Knee Pain only on left knee
 

I have tried to get into 4 years ago but had terrible knee pain in my left knee only when peddling. I went into the sports doc for a fitting/evaluation and he prescribed that I needed pedal extenders as my hips are wide as I think most clydes are so I was trying to get my legs over the pedals correctly and was putting excessive pressure on my knees. I installed the extenders 1" on both pedals and rode. Problem didn't go away. Took about 3-4 years off of the bike due to kids, work changes, and an additional job. I am now looking to get back to riding but the pain is still occuring. I am not using clipless and riding with athletic shoes and platforms. The bike is a trek 1.2 but the bike doesn't seem to make a difference as I have an old Steel trek road bike and a Rigid Univega also that all give the same problem.

I know asking here will get lots of answers but just looking for support more than anything. I have thought about seeing a fitter at a reputable shop but not sure if the cost will make a difference.

If my left knee starts hurting, I know that my seatpost is slipping and has dropped too low.

For me:

Left knee pain = saddle too low
Low back/sciatica pain = saddle too high
No Pain = just the right saddle height

I would suggest you have a good bike fit done by a qualified bike fitter and communicate your issues to them.

Everything I've heard about professional fitters make me think it's worth while doing, and certainly if I was having pain but wanted to continue riding I think I'd go there. It sounds like you went to a fitter/sports doc though, what did they do? Did they get you on a bike and analyse you while pedaling?

Unfortunately, there are dozens of different things that can cause knee pain.

Improper saddle height is the biggest problem for a lot of people. The saddle should be as high as possible while still maintaining a slight bend in the knee when your leg is at full extension. Note that "full extension" is usually not when the pedal is at the 6 o'clock position. If the seat tube is angled toward the rear of the bike, and almost all of them are, then maximum leg extension happens somewhere around the 4 or 5 o'clock position ( or 7-8 o'clock, depending on which side you're looking from).

Putting too much pressure on the pedals is another problem that can cause knee pain. In general, it's better to spin the pedals at a high cadence (= RPM) than to mash them at a slow cadence. If you're riding a geared bike, you can try riding in a gear that's 1 or 2 notches easier than what you'd normally use. You'll have to spin the pedals faster to maintain the same speed, which will increase the strain on your cardiovascular system, but you'll also reduce the strain on your knees.

The final thing I've found is that foot placement on the pedal makes a big difference to my comfort, especially on longer (20+ mile) rides. If my foot placement is a little off and I repeat the same poor pedal stroke 100 times/minute for hours at a time my knees will hurt no matter what. The solution, for me, was to switch to a clipless pedal system that allows very little "float". Because the pedals (Shimano PD-M520) keep my feet in the same position, I end up repeating the same perfect pedal stroke. If you don't spend the time to get the cleat placement just right, however, these pedals can feel absolutely awful!

If you are only having pain in one knee you might also have one leg longer. I'll echo those that have said go see a local fitter and communicate exactly what your issues are. How stiff are your athletic shoes? Cycling specific footwear is stiff to better transfer power to the pedals while giving required support. Athletic shoes with flexable soles can do a poor job of supporting the foot on a pedal. I eliminated foot pain by going clipless and adjusting cleat placement. It was not an all at once solution but took a few adjustments. The fitter (owner) at my LBS helped me work through all my issues as value added service with the purchase of shoes and pedals. As well as bike but the bike purchase I doubt had much to do with it. He seems to really care that folks are comfortable on their bikes, knowing that if he treats customers right they will be back when they need parts, service, or new bikes.

Where does the knee hurt? Inside? Outside, front? Back? Top, below? All makes a difference in where you start. There are lots of articles and information online to help figure it out. Yes get a good bike fit done, well worth the money.

My story - started riding again after years off, worked up to 40-45 mile rides over 3 months, only then did I start getting knee pain. Did ice and ibuprofen and that helped some. Took a couple of weeks off at one point. Also went to physical therapy and got some exercises and stretches to do. And had a pro bike fit done. Also moved my cleats around on my shoes. Made an effort to increase my cadence to spin more than mash. Over the next 4 months or so as I got stronger the pain went away.

