knee troubles
 

My right knee is killing me. I fell on it on some stairs a week or two back, but for about a week I had my bike dialed in with a really bad fit for some reason, I changed up a few things, lost my allen wrench and things were uncomfortable as hell until I found my allen again. Anyways bike fits perfect again but my right knee is suffering as the pain has been magnified by the crappy fit.

I already took 2000mg of MSM / Gloucosamine, anything else I can do? Rub it, ice it, any sort of rehab type exercise?

Take lots of ibuprophen.
Keep taking the gloucosamine (everyone who uses their knees should take gluc)
Ice
lower your gear ratio.
use straps or clipless pedals and get a better spin.
keep riding, but take it easy.
See a doctor.

I fell down two weeks ago, and went through the same trip myself. Now it's all better.

raise your saddle
lower gear
take a week off the bike, then go ride!

RICE now, rest, ice, compression, elavation. When it feels better be sure you are set up on your bike correctely. The key to strong knees are strong quads, this is very important for your future knee comfort. The best excercise for strong quads is bicycling in a correct way.

Well, I did some RICE, more gloucosamine+MSM, and took the ratio down from 49x16 to 49x19. Saddles already pretty high, hoping this helps out. Man, I love that high ratio too.

Knees take a long time to heal.

I wonder why some folks recommend raising the saddle.

According to my understanding, the knee should always have a bend in it, even at the bottom of the stroke.

I also have a different outlook on the role of what people call the quads.

The top/front muscles of the thigh tend to pull the shin bone up into the knee joint, compressing the knee joint and increasing the load on the knee.

Try visualizing bringing the knee up to the handlebars during the spin.

Of course, one cannot bring the knee up to the handlebars, but the visualization of doing so changes the organizational intent of the muscle groups, and moves the muscle effort out of the thigh muscles and more into the hip muscles, which takes some of the load off the knee.

I have no idea what you just said. "Quads" or quadriceps hold the knee in place. Strong quads=strong knees. This is not an "outlook". Just how the body works. Yes the knee should bend a bit about 1.09 X your inseam= (the length from tip of seat to the center of axle of pedal while resting at the bottom)

People tell others to raise their saddles because from a pedaling ergonomy/knee health point of view, the vast majority of people ride with too low saddles. Silly considerations like being able to get up on the saddle without a stepladder and being able to put a foot down etc. Too low saddles cause hellish knee pain. Pretty simple.

Also, there is some evidence that raising the saddle even higher than is ideal for power transfer will further improve the knee situation.

The quadriceps don't hold the knee in place.
They extend or straighten the knee.

Four ligaments hold the knee together while also allowing it to move: the medial collateral ligament (MCL); the lateral collateral ligament (LCL); the anterior cruciate ligament (ACL); and the posterior cruciate ligament (PCL).
Ligaments connect bones to bones and allow movement while keeping the bones in proper relationship to each other.

If a seated person straightens one of his legs, he has extended his knee.
Conversely, when he bends his knee, he has flexed his knee.

We have four main muscles in the front of our thigh, hence the "quad" in quadriceps.
When we extend our knee, we do so (in most situations) by shortening the quadricep mucles in the front of our thigh.

One of the quadricep muscles runs all the way from the front of the hip bone to the front of the shin bone via the quadriceps tendon.
The other three quadricep muscles run from the femur, or thigh bone, to the front of the shin bone, also via the quadriceps tendon.

For a picture of the four knee ligaments and the quadriceps tendon, go here:

http://www.kneepaininfo.com/kneeanatomy.html

All four muscles attach to the quadriceps tendon, which runs over the knee cap and thus to the front of the shin bone, or tibia.
In regards to the quadriceps tendon, the kneecap (patella) serves at least two functions.
First, it gives the quadriceps tendon a better angle on the shin bone, for extending the knee; and, secondly, it redirects some of the force into the knee (pushing the knee backwards) instead of up on the shin bone.

Check out this picture, and it might make more sense:

http://en.wikipedia.org/wiki/Image:Gray350.png

Bookmark the above in your mind and let's discuss pedaling for a moment.

We all learned to pedal by mashing.
With flat pedals and conventional shoes, we had no other choice except to mash down on the pedal.

