I did just this and it helped dramatically. I didn't have knee issues really but because of a broken leg, I had a lot of atrophy in the leg which I had no real idea on how to correct. Went to a sports focused PT and they were able to structure a plan to get my leg and knee to a point where it was back to normal. Most will work with your insurance also.

Hahaha. I just got my new bike and it was mail order so some assembly required (attaching handlebars and inserting seat). The geometry of the new bike is VERY similar to the existing bike. I misread the seat height on the older bike and I missed by about 1/2". It was close enough and I did not ride the bikes back to back so I didn't notice. I went on a 20 mile ride and dang my left knee was not happy. Nothing too serious and a longer ride on the old bike the knee was OK. I raised the seat 1/2" and now my knee has stopped complaining.

Who is to say that your bike doesn't have a similar issue? If you want to be biking 30 years from now, I recommend that visiting a physical therapist would be in order. And perhaps a professional bike fit. First, though, is understanding (not guessing!) the cause of your knee issues.

I stopped riding a decade or so ago because of knee problems, so I live in fear of future knee problems. I will not hesitate to seek medical professional if knee problems recur.

Yes, be sure to get a second opinion if you go see a doctor and he pulls out the surgery card early.

After I injured my shoulder, I was fortunate to find an orthopedic surgeon/sports doctor who did not recommend surgery immediately. He treated surgery as a last resort.

It usually takes me about 15 miles before I start feeling a seat position issue in my knees. Of course once it starts to hurt the adjustment doesn't make it better just stops the progression. Took me a week of riding and over a 100 miles to dial in my new seat's position a few months back even knowing where the old one was.

Posted a bit here...
https://www.bikeforums.net/bicycle-me...now-tires.html

Looking through this thread.

I'm thinking it was just running vs. bike riding, and my knees and hips are weak. I need to figure out how to loosen up muscles though. Rest most likely. Stretching, massage, foam rollers, all that... Can work, but doesn't always work or seem to have much effect. What I really noticed was doing squats with some weight, about 80 pounds. I think that stretched out the muscles above the knee and things kind of reset. And healed up with some time. Running more seems trigger it. But I can run more than I could when I first made this post. Things improved.

A couple thoughts crossed my mind more recently....
After I initially noticed how much squats improved things, I thought I felt muscles pulling up on my kneecap while bike riding. That was on a hard pedal. Squats stretched things out that day and I noticed it. I had been thinking the knee cap might be pulling sideways, but that made me think it might be pulled upwards. Tight muscles, weak supports on the legs all around... If I run and that tightens things up a little more, maybe the knee cap gets pulled up.

I wonder if my knees bend slightly inwards when I'm riding my bike. I read when doing squats it's ok to have the knees go out more (not ideal, but ok). But having them move inward is bad... while doing squats. I wonder if that's generally true, and if my knees bend slightly inward while I'm pedalling.



Still reading posts...
No doctor. This isn't serious enough. 95% healed now. I've already pushed a little for running. I recognize the feeling of weak knees and hips I think.

Backing is an option. Stopping completely probably isn't wise. Things will heal up differently. Stopping completely for bike riding isn't really an option since it's my transportation, but I can coast more than pedal.

I also took glucosamine. Who knows whether that actually did anything. I take plenty of vitamins, eat fish, take fish oil, too....


Afraid of a doctor? I'm afraid of spending money for them to tell me RICE for treatment. Duh. I'm less impressed with doctors for things like that. I don't want to pay for common sense either. If I see a doctor it's automatically $200+ just to see them. Before I would do that, I'd invest some time fixing myself on my own. That's what I've done and it worked. I understand things a little more now, and it's healed.

Running... I was running on grass last year. I stopped (probably because of the winter) and went with pavement. Streets, so there's no curve in the part I'm running on. Country roads angle to the sides a lot more. I'm on flat streets.

Muscle imblance is what I'm thinking. Muscle use. Imbalance. Weakness. Weak hips and knees are very common I've read.

Answers here are still valuable. I'm bouncing ideas off you here. I'll get input from you and from myself. It works in general. Just putting an idea in writing helps and has solved problems many times -- I post on a forum and turn around and answer my own question. More input is good though. I would actually say comments here are probably ask good as a doctor's advice would be.

What is "mashing?" Mashing vs. spinning. I don't understand that. I'm assuming it's the metal click sound from the bike chain slipping over cogs, or it's putting a lot of muscle effort into pedalling.


I don't belong to a gym, but I've invested in my own collection of things, stuff like dumbbells, kettle bells, a little bench. Small things that can be moved in a car. I'm focusing on leg exercises a lot more after this knee thing. Pain is very motivating. Results are very motivating too.

