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Thread: Ah, knees......

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    Ah, knees......

    The backstory: bought a Specialized Sequoia Elite in late May. Rode it ~360 miles in June, lots of hills. Longest ride was over 60 miles, average ride is around 25 miles.

    I'm 48, 6-4" and 220 lbs. Have had an active life.

    I injured my right hip badly in 1988, skiing, and it definitely has led to some body symetry issues. Also, that leg is shorter than my left leg, which is just how I'm made.

    As I advance in my conditioning and aggressiveness with my riding, I'm battling my right knee a bit. There's two things going on. One pain is just to the inside of, and slightly below, the kneecap. This is a "push" pain. It'll get pretty sore around 15 miles. HOWEVER, taking a 5-minute break off the bike almost always cures it, flat out cures it. On my 60+ mile ride, at about mile 40 I was seriously concerned about the knee..... we took a good 15-minute break and viola! All better. Weird.

    In my left knee (let's call it my good knee, just because that's kinda funny!) I feel some strain at that corresponding spot under heavy load, just not pain per se, so taking a glass-half-full approach, I'm thinking that the right knee getting sore in that spot is not abnormal; it's just a sign that it is getting worked hard.

    The other pain I get in that right knee is more concerning... it's on the outside of the joint, pretty much right at the hinge there. This is a spot I injured last fall backpacking; stepped funny on a rock, thought "hmm, wonder if that's going to be a problem?" and yes, it was. I was able to finish the trip but it's come and gone since then. This is a pain that sometimes I never feel, is the weird thing. I've had numerous rides (half of them?) where I never feel it at all. However, if I DO start to feel it, it gets worse and worse and that's just how it is. It'll be stiff that night, then usually be fine the next day.

    I know the answer here- go to a sports doctor. Ok, will set that in motion. In the meantime, if the issues I described above ring a bell for you, I'd love to hear what worked for you, diagnosis, etc.

    My left leg is a cannon, a champ. If both my legs felt like THAT when I rode, I'd be able to ride every day, which would be great.

    I'm at the doctor as I type this, for a final wrap-up on my head injury in '11, and I'm going to ask for a referral to a sports doctor.

    Anyway... long post. Just fishing for info here.

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    Hi,

    <Redacted by Admin>so excuse my brusqueness :

    Knee problems are generally the saddle is too low.

    On the ball of each foot on the bottom of the stroke
    you should be able to lift off the saddle if you want to.

    On your instep it should be ~ 50/50.

    Heel in the pedal you can't lift off the saddle.

    If your legs are different lengths the above should apply to
    the shortest leg. If a real issue use different length cranks.

    It really doesn't get any more complicated IMO, i.e. there
    is nothing much you can do to make it in reality any better.

    If you still have knee problems with the above you basically
    have dodgy knees that any bikefit cannot address or fix.

    rgds, sreten.
    Last edited by Tom Stormcrowe; 07-27-13 at 08:30 PM.

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    http://www.stevehoggbikefitting.com/.../11/knee-pain/

    has a pretty thorough discussion of knee issues.

    Personally I get knee pain when my saddle is too low, and haven't ever had to look into the other factors mentioned.
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    Quick update: tried 3/8" worth of riser under my short leg, and rode 25 flat miles yesterday evening. I didn't push it- 15 mph average. 92 degree heat at the start of the ride helped keep me focused on mechanics and cadence rather than crankin'.

    The difference was fairly astounding. My riding mechanics were REALLY out of symetry. I didn't realize that until they weren't. Holy carp!

    The issue on the outside of the joint didn't flare up even though it was still a bit sore from the last ride. It felt like a much "cleaner" application of power through the knee in general. I've got hopes that this will put out the small fire brewing in that other area- under the kneecap basically.

    I *think* my saddle height is right for my long leg but was too high for my short leg, causing all kinds of goofiness.

    I'll report back as I ride more.

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    Have you thought about a leg length shim between the shoe/cleat of your shorter leg? If you're certain of a leg length discrepancy, most recommend accommodating about 50% of the difference...

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    I'll look into that. It's an available option in the world of cleats I take it?

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    absolutely. www.bikefit.com

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    Hi,

    And FWIW whilst the powerful heavy types tend to like pounding along
    at lower cadences the skinnier can't manage at the same speed, "mashing",
    there is a lot to be said for mixing it up and giving your knees a rest half of
    the time by "spinning", higher cadence pedalling in a lower gear than normal.

    Heavy powerful types who can spin with power, can go like a rocket,
    not for that long mind, but nice to have that burst of real speed.

    rgds, sreten.
    Last edited by sreten; 07-22-13 at 12:08 PM.

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    Quote Originally Posted by Long Tom View Post
    Quick update: tried 3/8" worth of riser under my short leg, and rode 25 flat miles yesterday evening. I didn't push it- 15 mph average. 92 degree heat at the start of the ride helped keep me focused on mechanics and cadence rather than crankin'.

    The difference was fairly astounding. My riding mechanics were REALLY out of symetry. I didn't realize that until they weren't. Holy carp!

    The issue on the outside of the joint didn't flare up even though it was still a bit sore from the last ride. It felt like a much "cleaner" application of power through the knee in general. I've got hopes that this will put out the small fire brewing in that other area- under the kneecap basically.

    I *think* my saddle height is right for my long leg but was too high for my short leg, causing all kinds of goofiness.

    I'll report back as I ride more.
    Hi Long Tom, May I ask what you used for a 3/8" riser? Did you attach it to the pedal semi-permanently? I think I need to do the same.
    Thanks,
    dancinmikeb
    Last edited by dancinmikeb; 07-27-13 at 10:36 AM. Reason: misspelling

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    Well, since I wasn't sure it was the thing to do, I just went to the drugstore and got the cheapest, flat, foam insoles from the Dr. Scholl's rack, and doubled them up inside my bike shoe.

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    Quote Originally Posted by Long Tom View Post
    Well, since I wasn't sure it was the thing to do, I just went to the drugstore and got the cheapest, flat, foam insoles from the Dr. Scholl's rack, and doubled them up inside my bike shoe.
    Fair enough, but definitely investigate the leg length shim. If one leg is shorter than the other you are bound to run into knee issues, even without other injuries. You could also end up with lower back problems as your pelvis will twist to compensate for the shorter leg, I guess. A proper fit and suitable shim will sort you out.
    There have been many days when I haven't felt like riding, but there has never been a day when I was sorry I rode.

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    I'm confused.... I'm using these insoles to do exactly that! Keeps my pelvis stable and my mechanics MUCH more symmetrical.

    Are you saying I need to address this "more properly" than with the insoles? I certainly agree.

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    Quote Originally Posted by Long Tom View Post
    I'm going to ask for a referral to a sports doctor.
    Good idea.
    You have an old injury, your continued problems cycling suggest more professional evaluation than an internet forum can provide. Your sports doc may be able to include an orthopedic specialist and hopefully an experienced bike fit specialist in you area to address your knee issues on the bike, and a formal recovery plan.

    -Bandera
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    Leg length discrepancies will likely effect knees but so will pedaling at too slow a cadence. To slow pedaling is a common occurrence in new cyclists. This is equivalent to an internal combustion engine trying to take a hill in too high a gear. The engine will lug down and sound unhealthy. It does take some practice to get up to typical cadences for longer rides of, say, 85 to 95 RPM. This may not be your principal issue but it is something many of us newbies have to work on. I occasionally do a ride where the focus is to spin the pedals.

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    On your instep it should be ~ 50/50.

    What does this mean.
    When you click in what should be 50/50

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    I think he meant to say "add a shim to fill in 50% of the length discrepancy," but I don't see why you don't add 100% of the discrepancy to the short leg, and make them nominally equal. Perhaps a subtlety is whether the difference between legs is in the femur or the lower leg?

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    Knee pain (more in the front of the knee) if saddle height related, tends to on longer leg. Although a Leg Length Shim does sound like a good idea http://bikefit.com/c-3-leg-length-shims.aspx The body tends to compensate some so that is why you usually do not make up the complete difference in length.
    Sounds like other fit issues are happening.
    I would also read this http://bikefit.com/s-13-road-bikes.aspx and see what seems to make sense. Find a BikeFit Pro. You need good advice on this.

    Good luck

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