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Thread: Knees, Please!

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    Born Again Pagan irclean's Avatar
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    Knees, Please!

    I've been having some knee pain so I decided to do a "sore knees" search here in BF and I read a lot of good stuff. Before I get into that I should give a little description of myself and my bike: I'm 42 (for about one more month), weigh around 300 lbs., and I am back on a bike after an almost 20-year hiatus. Before getting the bike my activity level was almost nil. My bike is a dept. store (pause for the collective gasp!) Schwinn hybrid with suspension forks and a suspension seat post. (Please ignore the necessary evil parked behind the bike):



    I've been riding my bike quite regularly since its purchase and have occasionally had some knee pain, but I figured it would just go away with time as did the butt pain. The knee pain has come and gone, switching from one leg to the other, but I never really noticed any knee pain at all before I started biking. At first my bike rides were all recreational and averaged about 10-15 km or 6-9 miles. Since September I've been back at school and my cycling has been almost exclusively commuting which is only a 6 km, or about 4 mile round trip. I took the above picture on a day when I wasn't at school and I had just taken the bike on a 15 km ride (I had to test out my new studded tires and fenders). That was Wednesday of last week. Since then my right knee has been constantly sore and I really notice it when I ride.

    So on with my story: I read a lot of tips about proper fit (which came as no surprise), high cadence/low torque, proper cleat/shoe fit (n/a with my platform pedals), and one tip I hadn't thought of: nix the suspension seat post. In retrospect this was one of those "D'oh!" moments that should be a no-brainer. I plan to change to a rigid seat post at my earliest convenience and I was curious to see if anyone here has had a similar experience and if so, did you find that changing to a rigid seat post helped? Any other advice (other than going to see my doctor - that I will do if the pain persists) would be greatly appreciated.
    Gettin' my Fred on.

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    Dumping the suspension seat post helped me.

    I found that when I was at the beginning of a ride, the post would be fine for height, but it seemed like the post was lower at the end of the ride. I found that at the end of the ride, I was carrying less weight on my legs than at the beginning of the ride. This caused a lower seat height and sore knees...got rid of the post and no more sore knees.
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    Tilting with windmills txvintage's Avatar
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    Yep, lose the suspension post. Another thing to consider when putting the new post in is to make 1mm Sharpie marks on the new post and check you fit by moving the post up or down 1mm at a time to see if you can improve on where you are starting with the seat adjustment.

    Only change 1mm at a time and give it a couple of days to see how it feels. Once you find your sweet spot mark it well on the post so can always find it again.

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    Where in the knee is the pain exactly? I know you mentioned fit but I found that if the pain is emanating from certain areas that can clue one in to how the fit is wrong. I found it helped me to move the cleat back in my shoe too.

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    My story is not dissimilar from yours with the exception of the duration of your hiatus, but I was suffering from knee pain when I first began riding again, and my best advice is to get stronger.

    My knee pain is a distant memory at this point after logging 4,000 miles last year and 5,000 this year, my leg strength has increased immensely. When my leg muscles were not able to handle the load that I was placing on them, my knees were the ones paying the price, but now my muscles are able to handle anything I throw at them I have no joint pain.

    Its not only the primary muscles that need to be stronger, there are many stabilizer muscles in your leg that help support your knees and if they have not been exercised after many years of inactivity they are unable to support the knee joint properly, but with regular exercise your knee pain should steadily decrease. There is a risk of doing to much too fast and causing permanent damage to your knees so try not to do too much too quick.

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    Born Again Pagan irclean's Avatar
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    Thanks for the tips. The pain seems to be isolated to the front of the knee (surrounding the kneecap) and it radiates approx 45 degrees to the outside. I remember from my anatomy class that there is a big tendon that encapsulates the kneecap and attaches to muscles on both the tibia and fibula. It would make sense that this area would be tender if overworked (tendonitis?) so I'm going to follow everyone's suggestion and replace my suspension seat post today. I'm going to go to my LBS to do it so maybe I'll get them to fit me while I'm there. I'll post the results of my ride when I return but I'll be taking it easy since the knee is still tender.
    Gettin' my Fred on.

