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Old 07-20-07, 10:34 AM   #1
Yen
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Knee pain

I have a little pain in my left knee that began last week. Actually it's not really IN the knee... it feels like it's on the front, just below the kneecap. Now, I had knee pain before I began losing weight 3+ years ago so this isn't the first time, and it's a LOT better now.

This morning I worked out on the mini-stepper and noticed the pain after about 20 minutes. I started to wonder if the bike fit is causing it. But if it was (were?), wouldn't the pain have started as soon as I started riding? My skills are better, my legs are stronger, and I am not allowing myself to strain up hills... I ride in the lowest gear necessary and don't push it too hard.

I don't want to rip a tendon and be laid up for weeks.....
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Old 07-20-07, 10:38 AM   #2
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I have a little pain in my left knee that began last week. Actually it's not really IN the knee... it feels like it's on the front, just below the kneecap. Now, I had knee pain before I began losing weight 3+ years ago so this isn't the first time, and it's a LOT better now.

This morning I worked out on the mini-stepper and noticed the pain after about 20 minutes. I started to wonder if the bike fit is causing it. But if it was (were?), wouldn't the pain have started as soon as I started riding? My skills are better, my legs are stronger, and I am not allowing myself to strain up hills... I ride in the lowest gear necessary and don't push it too hard.

I don't want to rip a tendon and be laid up for weeks.....
My knee pain in February was in the exact same place. It came on suddenly, without a cause I could pinpoint. I went to three different doctors, x-rays, you name it. It was so painful I had to stay off the bike for seven weeks.

Since then, I get very mild, and very occasional knee pain in the same place, but it doesn't keep me off the bike. I don't think biking is causing my problem.

I did make some adjustments on my bike (saddle height, position fore and aft, etc.).

I guess I have no good advice except do NOT ignore knee pain. Someone here will advise you on what to adjust on the bike. I can only tell you if the pain gets worse, IMHO you have to stop riding for a while. It really killed me to stop riding, BUT it worked.

Good luck!
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Old 07-20-07, 10:53 AM   #3
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Thanks DG. I'm glad your knee feels better now. It must have been a great relief to get back on your bike again. When your pain started, was it continuous and very painful right from the start? At this point, the pain is mild and only occasional, and actually I also notice it sometimes when going up stairs. I do a lot of walking that includes stairs, in addition to the cycling and stepper. Since the pain isn't persistent, I will keep an eye on it and take necessary precautions. My brother recently tore his rotator cuff while doing an easy, common maneuver at work; it was a very big tear that required surgery and many months of recovery. I don't want to go there!
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Old 07-20-07, 10:56 AM   #4
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Thanks DG. I'm glad your knee feels better now. It must have been a great relief to get back on your bike again. When your pain started, was it continuous and very painful right from the start? At this point, the pain is mild and only occasional, and actually I also notice it sometimes when going up stairs. I do a lot of walking that includes stairs, in addition to the cycling and stepper. Since the pain isn't persistent, I will keep an eye on it and take necessary precautions. My brother recently tore his rotator cuff while doing an easy, common maneuver at work; it was a very big tear that required surgery and many months of recovery. I don't want to go there!
Yes, my pain back in Freduary was sharp, and immediate. I had to limp. There was a suspicion I had torn my meniscus, but who knows? I even tried biking VERY slowly but the knee barked too loud so I had to quit for a while.
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Old 07-20-07, 11:08 AM   #5
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Yen, it might be just a bit of tendenitis from overuse. If that's the case, here's what helped me. As they say, your mileage may vary:

1) Do a little less exercise than you want to or think you can--but don't be immobile either. Lots of sitting tends to make it worse for me.

2) Ice the area a couple times a day.

3) Ibuprofen in reasonable amounts.

4) Stretch those quadraceps early and often--especially AFTER exercise. An example of a good quad strectch (and some overall cycling stretches here) http://www.grouptrails.com/Stretches.htm
I can't emphasize how much stretching has helped me deal with and avoid injuries (I never felt the need to stretch at all before I turned 50).

5) Be patient, if you can. If you can't see 1) above.
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Old 07-20-07, 11:34 AM   #6
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DG: So glad you are back on your bike without surgery, given the "sharp and immediate" nature of your pain. That must have been a bit scary. 50+ bodies don't heal as quickly, but the regular exercise you'd done on your bike probably helped you heal faster than otherwise. Don't discount that!

JT: I considered the possibility of overuse. When I first mentioned it a few weeks ago, Hubby said "Uh oh, that could be a tendon...", so your guess of tendonitis sounds like a good possibility. I have a VERY sedentary job and when I get up after a few hours in the chair, I walk like an old woman for a minute before everything loosens up (hips, knees, ankles). I always stretch after I exercise, it's a regular part of my routine, so I will make sure I continue to do that, and thanks for the link that shows a couple of exercises I do not do. I will be patient.... and careful.

Thanks!
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Old 07-20-07, 12:39 PM   #7
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Ice is a good friend!!

Also teeny seat adjustments can help enormously.
Patient and careful sounds good.
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Old 07-20-07, 12:49 PM   #8
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Freeze paper cups of water in the fridge. After riding, take out a cup, tear the paper enough to expose the ice, and massage your knee(s) with the ice chunk for 10 mins or so. You'll notice blood circulating around your knees. Good. Then dry off, give 'em a little rub, and walk away. Ice is the cheapest mild medication out there for tendinitis-type inflammations. Take the remaining ice chunk and drop it into your anti-oxidant green tea...or glass of Endurox...or down Hubby's shirt. Whichever.
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Old 07-20-07, 12:50 PM   #9
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...down Hubby's shirt.

Or his pants!
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Old 07-20-07, 01:24 PM   #10
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...down Hubby's shirt.

Or his pants!
If Hubby is properly exhausted from cycling...there may be no need. Yen, Malkin and I will try to stop this train of thought right here.
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Old 07-20-07, 01:25 PM   #11
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Thanks....
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Old 07-20-07, 09:14 PM   #12
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My doc who is a biker, recommended cycling to me to help my knee's, and it did, he warned me, clipless is good but not for me, as of late I haven't seen the doc for year or two, and I got some clipless pedals and shoes, sure enough I feel it in the knees,, I don't get it, why me, but I will try them for a ride or two and if they hurt I can send them back. He uses Speedplay, he said they float....my Shimano seem to float, I think.
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Old 07-20-07, 10:48 PM   #13
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Well then, on the bright side, I have a good excuse to not go clipless. Let's see.... first my wrists and neck qualify me to be an upright hybrid rider for life, my thumb (still recovering from surgery after I severed the tendon in an accident last year -- the same hand as the wrist implant) further limits my handle bar options, and now my knees can be my excuse for keeping the rinky dink pedals. Thanks!
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Old 07-20-07, 11:27 PM   #14
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This is all great advice. I work very hard at "Body Maintenance". I not only have the stresses from bike riding, but I play a lot of tennis. I'll reemphasize the stretching. The other thing I highly recommend is a Homedics ball massager. They're not very expensive, and they can be used while vegging out in front of the TV or computer. Bed, Bath and Beyond has some nice models. Work it all around the muscles surrounding the knee. Also use it on the calves, quads, achilles area, and hamstrings. After about 15 minutes of the massager, the blood will be flowing to these areas, and follow-up with some stretching. I find that this cuts my recovery time at least in half.

Quote:
Originally Posted by Jet Travis View Post
Yen, it might be just a bit of tendenitis from overuse. If that's the case, here's what helped me. As they say, your mileage may vary:

1) Do a little less exercise than you want to or think you can--but don't be immobile either. Lots of sitting tends to make it worse for me.

2) Ice the area a couple times a day.

3) Ibuprofen in reasonable amounts.

4) Stretch those quadraceps early and often--especially AFTER exercise. An example of a good quad strectch (and some overall cycling stretches here) http://www.grouptrails.com/Stretches.htm
I can't emphasize how much stretching has helped me deal with and avoid injuries (I never felt the need to stretch at all before I turned 50).

5) Be patient, if you can. If you can't see 1) above.
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Old 07-21-07, 04:34 AM   #15
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Well then, on the bright side, I have a good excuse to not go clipless. Let's see.... first my wrists and neck qualify me to be an upright hybrid rider for life, my thumb (still recovering from surgery after I severed the tendon in an accident last year -- the same hand as the wrist implant) further limits my handle bar options, and now my knees can be my excuse for keeping the rinky dink pedals. Thanks!
This guy who lives at "the close place" is like 60, got cancer, pedals with a limp, exwife and kids on dope, he is proud to ride that 20 year old Haro with the best platforms money can buy(at a yard sale), he may look like hell, but don't try to tell him to modernize, man you will get an ear full.

My neck is ok, my back hurts, I have a torn rotator cuff, my knees are worn out, , I just hope to die fast.

You get no sympathy here, but I will buy you a coffee if you are in town.
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Old 07-21-07, 06:02 AM   #16
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Well then, on the bright side, I have a good excuse to not go clipless. Let's see.... first my wrists and neck qualify me to be an upright hybrid rider for life, my thumb (still recovering from surgery after I severed the tendon in an accident last year -- the same hand as the wrist implant) further limits my handle bar options, and now my knees can be my excuse for keeping the rinky dink pedals. Thanks!
nope... no excuse

of course you'll pay attention to the knee thing by getting some 'real' help on position.
with low miles and riding times position may not be an important thing, but as you increase miles, times and intensity, its the number one thing which will make riding for thousands of miles possible. Some riders find it 'naturally', others really need some work and help. Many, like me, find they need to 'tweak' it in an ongoing basis, depending on body and need.
as you make changes, keep notes, >measure< everything, note in mm - then you'll really see whatz happenin.
already mentioned but I'll add em-fah-sis ,stretch, not just after a ride. Develop a real stretching program that you can do at least 20 min a day.

clipless pedals are for everyone.
no need for worry - get something with good amount of 'float', like crank bros eggbeaters, most SPD, Speedplay frogs and you'll be fine, knee wise. They will improve your form and aid. Loose feet on the pedals can be real trouble for any distance, cause when one gets fatigued sloppy pedaling and changing foot position can cause injury.
clipless just needs a bit of practice and time to become second nature

keep at it, you're doin good!

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Old 07-21-07, 06:56 AM   #17
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I've mentioned this before, but one thing to look into is shorter cranks. Everything on a bike is completely adjustable except for the crank arm length. Whether a tiny small woman's bike or a 7 footer's bike they all come with a crank arm of usually 172 to 175 or thereabouts.
I started a bit of left knee pain and went from 175's to 152's and slightly geared down my front chain rings. Cadence went up a bit of course. But not only the pain went away but the bit of post stroke weakness on the left side went away, too, by spinning more and shortening the arc of your knee extension/flexion. And not trying to push big gears with the greater arc of the knee, not even mentioning muscle function, etc.
I'm totally sold on shorter crank arms now. I rode my wife's bike 1/2 mile the other day for the heck of it and could feel the spot where the knee pain would start and I'm convinced it would come back if I went back to the big ones. And her bike is a carbon fiber lightweight TREK.
Too bad more bike shops wouldn't get adjustable crank arms for rent or trial and error. Try different lengths till you find the one that is best for YOUR knees, not Lance Armstrong's or anyone elses. There are a couple companies that make them, and if I remember correctly might be found on the Angletech web site, or Hostel shoppe web site, both bent web sites, but crank arm length is equally important on DF bikes I'm convinced.
After using them for a year and a half I'm convinced crank arm length is as important or even more important than any other measurement of a bike, upright or recumbent. But manufacturers continue to put fixed long ones on EVERY bike they sell. Aren't our femurs and tib/fibs different lengths or are all humans built with exactly the same leg length? Not the last time I checked anyway! If they are, then we may as well forget about any discussion of X seam length as suchlike? LOL
The only problem with the 'trial and error' method of finding the correct length for you is that as you shorten the crank arm, the mechanical advantage (remember physics 101) goes down and the gearing goes up! This is why it's not quite as simple as shortening up the cranks alone. You need to gear your front chain rings down a bit to compensate. Not much, but a bit.
I've had people argue - 'won't I spin out quicker on the top end?' Yes you will, but after shortening my cranks and gearing down the front chain rings I spin out at about 40mph instead of 45 - 48 or so. It takes a pretty good tailwind and downhill for me to hit this speed anyway and that's fast enough for an old guy like me anyway. And how many of us hit 40 mph or cruise hour after hour at even a low speed like 30mph? Heh! But in my humble opinion, spinning is one of the most important ways to go to save your knees! For the majority of average fitness bikers, the non racers, riding your bike should be like driving an underpowered car - gear down and keep the rpm's up!
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Old 07-21-07, 07:09 AM   #18
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Hey Yen, with all your hand problems, you should try a bent. Seriously! No hand or carpal tunnel problems! That's a gimee! When I get off my DF and rip off those awful hot padded biking gloves and climb on my bent I tell my upright friends that I don't need boxing gloves to put my hands on the handlebars. (Nor do I have to wear diapers) LOL
Same with Nycycle if his/her post is serious.
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Old 07-21-07, 08:23 AM   #19
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What kind of pedals/clips are you using? If they are SPD with no float it could be the source of your problems. Assuming bike is fitted properly a cleat with more float such as Bebop or Speedplay may help.

Proper bike fit resulting in proper riding position is the key to comfort.
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Old 07-21-07, 06:22 PM   #20
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I use the stock platform pedals that came with the bike, but I removed the straps immediately after I brought it home. I think of clipless every time my foot hops off the pedal, but it will be a while before I try them. I want to concentrate on perfecting the basic skills first (cornering, maneuvering in traffic, etc.) before I try clipless.

It seems that if the problems were the cranks, wouldn't my knee pain have started sooner? I think the "overuse" diagnosis is probably the best one... my knees hurt most when I go up stairs, but the bike isn't a problem (until the other day... and today). But, I will keep the crank possibility in mind, thanks.

I stretch for 15-20 minutes after every ride, and occasionally on non-ride days. I'm a big believer in stretching!

Thanks for the tip on the Homedics ball.... I'll look for that.

Today I learned that a bag of frozen cranberries makes a good ice pack.
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Old 07-21-07, 09:00 PM   #21
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I have a little pain in my left knee that began last week. Actually it's not really IN the knee... it feels like it's on the front, just below the kneecap. Now, I had knee pain before I began losing weight 3+ years ago so this isn't the first time, and it's a LOT better now.

This morning I worked out on the mini-stepper and noticed the pain after about 20 minutes. I started to wonder if the bike fit is causing it. But if it was (were?), wouldn't the pain have started as soon as I started riding? My skills are better, my legs are stronger, and I am not allowing myself to strain up hills... I ride in the lowest gear necessary and don't push it too hard.

I don't want to rip a tendon and be laid up for weeks.....

Yen, I used to have that pain fairly often, but less severe than yours. This year its a lot less. What's changed is that I got a bike fit done. My saddle is a little higher and farther forward than in the past, and I can spin more easily. Maybe you jiust need some professional advice on getting your saddle in the best place for now.

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Old 07-21-07, 09:02 PM   #22
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Road Fan, thanks for the suggestion, I'm considering a fit. But.... wouldn't the knee pain have shown up sooner if the fit is the problem?
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Old 07-22-07, 04:56 AM   #23
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I'd like to offer my 2 cents. See a doctor.
BF members have a lot to offer with regard to biking issues and they can give you info to augment what your doctor suggests, but getting medical advice exclusivly from BF members is probably not the best way to adress a medical problem.

See a doctor.
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Old 07-22-07, 06:50 AM   #24
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Yen, if you think it's not the bike causing you pain, maybe you should consider your shoes. If you walk a lot, climb & bike, then maybe you need new shoes or different shoes. I once had a pair of shoes I had to get rid of because I started having knee pain. I think they weren't supporting my foot enough along the big toe side. I walk every morning (2 labradors) so have to replace shoes every 3 months or so. Luckily, I don't walk on cement - just dirt, sand & gravel.
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Old 07-22-07, 12:17 PM   #25
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I'm very happy to report that my knee feels completely painless today after our 27 mile ride yesterday and icing it 3x (using a bag of frozen cranberries). I will continue to pay close attention to it, and perhaps minimize the stair-climbing walks during the week.
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