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Knee pain, is this online guide correct?

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Knee pain, is this online guide correct?

Old 08-09-13, 04:43 AM
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cerealkilla
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Knee pain, is this online guide correct?

Just completed 158 miles this week, and developed an outside, 'IT' Knee injury... it burns with friction to the outside of the right joint. This link; https://www.cptips.com/knee.htm has a clear definition of where the pain has developed from and how to put it right. But is this correct?

I got a new bike 3 weeks ago, have lots of hills on my normal rides, up to 3000ft climbs over 25 miles etc.
New bike isn't compact and is standard double at 53/39 so have put in more miles than normal and applied more effort.
Bike fits well IMHO, no other pain and if it wasn't for this I'd have topped 200, easy...

Haven't had this injury before, but this is the same leg trashed when some person pulled out when on my motorbike, breaking my femur and a fair few other bits and bobs... in 2007.

Opinions welcome

Last edited by Siu Blue Wind; 08-09-13 at 08:14 AM. Reason: That took some effort. Don't go around the censor.
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Old 08-09-13, 04:58 AM
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I believe you kind of answered your own question. Big miles + full size crank + previous injury.
If you notice pain after the big miles and not riding leading up to it, I would say its the miles + your gearing.
I would stay off the bike for a while, anti inflams, ice three X's a day and don't ride the bike until your knee feels better. If it doesn't get better, go to a doctor. I would also get a compact crank or change your gearing in back if you are climbing a lot of hills and riding a long way. I just put an Ultegra compact on my buddies Cervelo who is a big boy to help with his climbing.
Sorry to hear about the motorcycle thing. As a guy who loves motorcycles..riding and customizing, I can tell you what you describe sadly affects a lot of owners...lots of guys get injured on them.
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Old 08-09-13, 05:04 AM
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No one page guide to knee pain could ever cover all the things that could cause, alleviate or describe different kinds of knee pain. My advice would be to ask your physician. If you have access to a physiotherapist that might be a good idea as well. It is better to get it looked at early and address whatever is the issue, than to wait until it becomes a real problem.

You should be able to cycle 200 miles a week without it causing any pain in the knee under normal circumstances. But then again, you have had a previous injury and put your knee through a lot it seems. What would worry me is that you never experienced this before, and it started after you just got a new bike. You say the bike fits well. But are you sure about that? I would personally try a few things to adjust bike fit, since it is so often the root of the problem. Not saying your fit is not good, just saying it is worth investigating.
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Old 08-09-13, 05:29 AM
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Originally Posted by Campag4life View Post
I believe you kind of answered your own question. Big miles + full size crank + previous injury.
If you notice pain after the big miles and not riding leading up to it, I would say its the miles + your gearing.
I would stay off the bike for a while, anti inflams, ice three X's a day and don't ride the bike until your knee feels better. If it doesn't get better, go to a doctor. I would also get a compact crank or change your gearing in back if you are climbing a lot of hills and riding a long way. I just put an Ultegra compact on my buddies Cervelo who is a big boy to help with his climbing.
Sorry to hear about the motorcycle thing. As a guy who loves motorcycles..riding and customizing, I can tell you what you describe sadly affects a lot of owners...lots of guys get injured on them.
IMHO - bikes of any kind are prone to injury! being more exposed is part of the fun I feel :-) I'm 99% over the smash in 2007. Was not good though... femur snapped coz knee tried to bend the wrong way, hit side of car at approx. 70-80mph. Both fore arms, wrist bones crushed. Left thumb removed and reattached, three fingers dislocated, 5 ribs and a cracked cheekbone. But none of that hurts. Just the knee... and this is the first time its hurt since.

Maybe I go back to compact or will a bit of careful training see me through the barrier? I like the added pace I'm getting with a standard double. I just cannot ride it for as long ATM?
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Old 08-09-13, 05:31 AM
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Originally Posted by Cookiemonsta View Post
No one page guide to knee pain could ever cover all the things that could cause, alleviate or describe different kinds of knee pain. My advice would be to ask your physician. If you have access to a physiotherapist that might be a good idea as well. It is better to get it looked at early and address whatever is the issue, than to wait until it becomes a real problem.

You should be able to cycle 200 miles a week without it causing any pain in the knee under normal circumstances. But then again, you have had a previous injury and put your knee through a lot it seems. What would worry me is that you never experienced this before, and it started after you just got a new bike. You say the bike fits well. But are you sure about that? I would personally try a few things to adjust bike fit, since it is so often the root of the problem. Not saying your fit is not good, just saying it is worth investigating.
Haven't consulted the Doc yet as its just a pain that seems to be easing, but I want to sort it before it becomes compounded.
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Old 08-09-13, 06:05 AM
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Are you clipped in? It is not uncommon for the person who did their own cleat setup to have knee issues.
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Old 08-09-13, 06:42 AM
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Originally Posted by killa View Post
IMHO - bikes of any kind are prone to injury! being more exposed is part of the fun I feel :-) I'm 99% over the smash in 2007. Was not good though... femur snapped coz knee tried to bend the wrong way, hit side of car at approx. 70-80mph. Both fore arms, wrist bones crushed. Left thumb removed and reattached, three fingers dislocated, 5 ribs and a cracked cheekbone. But none of that hurts. Just the knee... and this is the first time its hurt since.

Maybe I go back to compact or will a bit of careful training see me through the barrier? I like the added pace I'm getting with a standard double. I just cannot ride it for as long ATM?
It will all hurt when you get to my age brother.
Quite a crash. You know the saying about motorcycles...not if but when. ATGATT. You know what that means if you are an avid rider.
You said 99% percent. Its that lingering 1% that spoils it a bit. Few things rival the thrill of hanging off the seat on a big power sport bike.
Ride safe.
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Old 08-09-13, 07:11 AM
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Hi,

I would not mess with the bike setup just yet. Try to use a roller to stretch the IT band. I get that pain too when I put in too many miles in a week.
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Old 08-09-13, 07:27 AM
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That's what I'm thinking first... Maybe I need to see through the pain barrier and let the 'first batch' of stretching ease off? Its their a technique, whats this roller you mention?

