Training & Nutrition - Another sore knee query

I am trying to figure out a problem with my knee. At the risk of too much detail, here’s my story. 5’8”, 140 lbs, male. I did two years of racing in high school (until mono knocked me off the bike and college took all my time). I never had any knee problems. During the 90s, I rode little, but I started seriously again last summer—a wonderful way to get to know the German countryside. I ride about 200-220 kilometers a week. I am riding the same bike as before, but with SPD pedals rather than toe clips. Since I am still early in my season, I have using a higher cadence in low gears (105-115 rpms on the flats). I am avoiding hills at the moment, but I need to attack one on my way out of town—cadence in the 80 zone, and I’m pretty warmed up by then.

I have been tinkering with my saddle and cleats a lot, and seem to have solved a slight pain in the left knee. I had my saddle too high, but it seems about right now. But, today, at the end of a 62 km ride, my right knee was really bothering me. It hurts specifically on the inside, just about 90 degrees around to the left from the front. Vertically the pain lies mid to lower knee. On the bike it hurt more, almost a sharp pain, on the downstroke—logical, since that’s where the power is. It slowly got worse throughout the ride.

Any ideas? Various posts have suggested saddle height and position and cleat position as potential causes. True for my case? Any suggestions on pinning this down? I am getting a bit worn out with the constant cleat adjustments. I’d be astonished if it came from my high cadence work. But, one culprit could be that the weather only started permitting serious riding this month (I rode a couple of days in February). I jumped right away into my 200 km a week.

I am much obliged for any advice, comments, etc.

Cheers,
Jamie

Do your shoes/cleats allow some float?

Yes, the pedals allow 5 degrees of float (shimano SPDs).

But, I am not I have this float idea clearly. I have the tension set on the lower end (2 out of 5). I have the impression that my cleats click around in the pedals, but in an annoying, all direction, power reducing fashion. This does not feel like the side-to-side float needed for knee relief.

When I purposefully push my heal out slightly (as if to disengage), I can do it, but it requires more force than my foot/leg exerts in usual riding motions. So, if *this* is what is meant by float, I am not getting much benefit from it.

Is there something I don't understand? (I mean on this issue--there's lots in life I don't understand.)

Hmmm... idea: maybe I'll play with the tension and see what happens.

Thanks in advance for any imput.

Cheers,
Jamie

It doesn't sound like your knee problem is related to pedal float. But from your comment, it sounds like maybe your shoes might be interfering with the cleats.

Your description doesn't sound to me like the classic knee problems from saddle height or position. It might be a good idea to go to a trusted bike shop and get a second opinion about your bike setup and cleat adjustment.

It may just be that you've jumped in a little hard this early in the season. But knee pain should always be taken seriously. It would probably be a good idea to take an anti-inflammatory such as naproxen, sold under the name Aleve in the US, or ibuprofen, sold as Advil or Motrin in the US, before your rides. Maybe cut down on the distance, too, until you determine what's causing the problem.

Thanks, Roadbuzz, for your advice. I am going to remain around 200km a week for a while, instead of my planned increase.

I did some close evalutation of my foot placement on the pedals today. One thing that I eventually noticed is that I have been riding with my right knee rather far out to the side--John Wayne style. I think this is to compensate for my foot placement being not quite right. I now just have to figure out whether this means I should move the cleat to the left or the right. But, a little trial and error should sort that out. But, as soon as I was conscious of my Lone Ranger habit, I corrected it and noticed that a tension in my foot and lower leg was gone.

Thanks again,
Cheers,
Jamie

i had overuse problems with my knees about 2 years ago when i was racing a lot and really training hard...

but your problem sounds quite a bit different - i almost never had pain on the bike, but my knee would swell up the next day and i often had trouble walking the day after a big ride...

anyway, if you're serious about riding and training which it sounds like you are, consider going to a good bike shop and getting a professional bike fit - i'm the kind of do-it-yourself person, but after lots of encouragement from friends i forked out $40 for a bike fit --- the guy spent about 30 minutes measuring everything and i ended up with different cleat placement and a riser bar --- i think it was well worth the $$$

an anti-inflamitory (ibuprofen) usually helps

i later saw a bunch of orthopedists (i was convinced one leg was longer than the other - i do lots of running too) and most of them basically said i was super healthy and there was no problem - 'just take it easy and rest for a few weeks and then ride a few days a week' which was like a prison sentence for me...

