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Another Knee Issue Post

Old 03-02-14, 07:06 PM
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Another Knee Issue Post

I really don't know what caused it but my right knee started hurting on longer rides. It was the type of pain that was very "abnormal" and hurt every pedal stroke-especially when I was pushing pretty hard. The pain was at the "top/front of the knee cap". It was just the right knee and the left knee has been perfect as in "don't mess with anything" there. I've had good luck on fixing knee issues by changing the cleat position but lately no luck doing that this time.

The pain has been worse in the winter and I've always wondered if wearing knee warmers or tights tended to push the knee cap down more and caused irritation.....but why just the right knee?

I know, I know, I should go back and get another fitting but I've always been really good at troubleshooting and fixing things myself so what could my LBS guy do that I couldn't do???

The rule of thumb has been that one of the causes of knee issues in the "front" or patella area were caused by saddle being too low or pushed too forward.

When I was looking at my cleats last night I noticed the right cleat was crumbling and needed replacing anyway. I use the Look Keo cleats. I looked at what I had on hand and normally I use the red cleats which have the most float. However all I had were some of the gray cleats with less float from when I bought the pedals and they were in my bike box. So I put one of those on the right shoe only. I positioned it so it was as far under the arch as possibile (as opposed to going towards the toe). This make the "reach" or length of the right leg a little longer. I also moved the cleat to as far to the instep as I could so it would better align and didn't feel like I was riding "pigeon toed". I suspect if I'd done a fitting they would have just put the rods on the my shoes that would have showed how the shoes were pointing. I also raised the seat post ever so slightly..maybe 3 mm.

That seemed to have worked. I did 100+ miles today with the new setup........it is really risky doing a ride that long with a different setup.....but no knee issues the last half of the ride. It also felt like I was using more of the larger leg muscles when climbing so right now all is good. Only time will tell and I need to get on some longer steeper climbs to know for sure but hopefully things are back in the go zone......

I'm sure if I were to measure each foot and leg I'd find some differences.in fact I know my right foot is shorter so making the change makes sense but I was worried raising the seat would mess up my left leg. I suspect another issue is I bet I'm getting 60% of my power from my right leg and less from my left. That in itself could be contributing to part of the problem. It's just good to feel like I can do some longer rides without nursing the knee pain.
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Old 03-02-14, 07:23 PM
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Originally Posted by jppe
I ............... on the right shoe only. I positioned it so it was as far under the arch as possibile (as opposed to going towards the toe). ....... I also moved the cleat to as far to the instep as I could so it would better align and didn't feel like I was riding "pigeon toed".
I've also had some minor issues with my right knee. I also made a small adjustment with my cleats. I haven't had the success you had.... but have reconsidered revisiting the bicycles fit. I don't think my issue is necessarily bicycle related.... as I am nearing the tail-end of the off season here in the Midwest.

Thank you for sharing. Your experience might be helpful for me.
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Old 03-02-14, 08:09 PM
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Suppose that by moving the cleat toward your arch, you actually made your right leg effectively shorter (since your toe normally points down at the bottom of the pedal stroke, not up ), causing it to extend a little more, and by raising your saddle a smigden, your right leg was also required to extend that much further. It would be interesting to photograph yourself from both sides with the nearside foot at the 6 o'clock position, then measure the knee angle to see if there is any difference.
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Old 03-02-14, 08:12 PM
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The other thing is, maybe measure the length of each leg? See if one is longer? Also you could experiment with shims under the left foot cleat, while putting both cleats at the same position on the shoe?
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Old 03-03-14, 06:10 AM
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Wow, I seem to have started a rash of knee issues, sorry for the push into the pain zone. Joe, I hope you can figure your problem out, it hurts me to see one of the real mile and altitude eaters here down from an injury or problem. The lnly thing i found when I had my problem a few weeks ago was that my seat had gotten raised from my usual setting, probably during some maintenance when the seat and post were taken out and cleaned so carbon assembly paste could be applied. I guess I didn't measure when I reinstalled it and left it high. The idea about checking the fit over again sounds like a good one, the cleat being in bad shape set off an alarm for me, too. Best of luck.