The first skill we learn regarding any activity becomes the file within which we place the skills we learn afterwards.
We call this primacy of learning.
Everything we later learn about pedaling goes into our "mashing" file.
We mash by default, and only with conscious practice do we fill in the rest of the spin with effective work.

We mash by extending our knee.
We extend our knee by shortening the four quadriceps muscles (one of which runs all the way from the hip bone to the front of the shin; and the other three run from the thigh bone to the front of the shin).

As the quadriceps muscles pull up on the shin bone to extend the knee, they also push the knee cap back into the knee, so that all the forces work to force the bones of the knee together.
Gravity pushes the knee end of the femur down into the knee joint; the quadriceps pull the shin bone up into the knee joint; and, the quadriceps push the knee cap back into the knee joint.

With mashing, all the forces come together in the knee: up, down and back.

However, another method of extending the knee exists, which does not so much involve the quadriceps, but which makes use of the many muscles in the hip.
These muscles move the thigh bone (femur) forward, backward, left, right, and twisting.
These hip muscles would move the thigh bone even if we cut off the lower leg at the knee.

In fact, these hip muscles wold move the thigh bone even if we removed the quadriceps muscles.

And, for our purposes, these muscles could pedal the bike even if we removed the quadriceps muscles.

If we had only our hip muscles (and no thigh muscles), as long as our foot remained connected to the pedal, the hip muscles could pedal the bike by simply moving the thigh bone up and down.
The knee, then, would serve only as a passive hinge.
The four knee ligaments would hold the knee together and, in concert, the bones and the ligaments would perform as a hinge.
Gravity would still place a load on the knee hinge, but the quadriceps muscles would no longer pull the shin up into the joint, nor push the kneecap back into the joint.

By transferring some of the work from the quadriceps to the hip muscles, we remove two of the three loads on the knee; thus giving our aching knee more of an opportunity to heal.

How do we transfer some of the work from our quads to our hip muscles?

We can pre-organize the coordination of the various hip and leg muscles by "visualizing" bringing our knee to the handle bar as we pull up on the pedal during the back part of the spin.

Our knee will still follow the same path regardless of what we "visualize," but by imagining ourselves trying to hit the handlebars with our knee, we activate those portions of our brain that control the hip muscles; so that, as our foot goes over the top of the spin, we have our hip muscle brain centers pre-loaded and ready to push the thigh bone down during the "mashing" portion of the spin.
We will still "mash" with our quads, but, because we have recruited more help from the hip muscles, we will not "mash" as much with our quads as we usually do; and, thus, we will lessen two of the three forces working in our knee.

As for saddle height, over-extending the leg due to too high a saddle brings its own set of miseries.
It may feel good and extra-efficient, initially, to pull up with a fully-extended leg, but, this can put a huge load on the two internal ligaments, the ACL and PCL "cruciate" ligaments.
When we do this, we have a sense of a "swollen" knee, especially in the back of the knee.

Where our knee hurts can tell us a lot about the mechanism of injury.

Does the knee hurt on its inner side, where the two knees brush together?

Or does the knee hurt just below the kneecap, and, does it hurt just below the kneecap on the inner side, the outer side, or the center?

Or, does the knee hurt on the top of the knee cap?

We actually have seven different common manifestations of knee pain, all with different causes originating in body mechanics.

As for fitting, we can do two things that will at least set us up for less passive injuries.

Find your kneecap with your fingers.
On the inside edge of your knee cap, on the side towards the other knee, find the place where your shin bone and your thigh bone come together.

Or, follow the place where the shin bone and thigh bone come together, and follow that line until it bumps into your knee cap.

Note that place where the two leg bones and the knee cap come together on the inside side of the knee, and mark it with a pen or your memory.

Take a long piece of string, a coin and two pieces of adhesive tape, like scotch tape.

Tape one end of the string to "the place" on your knee and tape the other end of the string to the coin.

With you bottom in the saddle and the cranks horizontal with the subject foot forward, the string hanging from your knee should pass through the spindle of your pedal (and the spindle should pass underneath the ball of your foot and big toe).
Move your saddle fore or aft in order to get the string to pass through the pedal spindle.

As for saddle height, with the pedal in its full down position, your bottom on the saddle, and your heel as low as you can get it, you should still have a slight bend in your knee.

