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Any thoughts on this knee pain?

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Road Cycling “It is by riding a bicycle that you learn the contours of a country best, since you have to sweat up the hills and coast down them. Thus you remember them as they actually are, while in a motor car only a high hill impresses you, and you have no such accurate remembrance of country you have driven through as you gain by riding a bicycle.” -- Ernest Hemingway

Any thoughts on this knee pain?

Old 06-19-16, 12:04 AM
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Long Tom
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Any thoughts on this knee pain?

On a 50+ mile ride a couple days ago my right knee acted up about mile 35. By the end I was on one leg.

I trace this directly to an injury to the knee while backpacking in rugged country 4 years ago. It was problematic afterwards for a few months, then mostly faded away.

The pain is on the outside of the joint, and around the back a little. It isn't so much a power-application pain as a repetitive motion pain. Extending the leg hurts as much as bending it. No pain under the kneecap. My working theory is inflammation of a tendon or muscle sheath, or another similar band of harder tissue that things slide around in.

Two days later, I can barely feel it. That has been the case in the past as well, including the first occurance on the backpacking trip.

I know that addressing this with a fix can't really happen here, but I'm hoping for some thoughts from others who might have had a similar issue, to help me, I guess, self-diagnose this. Which is funny. But humor me here.

In my early 50's, tall, reasonably fit, ride 25-30 miles often without this problem.

Last edited by Long Tom; 06-19-16 at 12:10 AM.
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Old 06-19-16, 05:09 AM
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I have something similar to this. It turned out to be a flexibility issue. I went to see a physio because I didn't want to aggravate it and ruin my season. He gave me stretch exercises. I had to see him 5 times over 2 months.

I'll have to continue those exercises but it's like night and day now compared to before.

I strongly suggest you seek professional help. My insurance covered this 100%.
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Old 06-19-16, 07:03 AM
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VERY similar situation to yours - 50 mile ride, pain started around mile 35...and by the last 5 miles I cold barely pedal. It was the right knee on the outside.
For the rest of the day it was difficult to go up and down stairs
By the next day it was somewhat better, but there was still considerable discomfort.
At the start of the 3rd day, I considered calling my doctor to make an appointment...but let it go. By that afternoon I was pretty much back to normal.

Somebody here said something to the effect, that, your muscles build strength faster than your tendons and ligaments. So it was basically doing too much, too early.
Somebody also suggested massaging the quad, above the knee and towards the outside. That seemed to help. I think lowering my bike seat a little also helped.

But everybody is different. My issue could in fact be totally different from yours.
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Old 06-19-16, 10:18 AM
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Originally Posted by Long Tom View Post
On a 50+ mile ride a couple days ago my right knee acted up about mile 35. By the end I was on one leg.

I trace this directly to an injury to the knee while backpacking in rugged country 4 years ago. It was problematic afterwards for a few months, then mostly faded away.

The pain is on the outside of the joint, and around the back a little. It isn't so much a power-application pain as a repetitive motion pain. Extending the leg hurts as much as bending it. No pain under the kneecap. My working theory is inflammation of a tendon or muscle sheath, or another similar band of harder tissue that things slide around in.

Two days later, I can barely feel it. That has been the case in the past as well, including the first occurance on the backpacking trip.

I know that addressing this with a fix can't really happen here, but I'm hoping for some thoughts from others who might have had a similar issue, to help me, I guess, self-diagnose this. Which is funny. But humor me here.

