[dcdavis]

Hello, My stocker (wife) is experiencing knee soreness. We rode for about two years and she was fine then this last summer she started have problems with her knee. She is experiencing pain after about 20 miles. in her right knee. The pain seems to be on the outside front. We can adjust the seat but would like opinions on direction up? down? foward back. Anybody had experience with this?

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[galen_52657]

I think the rule of thumb is outside pain - seat to high, inside pain, seat to low.

[TandemGeek]

This article may be of some value to your research:
http://www.cptips.com/knee.htm

[SDS]

Sounds like it could be patellofemoral tracking syndrome, aka PFTS, PFPS, PFS. The quads are dragging the patella to the outside of the groove in which it is supposed to track on the end of the femur, and that is causing pain.

Anybody can get it, but being female, petite, and having wide hips are all risk factors. All of these things put a sharper angle where the femur meets the tib-fib, and the when the quads pull on the patella, which is anchored at the other end to the tib-fib, it tends to cut the corner and track to the outside of the groove in the end of the femur.

What to do?

1. Seek expert help in identifying the problem and considering treatments. That's not me. After seeing a doctor, referral to physical therapy might result in prescribed knee-strengthening exercises intended specifically to help the patella track properly. Stretching and warmup are always a good idea.

2. Narrow the pedal spacing by getting a shorter bottom bracket and a double crankset instead of a triple. Wide pedal spacing is thought by some to be a risk factor for PFTS. I don't take this seriously, but where it imposes no additional burden and not much more cost, I do it on my bikes. I use triples, but I buy narrow triples and use short BBs consistent with leaving room for the chain to drop, and I push the cleats on the shoes to the outside to narrow the foot spacing, which is what we are really after.

3. Be very gentle. Stay off steep hills. Spin, and limit the mileage until she is fully recovered. That might take three months. Limiting the mileage means that as soon as it hurts, you gently crawl home, even if that means that you got less than a mile. It would be better if it never hurt. Over time you will be able to go farther and harder.

When you say on the "outside front", do you mean on the front, but to the outside, or on the outer side, but toward the front? On the front, but barely to the outside of center, is a description that could be consistent with PFTS.

I want to emphasize that I don't know a darn thing about knees, legs, pedaling, etc. No medical training at all.

[rivrider68]

Is she riding a pedal with maximum float. I switched to Speedplay Frogs and thankfully eliminated my knee pain on the bike.

[GotATandem?]

When my wife and I rode in the Seattle To Portland ride this summer, I began to experience a great deal of pain in the exact same area, but on my left knee. After riding 206 miles, I simply thought I had over done it. But we had put in hundreds of miles over the spring and summer in preparation for the STP.

Seeing a doctor, I learned about Patellar Tendonitis - inflamation and abrasion of the Patellar tendon that stretches over the top of the outside edge of the knee cap. It is caused by over development of two of the four quadracept muscles in your thigh muscles.

When doing a lot of riding, you tend to develop the two larger of the four quads faster than the others. This can cause the stronger muscles to pull the knee cap to one side or the other which creates a lot of stress on the tendon and draws the knee cap (patella) to one side and rub against the end of the femur (thigh bone) - voila! Lots of knee pain. The doctor recommended several excercises to strengthen the remaining portion of my quracept group - in addition to a strong anti-inflamitory med to get the initial swelling down and in prep for future long rides.

I would recommend a quick visit with the doctor to dicuss these items. Hope some of this helps. I have not experienced any more major occurances of inflamation since July.

Not to discredit a good bike fit either, I would double-check with a local bike shop about having someone look at your bike geometry and make sure it does in fact fit the rider.