Move the saddle up or down so that, with the pedal at full bottom, seat in the saddle, and heel full down, you still have a slight bend in your knee.

Move the saddle fore and aft so that a string hanging from "the place" passes through the pedal spindle.

Get the relationship of your saddle to your pedals correctly adjusted and then start working on other knee things.

If my description of "the place" doesn't make sense, tell me and I'll try again, with pictures.

take a week off

When I read crap like this, I always think "how little your health must be worth to you". So, how much does an allen wrench cost, where you live?

Glucosamine will probably not help you. Go to a doctor (not a chiropractor, a real MD) to have it checked. I take glucosamine because I know I need to lubricate my knee joints. You, however, don't really have a clue what is wrong with your knee.

I noticed that too high a saddle will cause me great knee discomfort. This is related to the fact that my legs are not straight, and my joints don't evenly distribute the weight. Anyhow, your advice is not necessarily universally true.

I have a pretty good idea:

Poor bike fit, brakeless riding, high gear ratio, in no particular order.

Great. I am sure MDs will go out of business when people are as smart as you are.

Improper bike fit can contribute to the creation and perpetuation of knee issues, but riding brakeless and with high gear ratios should not create problems that did not already exist.

Regarding gear ratios: it takes a certain number of watts to get up a hill; and the gear ratio tends to change the time over which one expends those watts, but not the total amount of energy passing through the knees.

I think if we could put a load cell on bicycle pedals, we would find the loads do not exceed those we typically experience in other activities involving our knees, regardless of gear ratios.

Running impresses me as much more damaging to the knees than any form of bicycling.

Dude, calm down, I'm not the type to lose every little thing and say "oops, I give up, time to buy a new one!" Sure, it was dumb on my part to not burrow another allen wrench but the past is the past and I've re-established proper fit with my bike after diligently changing things, taking it out for a test ride, assesing comfort and making further changes until reaching perfection. No need to get in a fit over other people's mistakes when it doesn't personally harm you in any way.

Anyways, day 2 of glocousamine + MSM and my knee pain is mostly gone. I'm also running 49x19 again which is a great break but I'm not sure how much longer I'll be able to take it, hills/sprints just aren't as fun now but it is nice to be able to accelerate from stop faster and take it easier uphill. I'd be happier with 49x18 but not enough spare money for a new cog yet.

In a perfect world there would be enough MSM in our food for our bodies to ensure optimum glocousamine in our bodies, but things like ocean pollution and processed foods make this not possible. Therefore I don't see MSM / gloucousamine as a drug when really, just about everyone lacks sufficient sulfur (MSM) in their bodies without supplementing.

Ken - thanks for the post, but I am a visual learner and you should post pics... thanks though!

Dude, it takes more than 2 days for glucosamine to show any effect at all. Your improvement is not due to the glucosamine - if anything, the only improvement related to the glucosamine you took, was just placebo effect.

I was reminded of a guy who posted here on SSFG saying something to the effect of "Well I was in an accident and my knees are really hurting. I'd like to ride my FG but I have too high a gearing and can't afford another cog, so..."
My faith in humanity was re-estabilished when a few patrons called his BS.

Placebo's mighty strong than. Glucosammine and MSM are water soluble and can come into effect faster than you'd believe - the trick is taking enough. With MSM there is no level of toxicity, in the past I've done 10g daily with great results, as in I took it and the next day had incredibly soft hair and skin the following day (how's that for a placebo :)). With Glucosamine it's a sugar so I'd guess one would need to be a little more careful in taking a lot, but still, we're riding bikes here. So I'd beg to differ, what you put in your body today can have an impact today but we're all different biochemically as well so it's going to vary on an individual basis, but if you told me that say, fish oil or vitamin A is going to take a little longer to take effect I'd wholeheartedly agree because they have to become saturated in your body and build up to the point of being saturated in your cells, but the same is not so with a water soluble mineral and a carbohydrate.

I guess you were high? As in "whooow dood... my skin is soooo soft and my hair is sooo soft and I don't feel any pain! And everything is really really really slow!"

nah, weed is a lame drug. funny video though.

ding ding ding

Ken - that was an awesome post, and has helped answer SO many knee questions in relation to bikes that I have had..thank you (even if it was a bit long ;))


hahaha.. you know its funny when all the newscasters are busting up too :lol: