Knee issues... Will a fit help?
 

New road bike rider here...

I've had my bike for about 2 weeks and ride under 15 miles per ride with less than 60 miles on the bike but I'm experiencing some knee issues that are bad enough to keep me from wanting to ride again.

Some background on me and the bike...

• I'm a runner who's averaged 50 miles per month for years with no history of knee issues
• I had a basic "fit" done at the shop when buying my road bike. (saddle height, fore/aft, stem and bars) no measurements, just sitting me on the bike, letting me ride outside and making adjustments on the fly based on what they saw as I rode.
• I initially had platform pedals but went back for clipless and put the clips on myself during that first week. My clips have 6-7 degrees of float.
• I live in a hilly area where even a 10 mile ride will have multiple climbs. My last ride was under 15 miles with 600ft of elevation change according to my GPS. Climbs seem to put a lot of stress on my knees even in the smaller gears spinning a higher rpm.

Regarding the knee pain...

• Both of my knees "ache"...badly. No sharp pains, just feel tight and very achy all over. Left knee does seem worse.
• Pain is worse in the morning. They seem stiff and painful when waking in the morning but "loosen up" a bit and become a dull ache in the afternoon.
• It has been about three days since my last ride, and I don't plan on getting on the bike anytime soon because of the discomfort.

Is this something a fit will solve? I don't want to throw money away on a fit if it's not needed. I'm pretty happy with bar height and angle and wonder more about seat height/location and cleat adjustment.

Thanks for the help...

Besides fit, what is the gearing on your bike? How many revs per minute your pedaling cadence?

J.

11-28 cassette and 50-34 compact crankset. No computer yet, so I won't speculate on actual cadence. I try to spin on any flats with minimal pedal pressure in big gears, but I'm definitely mashing on some of the bigger hills especially the larger ones that max out my gearing. I often find that I'm riding the smallest gears trying to just make it up the hill.

I was surprised to find that this is NOTHING like running and it seems like it's twice the effort to climb the same hills I normally run on. Only carry-over seems to be the cardio.

Could be lots of things, but a good professional fit couldn't hurt. I wouldn't automatically get a fit from the LBS 'because they do it.' Make sure you're comfortable they're good at it; check around. I'm 73 and went through two which were just fair until I found one gent who fits triathletes. I did have knee problems and he solved them. Cycling may take a bit to adjust to but these past two years (since re-starting after a 43 year hiatus) have been enjoyable and rewarding.

Rich

Don't forget to stretch after your rides. It helps keep the muscles from getting overtight.

I DEFINITELY recommend a pro fitting if you have knee or other joint issues. As a matter of fact, I recommend a pro fitting for anyone who gets clipless.

Ask your local bike club/s for a recommendation on a quality fitter. I would be willing to drive out of town to get a great fitting.

As far as specific pedals, I recommend speedplay for any knee issues. They have abundant free float (no spring tension), so your legs/knees can track exactly as they please.

As a runner, your feet and knees aren't locked into the exact same position with each step, you follow a natural gait. Speedplays allow the same thing when you pedal.

Thanks for the gearing info. Gearing should be fine for that.

Cadence is going to be important here too. If your cadence is 60-ish, probably going to have issues because you're putting a lot of pressure on feet, knees etc... For instance, I was having some issues with foot pain a few years ago when i noticed my average cadence had slipped down to ~75rpm. This after I switched rear cassettes on a bike I had. I pushed my cadence back up to the 85-90rpm I typically ride with and all the pain went away. That's a significant change in pressure on the joints and feet.

That all said, getting a quality bike fit is a good thing to do no matter what. It's worth the money spent.

J.

I looked at the speedplays; Very cool. A little out of my price range for now, but definitely worth looking at in the future.

What level of fit is needed? They seem to range... I've seen prices between $75 and $250 for a 30-45 minute fitting. I would definitely like to spend on the low end. I did talk to some local riders and everyone recommends a different shop as their preference. I don't mind calling some places... Are there any questions I can ask to make sure I'm choosing the right person?

You're in a tough spot if you lack the budget for a fitting right now. I really don't know what to tell you.

A "pro" fitting can take up to 3 or 4 hours and cost up to $350-$400.

I recommend as thorough a fitting as you can afford.

A 30-45 minute fitting is not going to be very beneficial, to be honest.

If local riders recommend different fitters, call a few and see if you feel comfortable talking with them over the phone. You can then narrow it down to 2 or 3 you want to talk to in person. I think that will give you a good sense of which fitter to choose. When you visit in person, ask to see their fitting facilities. They'll put you on a trainer, but the best fitters have sophisticated computer software which can quantify exact angles and your performance.

I have to be honest and recommend you get a fitting ASAP, as you are experiencing knee pain while riding now. And I recommend speedplays for knee issues.

A proper fitting + speedplays can cost you around $450, maybe a bit more, maybe a bit less. It is an investment that is well worth it.

I'd love to tell you that you can get some of this stuff on the cheap, but your priority right now is your health.

I lucked out since I paid $50 for speedplay zero's on closeout, and I received a very thorough fitting for low cost when I bought my bike. But your priority is to ride comfortably and efficiently so make that investment!

You can do it! Cut out coffee for a few months, rent movies instead of going to the theatre, or negotiate an installment plan. Do what it takes. Your health is worth it.

Drink more water.
Get a thorough, professional fitting.
Check your toe - in on your pedals.

Btw, very wise to stay off the bike since you are feeling pain.

Stay off the bike as long as you are feeling pain, and don't even get a fitting until the pain is gone.

Do try 15 minutes of ice in the evening in the interim.

I'm naive when it comes to this stuff, but do recreational riders really spend $350-400 for a fitting session? I could see it for competitive endeavors, but that seems steep for my basic cross-training needs.

If you have knee pain or other joint issues, then yes, I recommend as thorough a fitting as possible.

For knee pain in particular, I recommend speedplay pedals along with a fitting.

Now I'm not saying you HAVE to spend $350; I recommend you get as thorough a fitting as you can get, and if you can pay less, then absolutely, that's great.

I encountered a great shop and we spent a few hours on the trainer, with state of the art software and I felt pretty darn good about the results.


In your case, take your time as I said. Don't get back on the bike at all until your knee pain subsides. In the interim, you'll have plenty of time to call a few fitters locally, and perhaps do some research on youtube and on bike shop websites.

The most thorough fittings involve having you work with a PT, checking your range of motion as it's relevant for bike riding, looking at your natural stance to assess how your pedals will fit, and doing extensive measurements to ensure proper fit on the bike, as well as additional analysis of your watts and efficiency, in conjunction with this fit.

In your case, you really don't want to take a risk with your health. Cut back on coffee, or junk food or in some other areas where you normally might splurge and consider it an investment.

I keep returning to the same point: you don't want to make any more mistakes with your fit and cleat alignment. I'd rather see you stop riding than not get a proper fit on your bike.

Hi,

Over the past 12 years I have done everything I can to destroy my right knee. First injury was at 16 years old, I am now 28....

2002: Broken femur, broken knee cap - Metal pin through femur
2003: Pin removed due to issues with scarring and movement restrictions
2005: Torn ACL, torn hamstring, torn cartilage - ACL reconstruction, metal pins and menisectomy
2010: Arthroscopy and general wash out
2012: Crack in bone in knee joint - Micro-fracture technique
2015: Torn cartilage, fractured bone - Menisectomy and 'smoothing out'

So yeah, knee is looking bad. After the microfracture in 2012 I was told I can't do any impact sports, (including simple things like running, twisting/turning) so bought a road bike and began pedalling.

Fell in love with it last summer and between putting the bike away for winter and getting it out this year have managed more damage and a final warning from the consultant... next thing for me is a knee replacement.... oh and I have tri-compartmental osteoarthritis just as an extra little treat.


I have a long list of additional issues as a result of all this including; sciatica, glute weakness, hipflexor weakness, poor balance, leg alignment issues and of course, pain and swelling.

I had a bike fit done which was very insightful and worth every penny. Cost me £70 in total but was worth so much more in terms of me understanding my issues and he gave me some specific exercises to strengthen my core and my glutes.

