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  1. #1
    Portland Fred banerjek's Avatar
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    Why am I wrecking my knees?

    I'm not wondering why they hurt, but why I seem to have so much trouble avoiding doing things that make them hurt? I'm asking this in a distance forum because sometimes I wonder what motivates us? I know there are many reasons, but in many cases, I suspect masochism plays a major role. I can't enjoy a ride unless I'm in some pain, and the rides I look forward to the most usually have me feeling pretty bad.

    I'm a big fan of long rides with extended tough climbs -- the kind where you grind in first gear (34/27 in my case) for miles and might even have to stand on that. This year, I've been doing 10K feet of climbing just on my weekend training rides unless pain stops me. Frankly, the only reason I don't do more on the training rides has to do with time.

    If my rides are even vaguely reasonable, my knees don't cause problems. However, I can't get myself to let things heal up properly so things have gradually gotten worse. It used to be that 10K feet caused no problems. Now it causes moderate pain that takes weeks to heal from (so I can't do them every weekend anymore), and the extended rides get pretty uncomfortable and I'm unable to fully recover between them.

    I think I could be pain free in a few months if I simply avoided extended climbs that I couldn't spin up or put MTB gearing on my bike. But for some reason, I can't get myself to do it. What the heck is wrong with me? I want to be able to still do challenging rides in a few years, but I seem to have a compulsion to do dumb things that could relegate me to easy flat rides.

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    I think one thing that separates me from my randonneurring peers is that I don't 'get' climbing. I mean, I like the reward of a gorgeous view at the top of a peak, but I always wish I can just fast forward through the part that involves an hour of grinding away at 7mph. It's not a threshold thing, as I'm willing and able to sustain hours of discomfort for a specific goal, but it's not something in which I revel.

    While I also don't mind pain (and am fond of the saying "pain is weakness leaving the body") I don't find it to be a requisite component of enjoying the ride. I suspect that might be why I don't enjoy climbing. I enjoy long rides partially for the challenges that they impose and pain is a signal that the challenge has been worthy; but I don't seek out pain for its own sake.

    Have you looked at getting orthotics or having someone else look at your pedal stroke?

  3. #3
    I can has bike ride? morea's Avatar
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    have you been checked out for any particular cause of your knee pain? I personally have a condition called "chondromalacia patella" which basically means that my kneecaps don't track straight, and I can wear braces that help to correct the problem. We have some monsterous hills here, and they haven't stopped me yet!

    I also just recently invested in a pair of those specialized footbeds (they help keep my pedal stokes going straight up and down instead of allowing my knees to lean inward) and they have been quite helpful, too.

  4. #4
    Portland Fred banerjek's Avatar
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    Quote Originally Posted by morea View Post
    have you been checked out for any particular cause of your knee pain? I personally have a condition called "chondromalacia patella" which basically means that my kneecaps don't track straight, and I can wear braces that help to correct the problem. We have some monsterous hills here, and they haven't stopped me yet!

    I also just recently invested in a pair of those specialized footbeds (they help keep my pedal stokes going straight up and down instead of allowing my knees to lean inward) and they have been quite helpful, too.
    My wife has been bugging me to see a doc, but I hadn't yet simply because I assumed I'd just be told to tone things down a bit. I should probably get this checked out. I hadn't thought of the possibility of something as simple as orthotics or braces helping (which is ironic because I wore braces for 18 years).

    I have had past history with my knees. I had to quit running 20 years ago. Cycling has really helped my knees overall -- they still feel better than they did back then. As a matter of fact, although I have been riding distances for a long time, I've only been doing really hilly distances for less than 5 years because I couldn't climb before without inflicting insane amounts of pain.

    I have had my pedal stroke analyzed. I'm told it is a little strange. The problem though is that I have a minor deformity that screws things up -- legs are different lengths and one foot points in while the other points out so it will never be picture perfect.

  5. #5
    Professional Fuss-Budget Bacciagalupe's Avatar
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    Lower your gearing, increase your cadence, and alternate cycling with swimming.

    Knees are very complicated and fragile. If you continue to engage in activities that cause you pain, you could be looking at some very serious damage, surgery & loss of functionality....