Stopping on this post... "I have similar experiences...about 6 or 7 years ago"

Another reason to see a real sports doctor (not a regular doctor - no guarantee a non-sports doc will know what's going on) is the doctor will not only be well-versed in exercise, but also be able to prescribe Physical Therapy.

Insurance-wise, this is important because PT is going to cost a hell of a lot more without the doc's prescription.

I'm assuming of course you have health insurance. If not, I sympathize with the bind you're in.

See a Doc I had knee pain from running ended up being torn meniscus, I was back on bike 10 days after surgery , sooner you see doc the better , had surgery in March,back running up to speed by summer with no issues ,I know everyone's situation is different, but better to get it checked out

"Mashing" is hard, slow, uphill pedaling. "Spinning" is rapid, low-gear pedaling. The latter is easier on the knees.

Keeping the knees straighter while exerting yourself on upgrades is also better for the knees. Achievable through correct seat height and also standing while pedaling. On my fixed gear bike, I stand up a lot, even on moderate inclines. You are using your body weight rather than leg strength to get you up the hill. Initially, this is very tiring, but the more you do it, the easier it gets.

Don't be a bonehead and go see a doctor that specializes in sports injuries. It's possible, not saying it's going to happen, but the trend that hear I you saying is that the knee(s) are only going to get worse especially with clicking going on. That clicking Running will make it worse faster, so either give it up or be prepared to see the doc about a knee job. To hear people moan on about how doctors are trying to pay off their student loans, or their new Maserati, or their 20,000 square foot home is just nonsense, sure some doctors may be like that especially plastic surgeons, but not all, and I've found most sports doctors to be pretty honest in their recommendations because most of them are in involved in sports too so they feel you. Once a sports doctor has a MRI done of your knees they can tell you how bad the situation is, it may be nothing more then him/her prescribing a routine of stretching and strength exercises, he may prescribe you a script to get some custom tennis shoes or inserts, and or do a biomechanics study of your knees if that's available in where you live.

You could try resting the knees for about 4 weeks and see if they're any better, but running would be the worse thing you can do to them after those 4 weeks are up, in fact if you want your knees to be around when you're 60's and 70's and beyond I would recommend that you stop running altogether. The other thing you could try is using a full float pedal on your bike, this will allow your knee to move and remove the stress off the joint. If you're boneheaded about running then I would get a pair of custom running shoes because your shoes could be causing some of your knee issues if they don't put your knee into proper alignment.

But I will guarantee you this, if you take no action due to fear, and really that's what you have...FEAR, whatever you're experiencing now will more than likely get worse. You might get lucky, and with rest, getting a bike fit, getting lucky in finding the right running and biking shoe, you could overcome this, but that's a lot of luck to try to risk it all on a set of knees you have to live with the rest of your life. Are you willing to play the slot machine betting that all knees come up and you win? if not you have to suffer the rest of your life and thus forgo any running or riding not to mention a life of pain and hobbled walking? Your choice, insert your money into the slot machine and give it a pull and see what comes up.

Just an opinion of course.

There's no knee pain now. It's been a few months. Normal wear and tear I think, in the direction of being pushed. This is what happens (and will happen again) when I push running.

But I want to know more about what happens....

My question now -- What muscles pull the kneecap downward, if any? In the scenario that pushes things and makes my knees hurt (sides and bottom of knees when there was pain), I'm pushing running distance. Bike use roughly uses the same muscles. Both bike and running are strengthening the upper leg muscle (quads I think). Those upper leg muscles can pull on the kneecap... and can pull the kneecap up. Use/push the upper leg muscle, the muscle recovers/heals... and firms up/shortens up just a bit. The hurt knee effect doesn't happen during the run. It happens after -- about a day usually, maybe 2-3 days later one time. I was thinking the kneecap was getting pulled to the side (still possible), and that biking pulled one way maybe, running pulled a different way. I noticed biking and running use the upper leg muscles differently. But now I'm thinking the upper leg muscles might just be pulling the kneecap up slightly. That's making the most sense.

I'm googling around, but I don't see anything except the ligament (bone to bone, not tendon which is bone to muscle) that pulls down on the kneecap. If this effect is happening, that would be good to know since I was also pressing/stretching/massaging that kneecap-lower leg bone ligament... which could loosen it and exaggerate the upward pull.

Here's a good pic.
https://www.kneestrength.com/wp-conte...-tracking1.jpg
I don't think anything pulls downward on the kneecap...

A broader question would be what's hold the kneecaps in anywhere? And what can pull on it?

