Fifty Plus (50+) - What have I injured?

A couple of days ago on a 50+ mile ride, I developed soreness near the inside back.. near the side.. of my left knee joint. It was most noticeable sweeping through the bottom of the pedal stroke and on the up-stroke when spinning. I can feel it when I just lift my left leg and flex the knee.

I rode a short 26 miler yesterday and still felt/feel the pain in that joint.

What have I injured? More importantly, how do I fix it? Just stay off the bike a few days?

I made a couple of small changes to my bike (and gear) prior to this injury. I installed a new Terry Liberator Y Gelissimo saddle (and discovered my old saddle was positioned too far forward) and added some partial inserts in my biking shoes that provide arch support. These changes provided greater comfort in the seat and a more comfortable and powerful (such as it is) spin on the pedals. I seem to have eliminated the hot spot issue I was having in the left foot.

Could the changes have contributed to the cause?


http://i27.tinypic.com/j979lf.jpg

http://i31.tinypic.com/11kgi1t.jpg

Could the saddle be a tad high by chance? Have you ridden more hills in a harder gear?

Lower the seat 1/2 inch. I had the same problem.

Yes, it could be the result of hyperextension, in which case a lower saddle position should help immensely. Ordinarily, I would lower it a few mm at a time, but perhaps 10 Wheels's 1/2-inch recommendation is sound in this case. If lowering the saddle solves the problem, then re-raise it very gradually to find the best height for you.

I'm with these guys re saddle height. I had a similar problem earlier this year. Depending on what you may have done, it may take a while to resolve.

I'm with these guys re saddle height. I had a similar problem earlier this year. Depending on what you may have done, it may take a while to resolve.

+1

I have similar trouble with my ACL (outside rear of Knee). My problem arises when the seat is too low; however, since you moved the seat back, it may have had the effect of "raising" the saddle height. Tinker with lowering a bit at a time. If that doesn't resolve it, you might try going the other direction.

You might want to have someone else watch as you ride. Our bodies -- mine at least -- seem all too willing to somehow adjust to adverse conditions. Looking from the outside it's pretty easy to tell when your position is somehow out of wack.

Thanks for the suggestions guys. Never considered seat height. The new saddle may be a bit thicker than the original Bontrager that came on the bike. Combine that with the rearward shift of the saddle and maybe that could explain the cause.

Using normal saddle height assessments... heel on pedal at bottom of the stroke... I thought I was positioned correctly (but I didn't change the height from the old saddle).

Interestingly, I'm at the beach right now... rented a bike here... beach cruiser with platforms... rode it 5 miles or so to the beach house and no pain at all. (wish I could rent something here with some drops... or at least flat bars on it, but no joy.) But I can't pedal it like my bike with clipless pedals either.

I'll work on that seat position when I get home and will report the results back here.

I suspect you have strained your illiotibial band (ITB) and the cause may well be the altered position of your foot in relation to the pedal caused by the new inserts. Effectively, the arch supports are forcing your foot to tilt out and downward. I don't think saddle height has much to do with it. In addition, are you a masher or spinner, or as observed by another, have you been pushing high gears uphill (you mention "more powerful" in relation to your pedalstroke)? Pushing harder gears or mashing will exacerbate the problem.

As to treatment... as with all these sorts of strains, correcti the cause, then rest. There are stretching exercises on the net for the ITB. If you mash, or are intent on "powerful" pedal strokes, return to spinning wiht lower gears. The ITB contributes to things like shin splints, and once you start having problems with it, it takes some patient work to fix it.

I used to develop shin splints when I'd work out on the treadmill with a pretty good slope. This isn't anything like that. I never was able to get away from shin splints once they started occurring, no matter how long I took betweek workouts (weeks). My only recourse was to lower the slope or limit the time. However, I recently did one of those 12 minute stress tests which uses a pretty good slope and in that time, did not experience any shin splints... but I digress.

When I say more powerful, I'm referring to feeling like my spin is more effective overall and that it feels like I'm able to put more power in for a longer time than before (again, all things are relative). Generally, I can only spin up fairly short hills.

I don't think that I'm mashing higher gears as jppe mentioned. I used to consider 90 rpm as a top end redline. Now it's more like a bottom end redline unless I'm just cruising or grinding out a hill once I've run out of energy to spin up it.

Since I got my Edge 305, I can look back over a ride and see what my average cadence has been. Generally the average is in the upper 80s and sometimes it's in the 90s for my normal rides.

Regarding cadence, I'm finding that, more and more, 100+ works better for me on the hills I normally ride and I can generally spin up 3-5% slopes unless they are too long. Getting down to around 90 cadence is becoming uncomfortable... which I find is an interesting observation.

So to answer the question, I don't think I'm pushing harder gears or mashing.

One thing I've seen recommended is using wedges. But looking at the picture on the site:
http://www.excelsports.com/image.asp?item=Bike%20Fit%20Wedge%20Shims.jpg
no doubt exaggerates the view, but my knees stay pretty much parallel to the vertical axis of the bike. I don't think I am experiencing that sort of alignment issue.

Googling iliotibial band, the description found refers to the outside of the knee. My issue is on the inside rear of the knee.

PrarieDog? This sounds more like your problem than what I'm experiencing.

http://www.eorthopod.com/public/patient_education/6512/iliotibial_band_syndrome.html

http://www.emedicine.com/pmr/fulltopic/topic104.htm#section~Introduction
Try this condition, pes anserine bursitis/tendinitis.
The culprit for the knee pain is most likely the multiple changes you made to bike and shoes.
You may have to systematically reverse those changes one at a time to find the problem.
Good Luck.

http://www.emedicine.com/pmr/fulltopic/topic104.htm#section~Introduction
Try this condition, pes anserine bursitis/tendinitis.
The culprit for the knee pain is most likely the multiple changes you made to bike and shoes.
You may have to systematically reverse those changes one at a time to find the problem.
Good Luck.

I'll need this site translated into English. ;)

Reading the history section, it doesn't sound like what I've been experiencing. The pain I was experiencing came from a pulling motion with the left leg, not a pushing motion like arising from a seated position.