saying makes sense though, so I'm hoping I can hear from a sports medicine expert that has a little more experience with cycling, and get thier opinion.

Thanks!

Were you fitted to your bike? The issue could be just the saddle position. When I just got in to cycling I got a "bike shop fit". Which was basically, some kid looking at me on the bike and saying "eh, good enough." When I started to ride more I had some serious issues with my right knee, which I injured couple years prior doing Martial Arts. After I got fitted by a professional the issue went away. As for cleats, well... The ones that don't allow the movement are actually a bit better, IF you have some one who really really knows what they are doing set them up and you can go back for fine tunning. That gets kind of expensive since most fitters charge the follow up fee. So the ones with float (you can move your foot side to side) are better since you don't have to be as precise in setting them up.

Saddle position might be the issue too. I originally had my seat set by the guy at the bike shop, and by doing some self-positioning using suggestions I found online. I had no problems with my knees at all for the first few months. Then, I had no less than 5 or so people tell me that my bike seat was too high, and I repositioned it an inch or two lower, and had the height confirmed by a different bike shop guy. I developed the knee problems sometime after that. Maybe I should take your suggestion, bite the bullet, and get a professional fit job done.

And if I do that, maybe I should get the black cleats installed before I get the pro-fit. Thanks for the advice!

Were you fitted to your bike? The issue could be just the saddle position. When I just got in to cycling I got a "bike shop fit". Which was basically, some kid looking at me on the bike and saying "eh, good enough." When I started to ride more I had some serious issues with my right knee, which I injured couple years prior doing Martial Arts. After I got fitted by a professional the issue went away. As for cleats, well... The ones that don't allow the movement are actually a bit better, IF you have some one who really really knows what they are doing set them up and you can go back for fine tunning. That gets kind of expensive since most fitters charge the follow up fee. So the ones with float (you can move your foot side to side) are better since you don't have to be as precise in setting them up.
+1. I am just getting into biking (about a year in). I got a bike shop fit on my new bike last fall and while I haven't had issues with my knees I am significantly increasing my mileage so I went for a professional fit. The fitter modified a number of things but I was most surprised that some adjustments to my cleat position made an immediate positive difference to how I feel on the bike. A knowledgeable fitter is very valuable.

It's the saddle height. One inch or two lower! OMG. It's a major deal to move the saddle 1/8". Start by setting the height this way: With your bike shoes on, sit on the bike while holding yourself up against a wall, table, etc. Get your butt into your normal spot on the saddle. Clip in one foot, Then with the heel of the other foot on that pedal, bring that pedal in line with the seat tube at the bottom of the stroke. Your heel should just barely touch the pedal with your knee completely locked out. Some people set it so that their heel doesn't quite touch the pedal, leaving about a 4mm gap. Try it with both legs. Don't rock your hips to "reach" for the pedal.

http://www.bikeradar.com/mtb/fitness/article/technique-how-to-get-your-seat-height-right-14608

Good info on "how to" for saddle height

Where exactly in your knee are you having the pain?

I recently tried the "black" look cleats and began having knee pain during one hour long session on the rollers. I am sure that they were not perfectly adjusted, I brought it up more just to point out how easily knees are bothered.

Yesterday I road my normal commuter bike to work. Right before I left the house for my 1 mile commute I swapped out my pedals (with toe-clips) for look pedals. I quickly noticed that the look pedals hold my foot higher than my other pedals, effectively lowering my seat.... I took the long way home (10 miles) and in that short period of time my left knee was feeling the difference!

Just my experiences..... for what they are worth.

and if you have never had a bike pro-fit it is worth it! I now find that I just cary the numbers and what I learned on to fit myself on my other bikes, but that first fit was crucial!

http://www.bikeradar.com/mtb/fitness/article/technique-how-to-get-your-seat-height-right-14608

Good info on "how to" for saddle height

I was going to look for this information later tonight. Thanks for the link.

I will always advocate going to a bike fitter with a spotless reputation. Did more for my knee issues than any single other intervention, though my PT helped some, too.

