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Old 10-31-10, 01:28 PM   #1
Jiffyjam
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Routine that stopped my knee pain?

Pain that had developed in my (L) kneecap had stopped me from riding. I could barely walk down a flight of stairs or even down a slope. Ortho Dr told me to keep riding but cut the mileage in half...still hurt . So I tried this routine...1st day- walk 3 miles including 1 mile of steep incline, 2nd day- bike 15 - 20 miles, including 1-2 long climbs, 3rd day- rest. Then repeat. My knee pain has stopped completely. Maybe it just healed or the longer interval between rides allows enough rest or maybe the walking is adding strength to other muscles that support the patella, don't know. I was wondering what some of you may have done in this situation and if it worked for you or not. Ride safe...
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Old 10-31-10, 02:00 PM   #2
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I had a similar situation, pain just to the inside of the patella. I found riding with a neoprene brace until I built up the strength in my knees provided just that added support needed. I still use it for the first few months of each season, so far mostly pain free although I have developed a little of what I think is arthritis in one knee that had surgery on it about 17 years ago.

Glad to hear you found something that worked for you, it can be real frustrating.
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Old 10-31-10, 02:54 PM   #3
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I had a similar situation, pain just to the inside of the patella. I found riding with a neoprene brace until I built up the strength in my knees provided just that added support needed. I still use it for the first few months of each season, so far mostly pain free although I have developed a little of what I think is arthritis in one knee that had surgery on it about 17 years ago.

Glad to hear you found something that worked for you, it can be real frustrating.
My pain is more on the outside (lateral) aspect. Its called "patellofemoral syndrome" among other things. I'v considered the brace and may try one. My concern with that so far has been compromising circulation because I'm a diabetic.
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Old 10-31-10, 04:19 PM   #4
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My concern with that so far has been compromising circulation because I'm a diabetic.
Can't help you with that - circulation is a big deal for your condition.
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Old 11-01-10, 06:58 PM   #5
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I also found somewhat steep incline walk on treadmill helped. I would lay off the hill climbs for a while if I were you until you are sure the root cause of original pain has been eliminated.


Are you riding a road bike or hybrid?

I was riding a hybrid and got the knee pain. It was diagnosed as Patellar femoral syndrome by an ortho doc. I laid off for a few months, while building up the inner lower thigh muscles using exercises I was taught by a PT. I also bought a road bike with speedplay X2's, Specialized BG road pros shoes (built in Varus wedge) , thinking that I would be using more glute power. The pedals and shoes were recommended to me by my fitter as being the best for people with knee issues. Started back gradually and knee pain has gone away. In fact I have had rides where knee hurt a little prior to ride and actually got better as I rode. Another thing that helps as I am riding is to keep knees, thighs, calves etc parallel during the pedal stroke. Don't let the knees open up to outside.

Then....after a few weeks on the road bike, went back to hybrid for one ride and presto, knee pain again, immediately, even though I had increased strength in inner thighs. I then took both the road bike and hybrid up to my fitter. He did a back - back check of how far saddle sits back from bottom bracket. Turns out the axial (parallel to ground) set back of seat relative to bottom bracket is too small on the hybird. It has been creating an obtuse torso / thigh angle, leading to shear strain (pulling the knee cap out of its groove). I was also getting a fair amount of knee flex at top of stroke. I am 5' 9 1/2 " tall, but inseam is around 83 cm. I ordered a 58 cm frame, which gives me a little more setback and allows the saddle and handlebars to be level. (but that's for another thread)

On the road bike, my kneecap is behind my pedal axle if you were to take a plumb bob from front of knee down to pedals. I have the saddle set back as far as possible on both bikes. Another thing, the road bike has a 172.5 mm crank arm; Hybrid has 175 mm although I doubt that made much of a difference.

So now, my wife has inherited a really nice hybrid, which she loves and I ended up with a nice road bike and am riding pain free for first time in quite a while.

