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Old 08-01-07, 10:59 PM   #1
justonwo
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Sudden onset of knee pain - what to do?

I've been doing mountain riding for the last three years exclusively, riding with my Sidis and SPDs. I've never had a problem with knee pain.

Recently, I bought a road bike and took a couple of really long, excruciating rides. I think I probably overdid things for those couple of rides, because I started to develop some knee pain on the front inside of my knee (on the inside front of my kneecap, extending down below the kneecap). My new bike has SPDs and I'm using the same shoes, so I'm wondering what causes the pain. Is it because I went too far without being in the proper shape (my legs and knees aren't very strong at the moment)? Something about the new bike? I'm riding a compact double and a pretty 12-25 cassette in the back. Seat height gets almost full extension on my legs.

Anyone with experience with this kind of knee pain feel free to chime in? Should I stay off it for a while? Take some yoga and do strengthening exercises? Go to a sports doc?

Never had knee pain before and I'm paranoid it's gonna put a damper on my cycling, especially with the excitement over my new bike. So I'm at a loss about what to do to correct the problem.
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Old 08-01-07, 11:21 PM   #2
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Old 08-02-07, 03:51 AM   #3
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I've been doing mountain riding for the last three years exclusively, riding with my Sidis and SPDs. I've never had a problem with knee pain.

Recently, I bought a road bike and took a couple of really long, excruciating rides. I think I probably overdid things for those couple of rides, because I started to develop some knee pain on the front inside of my knee (on the inside front of my kneecap, extending down below the kneecap). My new bike has SPDs and I'm using the same shoes, so I'm wondering what causes the pain. Is it because I went too far without being in the proper shape (my legs and knees aren't very strong at the moment)? Something about the new bike? I'm riding a compact double and a pretty 12-25 cassette in the back. Seat height gets almost full extension on my legs.

Anyone with experience with this kind of knee pain feel free to chime in? Should I stay off it for a while? Take some yoga and do strengthening exercises? Go to a sports doc?

Never had knee pain before and I'm paranoid it's gonna put a damper on my cycling, especially with the excitement over my new bike. So I'm at a loss about what to do to correct the problem.
same thing with me but i know what the problem is: tried to be hero and work the flats in too high of gear, increased mileage by 30% due to inspiration from tour de france, introduced a tough bridge (17th steet in fort lauderdale), all of this happened within a 3 week period of time which wasn't smart. im back to a normal gear and thus cadence, knocked off the bridge for a few weeks but kept mileage up and pain is going away.
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Old 08-02-07, 05:13 AM   #4
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Had the same problem, raised my seat 1 cm and felt great from then on.
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Old 08-02-07, 05:52 AM   #5
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Recently, I bought a road bike and took a couple of really long, excruciating rides. I think I probably overdid things for those couple of rides, because I started to develop some knee pain on the front inside of my knee (on the inside front of my kneecap, extending down below the kneecap). My new bike has SPDs and I'm using the same shoes, so I'm wondering what causes the pain.
Clearly, "real advice" isn't necessary for this question. However, in keeping with the spirit of the question, my asnwer would suggest getting a 16oz carpenter's hammer and pounding on your head until the pain becomes "excruciating" - then of course your knee pain will be nothing but a distant memory...... Good luck.
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Old 08-02-07, 06:10 AM   #6
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Had the same problem, raised my seat 1 cm and felt great from then on.
i raised mine 3 and am feeling much better in addition to my previous mentioned treatments. did 20 miles this morning and feeling very good.
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Old 08-02-07, 08:07 AM   #7
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Bike fit issue, get professional help
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Old 08-02-07, 08:55 AM   #8
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I feel your pain, literally-happens to me too. Check your setup: saddle position (height/fore/aft), cleat/pedal alignment, etc. I think road riding can really magnify minor geometry problems.
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Old 08-02-07, 09:31 AM   #9
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What's interesting is that I'm now getting pain on my mountain bike during steep climbs where that never used to happen before. I guess that area must be irritated from the road riding.
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Old 08-02-07, 10:14 AM   #10
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Brother, do I feel your pain. I just started a thread about a week ago on the very same subject. Same symptoms too. I think the best thing you can do for now is take a break. I finally got that through my thick skull after a couple weeks. I'm the type who thinks if I just back off abit and still continue on, things will resolve themselves. Well that hasn't worked. I haven't ridden for the past week and I plan to take at least 1 more week off in the hope things improve. Things are improving, although slowly. I can totally relate concening your excitement. Think of it this way. If you decide to continue riding despite your discomfort, you risk further injury and then you could miss some serious time on the road. Don't play around. Swallow your pride and just chill.
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Old 08-02-07, 10:24 AM   #11
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Tom, what caused your knee pain? Anything change? New bike? Or did it just come about all of a sudden?
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Old 08-02-07, 10:49 AM   #12
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I've had the same pain. It was how my feet were aligned on the pedals in my case. Changing from slightly toe out to toes centered or in just a little made the pain quit.