Saddle position might be the issue too. I originally had my seat set by the guy at the bike shop, and by doing some self-positioning using suggestions I found online. I had no problems with my knees at all for the first few months. Then, I had no less than 5 or so people tell me that my bike seat was too high, and I repositioned it an inch or two lower, and had the height confirmed by a different bike shop guy.

I developed the knee problems sometime after that.

You may have lowered the saddle too much.

Even if the saddle was lowered to the proper height - by lowering the saddle, it was MOVED FORWARD.

Remember - if the saddle is too far forward, it can cause similar types of injuries as a too-low saddle.




Maybe I should take your suggestion, bite the bullet, and get a professional fit job done.



Yes - and as you progress as a rider, go in for another fitting because the fit that worked for you as a beginner may not work for you as an intermediate. Also check the fitter for references.



And if I do that, maybe I should get the black cleats installed before I get the pro-fit. Thanks for the advice!

This is a horrible idea.

Even if the fitting goes perfectly, your knees will want some float at some point in your ride. Remember - you will be doing thousands upon thousands of repetitions (i.e. pedaling); to do so in the EXACT same position is begging for trouble.

Does this mean you should stay with the nine degree float of the red Look cleats (or even more float with some of the other pedal systems)? Maybe. Maybe not. You really won't know until you dial in the fundamentals with a proper fit. If you do a search, you will find some cases in which riders who went with alot of float also had knee issues; it's a basic case of too much being as bad as too little.

After three years, I switched from the grey cleats to the red last summer. When I became fatigued, my toes would drift and point to 10 o'clock and 2 o'clock position. This actually IRRITATED the tendons further. After a month, I switched back to the greys and made other adjustments (see comment below on prehab). This was a change for the better; but there was still a missing variable.

I'm now on Time RXS. As stated, it gives a little more float than the grey cleats of Looks. More importantly, it can be set up for as much as 2.5 degree lateral float (it's a subtle movement at the front of the shoes). Today was my first ride on 'em and my knees seem happier. I won't be able to make an objective comment until I put more saddle time in.

Now - and this is IMPORTANT - your ankles may not like the lateral play of the RXS. So for the time being, I suggest the following:

1) Do NOT ride until the fitting has been resolved. You will aggravate the knees and reinforce bad technique.

2) Consider the possibility of the grey cleats. Also research other pedals that offer slightly more. Time RXS gives 5 and Shimano has a 6 degree cleat. Speedplay also has different float options which you may or may not prefer.

3) Unless there is overwhelming information (to be determined by the fitter and your PT) to the contrary, stay the hell away from the black cleats.

4) When off the bike, focus your efforts on strengthening the ankles (as well as any other body part that is susceptible to injury). I call this prehab work and it is absolutely vital. For example, if you were to see me in the gym, you'll find me working on shoulder stability, core, adductors/abductors, hip flexors, hamstrings. In other words, you'll find me working on things that I need in order to improve as an athlete who has little or no down time. I also stretch daily and refined my nutrition. I'm also constantly searching for more information - as we all should.

5) Always work on pedaling in a supple and fluid manner. The French call this souplesse. Once you see a rider display this, everyone else will appear clumsy and oafish. Just because we're at our strongest in the downstroke does not mean you should neglect the second and third phases of the pedal stroke. You simply need to put in just enough effort so the downstroke leg is working more efficiently.

(There are cases in which you need to stomp down. When sprinting out of the saddle, you do NOT want to put effort into the back/up stroke as your rear wheel will fishtail. This, however, is a discussion on the art of sprinting...)

You may have lowered the saddle too much.

Even if the saddle was lowered to the proper height - by lowering the saddle, it was MOVED FORWARD.

Remember - if the saddle is too far forward, it can cause similar types of injuries as a too-low saddle.

Thanks! This makes sense. Hopefully all of this will be corrected by the pro-fit. I've tried the "heel to the pedal" sizing a couple of times, but i can never tell if I'm reaching down with my leg, or holding my hip up too much to "over-correct" the tendency to reach. Seems like everytime I try, I get a new seat height. Time to put this in the hands of a professional.



Even if the fitting goes perfectly, your knees will want some float at some point in your ride. Remember - you will be doing thousands upon thousands of repetitions (i.e. pedaling); to do so in the EXACT same position is begging for trouble.