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    Quote Originally Posted by banerjek View Post
    I have had my pedal stroke analyzed. I'm told it is a little strange. The problem though is that I have a minor deformity that screws things up -- legs are different lengths and one foot points in while the other points out so it will never be picture perfect.
    After experiencing knee issues on a charity century last month, I immediately went to a bike shop to get another set of eyes on my pedal stroke. The tech pointed out that while I pronated on both my feet, my right knee had a pretty severe swing outwards and put in a set of orthotics on my right shoe,which straightened it out. He also recommended a stretching regimen that I use after warming up and my knee pain has not returned (knock on wood)

    I can sympathize on the skepticism of the value of medical help; but if the staff knows their craft, one can be surprised with the helpfulness of advice that one gets.

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    Since you seem to thrive on pain I think you might be able to harness this desire to do shorter but more intense rides. Try limiting youself to one hard climb a week and then do hard fast fun shorter rides on less hilly terrain. Maybe this will lessen the knee problems.

  8. #8
    Vintage Punk, w/ Damage Eyeseeu's Avatar
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    A lot depends also on where your knee pain is. If it is right behind the knee cap, you may be pushing too high of a gear, or you may have damage in there. If it is on the outside, it could be your IT band, or it could be as simple as cleat adjustment. If you pronate or supinate when you walk, you may need to add shims under your cleats so you pedal the same way. For me, my feet always land on the outside edge when I walk or run, but with my bike shoes my feet were forced to be flat on the pedals. After riding 100 miles or more, it was very painful to walk. I read "Bike Fit" (by Andy Pruitt?) and added almost 1/2" of shim to the inside of each cleat. I have never had knee pain since.

    It could be medical, bike fit, cleat adjustment, or pushing too high of a gear. It will take some trial and error to find out which. I would visit a bike shop that really knows how to fit a bike, as well as a doctor.
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    GO SEE A DOCTOR, just in case you don't understand let me repeat myself; GO SEE A DOCTOR!!! Then at least you can get confirmation that your knees are fine.

    The Andy Pruitt book called "Bike Fit" is a very good book and you should either buy it or go to the library and see if they have or can get a copy. Also make sure your spinning at higher RPM's in lower gears rather then sluggin away in higher gears.

    Todays medical technology is superior, especially in knee repair-if you need something repaired. You may have something simple like a burr that can be easily removed, in fact most knee surgeries are simple these days and one on a outpatient basis. But first they'll do an MRI on it to find out if surgery is even needed. Your pain "appears" to be worse then a simple adjustment, but I could be wrong, problem is that if you do have a knee problem the more you wait to do anything about it the worse it's going to get.

    Some people have genetics that work in their favor, take me for example, I'm pushing 70 and have toured all over the US, Canada and parts of Europe since I retired about 12 years ago with a fully loaded touring bike going up and down very steep climbs (I admit some climbs were too steep and actually had to walk the bike). Regardless, my knees are fine. My neighbor and the other hand has knees that have been replaced and he's never abused them like I have mine; another neighbor is 80 and he runs everyday (not fast but he's 80 for gods sakes!), but he runs 10k runs with no knee issues, I tried running but for some reason my knees start to bark doing that but not riding a bike.

  10. #10
    Portland Fred banerjek's Avatar
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    Thanks for all the advice. I think I'm going to bite the bullet and see the doc.

    I've experienced various knee issues on the bike in the past, practically all of which I've been able to solve by adjusting my technique or equipment. However, the specific type of pain I'm experiencing now is new to me (or has only been with me for 2 months) and I can't tell what's wrong. I've been able to reduce discomfort significantly by riding less and going easier, but that's not a solution I want to implement unless I have to.

    This will be only the second trip to a doc in about 25 years that wasn't related to an accident-induced emergency. Coincidentally, the first was earlier this year when I followed my wife's advice to get a checkup just so I'd have a doc to call. Turns out doing that was a better idea than I realized at the time.

  11. #11
    touring roadie islandboy's Avatar
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    I agree you should see a doctor, caveat is that you may also want to go to a recently trained, GOOD massage therapist. A couple of members of my family have been convinced one leg is shorter than the other and coughed up for orthotics. My massage therapist noted a similar issue for me (as did a Chiropracter years ago) and worked on the muscles causing the difference until my legs were even. No more trouble.