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    On the stock springer post there is an adjustment screw. It is at the bottom inside of the post. Tighten it and lock out the spring. It worked on my Schwinn.
    Whether you think you can, or think you can't, you're probably right

  8. #8
    Neil_B
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    Quote Originally Posted by irclean View Post
    Thanks for the tips. The pain seems to be isolated to the front of the knee (surrounding the kneecap) and it radiates approx 45 degrees to the outside. I remember from my anatomy class that there is a big tendon that encapsulates the kneecap and attaches to muscles on both the tibia and fibula. It would make sense that this area would be tender if overworked (tendonitis?) so I'm going to follow everyone's suggestion and replace my suspension seat post today. I'm going to go to my LBS to do it so maybe I'll get them to fit me while I'm there. I'll post the results of my ride when I return but I'll be taking it easy since the knee is still tender.
    Yes, dump the suspension. Also, consider if you need extenders on the pedals. I do. In my case it's the difference between riding and not riding.

  9. #9
    Born Again Pagan irclean's Avatar
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    Quote Originally Posted by Mr Danw View Post
    On the stock springer post there is an adjustment screw. It is at the bottom inside of the post. Tighten it and lock out the spring. It worked on my Schwinn.
    Hey, thanks for the tip. I tried it and it seems to be working. I tightened it as far as I dared (after all it's aluminum) and while it still compressed, it did so much less than before. Sitting on it seems to take all the play out of it and I am essentially left with a rigid post. I will still buy a proper post but now I can wait a bit. Best of all I went for a 10km ride and my knees are fine! I felt them going up hills and when I had to mash to beat traffic, but they are not aching right now anymore than they were before I rode.

    The news is not all good, however; my butt feels sore like it did when I first got back on the bike. I've adjusted the angle, bringing the horn up as far as was tolerable, but I still felt myself sitting on the horn and continually having to shift myself further back on the saddle. The saddle is OE stock and is one of those rather plush models with spring webbing underneath. I am wondering now if it is too wide for my sit bones (even though the supporting flesh is generous in proportion) and if I should go with a narrower seat. I have a narrow saddle that came stock on my wife's bike (she swears by the plush one I replaced it with) and here it is for comparison with mine:

    The "torture device" vs. "ol' double-wide"


    I can't really afford a Brooks B17 right now so I'm stuck with these choices, or another "double-wide" that I have on my MTB in the garage. Is it worth it to switch and see how it affects the sit-bones on my 300 lb. frame?
    Gettin' my Fred on.

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    Born Again Pagan irclean's Avatar
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    Quote Originally Posted by The Historian View Post
    Yes, dump the suspension. Also, consider if you need extenders on the pedals. I do. In my case it's the difference between riding and not riding.
    I've never heard of pedal extenders. Can you provide links to any such products that you would recommend?
    Gettin' my Fred on.

  11. #11
    Neil_B
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    Quote Originally Posted by irclean View Post
    I've never heard of pedal extenders. Can you provide links to any such products that you would recommend?
    They are a part most shops can order through QBP (Quality Bike Parts.) "Kneesavers" is one company who makes them, but your shop should be able to get something like it for much less.

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    Wookie Fred chewybrian's Avatar
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    Since you said kneecap pain, you might get checked for chondromalacia. It's a condition where the kneecap does not track straight, causing inflamation when it rubs where it shouldn't. Mine was worse the more I rode.