In my early 50's, tall, reasonably fit, ride 25-30 miles often without this problem.
your post above describes me at the beginning of this season exactly. I was starting to get very concerned that I could not go beyond about 40 miles with pain. It was very discouraging. By paying close attention to how and where in the pedal stroke i figured out the problem was at the transition into, and out of, max extension of the leg. I lowered my saddle 1/4 inch and it was like magic. No more problems. You might give this a try.
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Old 06-19-16, 10:41 AM
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I've had good luck using MSM to treat/manage/prevent knee pain. In all honesty, I don't know if it's a placebo effect, actually helps the knee or simply masks the issue, but I don't care because it reduces or eliminates any pain, and after a regimen of 3 weeks or so, the pain doesn't recur for months.
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Old 06-19-16, 10:44 AM
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Possibly of use would be the chart (Chart 1) near the bottom of this page: BikeFit - Road Bikes
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Old 06-19-16, 11:55 AM
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Thanks for the input. Lower my seat, eh? Hmmm. It's been a while since I messed with my "sacred fit" but maybe it's time!
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Old 06-19-16, 03:40 PM
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Originally Posted by Long Tom View Post
Thanks for the input. Lower my seat, eh? Hmmm. It's been a while since I messed with my "sacred fit" but maybe it's time!
Be careful! Lowering my seat contributed to my recent knee pain.

It's worth it to first try to determine whether you're already on the low side of the recommended seat height by measuring knee angle (video, screenshot the video on your PC, and then Gimp or Photoshop to measure angle).
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Old 06-20-16, 06:32 AM
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Originally Posted by f4rrest View Post
Be careful! Lowering my seat contributed to my recent knee pain.

It's worth it to first try to determine whether you're already on the low side of the recommended seat height by measuring knee angle (video, screenshot the video on your PC, and then Gimp or Photoshop to measure angle).
Good suggestion - checking whether you are already on the low or high side of recommended saddle height is a good idea before making any changes. in my case, I had bumped up my saddle height a bit early in the season. Took me a while to figure out that it was related to the knee issue.
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Old 06-20-16, 08:19 AM
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I developed similar pain in my right knee after experimenting with decreasing the Q-factor before a long ride. What seemed to cause and/or aggravate it was the foot rolling to the outside through the power phase of the stroke. What helped me was increasing the Q-factor and focusing on applying the power through the base of the big toe to prevent the foot rolling. Changing saddle height up or down doesn't seem to affect it for me. I've since had a fit where we added a few wedges under both feet, so I'm now experimenting with applying the power more evenly through the balls of my feet, but haven't spent enough time on it to determine if it helps for this particular issue.
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Old 06-20-16, 10:13 AM
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Possibly iliotibial band syndrome? Google it
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Old 06-20-16, 11:56 AM
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Originally Posted by milkbaby View Post
Possibly iliotibial band syndrome? Google it
My first thoughts when I read the first post. It could be a fitness issue or a cleat issue. Hard to tell. Rolling it after a long ride helps
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Old 06-20-16, 10:45 PM
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Yeah, it's the IT band. The best treatment is stretches. These have worked well for me, mayb 3X a day to start, then 1X day:
https://www.bikeforums.net/road-cycli...l#post15372967

Loosening up the hamstrings does the most good. The figure 4 stretches are important too. You can't really stretch an IT band, but you can loosen up the tendons which are being irritated by it, which is kind of the same thing.
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Old 06-21-16, 06:41 AM
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I have IT band pain in my left knee, and it's completely different from the issue in my right knee I described previously. This article explains well how to diagnose it: https://www.painscience.com/articles...s-location.php

Last edited by Fiery; 06-22-16 at 06:33 AM.
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Old 06-21-16, 07:16 AM
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It sounds like the kind of pain I get when my saddle has slipped backwards past a certain point. (Damned trek 1-bolt clamp.) is it possible that your saddle has slipped? Or that it's getting worn out and somehow causing your position to move back a little? You should double check that. Sometimes these things happen so slowly you don't notice it until it reaches an extreme position.
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Old 06-23-16, 12:41 AM
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An update.... Before messing with fit on a bike I've put a lot of miles on, I decided to try to roll my IT band, since I easily could. Did several reps last night and a couple more today. Ouch.

My wife and I walked about 5 miles this morning, and I rode 30 miles this evening... not even a twinge. Guardedly optimistic. Thanks for the help folks!
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