    It made sense to me because my right leg is dominant and the muscles tend to be stronger and tighten up more. The minute I feel knee pain now I concentrate on dropping my heels and it goes away.

    Quote Originally Posted by banerjek View Post
    I have had my pedal stroke analyzed. I'm told it is a little strange. The problem though is that I have a minor deformity that screws things up -- legs are different lengths and one foot points in while the other points out so it will never be picture perfect.

  12. #12
    Chocolate and nap Michelangelo's Avatar
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    Also having some knee pain from time to time, I also would subscribe to the "go for the doctor" advice. A good doctor (since you are also a runner, pick one who is specialized in triathlon, which is a significantly different exercise from just cycling) may find other causes and other cures as those already suggested above:

    1 - A pedal which has received a shock and gone wrong (try another bicycle to check if its pedals also look right to you)

    2 - A bad angular position of your cleats and no freedom of angular movement, then your knees go in wild movements after over 100 or 200 km. Ask fellow riders at the end of very long rides

    3 - If you are or have been used to running, your leg geometry may not be as precise as those of a pure cyclist. Speedplay pedals (frog if you go for long distance and not racing), with its angular freedom is a superb help for the knees

    4 - Try smaller gear ratios (like 28 / 28 or less): increasing velocity (but not too much) reduces the strain on the knees

    5 - If you use a regular bike, try standing up from time to time, including in climbs, including in long climbs, to fully extend your legs and let them take the positions and movements each prefers (the speedplay pedals or equivalent with wide angular freedom and no spring would help in this). This takes long training to get used to it

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  13. #13
    You need a new bike supcom's Avatar
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    Quote Originally Posted by banerjek View Post
    ...The problem though is that I have a minor deformity that screws things up -- legs are different lengths and one foot points in while the other points out so it will never be picture perfect.
    You should see a sports orthopedist. They deal with this sort of thing. Leg geometry problems commonly show up as knee pain.

  14. #14
    Senior Member donrhummy's Avatar
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    Go see a doctor BUT...

    You should look into getting a foam roller. They're amazing. Use it before every ride on your IT band, tensor fasciae latae (TFL), quads and the back of your knee (where the calf attaches). It really helps more than anything else to free your patella and can help a lot of people eliminate knee pain. Obviously, you need it diagnosed but the foam roller's amazing.

    NOTE: when you do the IT band, make sure you roll it along the side of your upper leg and also the side/back part as well (the side but just underneath the femur). Oh, and it WILL be painfull the first few weeks.

    Don't use the roller if you have diabetes or high blood pressure.
    Last edited by donrhummy; 08-15-07 at 11:38 AM.

  15. #15
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    Quote Originally Posted by donrhummy View Post
    Go see a doctor BUT...

    You should look into getting a foam roller. They're amazing. Use it before every ride on your IT band, tensor fasciae latae (TFL), quads and the back of your knee (where the calf attaches). It really helps more than anything else to free your patella and can help a lot of people eliminate knee pain. Obviously, you need it diagnosed but the foam roller's amazing.

    NOTE: when you do the IT band, make sure you roll it along the side of your upper leg and also the side/back part as well (the side but just underneath the femur). Oh, and it WILL be painfull the first few weeks.

    Don't use the roller if you have diabetes or high blood pressure.
    When you say "foam roller", do you mean something like "the stick"?
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  16. #16
    Senior Member donrhummy's Avatar
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    Quote Originally Posted by USAZorro View Post
    When you say "foam roller", do you mean something like "the stick"?
    No. The stick's not a good idea. For Self-Myofascial Release (SMR), it's a much better idea to do it passively like with a foam roller such as:

    http://optp.com/index.cfm/pageid/243



    You can buy them at Yoga studios or from physical therapists for $12-15.

  17. #17
    Cycling Skier songfta's Avatar
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    Quote Originally Posted by supcom View Post
    You should see a sports orthopedist. They deal with this sort of thing. Leg geometry problems commonly show up as knee pain.
    +1

    And since you very likely have leg length disparity/alignment issues, this should've been your first visit in the bike fitting process. You'll probably end up getting your shoes shimmed to make your pedaling mechanics correct, which will save your knees, hips and back.

