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  1. #1
    Nighttime Rider
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    Can a recumbent help my knees?

    My doctor told me today that my knee caps tilt to the outside.

    I know that the recumbents use different muscles and i was curious if one could help me strengthen the opposite muscles to re align my knee caps.

    CE

  2. #2
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    Are you experiencing knee pain? You might need cleat wedges. By changing the angle at which the foot sits on the pedal, its possible to bring wayward knees into alignment. http://www.bikefit.com/c-1-cleat-wedges.aspx

    My knees used to wobble side to side thru the pedaling cycle, causing shooting, needle-stabbing pain after about 30 miles. I've been using wedges for 6 years and no more pain .

  3. #3
    Nighttime Rider
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    Yeah, I have pain. The Doctor seems to think that I need to strengthen the muscles on the inside to pull the knee cap back into alignment.

    After some thinking, it occurred to me that recumbent riders use slightly different muscles and that maybe it would be the best therapy.

    My pain is a soreness, apparently I'm irritating the cartlidge by the misaligned cap.

    CE

    P.S.
    I only use platform pedals now.

  4. #4
    rebmeM roineS JanMM's Avatar
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    We all use the same muscles; they're used somewhat differently between upright and recumbent bikes.
    Perhaps a physical therapist could give you some direction. Is your doctor an orthopedist?
    RANS V3 (steel), RANS V-Rex, RANS Screamer

  5. #5
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    Quote Originally Posted by CrimsonEclipse View Post
    I only use platform pedals now.
    The problem with platforms is there may not be enough float during the downstroke. Too much friction between shoe & pedal for your foot to have a healthy angle of rotation. Your toes might want to rotate a few degrees but your foot is stuck in one position. Maybe try some Speedplay pedals.

  6. #6
    I am the Snail~! Peter_C's Avatar
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    IMHO the answer is NO~! One knee replacement (so far) out of nine knee surgeries in the last 30+ years here. I am not any kind of Doctor - see the part about my opinion. I ride a recumbent trike now. I do love it, and have less pain everywhere *BUT* my knees - my knees seem to do worse on the trike than on my upright "Suede DX" comfort bike.

    On any form of a recumbent it is *easier* to strain your knees due to being able to push against the seat-back. Even going to shorter cranks (152mm) has not offset the difference between bike and trike. Am 6'0" so shorter cranks are not needed for me, but rather to allow me less torque per pedal stroke.

    I would advise two different things - do both - see a real Ortho if you haven't yet, and, go to a PT DR that is *into* cycling (like I did), and he will teach you exercises to strengthen any weak muscle areas.

    Last point? The less you use them (your knees) the weaker the muscles will become - same idea with braces - they can both help and hurt you - so no brace unless an Ortho proscribes it for you
    Peter_C
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  7. #7
    Nighttime Rider
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    I've seen 3 different orthos. None of them want to do anything. One sent me to therapy, and it was completely useless.

    I've had a bad string of "doctors" that seem blind to anything but charts.

    I can't bike, I cant run, but apparently I have no problems.

  8. #8
    Member bclc4life's Avatar
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    Runners knee

    Sounds like you have what is also known as "runners knee". I had it before and is not very fun. The only thing that I found to work was a strap, not a brace, that you put just under the knee cap. You can pick these up from just about any major store. Here is a link for one, not the same as what I used but similar. All this does is to keep your knee cap in line. http://www.amazon.com/Imak-Knee-Stra.../dp/B00169YA2S

  9. #9
    Senior Member Northwestrider's Avatar
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    I have ridden several thousand miles on a bent, to answer your question, I doubt it very much. A bent is supremely comfortable, but for me, when climbing hills it has always seemed harder on my knees than if I were standing on my pedals using my DF bike.

  10. #10
    Senior Member jmio's Avatar
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    i rode my xstream for 1 month straight, no knee problems, rode my DF once last week, and my right knee started acting up. who knows, I was really hammering on the DF, standing and sprinting, drafting and sprinting to the sign. Fun times that you cant do on a recumbent. I could probably use a fitting hahahaha, that was sarcasm

  11. #11
    Senior Member Cyclebum's Avatar
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    I'd check out other physical therapists for advice here. They're more experienced than most docs dealing with such. Maybe try to find one who is a cyclist. 'Course the therapist will have to get a docs approval for any exercises/treatment.