anyway, i'm not a doctor, but my guess is one of 4 things:
1) your set-up is wrong (pedals, saddle, cleats, bars, etc)
2) you're either using bad technique (pedalling square instead of circles or pushin big gears, etc)
3) you previously injured your knee (like chipped the platella or tore a ligament that didn't heal right)
4) your body just can't handle the miles - the knee joint runs with the cartilage always rubbing and con only take so much abuse

if i were you i would do all i could to find out if the problem is the bike (get professional bike fit, then see orthopedist - try and find a sports specialist although that isn't guaranteed to help - my doctor was a running specialist but he still didn't understand the 'athlete' thing) or you can also try the most knee-friendly pedals -- the Speedplay Frogs which have like 20degrees of float although they're really hard to find in Europe (i'm looking for a replacement pair right now)

then if it's not the equipment, concentrate on your stroke and cadence and all that --- i'm not sure of the research behind this, but a sports-medicine guy told me that riding with the knees IN towards the frame rather than out like you described is better...

then, if none of this works, try ibuprofen... and worst case, is to ride less...

good luck - the knee's an amazing joint (the physics/mechanics are impressive and engineers still can't duplicate it as efficiently as the real thing - i mean robots here) but it sucks when it gives you trouble

I would not say I'm an expert... but, I have had both knees operated on (high school sports '74-'78), and both ankles damaged in a car wreck ('88).
First off, I take Motrin every day... and second, when a knee joint aches... slow down... period.

It is difficult to lay back when you want to ride, but it is the discipline(spelling ?) that will benefit in the long run.

By the way, I ride all year round... winters on my Lifecycle, and road and mtn. bike in season. At peak season I ride 700 miles a month. I also lift weights regularly... and I use my aches and pains as a gauge to what I do with my fitness program. And at 41 years old, I have plenty to live with.

If it aches... slow down. Otherwise you WILL have to stop riding.

Have your LBS assess your position in the saddle... they may be able to improve on it.

I am not an orthopedist, but I am 51 years old, your height and weight, and I have a history of kneecap dislocations. I like the little paperback, "Save Your Knees," by orthopedic surgeon James Fox. Do quad stretches (heel to buttocks), plus full-leg extensions (sit with the knees straight, bend them about 15 degrees, and re-straighten) to strengthen the vastus medialus, to stabilize the kneecap. Five degrees does not sound like enough float to me, but then my knees feel best when my heels barely clear the cranks. Above all else, use low gears instead of stomping high ones.

10-4... Where my cleats are set, my heels just barely touching the cranks as they pass by (at the insde float limit).

No matter how I'm feeling on any particular day... I force myself to stay in low gears... (except for major down hills.)

"He-Man" stuff will never improve you as a cyclist... everone responds differently to exercise.:beer: :beer: :beer:

Thanks all for the advice.

In the meantime, I think I may have solved this problem. I readjusted my right cleat before riding yesterday. I kept the angle the same, but set the cleat so that my foot is a couple of millimeters further back and about as close to the inside as possible. This actually matched more closely the positioning of my left foot. This helped a lot at making me feel like my foot was firmly on the pedal, which in turn almost naturally gave me a straight up and down knee action (with the knee close to the bar). Just a little added consciousness was all I needed to cure my leg-out habit.

In any case, I went out for a good 55 km yesterday, with no tension, no pain, nothing.

As I mentioned above, I am going to increase my mileage more slowly than planned. But, I want to make clear, I have *not* been pushing high gears. I have been been concentrating on high cadence (105-115) and that forces me to remain usually in my three lowest gears (42 x 20, 22, 24). Given this regimen, I was really astonished to find myself in pain.

Since I don't like my SPDs much, I am thinking about Speedplays, having heard how wonderful they are.

NathanK, for finding Speedplays, you may want to check out H & S Bike Discount here in Bonn. They have a website from which I think you can order (www.bike-discount.de). I have seen Speedplays on the website, but the last time I was actually in the shop I didn't see them.

Once again, thanks for all the advice. Cheers!