Hosscooper

Well last year I did pretty well and am starting to get back in form, but I have run into a new thing. I am having some new knee pain. Not bad or anything and uping the naproxen has helped but still. By this time last year I had gotten my form together and was feeling little to no pain even when I pushed it a bit. I am 43 and a clyde so it could be getting older and maybe even arthritis or something else all together. A doctors visit is planned in the next week or so. In the mean time. Assuming all things are normal, bike fit etc.... what can a fella do to take stress off of the knees while riding? Also what are some off the bike things that I could do, stretching etc. Last and least desirable what are some things to do other than riding as I rehab or rest my knees, so I can get back on the bike asap.

deapee

Throw up an answer to these questions should help someone knowledgeable chime in a little better. Just realize that this is an internet forum ;-) And if a bike fit question is in order, the best thing to do is post a video on a trainer from the side.

When does it hurt?
Where does it hurt?
Does it also hurt when you get off the bike? For how long?

How confident are you that your saddle is adjusted properly as far as height as well as setback?

Hosscooper

OK so it hurts inside and around the knee. It hurts in the morning(arthritis?) and gets better through the day. I do notice it the next day more when I push it or ride some hills. So far as fit I am not even sure the bike is the right size for me,but it is all I have and there is no possibility of a new, used or fitting of this one so all that is off the table. Having said that. Everything went really well last year. That is my confusion.

Hosscooper

Riding does not seem to help nor hurt immediately. Kind of loosens it up some but with some internal pain, again not bad. More of the later on after effect even the next morning type stuff

dual650c

Shift down a gear or two and spin, spin. spin. That is, ride an "easier" gear at a higher rpm.

I do this even on a recumbent now compared to 5 years ago.

Granted you're 43 and I'm now 60, things change at different rates for different people. By your age, I'd had 2 knee surgeries and serious back problems. In my 50s, I started riding again and went from a DF to a trike to the 2 wheel recumbent I ride now. But through all of that, I have become a randonneur and a bike tourer - the key being I now spin instead of grind/mash my way along.

YMMV

deapee

No worries -- let's start by seeing if your fit is dialed in to be approximately where it needs to be. AKA at least within a CM or two of where you really need it to be:

https://www.youtube.com/watch?v=FVu5Zrktm40

Let us know how that turns out...at least then we can rule out too high or too low of a saddle or some drastically wrong setback causing issues.

Drew Eckhardt 

knee pain causes by location

You can get close as a DIY exercise - measure cycling inseam standing against a wall with a book in contact with your groin and measure height, set saddle height to .883 times that; drop a plumb line from the bony protuberance below your knee with your foot at 3 o'clock and bisect the pedal spindle; and move from there - aft enough to take weight off your hands, heels just touch the pedals at 6 o'clock.

Take video - you can be subjectively wrong. I lost an inch of saddle height through some slippage and changing posts and was far below heels just touching the pedals. That was an uncomfortable and expensive lesson.

You can post that to the fit forum and ask for pointers.

You can also mark parts like your seatpost and saddle rails with a Sharpie so you can get back to your previous location in case changes aren't right.

I did OK with a saddle that had dropped for quite a while before my knee pain started at age 43. Fit adjustments fixed that.

People can become more sensitive to things as we age.

travbikeman

I had some very serious knee stiffness issues this past February. I ended up making sure I kept hydrated, spinned easier with my bike on the trainer, kept the spinning on the easier gears and started slowly and boy do I mean slow and then worked myself up to faster spinning while it was sore. Also many leg stretches. Stopped sitting, laid down on the couch when relaxing instead. Plus Aspirin helped as well. This all helped me, but surprisingly the slow to fast spinning on my bike is what helped the most. It helped work out the stiffness.

Hope you get better soon!

sstorkel

Once I have my saddle at the right height, I wrap a piece of black electrical tape around the seat post right where it meets the seat post collar. One or two wraps of tape around the seat post and you can easily drop it into the seat tube and get the right height every time. All of my seat posts are black so the black electrical tape doesn't stand out.

Hosscooper

Does keeping hydrated help that much? I kind of plan on taking a week off and stretching then starting up again in the lower gears for a while. what kind of stretching do y'all do for knees, it-bands, and other related muscle groups? Thanks for all the help.

travbikeman

My understanding it does very much. It helps to keep the joints lubed! I thought, and welcome being told I'm wrong that when your out for rides, many aches with knee pain and other joints could be a sign of dehydration.

79pmooney

You may be seeing chrondomalacia patellae, the kneecap not tracking properly across your knee and wearing into the cartilage. This is sometihing some of us seem t be predisposed to. Four things that can trigger it are: tight hamstrings (which throw the kneecap out of line - yes they are on opposite sides and that sounds impossible; trust me), riding with cold knees (my knees like to be close to body temperature, ie high 80s F. I wear very warm custom knee warmers. Edit: Riding with cold knees is, for me, like running my car engine with no oil.), high gears and building strength and conditioning too rapidly.

Below I have pasted something I wrote about my journey through CP. (The only way to make it go away is to dispose of your knees, replacements).