    Frankly, I find it hard to believe that pedaling any kind of bicycle would have much effect on where your knee cap lands horizontally. On tendons, yes. Tendonitis is a common complaint among cyclists.
    The bicycle is one of the great inventions of mankind. Delights children, challenges young men to feats of daring, and turns old men into boys again.--Me

  12. #12
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    I actually find adding some DF riding to my week helps my knees. I've had minor knee issues for many years that would flare up after a few hours of full court bball, or a long descent hiking.
    I attributed them to being out of shape. The bent exasperated the issue for the first several years. Well, riding really hard for a long time did, and still does. but now, instead of 15 or 20 miles before the pain begins, it's usually 50-80 miles.
    Riding at least an hour a day, helps too.
    running makes everything hurt.

    T

  13. #13
    I am the Snail~! Peter_C's Avatar
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    OK - nine knee surgeries here, 8 on left, 1 on right, then left TKR with rescission, then right THR. Plus, I have OA rather badly, so it's safe to say that my weight-bearing joints are pretty bad overall.

    I've found, like almost all folks with joint issues, that movement (hopefully without impact), daily will help those problem joints. Exercise, even light exercise, gets more blood flow to the muscles surrounding the joints in question, which allows more movement with less pain/stiffness.

    For me, the key is learning how much is enough, without it being too much. Depending on the joint, and, which surface(s) of the joint are bad, will vary the type and limit of repetitive flexing without increasing the pain, and/or stiffness.

    I now ride a recumbent trike, which I personally love. But it is much easier for me to over-use the knees on the trike than when I rode my upright bike. Why? On the upright, if you do not stand on the pedals, and you spin rather than mash, usually you are pretty safe. As member 'Tom' pointed out to me a few years ago, on a recumbent, even if you spin, it is very easy to use the seat-back for more leverage, allowing harder cranking than even an upright standing on the pedals. Because the trike also uses thigh muscles, it is very easy for me to over-power my knees.

    Once I learned to not go over XX watts power, my miles per day increased past what I could do on my upright bike. Granted, I am slower on my trike, but I am also not sitting on a 2X4 either

    One DR telling one patient (my Ortho telling me) that swimming is #1, and biking is #2, and walking is a far #3 - and forget running unless I wish to wear out parts fast and create new pain. (this is not everyone, this is me being spoken about) It is rather safe to say that the above is a fairly safe and reasonable statement.

    So, to answer the OP's question;
    Can a recumbent help my knees?
    My doctor told me today that my knee caps tilt to the outside.

    I know that the recumbents use different muscles and i was curious if one could help me strengthen the opposite muscles to re align my knee caps.

    CE
    I would be guessing as I am a patient, not a Doctor, and a sports-type Ortho is the best person to answer this question.
    My *opinion* based on all of my years of knee issues is thus; If the choice is riding a recumbent, or, doing nothing, then YES, riding a recumbent within certain limits will not only help, but may well also improve your quality of life~!

    Using myself as my example: 30+ years of knee issues and surgeries, and we are in 2008, my entire walking is this - from home to car, from car in to office desk, one 35 step walk from desk to restroom per shift, then from desk to car, from car into house, to my chair, then from chair to bed. That is five days per week. Weekends I might go crazy and go to a movie with wife, or stay in car driving wife from errand to errand (while staying in car), then coming home to get off my feet. At this point I weighed bout 387lbs or so, was seeing the heart DR weekly (always a bad sign), and said heart DR said "Replace the knee or die soon".

    Left knee was replaced 11/09, and by 03/10 I was riding my bike. First rides were like 400ft rides. By the end of that summer, I was doing 26 mile rides 4-5 times weekly, did one 40+ mile ride in a group, and by the APPT with the heart DR 09/10 I was given a clean bill to see him in one year (with a promise to keep riding). The only good change I made with to ride. Food, what I ate or drank, no real effort honestly made, but as of this week, I am bouncing around 320lbs. I also had shoulder surgery, right hip replacement, and four week long hospital stays for minor stuff like kidney failure, and multiple PEs (twice). in 2010 I did 650+ miles, in 2011 I did just shy of 540 miles, and I lost weight even with all the flat on my back time, rehab time, etc.

    I ride to live - literally~! I do not ride for speed, I do not ride for distance, I do not race, rather I ride for the *ride* itself - to enjoy the actual mechanics of the ride, realizing that I am going further than I can walk, seeing places I cannot see by car. These rides also lower my stress level (I'm the kind of guy that worries about everything). Not so much a general cure-all, but because I am comfortable while riding, my pace is based on the weakest link (my knees), so as to not over-stress them. I have no set schedule, no place I must hurry to get to, and usually no one I must keep up with. Stop when I like, look at this, watch those people for a while, head this way til the sun shifts the glare out of my eyes then turn-around.

    I have had a self-bypass, and a serious heart event and never knew it at the time. I have roughly some 80% function at this point, add to it all the joint issues, my weight, and yes, even more things too - and for me, riding at least 4-5 days per week for at least 2hrs at a time is what has both improved my health, my mental health, and my quality of life. So - back to the OP. If the answer is 'NO', then what? Do nothing? Will you swim 4-5 times weekly? Can you walk (at any pace) for 60-90 minutes 4-5 times weekly? if every answer is a 'no' - then pick the one that you *WILL* do, and learn how to do it within the limits of your knees.

    I wish you luck, and would like to hear/read what you end up doing? Getting the gearing low enough so you can always spin at 60-70rpm, possibly going to shorter cranks so you can't torque the pedals so hard, and becoming willing to go at your own body's pace, regardless of what is happening in the world. Some folks do better by doing odd/even riding. Ride one day to the point of mild stress, rest the next day, then all is well for the ride on the third day, and so on...

    Assuming that both the 'bent' and the 'upright' fit well, one will not make the issue worse than the other. But rather how you chose to ride each may determine that one could be ridden further than the other. - Does that make sense?
    Peter_C
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  14. #14
    A might bewildered... Dudelsack's Avatar
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    Quote Originally Posted by jmio View Post
    i rode my xstream for 1 month straight, no knee problems, rode my DF once last week, and my right knee started acting up. who knows, I was really hammering on the DF, standing and sprinting, drafting and sprinting to the sign. Fun times that you cant do on a recumbent. I could probably use a fitting hahahaha, that was sarcasm
    You need a proper fitting. And your stem? Flip it and slam it

  15. #15
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    Two thumbs up on the knee strap. Helps me out a lot. bk

  16. #16
    I am the Snail~! Peter_C's Avatar
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    Straps and braces are really two-edged swords~! They really can help. but they can also tear down muscle tissue! Unless you are an Ortho, no-one should use either regularly without first consulting an Ortho about their issue(s), and being advised to use such an item.

    These devices take on part or all of the workload of certain muscles (depending on type), granted, there are real needs for them, but every moment they are used, muscle-tone is lost. Now, if you tore something, and surgery is schedule in six weeks, the DR will most likely suggest a brace to be used at all times other than sleeping, as a reduction of muscle-tone is preferred to doing more damage, but also, future PT is assumed.

    To willy-nilly start using a 'strap' or a brace', simply because it 'feels good', or 'provides support', and so on... is plain crazy. If you have either enough pain, or swelling, or reduction in use, you really do need to see a Ortho, find out what is wrong, and develop a plan to resolve the issue. Anything else can possibly create more/new damage, and/or continued issues without relief.

    Rest, possibly ice for swelling, and an over-the-counter anti-inflammatory like "Alieve" (after reading the contra-indications) and elevating the effected joint above heart-level are basically the only *reasonably* safe actions to take if you want to see if it is a simple muscle strain, or OA, and the like. but if no improvement within 3 days - time to see the DR.

    Am not trying to be a pain. After 30+ years of multiple joint issues, surgeries, replacements, etc - I hate to see anyone risk possibly crippling themselves.
    Peter_C
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  17. #17
    Senior Member BlazingPedals's Avatar
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    Quote Originally Posted by Dudelsack View Post
    You need a proper fitting. And your stem? Flip it and slam it

    Yes, uprights are inherently comfortable. A $400 fitting should prove if it's a fit problem or a personal shortcoming. </sarcasm>

  18. #18
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    I have had, and still have knee problems. I have ALWAYS found that riding is good for them. Recumbents more than diamond frames. (Now, I am assuming one would be riding properly. Spinning, not mashing. Using the right gear, not a too hard gear) If your knee is pulling, there is some kind of muscle imbalance. Probably in the back of the knee. If you were to give it a try, I would definitely use clipless pedals. An eggbeater perhaps. And learn to both push and pull, that way you strengthen the knee area front and back. I did not notice any mention of any physical deformity, so strengthening the muscles front and back sounds like a good strategy.
    Rans Stratus XP-AL Sun EZ-1 "Retired" Mountain Biker

  19. #19
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    Crank length?

    Sorry guys to wander into this forum, but I am researching recumbents and one of our long-distance friends in Paris completed a PBP 1200 last year on a Performer recumbent.

    My research of recumbent set-up, and our friend's comments lead me to believe that shorter cranks are a much better proposition for bents.

    Our French friend, who has done an enormous amount of both DF and bent riding, felt knee pain and went from 175 to 165mm cranks and the pain went away. One of the sites I have been researching shows instructions for shortening crank length by redrilling and tapping the pedal holes, and the comments from the author indicated he had experimented with longer cranks, but reverted very quickly.

    It might be something for the OP to think about and for others to discuss, especially as crank length has an influence on DF bike fit, too.
    Dream. Dare. Do.

  20. #20
    I am the Snail~! Peter_C's Avatar
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    One of the secrets for people with knee and/or hip issues is the following (I learned this both from my Ortho and my PT DR - who races) different trikes and bikes make you sit differently, BB vs seat height and on and on. Everyone knows not to let your leg go out to lock, but the other direction can be critical as well. After you get the seat, etc all set up, have some one watch you pedal slowly - neither your knees or hips should 'close' greater than 90 degrees! You lose both strength and speed once either joint bends past 90 degrees.

    Crank length is one of the possible ways to fix this angle. For myself on my Rover, going to 165mm cranks solved this for me. Shorter cranks are favored by some, disliked by many, but by only making enough change here to protect the knees/hips from moving past 90 degrees can help a lot, both in power, speed, and cadence too.

    Not many people seem to realize it's all part of fitting well on your recumbent, and even if you have zero issues, doing the above *will* increase your performance.
    Peter_C
    http://s1103.photobucket.com/albums/g475/Peter_CC/ <-- My Photos

  21. #21
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    I actually feel most comfortable with a little more bend than some. So my knee bends MORE the 90 degrees. I am getting rid of my 170 cranks and going to 150mm. I am also getting Q-Rings. In a happy coincidence, the 150mm cranks will work well with the only triple Q-Rings that will work on my crank. 23, 33, 44 with 150mm to replace 30, 39, 52 with 170mm crank.
    Rans Stratus XP-AL Sun EZ-1 "Retired" Mountain Biker

  22. #22
    Senior Member BlazingPedals's Avatar
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    Short cranks, like knee braces, are a two-edged sword. They can help if you have range-of-motion issues; but in order to take advantage of them you have to use lower gears and spin more. Why? Because shorter cranks also provide less leverage. If you keep the same gearing, you actually end up pushing harder and potentially hurt your knees worse. And that is true whether we're talking recumbents or uprights.

    A lot of minor knee pain (that is, not serious bone or cartilage problems,) can usually be fixed with exercises. The best advice I've read here is to see a physical therapist to determine what's going on and if there are exercises that can help.

  23. #23
    I am the Snail~! Peter_C's Avatar
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    The stronger the 'knee', the safer the joint is~! I so agree with you BP!! I find it so scary when people start using knee-braces, claiming they feel better, safer, etc. Yes, there are of course times that a DR will put someone in a brace (been there sadly many times), but the stronger the muscles are that surround the knee, the safer the joint is overall.

    I've tried cranks of various lengths from stock 170s, down to 152s, and believe I have found my personal sweet spot (on my current trike) at 165mm. But, if/when I get a different ride, I will use roughly the longest crank length that helps me to stay between 3 and 90 degrees.

    Nope - I am not any kind of DR, and yes, people (and rides) are so very different - I just urge people to take the time to find what works best for them, and to protect those knees! Even if you have no issues now, you sure don't want them later! Weight-bearing joint issues are a pain...
    Peter_C
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  24. #24
    Senior Member delcrossv's Avatar
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    Can't speak to your specific problem but I I go without riding for more than a couple of weeks, my knees start killing me (50% cartilege loss in both). I ride a P-38. I alos do weighted sidepulls at the gym which help.
    Lightning P-38 / M5 M-Racer/Ryan Vanguard

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    Quote Originally Posted by BlazingPedals View Post
    Short cranks, like knee braces, are a two-edged sword. They can help if you have range-of-motion issues; but in order to take advantage of them you have to use lower gears and spin more. Why? Because shorter cranks also provide less leverage. If you keep the same gearing, you actually end up pushing harder and potentially hurt your knees worse. And that is true whether we're talking recumbents or uprights.
    Agree regarding the gearing. I always need to be mindful of how hard I am pushing. I spin lightly to moderate. Little or no hard pushing. I will lower my gear range with the change. The big plus is less damaging flexion.
    Rans Stratus XP-AL Sun EZ-1 "Retired" Mountain Biker

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