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Old 01-10-09, 04:03 AM   #1
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Sore Knees - Any Ideas?

Morning all -

I've joined to ask for a bit of advice if I may. I started cycling again aftre a couple of decades about thre months ago. I wanted to loose some weight and get my blood pressure down - it worked.

I cycle some or all of the route to and from work three to four times a week - about thirty minutes in the morning and about an hour fifteen in the evening - on roads which are pretty much flat (the odd hill).

I noticed after about a month or so that I was getting slight tenderness on the outside of my knees - from just above the knee to just below the knee on the lateral side of the kneecap/edge of the leg. This was only noticeable after about an hour or so cycling - soI didn't get it in the morning and it only stated when I was close to home in the evening. It was fairly insignificant and, after I'd showered in the evening, it went away. No symptoms the following morning and it didn't interfere with my cycling the next day.

Now..... On Boxing Day I went out to get some air and I took a route with a big hill at the beginning and a duration, in all, of about two hours - just foolishness on my part I guess. The pain was noticeable after about an hour or so and was pretty brutal by the time I got home. It didn't go away after the shower and, although walking on the flat wasn't too bad, going up and down stairs and bending my knees was very difficult and extremely sore. It lasted all evening and I had to take ibuprofen before I could get to sleep. On the following day the pain was still noticeable but it went away by the end of the day and didn't return until yesterday.

Yesterday I started my cycling back to work routine - the pain came on after about twenty minutes in the morning - although it stopped when I got to work and got off the bike. It did it again on the way home to the extent that I got off the bike after about thirty fairly gentle minutes and caught the Tube home (I live in London UK and use a Brompton folder - so public transport is open to me - which explains the shorter commute in the morning).

The pain pretty much went away after my shower in the evening and, this morning, it's only there as a sort of 'gentle echo' as I go up and down stairs.

Now, I could stop cycling - but I'd rather not. Does anyone have any ideas - what is this?, will it go away with time?, would support bandages help?, do I need to visit a physio?, should I just take more painkillers (joke)?

Any advice welcomed before I take my life in my hands and visit my doctor.

Cheers
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Old 01-10-09, 05:18 AM   #2
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The two classic causes of knee pain are incorrect seat height and riding in too high a gear for conditions.

So you may want to check with your LBS that your seat is the correct height, and you may want to opt for spinning faster in a lower gear for any given conditions.

I personally try to avoid any big hills until I am warmed up.
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Old 01-10-09, 05:33 AM   #3
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Quite a few things spring to mind- But the things that are relevant are saddle position and angle of the feet on the pedals.

First thing is feet on the pedals. Do you ride with toes in or toes out on the pedals? This will affect the knee joint and a lot of newcomers don't think about it. Make a point of pointing the toes in on the pedals. this takes stress on the knees to a different place and hopefully will improve the pain. It will either get worse or stop so you will have eliminated one problem.

Saddle height- Very important for cycling efficiency and stopping stress on joints. You should have the saddle at a height in which the leg is almost straight with the pedals at the lowest position. Easy way to do this is to put the heel on the pedal and get the leg straight at the lowest crank movement. Then with the foot in the correct position on the pedal you will have the saddle at the correct height. Don't worry that you can't touch the ground- if that is the case- as it is easy enough to slip off the saddle when coming to a stop.

Then fore and aft position of the saddle. Start by putting the cranks parrallel to the ground. Then put your foot on the forward pedal and the front of the knee cap should be vertically above the Centre line of the pedal axle. If it is not- then move the saddle forward or back on the saddle rails.

Of course- these are only guidelines but are a good place to start from. I like to have the knee in front of the pedal axle and I use clipless pedals that really give me a lot of toe in.

And Hills in London? And which part of London? I am down on the South Coast near Eastbourne.