Chrondomalacia patella. Yes, I can tell you a little about it. I was diagnosed in ’78 and given very good advice by the doctor (an orthopedic in sports medicine. He was also a novice bike racer, so he had more understanding of the cycling aspects of CP than most). I will do my best to pass on what he told me.

In CP, the kneecap is not aligned with the knee under it, hence there is chafing as the knee is moved. This causes wear, first to the cartilage, then to the bone under it. The wear accumulates with number of repetitions and pressure. At some point, the wear can cause permanent damage.

Some people are more prone to CP than others. It can be triggered by exercising in cold weather, exercising without adequate stretching of the hamstrings, i.e. touching your toes or less extreme stretches of the same tendons. It can be brought on by exercising without adequately strengthening the small quadriceps muscles just above the kneecap.

I brought on my CP by training to return my body to racing form after a very serious accident. (I was weak enough after my hospital stay that I was no match at 24 years old for any 7 yo. The accident was in November, and I returned to riding miles in March. I did nothing to keep my knees especially warm and did no stretching exercises (rationalizing that since my leg never extended to anywhere near straight, there was no chance of injury, hence no need to stretch). I was wearing just full tights and thermal underwear under them in Boston. The temperature was probably not much above 30. The ride that started it was 100+ miles on my racing bike, my first outdoor ride on that bike. It had 175 cranks. My trainer, with fixed gear and very low BB, had 168’s. After the ride I had a dull pain in my mid to upper knee in front. That Saturday was the first race of the season. I was forced to drop out, my knees hurt so much.

After that race, the race promoter introduced me to an orthopedic surgeon who diagnosed me in the back of a cold van. He laid out for me then and in later phone calls a plan that I will pass on here.

He first stressed that I had to stretch my hamstrings, touch toes or lean forward against a wall or post with one leg back and straight and stretch that hamstring or sit and touch toes. I now prefer the lean forward method. Very specific and hard to hurt yourself. (I am now a 48 yo, I damage if I am not careful.)

Second, he had me sit on the floor and do leg raises. He had me raise one leg at a time and hold it several inches off the floor for a while (I don’t remember the time, but 15 secs should work. Important – while the leg is raised, tense up your quads big time and tense up those little quads just above and beside the kneecap. Feel for them and get to know them. It is those little guys that keep you kneecap aligned. If you are in riding shape, you can do this with say 5 pounds on your ankles, but the tensing up is much more important than the resistance.

Third, KEEP YOUR KNEES WARM WHEN YOU RIDE!! For me, this is critical. I wear these dumb looking “knee warmers” for most of my rides, always below 70 degrees, often under tights. Since keeping the hamstrings loose is important, I had to stretch the elastic. To keep them from falling down, I sewed on garters that I clip onto my shorts.

Fourth, back off riding until you have been doing these two things long enough to make a difference. Keep up the exercises and especially the stretches after you resume riding. Build up your riding slowly. The doctor stressed this to me and it has been very true. My ability to come into real form and resilience on the bike is limited more by my knees than by my lungs/muscles.

After rides, take aspirin or Ibuprofen to speed recovery. I personally think aspirin is better, that my knees recover more with it. I disagree with the ice. I have always felt that moving my knees when they are cold is causing the damage I am trying to avoid. Perhaps ice speeds recovery, but I feel it also continues the damage (at least in my knees).

Big gears are the enemy of CP knees. I love to climb hills standing. I love to ride hilly country on fix-gears. It is a fact of my life that I can only ride certain not-so-steep hills on my commuter and that I have to have and use a granny ring on my custom. It is a fact that there are days, weeks and months when I have to let whippersnappers blow by me on hills where I know I can humble them.


Lastly, what you did not want to hear, but again what the doctor told me. Get used to the idea of CP. If you are at all like me, it will be a fact of your cycling life for a long time. 23 years later for me and I am feeling my knees now because of a very easy ride I did in street clothes without knee warmers at noon today.

Sorry to be the bearer of bad news, but you can still do a lot of riding. I raced that season (I already knew it was my last) and have done 60,000 (?) miles since. I still commute, but only on alternate days. (But for the first 7 years with CP, I did not own a car and rode everywhere.)


I took the time to spell all this out because in the 23 years I have had CP, I have never seen all of this in one place. In fact, I have only heard about the importance of keeping the knees warm from that one doctor. That is the single most important aspect of the program for me. Thank you Dr. Kish, wherever you are. I will probably ultimately need those carbon fiber knees, but by following the regime, I figure I can wait until a) the product improves, b) the price comes down and c) I’m old enough that my cycling level will be within the abilities of those knees. I hope to delay another 10 years.

Since I wrote this a year plus ago, my physician has recommended that I take glucosamine. He was very specific, that I should take 3000 mg/day in the form of glucosamine sulfate or glucosamine hydroxide, but to avoid chrondroitin. This I did faithfully for 9 months. Between riding steadily starting two years ago and the glucosamine, my knees never felt better than they did last summer. I was passing whippersnappers uphill. Then my riding tapered off, I tapered down on the glucosamine and got sick so my riding and conditioning dropped. Thanksgiving I rode 50 miles with 2500’ of climbing on a cool day. My knees hurt. How many of those rules outlined above did I break?


Ben