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Old 03-03-14, 07:06 AM
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Originally Posted by jyl
Suppose that by moving the cleat toward your arch, you actually made your right leg effectively shorter (since your toe normally points down at the bottom of the pedal stroke, not up ), causing it to extend a little more, and by raising your saddle a smigden, your right leg was also required to extend that much further. It would be interesting to photograph yourself from both sides with the nearside foot at the 6 o'clock position, then measure the knee angle to see if there is any difference.
Exactly my thought on overall leg length so thus the changes I made. Generally knee pain in the front of the knee is from having a seat too low or pushed too far forward. I'm guessing my right leg is a little longer than my left so it took the combination of the changes to make it work. I've actually had a saddle to high which lead to knee pain in the back of the knee.

Originally Posted by qcpmsame
Wow, I seem to have started a rash of knee issues, sorry for the push into the pain zone. Joe, I hope you can figure your problem out, it hurts me to see one of the real mile and altitude eaters here down from an injury or problem. The lnly thing i found when I had my problem a few weeks ago was that my seat had gotten raised from my usual setting, probably during some maintenance when the seat and post were taken out and cleaned so carbon assembly paste could be applied. I guess I didn't measure when I reinstalled it and left it high. The idea about checking the fit over again sounds like a good one, the cleat being in bad shape set off an alarm for me, too. Best of luck.

Bill
I wondered about the seat post sliding down a ever so slightly repeatedly over time. I can't recall the last time the seat post on my Pinarello was moved as I haven't packed it in a bike box and the seat post is extended far enough to put the bike on my bike stand. I didn't even measure it to see how high it now is but now that I seem to have found a happy place I probably should.

Hey folks..........food for thought-----anyone experimenting with fit issues should start by make any changes in really small amounts. Generally it doesn't take a large change to make a difference. Think in terms of millimeters........
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Old 03-03-14, 07:27 AM
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Originally Posted by jppe
Hey folks..........food for thought-----anyone experimenting with fit issues should start by make any changes in really small amounts. Generally it doesn't take a large change to make a difference. Think in terms of millimeters........
+1, and don't change but 1 thing at a time, you won't know which change made the difference, good or bad, if you have made multiple changes at the same time.

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Old 03-03-14, 07:52 AM
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Having knee pain threads brought up can only be helpful to all here. Thank you. Biking is my activity of greatest enjoyment because so much can be accomplished while minimizing knee issues while being free of anatomical correcting gear. Definitely a bother having to wear compression sleeves and Cho-Pat double knee straps during my marathons and all distances shorter.

Originally Posted by jppe
......Hey folks..........food for thought-----anyone experimenting with fit issues should start by make any changes in really small amounts. Generally it doesn't take a large change to make a difference. Think in terms of millimeters........
During last year's Tour, there was a shot of Cavendish along side the team car shoeless on one foot. IIRC, the team manager mentioned that he was unhappy with cleat placement so there was a 1mm adjustment made to resolve the issue.

As far as seat post adjustments, my frame is an ISP frame so no worries. As I age and shrink, I'll just cut it down.
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Old 03-03-14, 07:54 AM
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sounds like it could be mild chondromalacia?
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Old 03-03-14, 09:20 AM
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Originally Posted by jppe
.... I wondered about the seat post sliding down a ever so slightly repeatedly over time. I can't recall the last time the seat post on my Pinarello was moved as I haven't packed it in a bike box and the seat post is extended far enough to put the bike on my bike stand. I didn't even measure it to see how high it now is but now that I seem to have found a happy place I probably should....
I keep a paper back-up in the garage with most of my bicycle stats. I keep one of these in the clipboard.


And... BTW I decided to add a few jumping jacks to my daily exercises. Since cycling has no impact and a slight amount of impact exercise is needed for good joint health. I am hoping this very low impact exercise might help prevent a repetitive motion injury.... from cycling only exercises.
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Old 03-03-14, 10:44 AM
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My bike fit seems to have reached a point where I don't change much any more. In the past, when I was making weekly changes, I used a white out pen to mark the seat post, saddle tilt, bars or whatever was being changed. Those marks are still there so that if I try a different setting, I can easily get back to a previous setting. Just recently, on a ride, the saddle was causing some slight discomfort. Usually the saddle is not noticed at all. After returning home at the end of the ride, I inspected the saddle it it had rotated downward in front by a tiny bit. This was easy to see due to the white line on the rail housing.

I also have a troublesome right knee. To date my treatment has been knee exercises, particularly lateral movements because riding provides plenty of fore and aft exercise. If the knee acts up, I step up the exercises. This might not work for everyone but being as strong as possible is always good and, so far, it works.
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