Originally Posted by
locka
I've been plagued with medial (inside) knee pain in both knees since overuse injuries a few years ago. I did the damage on a long ride on a touring bike. Trying to recover I've ridden a few different bikes, including the touring bike, never any one for very long. I've experimented with saddle height and position endlessly, without results. Recently with the touring bike in the shop I used only a road bike for a full week. Pretty quickly noticed knee pain was not coming back. It's now been 10 weeks. The one difference between the bikes I had not looked at before was the TREAD or Q-FACTOR. Wider on the touring bike (not by much!) feet are forced apart just a little more. And that seems to make all the difference. Of course I injured myself originally on the touring bike, so that might well be part of it. BUT riding with a narrower tread had made all the difference, and I'm riding pain free, climbing like a beast and etc. I'm very very happy. Sheldon Brown mentions tread and suggests, basically, the narrower the better. If medial knee pain is a problem for you, tread, or q-factor, might be something to look at. Happy riding!
This is EXACTLY my situation. I climb steep hills here in the Philippines on my road bike (compact double) - no problem, even grinding up 10+% grades. But I bought a nice hardtail mtn bike to use over here a few months ago, with low mountain gears, thinking it would be easier on my knees.. Oops! Even with the lower gears - the first longer ride (1600' EG) caused problems with my medial meniscus. Ended up getting an MRI, hobbling on crutches, etc.
I kept my rides shorter after that, alternating with the road bike, did PT for the knee, carefully made some seat adjustments, did some shorter rides.. and the next longer ride the other knee was also in pain for 3 days. Fortunately I was being very careful and at the first twinge I headed back down.. I have eliminated the saddle height, fore-aft and other issues. It has to be the extra width between pedals, which is approx 20mm.
It was after it happened the second time that I remembered I had this same problem when I bought a touring bike that had a mountain crank a few years ago. Same medial knee pain after only 15-20 miles. I sold that bike immediately, realizing it had a rather huge Q-factor due to the low end crank, and promptly forgot about it. My prior Cannondale touring bike had used a narrower road crank that never caused a problem.