ColorChange

A couple weeks ago I was out on a long ride (100 miles) and started to experience knee pain after some steep climbs. I think climbing out of the saddle was the cause. I think I was pulling up too hard with the trailing leg.

The pain was originally on the inside and outside of both knees, most pronounced on the left outer knee. The pain got pretty bad at mile 75 but I was 25 miles from home so ... oh well. This is a sharp wincing pain, not like the duller knee tendinitis pain I am more familiar with.

I took a few days off and went out for another long ride today. At about mile 50 the pain started slowly again, only on the left outside knee. It began with hard efforts but didn't bother me at normal power <350 watts. As the ride continued, it got worse and worse. Sometimes it wouldn't hurt for a while, and other times hurt real bad. It would hurt under no load, under heavy load for sure, and of and on at intermediate powers.

Anyone have a similar experience or have any suggestions? I took a big dose of ibuprofen when I got home and am icing it now. Sorry for the length of the post.

TIA

Steve90068

sounds like your IT band. take it easy and get a foam roller.

ColorChange

Also, the knee only hurts while bending. Once bent, fine. Can jump up and down on it when straight with no pain. Bending it under no load hurts.

ColorChange

Wouldn't the IT band tend to hurt up by the hip as well, instead of just at the outside of the knee? I'll try some IT band stretches.

Tunnelrat81

I had a very similar issue with my left knee that is quick to return under the right circumstances if I'm not careful. It (first?) showed itself on a century with 12k ft. of climbing. I took it easy afterwards and it slowly improved. A couple of years later (last Aug. 2010) I did a 4 day mountain climbing tour with over 30k ft. of climbing and 300+ miles. It came back and didn't improve.

After lots of pondering, online research, some theorizing, and a little bit of luck, I think I've finally figured it out. This was my thought process:

The long climbing days meant that I, too, was out of the saddle more than usual. Riding out of the saddle involves rocking the bike back and forth. While rocking the bike and pedaling down, you're leaning your bike away from the downward pedal stroke. That changes the angle on your foot as you pedal, with the arch and ball of your foot losing their support on the downward (power) side. I had already known that I needed arch supports in my shoes, but had never before correlated that with changes in foot angle with riding out of the saddle. Once I figured this out I wanted to test it somehow. My knee pain was still there, so reproducing it was easy, specifically while out of the saddle. I forced myself to ride out of the saddle (awkwardly) with the bike perfectly vertical. I could instantly tell the difference. I could even put some effort into it without the sharp pain. This gave me the confidence to move forward.

I decided to attack the problem with in two ways. First, I ordered up some fit shims (for between your shoe and cleat) and also decided to replace my speedplay pedals with Shimano SPD-SL's. I'd had no problem with heal movement while on the speedplays, but I DID have a decent amount of side to side rocking. If I was going to shim my shoe angle, I wanted to be able to carefully control that angle, and thought that a more solid platform would be better. Each shim is supposedly 1 degree, so I decided to jump directly to 2 degrees, assuming that a 1 degree is tiny compared to the side to side movement of my bike while standing. The shims (of course) install with the thicker part on the inside, which angles your foot outward. I adjusted my new cleats to the same position that I'd had my speedplays, only this time with the shims, and started riding my normal schedule. One week later I was only occasionally feeling discomfort, but no pain. Two weeks later, the discomfort was all but gone. And by about three weeks it was the furthest thing from my mind. Since then, I've been back to riding normally, and now that the season is started my intensity is up and I've had no recurrences, even while riding hard out of the saddle. I am careful not to be too crazy with the bike rocking, but it isn't something that I really think much of. In the end, it's pretty clear to me that it all came down to foot/shoe angle (lateral angle that is, not heal-in/heal-out angle)

I also couldn't be happier with the pedal change. They aren't as easy to get into and out of but I absolutely love the solidity that they provide. Shimano makes a great pedal, and after months of regular use, the pedal/cleat junction is still as tight as when they were new, something that I never had with speedplay.

There's no way of knowing if you are having the same issue that I did, but you asked for similar experiences, and mine sounds exactly like what you're going through. Funny thing, once I started thinking about it (still around the time of the change) I started noticing it off of the bike. We have a sloping lawn, and when I would mow one direction (sloping down to the right of me) I could feel it in my knee. Turn around and mow the other way and I'd have no pain at all. You might be able to do some basic tests with squats on a slanted floor or driveway before spending money on shims etc.. Also, look at the shoes that you wear during the day. Knee issues might be worsening on the bike, but are being contributed to while off of the bike. Anyway, Let me know what you find, I'm quite curious. =) And I hope this helps. Nothing worse than pain that keeps you off the bike.

-Jeremy

ColorChange

THANK YOU Jeremy! This makes a lot of sense.

Just to be clear, your pain was on the outside of the knee and you put the shim on the instep of that knee right?

Tunnelrat81

I actually had a hard time locating the pain in my knee, so I really can't compare it's location with yours. It wasn't clearly on the inside or outside. However, I knew that my knee hurt while riding out of the saddle, and that riding out of the saddle rolled my foot inward. So to address this, I "pre-set" my foot a bit in the outward direction. Here's a link to a some information on the theory behind the shims:

https://www.excelsports.com/inform.asp?page=31

Specialized also makes a wedge that goes into your shoe rather than between the shoe/cleat to accomplish a similar goal, but I have no experience with that solution.

-Jeremy

zigmeister

I was fitted with wedges during a fit with these. My right outside knee, and knees in general have been swelling. Right one in particular where I almost can't pedal after 10 minutes. The wedges aren't going to help/solve anything. There is something else going on in my case. Seems like the IT band just to the right below my kneecap.

Tunnelrat81

Well my advice was directed to the OP and his specific issues as described, and based on my similar experience.

So is your advice to the OP that if fit wedges didn't work for you, they won't work for him?? I'm a bit confused. Or were you just posting frustration with your situation?

-Jeremy

zigmeister

No, you made a general statement as if wedges would help by specialized, but you have no experience with that. As someone who currently uses these exact wedges by Specialized in my Specialized Road Carbon shoe, I'm saying I have experience with that, they might not help and be a waste of $50.