Last edited by MorganRaider; 11-01-10 at 07:02 PM.
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Old 11-01-10, 07:40 PM   #6
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Originally Posted by MorganRaider View Post
I also found somewhat steep incline walk on treadmill helped. I would lay off the hill climbs for a while if I were you until you are sure the root cause of original pain has been eliminated.


Are you riding a road bike or hybrid?

I was riding a hybrid and got the knee pain. It was diagnosed as Patellar femoral syndrome by an ortho doc. I laid off for a few months, while building up the inner lower thigh muscles using exercises I was taught by a PT. I also bought a road bike with speedplay X2's, Specialized BG road pros shoes (built in Varus wedge) , thinking that I would be using more glute power. The pedals and shoes were recommended to me by my fitter as being the best for people with knee issues. Started back gradually and knee pain has gone away. In fact I have had rides where knee hurt a little prior to ride and actually got better as I rode. Another thing that helps as I am riding is to keep knees, thighs, calves etc parallel during the pedal stroke. Don't let the knees open up to outside.

Then....after a few weeks on the road bike, went back to hybrid for one ride and presto, knee pain again, immediately, even though I had increased strength in inner thighs. I then took both the road bike and hybrid up to my fitter. He did a back - back check of how far saddle sits back from bottom bracket. Turns out the axial (parallel to ground) set back of seat relative to bottom bracket is too small on the hybird. It has been creating an obtuse torso / thigh angle, leading to shear strain (pulling the knee cap out of its groove). I was also getting a fair amount of knee flex at top of stroke. I am 5' 9 1/2 " tall, but inseam is around 83 cm. I ordered a 58 cm frame, which gives me a little more setback and allows the saddle and handlebars to be level. (but that's for another thread)

On the road bike, my kneecap is behind my pedal axle if you were to take a plumb bob from front of knee down to pedals. I have the saddle set back as far as possible on both bikes. Another thing, the road bike has a 172.5 mm crank arm; Hybrid has 175 mm although I doubt that made much of a difference.

So now, my wife has inherited a really nice hybrid, which she loves and I ended up with a nice road bike and am riding pain free for first time in quite a while.
Great post. I did sort of the opposite by going from 58cm to 56, ( road, touring ) but the crank length is the same at 175mm. Inseam is 33in. The tip of my saddle falls behind the BB axis and my kneecap about even or slightly behind the pedal axle. Should have mentioned this change in the original post along with the other things. My doc seemed to think that overuse was the culprit but I suspect it was a combo of things. Now my previous bike really fit about the same as this one despite the stated size difference, I just wanted to get a Long Haul Trucker and their sizes run a tad bigger (according to the LBS). I'll continue with the walking routine as I feel stronger overall after starting it till next spring and then see how things go. Also, like you mentioned, the pain would actually get better or stop AFTER riding since changing everything to the point that I now have no pain. Maybe the new bike is the hero. Its good to hear that you beat it also, regardless of the method.
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Old 11-02-10, 10:14 AM   #7
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@Jiffyjam:
The thing that perplexes me to this date is how I could put 400 or so miles on the hybrid last fall with no knee pain. My fitter, who also happens to be a cycling coach and married to a physical therapist, said it was probably a build up overtime. After a 4 month layoff, the pain started right away and would not go away. So one may not feel pain right away. All I know, it's fixed and I could not be happier to be back in saddle, albeit with a late season start.

Relative to your Surly running a big. My 58 cm roadbike has a 57.3 cm effective head tube length and a tall (190mm) head tube, which along with my longer inseam, is probably why I can get away with the bigger frame. It's a TREK 2.3.
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Old 11-02-10, 11:02 AM   #8
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Originally Posted by MorganRaider View Post
@Jiffyjam:
The thing that perplexes me to this date is how I could put 400 or so miles on the hybrid last fall with no knee pain. My fitter, who also happens to be a cycling coach and married to a physical therapist, said it was probably a build up overtime. After a 4 month layoff, the pain started right away and would not go away. So one may not feel pain right away. All I know, it's fixed and I could not be happier to be back in saddle, albeit with a late season start.