My bike has been modified too. Something I would never have known I needed. Shorter stem, lower handlebars, new pedals (speedplay) and I needed a new seatpost with more setback, 25-30mm. This is the main thing I took away from the bike fit. My pedal stroke was forcing my knee to move inwards toward the frame on each downstroke. With the extra setback and a lower seat, and am much straighter on my stroke and I have noticed less pain down the outside of my knee.

Hope you find this useful... oh and don't be put off by the claims that speedplay require lots of maintenance... they don't. Just a bit of lube and a bit of TLC.

So... lots to discuss :):thumb:

While looking for a fitter you can do some modification that may help with the knees. Peter White has an excellent site for doing a fit and can be found at How to Fit a Bicycle. Focus on setting up your fore-aft and seat height correctly as these have a big impact on knee pressure/pain. My knees are sensitive to 2mm in height adjustment when cycling over 25 miles.

Also when I first got started and increased the miles and hills my IT band would cause my knees to ache badly finally to the point of having trouble walking and no amount of stretching would fix it. If you have a foam roller, I highly recommend you try that to free up any adhesions in the IT band and really the muscles attached to the band (DON'T Foam-Roll Your IT Band! | ASM Wellness).

Did you have this problem with platform pedals?

Great article, thank you for sharing.

Raising the saddle has helped quite a bit. I adjusted based on the average of the different methods found online. (Lemond's chart seems to have gotten me near where I want to be). Based on that, it was actually about 1.5cm too low. I may be a tad (1mm or so) high now. I feel some tightening/stretching in the back of my legs at points.

I have some residual pain from when the seat was low in the petellar and quad tendon, but nothing like what I experienced before where it was a global ache in both knees.

I also did the fore/aft alignment (KOPs) as well. I think I'm in a good neutral spot, maybe slighting forward as some recommendations said being a little more forward is less detrimental than backwards. Seat tilt is currently level.

I have a few questions on fine tuning... What is the best bet for climbing. Should I adjust a little more forward or backward? I have a lot of medium sized climbs and any 15 mile route could include 900ft of elevation change over multiple hills from 2-12% grades. I spend most of my time climbing seated, if that makes a difference.


Also, Speedplays seem great. May be my first upgrade as I move along with this.

Generally when my seat is too high I get pain in the back or side (near the back) of the knee, if I lower it 1-2mm that alleviates the pain almost instantly. In this instance I recommend lowering the saddle height by 2mm and see if the pain goes away, if so then lower it an additional 1-2mm because everyday will not be your best day.

Fore-aft saddle position should not change based on climbing, but should be set as the forward-most position that allows you to balance you weight between your hands and torso. Generally though further aft is good for seated climbing, but you do not want to be too far back because you will feel it in your knees. The area where I ride is roughly like yours, but with rolling hills in the 5-10% range, be sure you keep a higher cadence which helps to prevent large sustained stresses on your knees.

As far a cleats/pedals, have you angled your cleats to match the angle of your feet (assuming there is an angle to your feet)? This essentially increases your float. I am toed-out and if I do not match that with my cleat angle, then I have knee pain.

I think I have sorted out most fit issues. Still adjusting my cleats on each individual foot. Also wondering if I should switch to an 11-32 Cassette for climbs to spin more on elevations.

Depends, I guess. Are you able to pedal in a gear now that keeps the pressure down on your feet/knees? What grades are you climbing and what is the cadence you are able to hold on that grade with your 11-28/34?

I wound up with an 11-32 (long story) and took it off and replaced it with the 11-28. I'd go to a 12-28 if there was a reasonable priced one around. I didn't like the spacing on the shimano 11-32. The spacing just seemed awkward to me. If I were to go back to an 11-32, I'd look at the SRAM one first. IIRC, it has the 16 cog in there and I liked the spacing better.

J.

A good start for "what it's supposed to look like" and balance is this video:
https://www.youtube.com/watch?v=z04uoO7U_SA

KOPS is a good start, but then look at your balance. My best fit is well behind KOPS.

Saddle height is very simple: On the bike, riding slowly on the flat, unclip one foot and put that heel on the pedal. Then resume pedaling very slowly. If your knee needs to be completely locked out to stay in contact with the pedal, or if your heel slightly loses contact with the pedal even though the leg is straight, your saddle height is about right. Try it with both legs. Be careful not to rock your pelvis while doing this. Your saddle may want to be a couple mm above or below the heel touch point. You have to try it and see what works for you.

