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Clydesdales/Athenas (200+ lb / 91+ kg) Looking to lose that spare tire? Ideal weight 200+? Frustrated being a large cyclist in a sport geared for the ultra-light? Learn about the bikes and parts that can take the abuse of a heavier cyclist, how to keep your body going while losing the weight, and get support from others who've been successful.

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Old 05-29-09, 08:11 AM   #1
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Uh-Oh... knee pain

Well After 2800 miles, I am experiencing my first knee pains and it has me a little scared. I can't imagine not being able to ride my bike.

I first experienced it the day after a semi-vigorous ride, especially when I would get out of the saddle. It is in my left knee just above the knee cap and below the knee near the shin.

It went away the day after, but came back in the middle of yesterday's fairly vigorous ride. There was a point yesterday that I had to pedal with one foot because my knee was hurting so bad.

Nothing has changed in my bike setup so I'm not really sure what it might be.

I'm hoping a few days off the bike might do the trick. I am also icing it a lot.

Anyone have anything similar or any ideas?
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Old 05-29-09, 08:27 AM   #2
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Sounds like maybe stress fracture or a tendon issue. your current course of care sounds good, although it may be a couple of weeks as opposed to a week depending on severity.
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Old 05-29-09, 08:43 AM   #3
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I experienced a pain like that on the return leg of the MS150 last year and it hurt like heck. It took the better part of a month before it felt good again. I've had my eye on this particular device



from Cho Pat. https://secure.cho-pat.com/products/...roduct_type=10 If I get the pain again this year I am going to buy one of these. I admit that I am concerned about it sliding down but it looks like it would put pressure directly where I (and you) was experiencing knee pain.
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Old 05-29-09, 08:49 AM   #4
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You can also get pains like that if your seat is at the wrong height. Check to make sure that the post hasn't slipped.

Or, if your cadence is slow (as in less than 85 or 90).
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Old 05-29-09, 01:07 PM   #5
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http://www.sheldonbrown.com/pain.html

Quote:
Originally Posted by SHELDON BROWN
Knees
Cycling, done properly, is much less stressful to the knees than many other aerobic activities, since there's no impact involved. Nevertheless, knee injuries do occur, usually as a result of poor technique or position.

Gear Selection
A principal cause of knee problems is over-stress as the result of using too high a gear. For more on this, see my article on Gear Shifting.

Saddle Height
Another common cause of knee problems is incorrect saddle adjustment, particularly if the saddle is too low. See my article on Saddles for more details on this.

Cleat Adjustment
Some knee problems result from incorrect placement of shoe cleats. Everybody has a natural angle that each of their feet prefers to be at; some are duck-footed, some are pigeon-toed, whatever. When you walk or ride with plain pedals, your foot assumes this angle, and everything is hunky-dory. If you use cleated shoes and matching pedals, it is important that the cleat is adjusted so as to permit your foot to be at its natural angle. If your cleats are misadjusted, the resulting twist on your lower leg will affect the alignment of the knee joint, and cause serious problems.
This is less of an issue if you ride pedals with "float" (limited rotational freedom) in the cleat attachment. Most newer clipless pedals offer at least some float.

The N.E.C.A. Fit-Kit includes a cleat adjustment procedure called the "R.A.D." (Rotational Adjustment Device) which is very worthwhile for "problem" cleat fittings.

Lateral Movement--Chondromalacia
The knee joint is basically a ball-and-socket joint, with the ball at the bottom of the femur and the socket at the top of the shinbone. A common cycling-related injury is called "chondromalacia", and has to do with irritation of the cartilage pad in the "socket" which provides lubrication for this joint. Reputedly, an edge of this cartilage can get turned up and dog-eared, causing irritation and inflamation.
Chondromalacia is often blamed on lateral movement of the joint, and a common prescription is to strengthen the quadriceps muscles which run along the front of the thigh and along side the front of the kneecap. It is these muscles which provide lateral positioning for the joint. The usual exercise prescribed for this is to sit in a chair with one leg at a time held out straight, unsupported. Sometimes it is suggested to place a pillow or other weight on the foot for this exercise.

Something the doctors don't seem to think of suggesting, but which really helped me a lot, is to make a concious effort to avoid lateral knee movement during the pedal stroke. Watch your knees as you ride (in a low-traffic setting!) They should move up and down as you pedal, with no sideward motion. Many cyclists have a sideways hitch in their pedaling motion, which I believe is a major contributor to chondromalacia. If you pay occasional attention to this, it doesn't take long to train yourself to keep the knees in line.