Welcome by the way but you have let yourself in for it now. You are close enough for my slice of PIE to arrive fresh
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Old 01-10-09, 06:36 AM   #4
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The other factor is simply that you're riding too much. Back off and take a rest for a bit. Still ride but don't do as much. The issues mentioned above are important and need to be checked, but I'm betting a fair bit of it is just your poor old body complaining (guess how I know this)

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Old 01-10-09, 07:03 AM   #5
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If europa has it right, then you absolutely must back off and ease up for a bit. As someone who played school sports, I learned to ignore pain to "play through it," to rub dirt on an aching elbow, etc. You might be able to get away with this, to an extent, when you're a kid, but at our age, the body takes longer to heal. I won't bore you with the details of how I know this.
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Old 01-10-09, 07:58 AM   #6
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Me, chronic knee pain and knee surgery has me very aware of my knees and cycling. When I got back into riding I followed the suggestion of the owner of my LBS and had him fit me for the bike. I raced years ago and had constant knee pain. I told him I just expected to have knee pain when riding and he was very emphatic that he could eliminate my knee pain by proper fitting of the bike, he was right! I was shocked how he was able to eliminate all my knee soreness and pain by adjustment of the following, seat height, fore and aft position of the saddle, saddle angle, cleat position fore and aft and toe position pointed in or out by cleat position.

The techniques for adjustment of your position on a bike are so much more sophisticated than they were when I raced 25 years ago. My LBS owner cracked up when I explained how I fit myself to a bike back then. Remember? Heals on the pedals, pedal backwards, raise the seat until your hips start to rock then move it a tab back down. Place your elbow at the front of the seat and extend your forearm and your finger tips should just touch you bars, hahahahahah, times change, and for the better in this case.

I ride now and have no knee pain thanks to my LBS. I must admit, out of habit I still ice both knees for 20min after each ride.

Go spend the money for a full fitment session by someone good in your area.
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Old 01-10-09, 08:24 AM   #7
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You didn't say whether you use clipless pedals. If you do, cleat position is critical for many of us. I have to disagree with stapfam about one thing, some of us toe-out, I toe-out so much I have to use pedal extenders or my heels hit the crankarms.
Everyone is right about the cadence thing, too. Learn to spin as much as you can, your knees will thank you.
Fit on the bike is also critical. Some people start with the saddle too low.
Another thing to remember is that some of us need time for the knees to adapt. I've read that the glands that lubricate the knees will improve over time to help with the rigors of cycling.
It may also help to keep your knees covered in colder weather.
I don't think 5-7 hours per week is excessive, but if you are having pain, you need to figure it out.
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Old 01-10-09, 09:00 AM   #8
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It may be that you are simply using muscles and exerting pressure in areas not used to it. Or you could have a problem in the knee area. If it goes away after a ride, then it's likely it could be an adjustment on the bike rather than a knee problem. Have an experienced rider, or your local shop, help set up the bike to fit you. And it may take a while for muscles you aren't used to using to get fit enough for their new tasks. If it continues, see a doc or phys therapist to be sure your knees are ok, and that you aren't causing injury to what could be an existing problem.
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Old 01-10-09, 09:16 AM   #9
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Good topic, what if you don't have normal knees??

I too experiance a level of knee pain but then I'm quite "knock kneed", should of had special supports as a child, Mom couldn't afford them. So my knees point "outward, I use old fashion Christopher METAL half-clips, I've seen "way to many" fallers both on and off road using the clipless pedal systems. So I guess it would be "natural" for me to point my toes "outward" but the half-clips kinda hold the center of the shoe so that forces my knees a bit "inwards". After this topic I think I will try to "re-position" my half-clips a bit more "outward" on the pedals and see if that changes anything, thanks!
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Old 01-10-09, 09:39 AM   #10
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As the post prior to this suggest, there are many possible causes for your knee pain. Given the ciritical nature of the knee joint to cycling, I'd encourage you to get some help from a good fitter. Someone who is knowledgeable can help spot things that you simply can't see. From my perspective if you remain serious about cycling, investing in professional help in resolving these kind of issues is well worth the investment. I know my recent experience with a fitting system was an eye opener to me. See my thread: Retul Fitting Report - long
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Old 01-10-09, 10:43 AM   #11
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What you're describing kinda sounds like what I've seen wrt IT Band syndrome. I know nothing about it other than that- but the folks on the Training/Nutrition forum on this board do.
Also, I just went thru some knee issues- muscle imbalance puling knee cap off center- there's a fancy name for it that escapes me. But what's relevant here is pedal position and cleat alignment- if you're using clipless, and have any knee issues at all, then go get your cleats aligned. Period. And not just fore-aft- your entire pedal stroke/hip/knee/foot alignment needs to be checked/adjusted. About 60.00 US.