I developed some knee pain from jogging and running at 5'8" and 280 lbs....my research then led to the conclusion that a lot of knee pain is actually from weak muscles in the butt area :-)...those muscles also stabilize the knee joint.

So I am scheduled for a fit on Thursday the 16th. The only issue I am running into is the fitter says I need a bike short that is form fitting since he says with the baggy mt bike shorts I normally ride with are not going to be able to show him what he needs to see. I really don't want to spend much as I am spending enough on getting clipless pedals and the fit at this time.

ANy suggestions.

It sounds to me like you have three choices:

1) Buy shorts locally
2) Reschedule your appointment
3) Wear your current shorts to your fit and hope for the best

You haven't told us where you live nor what your budget might be, so it's difficult to say anything more specific. If you have a a chain bike store near you (REI, Performance Bike, etc), they'll probably sell a "house brand" short that's pretty inexpensive (~$40-60). I personally like Love2Pedal.com's Falconi Deluxe bib shorts (~$37) but they might not reach you before your appointment.

Wearing form-fitting lycra shorts will make it much easier for your fitter to see whether you're rocking your hips as you pedal, whether your knees are tracking properly through the pedal stroke, whether you're sitting at the proper spot on the saddle, etc. If you're going to pay for a professional fit, it's probably worthwhile for your fitter to know these things...

Sorry I live near Madison, WI. We do have lots of shops and I have visited everyone of them on the past 2 weeks looking at there clothes and trying to find something that for one fits my size and 2 isn't going to cost me the same as the speedplay pedals I was instructed to get by the fitter also. I am a XL size. I think I have found a few in what I would consider reasonable so I am planning on going at lunch to look again at these. I tried some brand from Dick's sporting a few years ago and just couldn't get accustomed to the chamois in them (very thick). I see the ones that I have been looking at now are thinner chamois so hopefully they are more comfortable to wear.

If you have knee issues then the recommendation for Speedplay is probably a good one. As much as I would like to use mountain bike pedals (since things like AIDS/LifeCycle involve much more walking than you think), I do Speedplay because it helps my knees. The Zeros are also available in different spindle lengths, so you wouldn't need the extenders.

Do ask your doctor about being checked for a leg length discrepancy. Mine turns out to be 1.5cm. Which is, apparently, a lot.

I did hear from the fitter about the pedals and he felt the extensions were not needed so I removed them when installing the speed play pedals. I unfortunately haven't been able to try them much do to the wife's work schedule and the weather. Looking forward to this fit on Thursday and hopefully get to bottom of it.

UPDATE!!! I had my fit done last night and it went very well. WE spent most of the entire session working on the knee problem. we got to a point that he decided to move me over to this contraption they usually use for TRI bike setups. It was very interesting the way he could just turn a crank here or pull a lever there to manipulate all aspects of a normal bike. He determined the pain to be from compressing the knee at the top stroke too much. He moved everything around possible on my stock bike to help eliminate the pain but was not able to completely remove the pain. The way to completely correct at this time is to put a shorter crank arm setup on to eliminate that hard pinch point. I got an estimate to replace from the shop while I was there and will eventually have that done when funds allow. I decided since I still had some daylight left I would go take a spin on the lake loop. I was very pleased with myself that I got a brief 4 mile ride in with very minimal knee pain. I think I can handle this amount of knee pain until I can get the crank arms changed out. Good part is when I get the arms done I can stop in and do the fit readjustment.

Interesting that they wouldn't just shim one shoe to compensate - how much of a difference was there? Most people use one of a 170, 172.5 or 175mm crank, and the difference between them is pretty minimal, really.

So is this compression happening from a leg length discrepancy? It sounds like it. I would get that measured. If it's only on one side then doing the crank arm solution is pretty odd. Having a 1.5cm difference (which is, like, a lot apparently) I'm shimmed. And if you're using speedplay they're VERY easy to shim.

I agree with your thinking on the length and that was ruled out but we both feel it is from a past surgery/repair. I had some work done on the muscle on that leg about 6 years ago that they clipped a muscle and it was allowed to reattach on its own which we feel the problem is coming from how the muscle and tendons all healed, I also crashed a motorcycle on the same knee. I never had problems when riding bike when I was in my 20's. of course I took about 5 years off before the surgery also.