NoSleepTill

Hey everyone.

About two weeks ago, I got on a bicycle for the first time in 14 years and I did a 9-mile ride. It was fantastic, but my left knee started hurting during the ride. For three days after, my left knee was in pain. It was at the front, right part of the left knee. I had *no* problem walking (and I didn't even remember my knee was hurting if I was walking). It was only when I would bend my knee (which included crossing my legs and getting up from or into a seat). The pain was dull...certainly not sharp or excruciating, but it was there. Some research and talking to friends made me realize that the likely culprit was a bike seat that was several inches too low, and I was putting *way* too much pressure on my knees (though that it hurt in one and not the other was troubling).

After three days, it died down a lot. Five days after my bike ride, I took it out again when my knee was better. I got only 2 miles until my knee started acting up again (though not as bad as before). A week later, I tried the bike again. This time, 5 miles before it started acting up. When I'd get home, the pain was gone.

Several days later, I went out for another 9-mile ride. Part of the way through, I felt my knee a little bit. By the time I got home, I felt it more. As of now, I'm doing the RICE (rest, ice, compress, elevate) as well as taking anti-inflammatories, and doing some stretches.

I haven't seen a doctor, and from online research, I think I hurt my IT band (it's in the exact spot where the pain from those injuries usually occurs, the symptoms match, and it's a common injury, from what I've read). [and I recently remembered, when I took a spinning class last year for the first time, again my left knee was acting up, though it resolved itself in a couple of days].

I was doing more online research, and I came across this site about cycling with IT Band Syndrome: https://alexreisner.com/itband

Two things stuck out to me and worried me:

1. It says I should lower my seat again. I thought that's what got me into this mess in the first place! My bike seat is now at an appropriate height, but now the site is telling me to lower it. As I new biker, I find this contradictory information confusing. And I'm not sure if the average bike shop person would know how to align bikes for people prone to this condition. Which gets me to...

2. I am very bowlegged which this site (and others) have stated often leads to IT Band Syndrome. (My feet also point outwards, not straight forward - putting them straight forward feels awkward and uncomfortable) I obviously can't fix my legs, but if bowleggedness contributes to this injury, am I going to be unable to bike? (or not bike unless I take one of the uncomfortable remedies on the site such as pedaling on my toes, using my butt more, using a brace, etc.). That would suck, as I just got on my bike and I'm enjoying using it.

Any tips/advice/help is greatly appreciated, especially from those who have had this condition.

Thanks!

cyclist2000

I suggest that you see your doctor and get the name of a good orthopedist.

And it sounds like you need a get fitted to your bike.

steve0257

Because of knee injuries in my youth I have to ride with my saddle turned just a little bit to one side. If the nose is not turned just a little less than 1/4" to the left from being straight I get I get a pain in the front of my right knee.

If the saddle is perfectly straight, depending on the saddle height I get pain either in the front of the right knee or the back of the left knee.

Nermal

Another small point might be the force on the pedals. If you're significantly in too high a gear, your knees are going to at least get sore.

009jim

I believe you need to increase in slow increments - only 1 mile per day for say 2 weeks, say, and then when your knee is strong enough for that increase to 2 miles per day for a few weeks.

ahsposo 

^^^ yeah, you need to ramp up slow.

You don't mention gearing or terrain. I would think easy spinning with no heavy pedal pressure would be a good thing and a higher seat would help this. But I'm just some ******* on the internet. I'd get a sport physician or some other local trainer to advise if you can afford it.

JusticeZero

I am going to do the easy one one and say "Maybe you're mashing." To reduce strain on your knees, you need to pedal faster, in a lower gear. This isn't natural to people and must be learned.

Remember that Michael Jackson song "Thriller"? yeah, you can't get it out of your head now, can you. Even if you hated it. da-DOOM-dah-dih-de-DOOM... da-DOOM-dah-dih-de-DOOM...
That song has a BPM of 93. Now, spin your pedals so that your right foot comes up in time with that song. Not half-time, one FULL revolution. Two revolutions for each base rhythm. You're going to have to shift way down to do this without pushing yourself, and you will feel like you're spinning the pedals and not going anywhere. This is normal! You actually will be making a lot of headway. Now, fiddle with the shifter and find the gear where you feel like you're having to push yourself just a little to spin the pedals that fast. Found it? Shift down one gear from there. Perfect.
Oh no it's a hill! Keep the music going. Keep the beat. Shift.
"Kung Fu Fighting" is 93 too. "It's My Prerogative" is 95. It's not that I think these are awsome songs, it's that these songs have beat lines that get stuck in your head easy. This is the same theory as why CPR classes no longer have you do complicated count things, they just tell you to hum "Staying Alive" because that's the right pace. (200 I think, which you could do if it's per knee)
There are web search thingies for DJ's to search songs by BPM. Between 90-100 is a good pace. Yeah, everyone has a natural pace, but that's usually an excuse for doing stuff wrong, so we're going to give you a nice pace to get used to and let you find your rhythm from there.

Easy, low pressure, you're actually moving at close to an optimum pace for your muscles (even if your nervous system is trying to reconcile it with a walking pace and going 'what the heck are you doing??') and hardly any pressure on your joints.

CB HI

There are many things that can cause knee pain - saddle too low, saddle too high, saddle not tilted right, saddle angled off line, clipless peddles that do not allow your foot to rotate left and right, mashing in too high a gear, a weak knee that needs strengthened and any combination of the above.

You best bet may be to see a sports medicine specialist.

Retro Grouch 

The FIRST thing that I would do would be to get someone to take a look at how you fit on your bike. LOTS of inexperienced cyclists ride with their saddle way too low. If that's the case, raising it a bit will make a huge difference. The price is right too. I'm an analog kind of guy so here's how I do it:
Go for a ride with somebody you trust. Warm up and settle in for 1/2 hour or so before doing anything.
1. Have your observer watch you from behind. If your hips rock from side-to-side, your saddle is too high.
2. Have your observer watch you from the side. If your heel drops below the pedal at the bottom of the stroke, your saddle is too low.

I also have that toes-out thing. The only way that it has affected my cycling is it impacted my choice of clipless pedal cleats. I use Shimano SPD pedals with the multi-release cleats. I stumbled onto that combination around 15 years ago and was surprised by how much easier it was for me to release. I've been afraid to try anything else since.

xrayzebra 

That's a nice, simple way to observe this.

I always see people riding the NCR with their seats way too low. Since I ride pretty casual and slow, I let them know, if they seem friendly. I've had one person get insulted and huffy. I've had a number of people thank me when I see them later, and tell me that it made a huge difference. One person who had just come back to biking told me he was thinking of giving it up again until he took my advice and adjusted his seat. Biking can be a miserable, painful thing if you don't do it right.