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Old 01-10-09, 01:04 PM   #12
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[QUOTE=big john;8156271] I have to disagree with stapfam about one thing, some of us toe-out, I toe-out so much I have to use pedal extenders or my heels hit the crankarms.
[QUOTE]

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First thing is feet on the pedals. Do you ride with toes in or toes out on the pedals? This will affect the knee joint and a lot of newcomers don't think about it. Make a point of pointing the toes in on the pedals. this takes stress on the knees to a different place and hopefully will improve the pain. It will either get worse or stop so you will have eliminated one problem.
Different versions to different problems and cures. One of which may work.

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I was shocked how he was able to eliminate all my knee soreness and pain by adjustment of the following, seat height, fore and aft position of the saddle, saddle angle, cleat position fore and aft and toe position pointed in or out by cleat position.
From this reply- you can see that a lot of adjustments may be affecting the knees- You just have to find the item that is causing the pain.
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Old 01-11-09, 01:14 PM   #13
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Eveyone seems to have it about right.

1) Stay off your bike for awhile until the pain goes away.

2) Make sure your seat is high enough. Ever sit on a little kids bike and try to pedal? Not only do you look silly, but you have very little efficiency. You wouldn't want to do that for more than a few feet, would you? Well, if your saddle is too low, you're approximating this. The less knee bend you have at the bottom of your stroke, the better, until you get to the point where you have to stretch to reach the pedal. Your knee needs to have a little bend at the bottom of your stroke but not much. Play with the saddle height until you get it as high as possible without being too high. A fraction of an inch will make a noticable difference.

3) Ride with a faster cadence. Not only will this save your knees, you'll also probably go faster. Try riding in your normal gear, checking your speed, then trying one gear lower on the same stretch of road. When I tried this I discovered I rode faster. Now I try and keep my cadence up (though, of course, too fast and you'll feel like a hamster!)
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Old 01-11-09, 03:12 PM   #14
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Originally Posted by Artkansas View Post
The two classic causes of knee pain are incorrect seat height and riding in too high a gear for conditions.

So you may want to check with your LBS that your seat is the correct height, and you may want to opt for spinning faster in a lower gear for any given conditions.

I personally try to avoid any big hills until I am warmed up.
+ 1 on the above and get some Raleigh white cream linament and rub it on your knees every night works great rub it in until you fell it get really slick . I got arthritis in my kness and tendonitis at times this stuf is a mircile ymmv thou ! If it gets bad you will have to rest a day or 2 now and then and not ride . I know that sucks but its part of getting older .
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Old 01-11-09, 03:49 PM   #15
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+1 Seat Height.

+1 Spin more (increase your cadence, use an easier gear).
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Old 01-11-09, 03:59 PM   #16
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Quote:
Originally Posted by Artkansas View Post
The two classic causes of knee pain are incorrect seat height and riding in too high a gear for conditions.
So you may want to check with your LBS that your seat is the correct height, and you may want to opt for spinning faster in a lower gear for any given conditions.