Long Cranks
The longer your cranks are, the farther your knees will have to flex on each stroke. Different riders will have different amounts of flexibility in this regard, but riding with longer cranks than you are used to can definitely cause problems.
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Old 05-29-09, 05:34 PM   #6
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Quote:
Originally Posted by JoelS View Post
You can also get pains like that if your seat is at the wrong height. Check to make sure that the post hasn't slipped.

Or, if your cadence is slow (as in less than 85 or 90).
+1. Your knee should never hurt. Something in your seat/height alignment has gone awry.
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Old 05-29-09, 05:36 PM   #7
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I'll check out the seat height. I've been paying a lot more attention to my cadence since I recently bought a sensor, so it is certainly higher that what it used to be, but obviously that is a good thing.

Thanks for all the ideas.
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Old 05-29-09, 05:55 PM   #8
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Make sure to stretch out properly after a good ride too. My knees definitely let me know when I haven't stretched.
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Old 05-30-09, 11:31 AM   #9
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Take a L-Glutamine supplement. Recoverite or you can simply buy them like vitamins. They really help heal soft tissue in joints after hard rides.
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Old 05-30-09, 03:13 PM   #10
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5 will get you 10 (Rockford files) that it is a cadence issue. I have been cycling since the mid 80's and just started to get the EXACT thing you described, even the left leg!

No pain while riding, but after there is a definite something (not painful, but something) above and below my left knee. It comes after pushing hard at a low cadence. I am also a freediver, and if I fin with big kicks and slow on the ascent.......same weird feeling.

I am no doctor, but my body tells me to boost the RPM's to get rid of it.

BTW- Freediving doesn't help bicycling, but bicycling REALLY helps freediving!
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Old 06-01-09, 05:42 AM   #11
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You stated that the pain came on after a vigorous ride, went away in a day, and then came back after a another vigorous ride. If the pain is mainly a burning type pain, then I would lead toward tendonitis. The pain from stress fractures often moves around some, and it also does not come on all of a sudden. To get a stress fracture, you have to ignore or try and "fight through" the pain for a decent period of time. Tendonitis, while an over-use injury (stress fractures are in this class as well), can come on rather suddenly, especially when you have a quick and dramatic increase in training intensity or duration.

I suppose bike fit could be part of the problem, but if you have logged 2800 miles pain free, and more importantly, nothing has changed recently (new bike, new pedals, new cycling shoes, different saddle, etc), I wouldn't bet on it.

Just my "not intended to be construed as medical advice in any way" $0.02 worth.

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Old 06-09-09, 11:18 PM   #12
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Thanks to all of you for your thoughts and suggestions. I thought I would update a few things. We went on vacation in Southern Cali and I didn't rest like I should have. (It was too beautiful not to ride there) I put is 65 miles which is about half what I had been doing previously.

I have two bikes, one is a single speed and the other is geared. The geared bike is actually a new a frame after the original one was found to have a defect. It is the exact same frame and the seat height is back into the same spot. Another reason why I don't think it is the seat is because the single speed setup has not changed at all and the pain is present when I ride that too.

It could be a slow cadence issue, but it seems weird that the pain came shortly after I got the cadence monitor and increased my cadence.

Once it starts hurting (usually 5 miles or so) it hurts about 1/4 of the way on the down pedal stroke. It is a sharp pain. It doesn't hurt if I am pedaling at a slow cadence and a very slow speed, but obviously I am not mashing at that point. It hurts just as much at 110 rpm as it does at 85 rpm.

I've decided to really rest for the week. I am going to stay off the bike. That is really hard for me to write, but I AM going to do it. During the week, I am icing the knee and really concentrating on stretching. Some of the articles I have read indicate it might be a muscle mechanic issue that is related to a lack of flexibility.

If after the week, it still hurts, I am going to see a sports medicine specialist.

All that said, today was my first day of driving instead of riding and it was really depressing. I hate my car.

Thanks gain to everyone for their help.

Last edited by </intolerance>; 06-09-09 at 11:26 PM.
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Old 06-13-09, 05:00 AM   #13
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Try using Powergrips - or even pedals with no attachment system - instead of modern clipless pedals. After you rest.
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Old 06-13-09, 10:04 AM   #14
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Glucosamine Chondroitin is good for joints in a long term plan.

Also, look into Kinesio Tape. I started applying it to my knees about 6 months ago and am pleased with the results
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Old 06-27-09, 10:17 AM   #15
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stretch. stretch. stretch. For me, IT band stretches are the difference between riding and not riding.
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