Does this mean you should stay with the nine degree float of the red Look cleats (or even more float with some of the other pedal systems)? Maybe. Maybe not. You really won't know until you dial in the fundamentals with a proper fit. If you do a search, you will find some cases in which riders who went with alot of float also had knee issues; it's a basic case of too much being as bad as too little.

After three years, I switched from the grey cleats to the red last summer. When I became fatigued, my toes would drift and point to 10 o'clock and 2 o'clock position. This actually IRRITATED the tendons further. After a month, I switched back to the greys and made other adjustments (see comment below on prehab). This was a change for the better; but there was still a missing variable.


Great info here ... this is what i was looking for originally. Thanks! I think the Grey cleats may be exactly what I'm looking for. I'm having the same problem you are describing, where my feet tend to drift and point to 10 and 2, and it irritates the heck out of the inside and outside of my knee.

Thanks for the other advice as well. I'm already working on the majority of it (prehab, pedaling), it looks like most of my problems are fit and cleat related.

Someone earlier asked what parts of my knee hurt. The simple answer would be "everywhere". It's mostly the tendons on the inside, and somewhat on the outside as well ... plus the muscles and tendons above and below the kneecap. The kneecap itself doesn't hurt, and the back of my knee doesn't hurt. From the sounds of it, the pain on the top and bottom might be due to my saddle height. The pain on the sides might be due to the large amount of play in the Red Look cleats. I think some grey cleats and a proper bike fit will go a long way.

Someone earlier asked what parts of my knee hurt. The simple answer would be "everywhere". It's mostly the tendons on the inside, and somewhat on the outside as well ... plus the muscles and tendons above and below the kneecap. The kneecap itself doesn't hurt, and the back of my knee doesn't hurt. From the sounds of it, the pain on the top and bottom might be due to my saddle height. The pain on the sides might be due to the large amount of play in the Red Look cleats. I think some grey cleats and a proper bike fit will go a long way.

I was wondering where your knee hurt because I have had a similar expereince with my cleats causing knee pain. I injured my MCL about a year and a half ago playing hockey. Now when I bike with fixed cleats it aggrevates that area, but when I bike with platforms there is no pain. I will say though I don't think the knee aggrevation is completely from the cleats because when I really try to focus on pedaling with perfect technique it doesn't bother me as much.

Knees are the weak link in the legs - problems with alignment, flexibility, etc. typically will show up there if the problems are somewhere else.

If you're not finding the solution yourself, you need to find the best fitter in your area - if at all possible somebody who is also a PT.

It is true that some people do worse with cleats with more float.

I ride Speedplay pedals, and have since I started riding. I've only briefly ridden another type of pedal, and that was actually before I became a 'cyclist.'

I've had occasional pain in my knee(s). Sometimes due to saddle height issues, which I've been able to identify and correct with small tweaks. But one thing that I haven't gotten rid of is the tendency for my left knee to start hurting on the outside of the knee cap when I spend more time than usual out of the saddle. Interestingly, It's a similar pain as the one I get periodically while hiking/backpacking. I was thinking today about what I do to keep my knee pain from getting worse while backpacking, and realized that keeping my foot pointed slightly outward (duck footed) on that side keeps pressure off of the sore portion of my knee when it's under a load. It seems to me that the likely cause of the irritation is a twisting of my foot to the inside while under load. Do this too many times and it starts to hurt. Those of you who ride speedplays know that if you're not careful, your heals can rotate outward fairly easy while riding out of the saddle, effectively pointing your foot inward WHILE under load. I realized this today, and am seriously thinking about trying a pedal with more controllable float.

I feel like my knees track fairly straight while pedaling, especially when seated, and it seems that I may benefit from having better defined limits while out of the saddle.

I realize that this is not conclusive, and I'll hopefully be able to find a solution pretty soon, but I have a feeling that my 20 or so degrees of speedplay float is not only unnecessary for me, but could easily be causing some of my pain.

-Jeremy

I had knee pains on my road bike with Look Keo pedals. When I switched to SPDs, the pain went away. I made no other changes on my bike and it was professionally fit.