    I got big relief from a few simple excercises from the physical therapist. Basically, you strengthen the muscles on the inside of the thighs, and stretch the muscles on the outside--ten minutes a day for complete relief. I made 85 miles today without pain.
    Campione Del Mondo Immaginario

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    Born Again Pagan irclean's Avatar
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    I bookmarked the "kneesavers" website - thanks Historian, I'll keep that in mind. As far as chondromalacia or other skeletomuscular conditions are concerned I'll see how my knees are over the holidays and if they still ache I'll go see my GP in the new year. Thanks for all the advice everyone, and BTW since my 10km ride with my seat post adjusted ala Mr. Danw's suggestions my knee pain seems to have pretty much disappeared. Let's hope it stays that way. Happy Holidays to all my fellow Clydes, Athenas, and even to you skinny cyclists. Ride safe and keep the tips coming - healthy knees make a great Christmas present!
    Gettin' my Fred on.

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    Senior Member bigvegan's Avatar
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    Quote Originally Posted by irclean View Post
    Is it worth it to switch and see how it affects the sit-bones on my 300 lb. frame?
    It is ALWAYS worth switching saddles to see what fits best. As a fellow member of the 300+ club I HIGHLY recommend the Specialized Sonoma 175, as Specialized Body Geometry seems pretty well thought out.

    Whatever you ride, just realize it's a matter of frequent tiny adjustments until you get it perfectly dialled in.

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    Quote Originally Posted by irclean View Post
    Thanks for the tips. The pain seems to be isolated to the front of the knee (surrounding the kneecap) and it radiates approx 45 degrees to the outside. I remember from my anatomy class that there is a big tendon that encapsulates the kneecap and attaches to muscles on both the tibia and fibula. It would make sense that this area would be tender if overworked (tendonitis?) so I'm going to follow everyone's suggestion and replace my suspension seat post today. I'm going to go to my LBS to do it so maybe I'll get them to fit me while I'm there. I'll post the results of my ride when I return but I'll be taking it easy since the knee is still tender.
    Iliotibial band. I somewhat doubt that's your problem, but I am not a doctor. I have Iliotibial Band Syndrome, but I get it in the hip (which is rarer) and I get it from walking/hiking a lot, not bicycling.

    Performancebike used to have a good reference but I can't find it now. Maybe look at these sites (front knee pain may imply too low of a saddle):
    http://www.cptips.com/knee.htm
    http://www.bikeforums.net/showthread...-and-numb-toes
    http://www.sportsinjurybulletin.com/...e-injuries.htm

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    Born Again Pagan irclean's Avatar
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    Well, I ditched the "ol' double-wide" and replaced it with the "torture device" today:



    After that I took the bike for a little spin down to the supermarket for some raisin bread (about a 5 km round trip). I had to pull over after the first few pedal strokes to slide the saddle forward on its rails (good thing I brought my allen key). That was better but after a few blocks I said to myself, "There's no way I can do this!" I toughed it out until I got to the supermarket and did my shopping. I noticed no residual pain in my "undercarriage" from the saddle so I started thinking that maybe it is just going to take some getting used to. On the ride home I started to notice that there seemed to be a significant difference in my pedal stroke; it seemed somehow stronger and I also noted that there was no more rubbing on the inside of my thighs. When I turned the last corner for the homestretch I noticed another big difference: There is a slight incline on the last couple of blocks before my house and I usually have to gear down to save my knees, but this time I was able to keep up my cadence without gearing down and my knees were fine. So, after this experience, I believe that I'm on the right track - a narrower saddle combined with my now rigid seat post (thanks again, Mr. Danw) seems to both save wear and tear on my knees, plus give me more power in my pedal strokes (likely due to the fact that now I can fully extend my legs).

    The saddle that I'm using probably retails for $15 and it feels like it's worth every penny. I've been doing some searching on the Forum and am now in the market for a decent saddle. It's obvious that a lot of people swear by the Brooks B17, but before I shell out that kind of dough I want to get some advice from you, my fellow Clydes. Bigvegan recommended the Specialized Sonoma 175 and I'd like to hear any other suggestions (links to retailer sites or blogs would be helpful). It would be great to hear some testimonials. FYI I am an all-weather commuter, my rides are usually 15 km or less (although I hope to lengthen them starting in the spring), my bike is stored in an unheated garage (it can get cold here), it can be parked outside at school for up to 8 hours at a time, and I am definitely a Clydesdale.
    Last edited by irclean; 12-22-09 at 06:11 PM.
    Gettin' my Fred on.

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    Senior Member bigvegan's Avatar
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    One of my LBSs has a test policy on saddles, where you can return them within a reasonable length of time until you find one that fits. Call around and see if your LBS offers that, as it makes things easy.

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    are you stretching?

    Quote Originally Posted by irclean View Post
    The pain seems to be isolated to the front of the knee (surrounding the kneecap) and it radiates approx 45 degrees to the outside. I remember from my anatomy class that there is a big tendon that encapsulates the kneecap and attaches to muscles on both the tibia and fibula. It would make sense that this area would be tender if overworked (tendonitis?)
    Have you done any stretching for your IT band? A tight IT band can pull your kneecap out of alignment and create a lot of pain. A quick search on Youtube could probably give you some ideas. My favorite stretch involves laying on a foam roller and moving my body so the roller travels along the outside of my leg from the hip to the knee. This really hurt when I first started doing it. After the IT band got stretched out through this and other stretches, the stretch is painless.

    You might also try a few exercies for your gluteus medius. A week gluteus medius can create problems for the IT band.

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    Wookie Fred chewybrian's Avatar
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    Fisher seems to be describing Chondromalacia, as I mentioned earlier (or runner's knee). It it worth checking out. I copied these excercises from Bigkneepain.com , which were also given to me at PT. Although, you really should go to the doc, and get a referal to PT, to make sure they are right for you.

    The exercises emphasized in the majority of cases are those that strengthen the quadriceps particularly the inner division of the quadriceps. This usually is very effective. Spending a few minutes, a couple of times a day on these muscles and gradually working up to 20 minutes per day are sometimes all that is needed. Be patient. It can take several weeks to notice an improvement.

    Quad Strengthening Leg lifts:
    Lie flat on back. Bend left knee at 90-degree angle, keeping foot flat on floor. Keeping the right leg straight, slowly lift it to the height of the left knee. Hold for a count of 3. Repeat 10 times. Switch sides. Work up to 10 sets of 10 over several weeks. (my PT had me do these with toes pointed out.)

    Iliotibial Band Stretch:
    Standing position: Stand up. Cross right leg behind left leg moving crossing knee beyond the midline of the body. Lean from the hips to the left, the stretch being felt on your right hip, side of the leg and knee. Hold for 30 seconds. Repeat on other side.
    Campione Del Mondo Immaginario

  20. #20
    Senior Member exile's Avatar
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    Saddles are so personal irclean it's hard to make a recommendation. I have a Brooks flyer pre-aged on my commuting/touring bike. However my saddle is about even or slightly below the handlebars. On my commuting/hardtail bike I am currently using a Rido 2 saddle which I am still adjusting. It is replacing a BG Sonoma 155. On this bike my saddle is about even to above my handlebars.

    Remember with saddles there are other adjustments to consider beside saddle height. You have both fore/aft positioning as well as tilt. Both may help as far as comfort is concerned.

    I am not sure how long you have been riding but do you think it is an repetitive/overuse type injury? Maybe a few days off the bike would help (although i do know how addicting it can be). If you are going from a sedentary lifestyle to riding a few miles every single day without time off maybe its time for a break.

    Happy holidays and hope everything works out.
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    Born Again Pagan irclean's Avatar
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    Thanks again for all the great tips, everyone. I'm happy to report that my knee pain has all but disappeared since the seat post adjustment and saddle change, but to be safe I am making sure to stretch even before a short ride.

    Quote Originally Posted by exile View Post
    Saddles are so personal irclean it's hard to make a recommendation. I have a Brooks flyer pre-aged on my commuting/touring bike. However my saddle is about even or slightly below the handlebars. On my commuting/hardtail bike I am currently using a Rido 2 saddle which I am still adjusting. It is replacing a BG Sonoma 155. On this bike my saddle is about even to above my handlebars.

    Remember with saddles there are other adjustments to consider beside saddle height. You have both fore/aft positioning as well as tilt. Both may help as far as comfort is concerned.

    I am not sure how long you have been riding but do you think it is an repetitive/overuse type injury? Maybe a few days off the bike would help (although i do know how addicting it can be). If you are going from a sedentary lifestyle to riding a few miles every single day without time off maybe its time for a break.

    Happy holidays and hope everything works out.
    Thanks, exile, same to you. I appreciate your viewpoint concerning saddles. I'm sure that there are many saddles that people swear by that others find intolerable and vice-versa. My little experiment has proven to me that the mechanical advantage gained by using a rigid seat post and a narrower saddle not only protects my knees but makes me a more efficient rider. I have played with the tilt and the fore/aft adjustment using tips that I picked up here and I think I've got it right, but I carry my 6mm allen key, just in case. I just want a few saddle suggestions to consider because I need something to replace the cheap one that I'm currently using. I realize that I may be opening Pandora's Box as there are probably as many opinions on saddles as there are on any other bicycle component. Being a newcomer (albeit an aged one) to the cycling lifestyle I am in the dark when it comes to saddle choices. I am learning as I go and I have already replaced an estimated 15% of the components on my bike - I expect that in time the only original part remaining will be the frame. In the meantime I will keep searching the forums for information and in the new year I may start a "What saddle do you use?" thread. Happy Holidays, everyone!
    Gettin' my Fred on.

  22. #22
    Senior Member exile's Avatar
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    If memory serves me correctly I believe Brooks, Terry, and WTB saddles were some of the most popular.
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    Born Again Pagan irclean's Avatar
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    Update

    I got a new saddle in the mail today from MEC (the Canadian version of REI); the Terry Liberator Y.



    I went for a ride today and so far I am very pleased. It seems like a good compromise - not too soft like the "plush" saddle that came with my bike and not too hard like the cheap narrow saddle that I had on hand. Just like Baby Bear's chair the saddle is just right for this Goldilocks. If I can reach my goal for weight loss in 2010 I will consider a B17 but for now I will enjoy my new saddle. Thanks for the input to all those who responded to this post; I used it to make my decision.
    Gettin' my Fred on.

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    The usual suspects for knee pain are as follows:

    -Seatpost height (if its too high you are reaching to make the rotation and your knees will feel like they been pulled on, too low and you are stressing your patellar tendon by asking the knee to fold in a shorter arc than its designed to))
    -Fore/aft position (your knee in relation to the bb does matter)
    -Tilt (too far down or too far up will force your body to settle in a place thats putting undue strain on your kness)
    -Foot angle to the pedal (if you pronate or supinate against the pedal with insufficient support, your knees will also be displeased because your legs are not going in a straight line)
    -Foot position on the pedal (moving them closer to the center of your foot gives a better push off platform and less strain on the knee)
    -Float of your cleats (gives your knee room to flex the way it wants to (your particular mechanics) throughout the stroke.

    I have had knee problems for some time now. I have eliminated most of the problem by getting more float on my cleats, getting the seatpost height dialed in, shimming my tendency to pronate on my left foot, and ensuring the saddle was correctly placed in relation to the bb. I have a condition called tibial torsion, which causes the tibias to bow outward. In most cases it resolves itself by the growing process straightening the bones out. It did not in my case, and as a result of the bowing of my lower legs, my knee caps do not track like they should. I still get occasional discomfort, but nothing like the searing pain I used to get going uphill before I started doing something about it. I worked with a fitter for a month or so, then continued to fine-tune the adjustments I learned about.

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