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  1. #1
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    Advice needed for knee pain while climbing

    I had sent this post to the general category list, and someone suggested that I try to submit it here. I would appreciate any suggestions; thanks!

    I am having problems with knee pain associated with climbing... I don't have large hills to climb, but rides of 20 miles or more seem to often cause knee pain in the back, inside of my knee, usually the left leg. I think that I have ruled out the ligament, and I think that it is in one of the smaller muscles in that area. Sometimes I can go on the ride with no problems at all, then when I lift my leg to get out of the shower, the pain suddenly starts. Then, the pain is anytime I lift my leg, making me think that it is in association with climbing. Most of my rides are with a "train;" my 7 year old with me on a tandem, pulling a Piccolo with my 5 year old, pulling a trailer with my 3 year old. When I wear a brace, I am able to ride for a longer time without pain. My seat is raised to the point where my knee is slightly bent when it is straight down; and by what I have read, that is the correct height adjustment. Lately I have been made aware that cleat positioning can cause a problem. I have cleats that I think might be 1/2 a size too big. When I got them, I was using cages on the pedals, then I switched to the clips. How do you determine cleat positioning? If anyone has ideas of what might be the cause of the pain, and what strengthening exercises I can do, and what stretches would be good for this type of problem, I would be grateful! Oh yes, while this has been a left knee problem, last year on the first day of the MS 150 (two day, 150 mile bike ride to raise money for Multiple Sclerosis) my left knee did fine ~ I was wearing a brace ~ but my right knee started to hurt. The pain was also in the back, on the inside of the knee; the same area of pain as the left knee. I switched the brace to the right knee for the return trip and was able to do fine, and the left knee really didn't give me much of a problem. Any advice would be great; thanks!

  2. #2
    Senior Member
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    See a doctor. Seriously, I'm not being flip.

  3. #3
    just another gosling Carbonfiberboy's Avatar
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    Yes, doctor. And get a bike fit. See a PT person who specializes in biking issues. My guess is that you've just strained something or maybe have ITB irritation from pulling all that weight. I can't just ride our tandem, even though my wife is a decent stoker. I need to ride my single, too. Just riding the tandem tears me apart. My tandem issue seems to be that the bike doesn't accelerate when I push on the pedals, so it's a different kind of exercise. Anyway, you might try riding your single more. And I'll try riding the tandem more now that it's spring.

    Try setting your saddle height so that, with cycling shoe on and heel on the pedal, your leg is completely straight with your knee locked and your heel just barely touching the pedal. The type of pain you are experiencing is often associated with saddles that are too high, though that may have nothing to do with it.

    I don't understand your issue with cleats. Are you using clipless pedals, SPD or Look or other? Or are you using pedals with toe clips and straps, with or without special locking cleats on your shoe bottoms? Normal cleat positioning puts the ball of the big toe over the pedal axle. Some riders put their cleats further back on the foot than that. Are you using real cycling shoes? SIDI Dominator shoes with SPD pedals work very well for what you are doing.

  4. #4
    Junior Member
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    I guess I was using the wrong terms regarding the cleats... I used to use toe clips with straps with tennis shoes. I then bought some mountain bike shoes (no cleats, but could have them added) to use with the toe clips/straps. The main reason for that purchase was to get shoes with the laces covered by Velcro straps so they wouldn't get in the way, and for the hard sole. These shoes are a bit too big. If I were wearing them for every day use, I wouldn't have gotten them, but I wasn't thinking that shoe size would matter on a pedal. To make a longer story a bit shorter, my husband had my shoes switched over to clipless shoes, and bought SPD - M324 pedals to go with it ~ flat on one side; clipless on the other. I love them, but am wondering if the cleat is positioned too far forward since the shoe is a bit too big. I will need to get the bike out and see how the shoe and my foot fit on the pedal in relation to where they should be. Have I answered your question regarding the shoes?

  5. #5
    just another gosling Carbonfiberboy's Avatar
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    Yes. Cleats possibly too far forward, but that usually doesn't produce your issue. Usually "hot foot" or calf issues. Simple to move them back and try that.

  6. #6
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    Quote Originally Posted by Ann C View Post
    I had sent this post to the general category list, and someone suggested that I try to submit it here. I would appreciate any suggestions; thanks!

    I am having problems with knee pain associated with climbing... I don't have large hills to climb, but rides of 20 miles or more seem to often cause knee pain in the back, inside of my knee, usually the left leg. I think that I have ruled out the ligament, and I think that it is in one of the smaller muscles in that area. Sometimes I can go on the ride with no problems at all, then when I lift my leg to get out of the shower, the pain suddenly starts. Then, the pain is anytime I lift my leg, making me think that it is in association with climbing. Most of my rides are with a "train;" my 7 year old with me on a tandem, pulling a Piccolo with my 5 year old, pulling a trailer with my 3 year old. When I wear a brace, I am able to ride for a longer time without pain. My seat is raised to the point where my knee is slightly bent when it is straight down; and by what I have read, that is the correct height adjustment. Lately I have been made aware that cleat positioning can cause a problem. I have cleats that I think might be 1/2 a size too big. When I got them, I was using cages on the pedals, then I switched to the clips. How do you determine cleat positioning? If anyone has ideas of what might be the cause of the pain, and what strengthening exercises I can do, and what stretches would be good for this type of problem, I would be grateful! Oh yes, while this has been a left knee problem, last year on the first day of the MS 150 (two day, 150 mile bike ride to raise money for Multiple Sclerosis) my left knee did fine ~ I was wearing a brace ~ but my right knee started to hurt. The pain was also in the back, on the inside of the knee; the same area of pain as the left knee. I switched the brace to the right knee for the return trip and was able to do fine, and the left knee really didn't give me much of a problem. Any advice would be great; thanks!
    The knee is the weak link in the leg - any issues elsewhere in the leg usually show up in the knee.

    I agree with carbonfiberboy - start with a fit, ideally with somebody who is also a PT. I'd ask at a local bike shop or discussion group to find the good fitters in your area. It could be cleat position, it could be seat height, it could be that you are pushing gears that are too big, or it could be that you need some wedges under your cleats to get your legs correctly aligned.

    It's also possible that you are pushing gears that are too high. Trying to get up to around 90RPM can be good to help, though it may make things worse in the short term.
    Eric

    2005 Trek 5.2 Madone, Red with Yellow Flames (Beauty)
    199x Lemond Tourmalet, Yellow with fenders (Beast)

    Read my cycling blog at http://riderx.info/blogs/riderx
    Like climbing? Goto http://www.bicycleclimbs.com

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