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  1. #1
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    Knee pain -- ride it off?

    I had to drive in to work this morning because of knee pain that started last week. I started feeling something weird in my right knee last week, kind of like a clicking while riding and having my knee in the upstroke, but thought nothing of it. Then that night, while I was in bed, I moved my leg and felt this sharp pain, so I bent my knee, trying to see if I could make it go away (probably a bad idea), but it got worse.

    After that, whenever my knee is bent walking up and down the stairs, there's a sharp pain inside my knee. I don't think it's the knee cap, but some sort of ligament or tendon. No swelling, so hopefully it's not tendonitis.

    I stayed off my bike all weekend and it seemed to be better Monday morning, so I rode in to work. Bad idea. The knee pain returned. Tried to ride it off on the way back, but that just made it worse so I had to get off and do the walk of shame =(

    I'm not really sure how I injured myself. I've avoided mashing on the pedals and it seems to be more painful the higher my cadence. My knee feels fine when I walk. It just doesn't seem to like it when I bike. Maybe I need to raise my saddle, but I thought it was pretty high already. Has anyone gone through this? Is this a case of "ride it off?"

  2. #2
    Senior Member
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    When is the last time you got a bike fit? Knee pain isn't something you can just ride off or ignore.

  3. #3
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    Don't ride it off at all. If the pain feels like it's behind the kneecap it's usually your cleats that need to be adjusted (i'm assuming you're riding with clipless pedals). Saddle height also should be checked.

    The cleat should put the ball of your foot directly over the pedal axle when your foot is level and not tilted forwards.

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  4. #4
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    I ride with platform pedals and I never professionally got my bike fitted. I had the seat adjusted by the guy at my LBS to my height while standing on the pedals, if that counts.

  5. #5
    Sophomoric Member Roody's Avatar
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    How old are you? Ever have an injury there, even years ago? Is the pain worse in the morning? Have you had an x-ray?


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  6. #6
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    Do you mash it up the hills? When I get knee pain it means it's time to start downshifting more often and/or I need to adjust my saddle
    In the words of Einstein
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  7. #7
    Commuter First newbojeff's Avatar
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    My 2 cents. I get knee pain -- a bit of tendonitis -- sometimes when my cleats are out of alignment or for no clear reason (maybe mashing too hard). I use ibuprofen and try not to mash (and fix cleats of course). The pain never gets worse and is usually gone in a few days to a week.

    Having said that, my knee pain is just me "overdoing it" a bit. I've never had to get off the bike and walk. The clicking makes me think you might have a torn meniscus (cushions that run around the outside of the knee joint). You should see your doctor.

    In the meantime, I would avoid the bike if it is giving you any pain after adjusting the saddle height and saddle fore-aft.

  8. #8
    34x25 FTW! oboeguy's Avatar
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    I've had two knee problems in the last two years. One I'm pretty sure was the result of shoe stretch and lots of miles. The other appear to have been the result of too-low saddle. Both sucked, but a new shoe fixed the first problem enough to ride through it as the problem slowly dissipated over the course of the following months. The second problem was much worse, with two months of virtually no riding and I'm only now starting to train for real again after a month or so of riding cautiously. My suggestion? Check your bike fit and see a sports med doc. A regular doc could say "tendonitis, take ibuprofen, chump". Imagine if I'd listened to that and hadn't gotten the PT I clearly needed? Two months off the bike could have been more, much more.
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  9. #9
    newbie commuter
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    Quote Originally Posted by Roody
    How old are you? Ever have an injury there, even years ago? Is the pain worse in the morning? Have you had an x-ray?
    23, no real knee injury ever. There's usually no pain in the morning until I do something like go up/down the stairs or bike. No xray.

    I don't mash up hills but the pain seems to be while my leg is going up rather than pushing down, so I don't think it's mashing that did it.

  10. #10
    Live Deliberately. davidmcowan's Avatar
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    nakedsushi,

    You and I are in the same boat right now. I was riding two weeks ago on a 40 mile ride and the knee starting killing me! I had to ride home but barely made it. Stopped at the LBS and the guy noticed that the saddle I switched in was too high and was working my knees over. Problem was it was too late. My knees are jacked my commuting is way down and at this point I'm not sure what to do about it. Stop riding fixed for the time being and try to ride my road bike here and there until my knee starts to feel much better I suppose. I've got a triathlon in two months and RABRAI in 3 so I want to play it careful.

    If you come up with any magical remedies, PM me. I need help too!

  11. #11
    Senior Member mtnwalker's Avatar
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    ICE and Ibuprofen(anti-inflammatory) should help you guys a bit + a lot of stretching + bike fit. Bike fit most likely is the culprit.