I have a bad knee anyway though - so your results may differ.
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Old 08-02-07, 10:50 AM   #13
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Well, a couple of things. Firstly for too long a period of time my seat was set too low. When I first started riding after a very long layoff I felt very uncomfortable sitting so high up. I lowered the seat as low as possible. That was my first mistake. Now, I've been riding for 3 years now and it has never been an issue. No knee problems prior.Now when I decided to increase my riding from 25 miles to 35 - 40 miles, then I ran into problems in very short order. Same thing as you. Same symptoms, same effected area. I had the seat then raised by a person at a local bike shop and she understood right away my dilema. Now the seat is much higher. The unfortunate part of the matter is that despite this, the discomfort didn't recede. It stayed the same, not getting better. I realise I did some damage on my knees with all the stress placed on them. Because I smarted up, it wont be very serious. I'm not concerned and I say this with confidence. Sometimes you just have to be smart and realise it's not worth risking further injury. It does really bother me not being able to ride, but if I manage to relax for awhile I'll get back out there again soon. You really have to look at the bigger picture. I learned the hard way.
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Old 08-02-07, 11:57 AM   #14
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Stay off the bike for a week or two; when you get back on spin lower gear and don't push it at all; if trouble persists (you will know immediately) see a doctor and get a proper diagnosis.
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Old 08-02-07, 12:29 PM   #15
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I've had the same pain. It was how my feet were aligned on the pedals in my case. Changing from slightly toe out to toes centered or in just a little made the pain quit.

I have a bad knee anyway though - so your results may differ.
You know, this is a good observation. The way my cleats are set up right now, my toe is slightly out. I've read online that toe out will cause your inner knee to hurt. Perhaps my cleat needs to be rotated slightly. But, for this to work well, don't you have to restrict the float on your pedals? My float is set to the maximum possible at present (loosest setting on my SPDs).

I have an appointment with my LBS on Saturday. We'll see what they say.

Last edited by justonwo; 08-02-07 at 01:13 PM.
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Old 08-02-07, 01:26 PM   #16
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You know, this is a good observation. The way my cleats are set up right now, my toe is slightly out. I've read online that toe out will cause your inner knee to hurt. Perhaps my cleat needs to be rotated slightly. But, for this to work well, don't you have to restrict the float on your pedals? My float is set to the maximum possible at present (loosest setting on my SPDs).

I have an appointment with my LBS on Saturday. We'll see what they say.

Post up when you are done - I'd like to know if I'm doing the right thing. A week or so ago mine was hurting bad enough I was considering getting off and walking the bike the rest of the way. Instead I changed foot alignment and rode the 4 miles I had left - my knee had stopped hurting by the time I finished. I had heard riding "pidgeon toed" is better for you, but that's not really comfortable for me.
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Old 08-02-07, 01:30 PM   #17
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I found this site doing a web search. Makes a lot of sense. If you aren't perfectly flat footed, your knee will tend to bend inward in most cases. Shimming the cleat rotates your foot outward again. That could be another thing to consider.

So is it better to limit float so that the cleat will actually hold your foot "pigeon toed?"

http://www.bicyclefit.com/forefoot.htm
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Old 08-02-07, 01:36 PM   #18
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I don't know, I'm just forcing myself to hold it that way right now. The knee is way better but it's a little distracting for me to have to remember to hold my feet a way that is not natural for me. If my knee continues to be fine for the next couple of weeks I'll probably modify something so I don't have to think about it. If the pain comes back, I'm going to go see the doc. I know I have damaged miniscus in that knee - hate to see the doc because I know he will want to work on it and that will have me down in warm weather months. Of course if it's not hurting this winter I probably won't get it fixed then either.
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Old 08-02-07, 01:39 PM   #19
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The truth is you need an exam by a sports doc and then by a fit expert or may be fixing somehting that doesnt need to be fixed and jumping around to all the different knee problems that may give you knee pain. Assuming you did no internal damage most issue are related to position on the bike and increase mil. or intensity to quickly. Good luck
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Old 08-02-07, 05:05 PM   #20
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Just to satisfy my curiosity, is it possible to rotate SPD cleats on Sidi Dominator shoes? The bolt receptacles look like they will slide back and forth, but I don't see how you can rotate the cleat to change the rotational position of your foot. Are you just relying on slop in the bolt holes to adjust rotational position?
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Old 08-02-07, 07:58 PM   #21
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i have knee pain aswell, but mine is at the back of my knee, not sure if it overtraining, or new shoes as i have been training hard for the last 2 months, plus gotten new shoes.....
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Old 08-02-07, 08:21 PM   #22
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From the copious reading I've done today, several sites have mentioned that pain in the back of the knee can result from the saddle being adjusted too high.
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Old 08-03-07, 11:07 AM   #23
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From the copious reading I've done today, several sites have mentioned that pain in the back of the knee can result from the saddle being adjusted too high.
+1. Also the new shoes can add to that too if not properly set up, and the fact that you are using them with the harder work loads.
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