Relative to your Surly running a big. My 58 cm roadbike has a 57.3 cm effective head tube length and a tall (190mm) head tube, which along with my longer inseam, is probably why I can get away with the bigger frame. It's a TREK 2.3.
I was fine for about 500 or so, then one morning went out for a flat 25 miler. A few miles into the ride my knee started up so I stopped and walked around a bit till it stopped. Finished the ride w/ no problem then the next day it really started up...go figure. Nothing had changed I knew of, this was on the REI Randonee that I ended up taking back. Fixin to go for my walk as I write this and am considering how to outfit for a much cooler ride tomorrow. Thats another issue, when its cold out its worse on the joints...we will see. Ride safe
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Old 11-02-10, 11:55 AM   #9
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I apparenlty strained a ligament or something last year about this time. Never went to the doctor. I could ride about 5 miles, no pain. Somewhere before 10 miles I could feel it, 15 miles was pretty painful and by 20 miles my muscles would kick into spasms.

I was off the bike for a little while with that. My wife bought me a single speed for Christmas. I thought that might be a terrible mistake because I feared my riding days were over. Instead, I think the ss helped me heal. On my other (geared) bikes, I tended to baby the knee by only riding while sitting and keeping a more or less consistent cadence. On ss, both of those are not really possible. My cadence varied all over the place cuz I couldn't change gears, plus I needed to get up out of the seat to climb hills. I think the strain was made worse by the consistent repeated movement. On the single speed there was enough variation that I didn't seem to aggravate the condition in my knee. After a couple weeks on the ss, the knee felt fine.
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Originally Posted by bragi "However, it's never a good idea to overgeneralize."
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Old 11-02-10, 01:12 PM   #10
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I apparenlty strained a ligament or something last year about this time. Never went to the doctor. I could ride about 5 miles, no pain. Somewhere before 10 miles I could feel it, 15 miles was pretty painful and by 20 miles my muscles would kick into spasms.

I was off the bike for a little while with that. My wife bought me a single speed for Christmas. I thought that might be a terrible mistake because I feared my riding days were over. Instead, I think the ss helped me heal. On my other (geared) bikes, I tended to baby the knee by only riding while sitting and keeping a more or less consistent cadence. On ss, both of those are not really possible. My cadence varied all over the place cuz I couldn't change gears, plus I needed to get up out of the seat to climb hills. I think the strain was made worse by the consistent repeated movement. On the single speed there was enough variation that I didn't seem to aggravate the condition in my knee. After a couple weeks on the ss, the knee felt fine.
Makes sense that could be happening. I was thinking the same about mixing the 3 mile walk in with my riding, that the different routine might be making the difference. BTW, what a BAD feeling it is to think you may have to stop riding....
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Old 11-02-10, 01:32 PM   #11
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No, the BAD feeling was thinking I might have to give up riding, and then my wife BUYS ME A BIKE for Christmas. I actually pulled her aside and told her the bike might have to go back and she started crying; she thought she had gotten me the best present EVAR and was heartbroken when she heard I might not want it.

Finally, I said that okay, I'll try it. Good thing she cried, because when I tried it my knee felt better on that bike than it had on anything else for over a month! It turned out that it was the best present EVAR.
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Originally Posted by bragi "However, it's never a good idea to overgeneralize."
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Old 11-02-10, 02:13 PM   #12
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That change of routine may have been the solution, or, as you say, it might have gotten better by itself.

I've had many experiences with pains that go away dramatically even though I've changed nothing. People often swear by some treatment (e.g. glucosamine) simply because the treatment was initiated just as it was time for the pain to get better.

Also, this kind of thing can work on a threshold basis. That is, when the inflammation reaches a certain point, the inflammation makes things rub more, and makes everything worse. Stay below that initial threshold, and you're fine.
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