    Other things to work on:

    Flexibility. Develop a good stretching routine that loosens up your legs, hips and back for your rides. Yoga is good for this, as is almost any kind of good, methodical, deep stretching routine.

    Core Strength. The most overlooked bit of strength training for most cyclists, your entire pedaling dynamic will improve with good core strength. And make sure to work your back and lets just as much as your abdominals: too many people neglect the back because it falls under the "out of sight, out of mind" category.

    Relaxation. This is mental training, but it'll help relieve a lot of muscle and joint pains. If you get good at it, you can literally will your muscles to relax, which improves recovery time both on and off-bike.

    Sports Massage. Worth it for the faster recovery time and the ability of a good therapist to loosen hard-to-reach deep muscle structures. They can also help keep joints limber and advise on stretching exercises.

    Spinning. You describe "extended tough climbs -- the kind where you grind in first gear... for miles and might even have to stand on that." It sounds like your cadence drops a bit, and thus you compensate by mashing the gears. This often causes muscular imbalance in the quadriceps, which in turn can cause patellar tracking problems, ITB pain, and lots of other maladies.

    The key to long climbs is to set into a good spin at a higher cadence (e.g. 75-90 rpm) and stick with that cadence for the duration. You'll work more muscles in your legs in a more even fashion, which will help save your knees, hips and back. You can stand up every so often, but with a good spin you're often most efficient staying seated. Learning a spin like this takes time, but it pays off big on rides with a lot of sustained vertical.

    As you already have a compact setup (34/27 is your low gear), you're more limited in your options. You could replace the compact crank with a triple, which would give you a 30/27 low gear option. Or you could swap out your casette and rear derailleur (and chain) for a MTB setup, with an 11-32 cassette being controlled by a XT or XTR derailleur. That'd give you a low end of 34/32, and would preserve a good, fast high gear.

    (Of course, if you're running 10-speed in the back, you might need to look to Sheldon Brown and Harris Cycling for a custom 10-speed, wide-range cassette.)

    But definitely get an orthopedist involved with a refit of your bike: you'll probably find most of your solution there.
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  18. #18
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    Quote Originally Posted by banerjek View Post
    I'm a big fan of long rides with extended tough climbs -- the kind where you grind in first gear (34/27 in my case) for miles and might even have to stand on that. This year, I've been doing 10K feet of climbing just on my weekend training rides unless pain stops me. Frankly, the only reason I don't do more on the training rides has to do with time.
    For long steep climbs, that gear is way way too high; I live in hilly country (Central NC) and currently have a low gear of 26/34. it doesn't get much use except on long climbs with the kid trailer, but it lets me haul the kid+trailer up just about any hill here WITHOUT hurting my knees.

    If you don't want a triple, you could still significantly lower your gearing - a 34/34 (stick an 11-34 on the back) wouldn't be a bad place to start; you could also do a wide range compact double if you shift friction in the front (i.e. a 29/48 could probably be made to behave).

    You might not need a 26/34, but I'd at least shoot for a low gear of about 1:1.

  19. #19
    Portland Fred banerjek's Avatar
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    Mounting an MTB derailleur and gearing on the back is an attractive option for me. The main reason I haven't done it already is that my current setup is fabulous for all around riding and that there are only a handful of rides a year that really call for lower gears (all of which require travel). Also, the guys at the shop are concerned that it will mess with my shifting -- right now, it's about as perfect as it gets. Having said that, I can always put my old RD on when I'm not going to need the 32T.

    I have made some progress on improving the knee situation. One of the things I discovered when doing a late night ride on my trainer a few nights ago is that problems appear in my stroke on my left side (which is the knee with the problem) if I ride when I'm exhausted and don't focus on using proper technique. If I'm not tired, I seem to automatically do the right thing. However, if my legs are tired and my head is a bit foggy, things start falling apart. Forcing myself to pay attention and do the right thing makes a huge difference.

    Also, I'm thinking of starting swimming again. I used to swim about 1 km per day but quit when I switched jobs earlier this year. I actually don't like swimming, but I love what it does for me -- that helped my knees and back more than anything else I've tried.

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