If I go to a doctor, I'm paying for the whole thing myself. Whatever it costs, it's on me. I'd guestimate about $500 to be told RICE.

This is interesting. Not just for knees.

I already got fitted to the bike when I got the bike. And I already looked/checked. My legs match how they're supposed to be.

Whew, lots of stuff here.

Running an Knees:
I'm not convinced that running is particularly bad for the knees. But moderation is key. Perhaps run every other day, or every couple of days. Don't run hard 7 days a week. Give your body some time to recuperate.

Kneecap:
Tendons hold the lower end. Muscles pull on the upper end. The purpose is to give leverage for the extension or straightening of the knee.

Mashing:
Low cadence riding. It can be on hills or flat. Just preferring larger gears. I rarely break 60 RPM, and am often below 50, and can do it for many miles. I hear a lot of echoes of Mashing (slow cadence) being bad for the knees, but I haven't found any research papers supporting that, especially long-term damage.

Knee Pain:
Now, this is a big one. Everyone can feel pain "down there".
One might separate it into joint pain, tendon pain, and structural damage (tears) which is probably difficult for the lay-person to differentiate.
And, with many types of knee pain, there are many potential solutions.

Doctors:
Have you considered orthotics, I think often prescribed by non-MD orthotist? They might help get everything in balance.

Cleats:
I've ridden toeclips most of my life. I jumped to cleats a year ago as I wanted more stability in the foot retention. I use simple 2 screw SPD cleats. Apparently the larger 3 screw cleats can be set at angles for more control of foot position.

Stuff you can do:

• If you've changed your routines, it may take some time for things to settle down again.
• Continue with exercise. Doing nothing may be harder on the body that moderate exercise.
• WEIGHT IS A KILLER FOR KNEES. Keep body weight in check.
• Multi-Sports. Moderate impact from running may be ok, but don't do it every day. Change up your routines some, and let your body recuperate.
• Drugs? Personally I'm not big on drugs. Some people suggest routine anti-inflammatory drugs. However, there is at least some evidence that chronic NSAID use prevents tendons from properly healing, and long-term NSAID use can lead to damaging tendons and ruptures. Other parts of the joints are less clear.
• I've found that a wrist weight seems to alleviate elbow pain to some extent. I don't know if this also applies to knees, but they are easy to try out.
• Braces, Covers, Neoprene. Probably won't hurt. May be worth trying. They can help with comfort.
• Cadence? I'm mixed on this. I think my cadence is naturally evolving a bit, but I'm not convinced that high cadence is the only answer. However, it certainly would be worth evaluating for yourself.

Overall, keep exercising (in moderation), however you choose to do it. But, also be aware of potential structural issues with both your equipment (orthotics? cleat angles?) and your body (cartilage tears, tendon stress, bone abnormalities).

No health insurance? That sucks.

Thanks to my health insurances a doctor visit only costs $20.

A real sports doc would do better than just tell you to RICE.

Thanks to Obamacare the deductible is now like $6,000-$6,500. I pay everything up to that, and then insurance starts kicking in. I probably still wouldn't go to a doctor for it, even with a $500 or a $1,000 deductible. Although in that case, the old way, insurance would pay something right away.

Holy crap, I never had to pay a $6000 deductible, even under the crappiest health insurance.

No other comment, other than good luck, sir.

Ha ha, here in the Philippines, I have no health insurance, but good docs at major hospitals are cheap. My last MRI = $275, DR visits = $10-20. Pay as you go here is very affordable as doctors don't think they're rock stars like in the US.

I was going to say I think you're on the right track. My only advice is PT (physical therapy). Twice I've had it for knee pain that was bad enough I could barely walk and within 6 weeks - good as new. Seriously, those guys are great in my experience. I have some osteoarthritis and small meniscus tears from damage but having had both knees scoped before I don't want to lose more cartilage so I wanted another approach than surgery. My ortho said "try it - can't hurt." I did and it did the trick for me.

Hey that's not a bad idea. For $6000 you could fly to Manila, Philippines or Singapore or some other place where doctors are high quality but low cost, and still have plenty of money left over for hotel, food, drink, etc.

How can you assume your position on the bike is as good as it can possible be? I went to the orthopedic specialist about recurring/chronic patella (knee) tendonitis. The two solutions they gave me were:

a. Get a proper bike fit.
b. Physical therapy (which I had done in the past and never helped).

So guess what? I paid for the bike fit and the knee problem was 100% resolved. I had previously been a skeptic, but never again.

edit: To be clear, I do see you were fit when you purchased the bike, but if the pain is as you describe, I suggest you get another fit from a shop that uses a different system. What system did the first fit use?