    I had knee pain just a week ago. Right below the knee. I did my own fitting and is still currently tweaking here and there though most of the pain is now gone. I raised the seat 3mm and set it back 2 mm and it seems to be much better, point is a few mm's here and there makes a world of difference. Or you could go to an LBS and do a professional fitting which will be faster and more convenient.

    Check out this site for what causes the different types of knee pain and how to fix/prevent them.

    Fatigue can also be a factor. If your quads are tired and you keep mashing/pushing hard the knees will take the stress that your quads/muscles are not supporting. Recovery rides are important especially if you commute every day.

    Lastly, you will need to start watching your "form" on the pedals. Since I don't use cycling specific shoes(clipless) I noticed that too much bending at the ankles while pedalling can cause knee pain too.

  12. #12
    Senior Member Brian Ratliff's Avatar
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    I have had knee issues before. Pain in front of and below the kneecap is caused by the seat being too low. Pain behind the knee is from the seat being too high.
    Cat 2 Track, Cat 3 Road.
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  13. #13
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    Icy/hot and advil work the best for me on my knee pain which comes from mashing it too much.

  14. #14
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    Brain Ratliff, I thought the pain behind the knee was due to my seat being too high, so I tried lowering the seat and I think that just made it worse. I guess to be more specific, the pain feels like it's behind my right kneecap on some type of tendon or ligament, but definitely inside my leg somewhere.

    I've been taking ibuprofen, but I'm not sure if it's helping anything, since there's no noticable swelling around my knee. Maybe I'll try the ice tonight.

  15. #15
    Feral Member Nicodemus's Avatar
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    You may find that it hurts less if you push harder - but that doesn't mean you're making it better. Otherwise, a general +1 on the responses so far. Don't mess with your knees, if there's recurring tetchiness get it checked and get your fit checked.
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  16. #16
    Feral Member Nicodemus's Avatar
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    Quote Originally Posted by nakedsushi
    Brain Ratliff, I thought the pain behind the knee was due to my seat being too high, so I tried lowering the seat and I think that just made it worse. I guess to be more specific, the pain feels like it's behind my right kneecap on some type of tendon or ligament, but definitely inside my leg somewhere.

    I've been taking ibuprofen, but I'm not sure if it's helping anything, since there's no noticable swelling around my knee. Maybe I'll try the ice tonight.
    To the left or the right of the knee? The tendon from the hip to the knee, on the outside, tends to commonly get too tight among those who cycle and such. There are specific stretches and exercises to fix that. This has been my problem(s). Best to check with a good physio or doctor if it persists.

    In my case, it took a good physio to diagnose it specifically - turns out the tight tendon was also pulling the kneecap over to the outside. Stretching that tendon, and working the kneecap back to the left (it was my right leg), fixed my problem.
    Quote Originally Posted by KrisPistofferson View Post
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  17. #17
    Feral Member Nicodemus's Avatar
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    Quote Originally Posted by mtnwalker
    Check out this site for what causes the different types of knee pain and how to fix/prevent them.
    useful site, cheers
    Quote Originally Posted by KrisPistofferson View Post
    Did you just say "minarchist?" I'm going to start a 10-page vaginathon because only Libertarians can define Libertarianism. Also, you're mean.

  18. #18
    WTF is that creak?! O.o sfrider's Avatar
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    Quote Originally Posted by nakedsushi
    23, no real knee injury ever. There's usually no pain in the morning until I do something like go up/down the stairs or bike.
    Sounds like overuse -- runner's knee. Inflamed tissues that get pinched or pinch nerves. Take it easy until it clears, make sure your saddle is high enough, and try not to use your calfs too much (keep your heels down).

  19. #19
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    Quote Originally Posted by nakedsushi
    I had to drive in to work this morning because of knee pain that started last week. I started feeling something weird in my right knee last week, kind of like a clicking while riding and having my knee in the upstroke, but thought nothing of it. Then that night, while I was in bed, I moved my leg and felt this sharp pain, so I bent my knee, trying to see if I could make it go away (probably a bad idea), but it got worse.

    After that, whenever my knee is bent walking up and down the stairs, there's a sharp pain inside my knee. I don't think it's the knee cap, but some sort of ligament or tendon. No swelling, so hopefully it's not tendonitis.

    I stayed off my bike all weekend and it seemed to be better Monday morning, so I rode in to work. Bad idea. The knee pain returned. Tried to ride it off on the way back, but that just made it worse so I had to get off and do the walk of shame =(

    I'm not really sure how I injured myself. I've avoided mashing on the pedals and it seems to be more painful the higher my cadence. My knee feels fine when I walk. It just doesn't seem to like it when I bike. Maybe I need to raise my saddle, but I thought it was pretty high already. Has anyone gone through this? Is this a case of "ride it off?"

