Mainframeguy

I'm getting slightly alarmed to find myself waking with knee pain on both sides a couple of days after I stretched myself with a 32 miler with a couple of hard climbs.

I have a context for this where my wife underwent a total knee replacement surgery for her right side and is looking at the same on her left in the next couple years or so. This has prevented our tandem riding this year and instilled a healthy fear of any similar procedure for myself.

One of the things I often say is that the knee is unlike other joints in our body in that we are able to build the muscle and work the joint to help prolong it's life. But now I am getting these grumbles and pains I am wondering....

So far it's nothing that an ibuprofen and a gentle moving of the joint won't fix. But are there others here with more veteran experience who might recognize this stage and have any advice? I intend to continue to extend the range and duration of my rides - unless others advise a more gentle approach.

On a more positive note I was flagged up for high Blood Pressure by the doctor, but the day after my ride it had dropped 25 points to a very healthy readout!

MikeD1

Some things to look at, you might already have considered but here they are;
- I would VERY gradually push the distance/intensity rather than too much, too soon
- How is your cleat placement? Do you have some float in your cleats to allow your knees to be neutral?
- Saddle height makes a huge difference for me and others. Too low, and you are really stressing the knees, too high is also a problem
- Leg length discrepancy? Very common, shims or such to even it out
- Cadence, gear choice. An easier, spinning cadence is usually much easier on the knees than pushing a big gear
I am lucky enough to have a good friend who used to do pro bike fitting. He really helped fine tune my position on the bike, particularly adjusting my cleat positioning and using shims to adjust for leg length difference and a "wobble" in one knee. Made a huge difference for me!
BTW, congrats on the lower blood pressure number. I've managed to "avoid" BP medication for over 30 years by means of exercise . . .

Midtown

What helped me was shorter cranks. I'm now knee pain free.

John E

My $0.02 worth as a former knee patient (a couple of patellar dislocations and evidently a congenital instability which makes me susceptible to these):

1) Read "Save Your Knees," by James Fox, MD.
2) Yes, definitely spin the low gears, instead of slogging the big ones.
3) Take turmeric and other natural anti-inflammatories.
4) Strengthen the vastus medialis, which is the only one of the 4 quad muscles which stabilizes the kneecap and keeps it from drifting outward

You are correct -- the knee is an articulation, not a joint (the hip's ball-and-socket is a joint). Your muscles and tendons govern the alignment of the bones, particularly the way they track each other.

rumrunn6

under 50 degrees F, gotta cover the knees

RoadLight

Hi Mainframeguy,

You've received some good advice. I can share a little of my experience in this area...

I train primarily for distance and, like you, decided to increase the length of my rides. Two years ago I was riding about 21 miles per day. This past year (2014) I increased it to 35 miles per day. At first I began to notice some mild knee discomfort, primarily at the front of both knees and I corrected this by both raising my seat and moving it back. I'm careful now to make sure that my knees do not extend too far forward (beyond the front of my pedals). The discomfort has gone away and I rode two centuries in 2014 without problem.

But my wife was having a lot of discomfort in her knees. She's short (5'2") and, like me, has a proportionally long torso (therefore, short legs). I shot some video of her leg motion as she pedaled and we both studied it. It seemed obvious that her 165 mm crank arms were too long because her knees were coming up too high. I did some research on the 'net and discovered Peter Jon White's website where he discussed fitting a bike---particularly crank length. He recommended measuring the leg length from the top of the femur to the floor while standing barefoot then using a crank length 18.5% of that length.

This worked out to about 150 mm for my wife. So we searched for a crankset of the proper length that would fit her existing chainrings and square-end bottom bracket of her vintage 1985 Fuji Sagres road bike and found a nice Origin8 alloy crankset. I installed it and she's been pain-free and extremely happy ever since.

Based on Peter White's recommendation, my crank length may be too long, also. I have a vintage Fuji bike similar to my wife that I've ridden for many thousands of miles and it has 170 mm crank arms. And I have a modern carbon Fuji that I've owned for only a few months that has 172.5 mm crank arms. The 170 mm length definitely feels better but I haven't noticed any pain yet after a couple hundred miles on the "new" bike with the slightly longer crank. The thing about White's recommendation is that it is just a guide---a place to start. He allows considerable latitude based on rider comfort and preference.