I wouldn't jump right into a pro fit. Your body hasn't acclimated yet to the position. Your best position will change over the next year.

You can spread the pedaling load out somewhat over the pedal stroke. This will reduce peak force on your knees. Push forward at the top of the stroke, like you are trying to kick a dog off your front wheel. At the bottom, pull back like you are scraping mud off your shoe. On the backstroke, think about lifting the weight of your leg up. Not pulling up on the pedal, but just getting the weight off it.

It's useful to do pedaling drills: in a very low gear on the flat, spin fast, concentrating on pedaling with the shoe upper as though there is a layer of air between the bottom of your foot and the shoe's insole.

I don't recommend trying to setup clipless pedals on your own. Let the shop do that.

You bought both the bike and the pedals at the shop. Return and tell them that you are having problems with fit. They should be willing to work with you to make sure you are pain free.

What bike do you have and what pedals do you have?

Fit issues seem to be gradually falling into place and your fitness for cycling will improve with more miles also. Be aware that as your fitness improves, your best position on the bike may well change also. My experience is that the best position is a moving target and small changes over time, as you adapt, can make a substantial difference. Then there is having the right gearing for the terrain you ride and level of fitness. Even tour pros change gearing for different events. Finally, technique can help or hinder. https://www.youtube.com/watch?v=HRFNKhNhhJQ Some tips in the link for climbing. I am especially taken with how smooth the narrator is while climbing and try to copy that for myself.

I set up the cleats on my shoes myself. No one can do it better for me since my pedal/cleat combination has some float. When I pedal, my toes will point inside some natural range. And sometimes I'll purposely point them more in, sometimes more out, just to change the force on my knees or when I purposely change my knee action while pedaling. I adjust my cleats so that I'm never up against the stop when my toes are pointing, as I say, inside my natural range. This makes Speedplays irrelevant for me.

OTOH, a minority have knee issues such that their feet must be fixed to keep their knees happy. These folks ride with a zero float cleat/pedal system and perhaps need an outside observer to get their foot angle set properly.

Personally, I would never pay anyone for a fit. Not to demean anyone's work, but it's not rocket science. There are plenty of information resources available on the web so that you should be able to fit yourself for free. Besides, you will likely find the right setup only after some trial and error. That is to say, you might pay someone to fit you, only to find that the general "rules" they use don't give you the right setup. You might also just start riding with your local cycling club...if you ask, someone will likely help you figure out the best setup for you.

As far as your legs hurting...you might just not be in good riding shape yet. It takes a little while. Although you have done some short-distance running, cycling is a whole different thing. So you can expect to be sore at first. Of course, how you feel is based on a lot...age, height/weight, bike setup, what type of riding (flats, hills, both), diet, etc. Personally, I wouldn't be too concerned about soreness. Like someone else said above...do some stretching after your ride (10 minutes or so worth). Start with the big muscles and work to the small. Also, your seat height and cleat positioning will have a tremendous effect on what muscles you're using. Basically, you want your leg 90-95% straight when you reach the bottom of your pedal stroke. You also want your toe directly above the ball of your foot at the halfway point of your pedal stroke (when your crank is perpendicular to the ground). What pedaling style you use is up to you. Different people like to use different techniques. From everything I have read, a relatively stable heel is the best best (not dropping or raising too much in the stroke). Something that I find helps maintain a good pedal stroke is riding a bike with clips or just naked pedals...pedals that don't allow you to pull on the up-stroke (like clipless). This helps me keep in the habit of keeping constant contact with the pedal on both the down and up-stroke. (I dunno, perhaps no one else gets anything out of this, but I find it useful). Of course, I use clipless for group rides.

Take two aleve after your ride, then another 12 hours later (although advil has always worked better for me, the black-box warning and some chest discomfort have pushed me toward Aleve). Icing the affected muscle (10min on/10min off) for an hour the night after your ride would likely help you a good bit as well. Drink plenty of fluids...but not just water. Go see a sports medicine doctor if you keep having these problems.