    I'm a sports med doc, so I see a lot of knee problems. It's nearly impossible to diagnose a problem over the internet but you could have something as simple as ITBS (iliotibial band syndrome) or something as bad as an osteochondral loose body that would need surgery to remove. Either way, if your pain is not getting better, have it checked out by a good sports medicine specialist or an orthopedic surgeon (or your family doc if he or she is good with musculoskeletal injuries). Sometimes things that seem simple, aren't.

  20. #20
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    Quote Originally Posted by Fheardhaigh
    I'm a sports med doc, so I see a lot of knee problems. It's nearly impossible to diagnose a problem over the internet but you could have something as simple as ITBS (iliotibial band syndrome) or something as bad as an osteochondral loose body that would need surgery to remove. Either way, if your pain is not getting better, have it checked out by a good sports medicine specialist or an orthopedic surgeon (or your family doc if he or she is good with musculoskeletal injuries). Sometimes things that seem simple, aren't.
    +1. See a doc.

  21. #21
    Senior Member cgchambers's Avatar
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    I have terrible knees, was a catcher for our High School and College baseball team and my knees really paid for it. I had a lot of trouble until I switched to pedals with a lot of float. Are you using clipless? If so there are many pedal systems out there that have a lot of float, which has saved my knees.

  22. #22
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    I'm not using clipless. Just regular platforms. I don't think I know what pedal float is.

    edit: Been off the bike a day and babying my knee. It feels much better this morning. No pain. I was tempted to ride to work again, but decided to give it another day and just walk to work.

  23. #23
    Senior Member cgchambers's Avatar
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    Oh well, there goes that theory! A lot of clipless pedals lock you into one position in the pedal, not allowing your leg to move. That is hard on the knees, pedals with float allow you foot to rotate 15 degrees or so, makes it much easier on your knees.

    But if you are on platforms you are exempt from that issue.

    Glad the knee is feeling better.

  24. #24
    Senior Member swwhite's Avatar
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    I currently am approaching three months of being off the bike because of pain in the right knee. It started with a feeling of discomfort with no event (injury, etc.) that I could recall, and got worse over a period of two weeks. I quit riding to give it a rest, and it did not get better. It would hurt to walk up or down stairs. It would hurt sometimes when I just moved it the right way. The pain seemed to be near the ten o'clock position at the edge of the kneecap, as viewed by bending over at the waist and looking at the kneecap.

    I went to the doctor, and he gave me a month's worth of prescription anti-inflammatory drugs ("naproxen" or something like that) and a sheet of exercises, and said to go back if it didn't get better. It has been getting better at an EXTREMELY slow rate, and the only reason I haven't gone back to the doctor is that it HAS been getting better, although slowly. I figure that if I go to the doctor and say that my knee hurts but it is getting better, he won't be able to recommend much besides waiting. It would make sense to do something only if it doesn't resolve all the way or if it comes back when I get back on the bike.

    After it started to get better, the pain would occur in a more reproducible manner. One of the prescribed exercises was a leg extension, that is, sit on a chair with the feet on the floor and then extend the lower leg out parallel to the floor, and then lower it. I noticed that I would get a little stab of pain at the point where the leg was almost horizontal, and then another little stab of pain on the lowering motion when the lower leg was almost vertical. However, if I had the kid move my leg for me, so that it was going through the full range of motion without any muscular contraction on my part, it would not hurt.

    Now, after almost three months, I can walk almost at full speed and have no pain under normal circumstances, but if I jar it or twist it just so, it still will hurt. When I walk, it doesn't hurt, but I still can feel that somthing is not quite right.

    My sister-in-law the licensed physical therapist says that pain on the inside of the knee by the kneecap can be related to tight muscles in the backs of the legs, and said I should stretch those. She recommended sitting on the edge of a chair with one leg extended and the other bent with the foot on the floor (for support). On the extended leg, pull the toes back and sit up straight. That puts a nice stretch on the back of the leg.

    I also have access to a weight room, so I have been doing leg presses, leg curls, and leg extensions on weight machines, starting light. I can go through the full range of motion with light weights, so that gives me hope that things will heal up. I figure that if it were bones rubbing together or something like that, it would hurt all the time.

    Consulting the amateur diagnostician's best friend, the internet, suggests that thing like this can take MONTHS to heal, so I have resigned myself to riding the bus for a while. If when I try the bike again the problem comes right back, or if it stays at its current point of "almost completely better," I will get myself back to the doctor, or maybe find some sports-medicine doctor who might know a bit more about the mechanics of the knee in relation to various physical activities.

    Good luck. Everyone should be able to get around under one's own power.
    Riding in search of the simple life.

  25. #25
    Raving looney
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    Yeah, I'd err on the side of caution - get a proper bike fit, don't be scared to spin in the lower gears instead of mashing it out when you do get back in the saddle (don't be scared of taking another day or two off). Above all, go to a Doc and make sure you're not making a mess of your knee, they're pretty darn important!

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