White recommends 165 mm for my leg length even though I'm a tall 6'2" (because my torso is long, my legs are proportionally short like my wife). So I'm torn as to what to do. On the one hand, I'm tempted to try a 165 mm crank to see how it feels. Plus, it would be nice to have my pedals a little higher above the road for leaning hard into fast turns. But my carbon bike has an expensive SRAM crank with carbon arms, making experimentation costly. I plan to add a new non-drive-side crank arm to my carbon bike next year. It will be a Stages Power crank arm with an integrated power meter. So I need to nail the correct length before then.

I've disassembled my vintage bike for some frame repair. When I reassemble it, I may put a 165 mm crank on it to see how it feels. If it is an improvement, then I'll look into getting a 165 mm SRAM crank for the carbon bike before I buy the power meter. If it doesn't make a significant improvement, then I have to decide is the extra 2.5 mm of the present carbon crank worth fussing over compared to the 170 mm length that I'm used to. More time with the bike will tell. Decisions. Decisions.

But one thing I have learned: Many riders today are probably using crank arms that are a little too long because bike manufacturers are not scaling the crank length to fit the frame size as well as they could. They scale a little---but not much---especially with the smaller frame sizes. For example, it's not uncommon to see them offer cranks from 165 to 175 mm across the size range of their frames. But a 150 mm crank for their smallest frame? You just don't see it and yet this is often what riders on the smallest frames need. Perhaps crank arms should be treated like pedals---don't include them---let the buyer make that selection at the LBS.

I hope my experience will help you.

Kind regards, RoadLight

berner

Mechanical solutions to knee pain or discomfort may be the solution to its elimination but that is not the only or best solution. For myself, what works is to strengthen the area with exercises of which there are many shown on You Tube. Slideshow: Exercises for Knee Osteoarthritis and Joint Pain
I do a number of exercises which are similar to those shown in the videos but since I've been doing then for some years, I use ankle weights, 10 pounds on each leg. The exercises I do maintain near pain free knee function and strengthen core muscles. These core muscles are the same ones that function with the diaphram for breathing. It is often difficult to isolate one function from others as the body is one complete system where one set of muscles will reenforce other muscles.

Kaminokaze

One thing I found out about knee pain. I never have knee pain of soreness in the summer. However in the winter I would have knee pains. I have had MRI's and X-rays and nothing is wrong.
How cool/cold was it? I would wear knee warmers and or leg warmers to help with this but I would still have soreness and pain when the temp dropped. About 3 years ago I went to riding with with two sets of warmers when the temp was below 55 deg. I have not had any pain or knee problems in the winter. Keeping the knees warm helps! Worked for me.

BlazingPedals

Trying a short crankset doesn't have to be expensive. But if you find you like it, THEN you may end up spending some dough. If they're the wrong size for you, are you going to ride them anyway just because they're expensive?

RoadLight

Hi berner,

How do you know that it is not the best solution in this case? The best solution should address the cause of the problem. If the cause is non-optimal mechanical geometry of the leg while pedaling the bike then fixing that by correcting the fit of the bike to the rider's leg is the best solution and no amount of exercise is going to offer a better solution.

Only the OP can answer this because we don't have enough information. The best we can do is offer suggestions---not ultimatums about what is best!

On the other hand, if you meant knee replacement surgery when you wrote "mechanical solutions", that is not even on the table. The OP stated that he plans to avoid that. This discussion is focused on the bicycle and the OP increasing his distance to 34 miles.

Regards, RoadLight

Carbonfiberboy 

"Knee pain" comes in many varieties with even more causes. No one can tell what your knee pain is about because you haven't told us anything about it. Some varieties:

Bursitis
Osteoarthritis
Tendonitis
Chondromalacia patella
IT band syndrome
and there may be more I can't think of right now . . .

Without knowing exactly what the symptoms are and where they are (photos are good), it's impossible to give any opinion that carries any weight, because so far no one can have any idea about what the problem is, much less its solution.

takenreasy

Have you changed your seat height lately? Low seat height is a notorious cause of bicycling related knee pain.