I personally try to avoid any big hills until I am warmed up.
Mashing too much. Spin more.
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Old 01-11-09, 06:41 PM   #17
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Not much I can add to the good advice already offered but I did want to welcome you to the 50+ group.
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Old 01-11-09, 09:48 PM   #18
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Avoid the big chainring, steep hills, and strong headwinds for a few weeks. Tightening the outside front derailleur limit screw is a good deterrent.
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Old 01-11-09, 10:08 PM   #19
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I'm with the take a rest faction. Do something else for a while.
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Old 01-12-09, 08:04 AM   #20
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My daughter started to have some knee pain so I googled for causes. They are saddle too high or too low, saddle fore/aft position, cleats at the incorrect angle and off course gearing too high.

From my own personal experience I would add increasing either time or intensity too quickly. It takes a while for the body to adjust. I've had this problem for both jogging and cycling. Even laying off a week or two, when getting back into it I have to be careful.

I've always followed the old rule that if I doing something and the pain doesn't decrease, stop doing it for a while and let the body recover. Then resume and build up slowly.

I've read that there are many types of arthritis, but they all respond positively to exercise. So if it's arthritis, staying off the bike for a while and then starting again but building up very slowly might work as well.

Another possibility is to add some weight training. Weight training contributes to joint health and corrects the muscle imbalances (and subsequent difficulties) caused by cycling, especially road cycling. Weight training is also necessary to counter the decay due to ageing which you may be experiencing. Aerobics is insufficient by itself.

An excellent source is the new book Weight Training for Cyclists, second edition. On the decay issue, Younger Next Year is a good source.

Al
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Old 01-12-09, 05:12 PM   #21
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I ride a LWB recumbent, but the general principles for curing knee pain are the same. Getting the seat setback (akin to height) was critical in relieving pain. Gearing down helped, too. What really helped a lot was changing from 170mm cranks to 160's. I was amazed at the difference. It really changed the angle of my knees at the top end of the stroke which made a big difference. bk
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Old 01-12-09, 05:54 PM   #22
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The shorter cranks are liked by the fixed gear brigade too, again to help with spinning. But looking at age factors, I wonder if shorter cranks become more applicapable as we get older.

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Old 01-12-09, 06:05 PM   #23
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Everyone here is on the money when it comes to spinning and seat height. I only wish to add one more way to cope with aching knees. ASPIRIN (or its equivalent) can keep a minor ache from turning into a big one, by reducing inflamation, which itself can cause further irritation in an ugly positive feedback loop. Take a couple of aspirin before you hit the hills, and boy what a difference it makes (and it worked even before I turned 50).
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Old 01-15-09, 08:11 PM   #24
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Quote:
Originally Posted by bjjoondo View Post
I too experiance a level of knee pain but then I'm quite "knock kneed", should of had special supports as a child, Mom couldn't afford them. So my knees point "outward, I use old fashion Christopher METAL half-clips, I've seen "way to many" fallers both on and off road using the clipless pedal systems. So I guess it would be "natural" for me to point my toes "outward" but the half-clips kinda hold the center of the shoe so that forces my knees a bit "inwards". After this topic I think I will try to "re-position" my half-clips a bit more "outward" on the pedals and see if that changes anything, thanks!
If you use pedals that tend to force your foot angle to an unnatural position, you might want to consider clipless pedals that allow a larger amount of "float" (the amount of rotation that the pedal freely allows, before the release mechanism starts to provide resistance).

My Shimano pedals provide 6 degrees of float, which is plenty for me. But some other pedal brands provide more float, or in some cases they offer different cleats that have different amounts of float (Look, for example). Some people who experience chronic knee pain swear by Speedplay pedals, which basically have unlimited float.

(Conversely, people who really want to feel locked into position can get pedals/cleats with zero float.)
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Old 01-17-09, 06:54 PM   #25
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Everyone here is on the money when it comes to spinning and seat height. I only wish to add one more way to cope with aching knees. ASPIRIN (or its equivalent) can keep a minor ache from turning into a big one, by reducing inflamation, which itself can cause further irritation in an ugly positive feedback loop. Take a couple of aspirin before you hit the hills, and boy what a difference it makes (and it worked even before I turned 50).
+1 Pre-medicate with your favorite anti-inflamatory.
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