CrankyFranky

Wow - this is a really good thread! Carbonfiberboy is absolutely correct - there's lots to go wrong with knees. For my knee issue, which is mild OA in my right knee - it flared up due to extended forced inactivity healing from my last foot surgery. It turns out that my knee doc correctly diagnosed that I had a weak core and prescribed PT which included leg lifts with ankle weights. I found an adjustable pair which one can add to at 1/2 lb. intervals up to 5 pounds. After about three months of thrice weekly exercise, I worked up to five pounds, and slowly my knee pain disappeared. I'm pretty sure that my bike fit is nearly correct. But the discussion about crank length has intrigued me - I'm going to check that.

One thing I've learned is that once your core is more toned, it is easier to rotate your hips forward while riding, which engages your glutes more in powering your pedal stroke. This also helps the knee, I think by balancing the efforts of the quads somewhat (?).

Mainframeguy's knee issue may be something else entirely, or a combination of physical and bike-mechanical and bike-fit. Or maybe simply he didn't spin enough. When I spend too much time in too high a gear my knees surely let me know.

Whatever it proves to be, OP, I do hope you keep your knees warm and that they stop complaining!
I wistfully remember lovely cycling around the Ayots in Hertfordshire, the South Downs, and dozens of other wonderful places I enjoyed whilst in the UK. Cheers!

mox

If you can change your route to avoid the hard climbs I'd recommend trying that just to see if it makes a difference. It's been my experience that climbing puts a noticeable strain on my knees, even a moderate hill causing much more discomfort than a 50 km ride.

newbie101

Check out some of Pete Egoscue's books: all of the joints are inter-related and work as a system so Egoscue's book is helpful and informative in that regard.

Mainframeguy

Wow! What a fabulous response! I am truly grateful to all who posted on this thread for taking the time to offer up things that have been helpful for yourselves and all the many strands of possible actions.

Rather than feeling this might be a problem looming I now feel about it more like an opportunity to tinker with my bikes and ride routes and cycling technique and background exercising to get myself pain free.

I'm fortunate enough that my lovely wife is buying me a new "ruby red" Brookes Colt to go on my touring bike soon - so I shall surely be tinkering with the saddle position there in the course of breaking it in..... The cranks are stock standard, but I shall make that measurement of my lower leg and calculate the percentage to see how that pans out. Since this is by far my greatest mileage bike it is arguably the most important to get right.

Recently I changed my road bike to a compact crank set, I'm simply too old and to be honest overweight to power the big gears on there as stock. The compact crankset has enabled me to keep the cadences up, EXCEPT on the big climbs. It would feel wasteful to swap out those crank arms after almost no time at all, but maybe I can Ebay the old set to offset costs.

Lastly our beloved tandem, where I'm unlikely to change my set up, always have great memories of feeling very healthy tired after tandem rides (no doubt due to the great workrate of my stoker wife!)..... In fact on one of our last rides before her surgery stoker managed to strip one of her crank arms! This was replaced without reviewing the sizing - though LBS had to go to thorn for a match, so must have been unusual.... Anyway, to cut a long story short I shall be employing all the advice in this thread and taking stoker and tandem for her to be professionally fitted given that she is post operative right knee and has only just recently achieved sufficient flexion in the joint to consider getting back to the tandem,

I've taken a load of words to say it - but basically I hope it i clear how grateful I am to every single poster on the thread for taking the time to share.

I shall try and remember to post into this thread any milestone actions and results thereof along the way (but might separate tandem issues to the relevant forum since that's a bit specialist and someone elses knees are involved!)

Thanks one and all!!

Mainframeguy

Since I brought the subject up and am well aware these are key factors for the old knees I better put some numbers to this - I'm hitting my 55 years old on December 12th and due to some medication/metabolism issues combined with age I'm weighing in at 15 stones presently, that's 210 pounds for the Americans. Target weight is to bring that down around 175 where I used to be not so long ago before meds (and oh my how relatively effortless the climbs would be then!)... and the context for my weight is a height of 5' 11"