Last edited by cerealkilla; 08-09-13 at 07:44 AM.
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Old 08-09-13, 07:43 AM
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Originally Posted by Campag4life View Post
It will all hurt when you get to my age brother.
Quite a crash. You know the saying about motorcycles...not if but when. ATGATT. You know what that means if you are an avid rider.
You said 99% percent. Its that lingering 1% that spoils it a bit. Few things rival the thrill of hanging off the seat on a big power sport bike.
Ride safe.
I ride well, always have done Last bike was a full Arrows Ti kitted R1 (2002-04 model)
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Old 08-09-13, 07:53 AM
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Did you get a professional bike fit? I had the same type of pain which was corrected through a bike fit.
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Old 08-09-13, 08:09 AM
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Not fully on a machine or roller/trainer type fit, but a basic assessment from the LBS where I bought it from. The fine tuning, is something I'm working on personally. But I'm OK with that. I know my dims from previous fits and what does and doesn't work. I'm thinking cleats ATM..... I've always felt the Speedplays to be a bit on the narrow side between left and right pedal. Maybe I need longer spindles. I can really fly up hills as its setup and all feels really well, It never crosses my mind that something feels uncomfortable at all.

Last edited by cerealkilla; 08-09-13 at 08:12 AM.
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Old 08-09-13, 08:45 AM
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Check your saddle height. In my experience, the majority of knee problems in riding are caused by having a saddle too low. Measure your standover and multiply by 0.886 to get a good baseline height from the center of the crank.
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Old 08-09-13, 09:05 AM
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Centre of BB to top of seat is a known figure, I use 735mm
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Old 08-09-13, 09:08 AM
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Just looked at a detailed model of where the IT Band is... its where I had two screws fitted just above the knee when I had the femoral nail fitted, now removed:


maybe its something that will go away....
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Old 08-09-13, 09:26 AM
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Make sure you maintaining at least 60 rpm while climbing. If you can't maintain 60 rpm going up your hills, get a compact. Spinning faster puts less torque on the knee.
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Old 08-09-13, 11:23 AM
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I was having what I believe was IT band pain, in my case the original cause was from a rough-country backpacking injury. Anyway two things seem to have cured it for me. First was going to cleats. But what I think really did it was addressing my different leg length issue. The leg I was having the pain on was my short leg, and so I was dropping my hip on that side and had all manner of pedal-stroke asymmetry going on. I bought a pair of cheap foam shoe inserts, just the flat ones, and doubled them up in my short leg's shoe. The difference was dramatic and the IT pain ceased almost instantly. I'm currently in the process of finding the right cleat shim height to replace the doubled-up orthotics.

Especially given all the prior injury and surgery to your leg, I'd advise paying great attention to your symmetry. Look for a hip drop, pelvis tilt, and/or a feeling that one leg is trying to overextend relative to the other. Get things symmetrical, get the seat height right, and get the cleat under the ball of your foot (which will engage your calf and hammie nicely). Then use a plumb line to see if your fore-aft seat position is ballpark.

I'd like to emphasize that I'm pretty much a noob here and just reporting what's worked for ME- not trying to represent myself as a fitting expert. Add salt to my thoughts as you feel necessary.

Good luck!

Last edited by Long Tom; 08-09-13 at 11:27 AM.
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Old 08-09-13, 11:38 AM
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Originally Posted by Long Tom View Post
I was having what I believe was IT band pain, in my case the original cause was from a rough-country backpacking injury. Anyway two things seem to have cured it for me. First was going to cleats. But what I think really did it was addressing my different leg length issue. The leg I was having the pain on was my short leg, and so I was dropping my hip on that side and had all manner of pedal-stroke asymmetry going on. I bought a pair of cheap foam shoe inserts, just the flat ones, and doubled them up in my short leg's shoe. The difference was dramatic and the IT pain ceased almost instantly. I'm currently in the process of finding the right cleat shim height to replace the doubled-up orthotics.

Especially given all the prior injury and surgery to your leg, I'd advise paying great attention to your symmetry. Look for a hip drop, pelvis tilt, and/or a feeling that one leg is trying to overextend relative to the other. Get things symmetrical, get the seat height right, and get the cleat under the ball of your foot (which will engage your calf and hammie nicely). Then use a plumb line to see if your fore-aft seat position is ballpark.

I'd like to emphasize that I'm pretty much a noob here and just reporting what's worked for ME- not trying to represent myself as a fitting expert. Add salt to my thoughts as you feel necessary.

Good luck!

Cheers Tom, that's very helpful.

Legs are more symmetrical than eva, had that checked and they had to reset and dynamism the broken femur once as I wanted it perfect.
I've done almost the exact fit you have described above. Even taken the time to give myself a full measure and fit. Details are:

Inseam: 85cm Bone to floor (feet 20cm apart)
Trunk: 61cm
Forearm: 36cm
Arm: 65cm
Thigh: 61cm
Lower Leg: 54cm
Sternal Notch: 147cm
Total Body Height: 174cm

I been using this fit technique, its worked on two previous bikes. Both were compact 50/34.



I used this site to take advice re measurements.
https://www.competitivecyclist.com/za...LCULATOR_INTRO

Measurements:
-------------------------------------------
Inseam: 85
Trunk: 61
Forearm: 36
Arm: 65
Thigh: 61
Lower Leg: 54
Sternal Notch: 147
Total Body Height: 174


Results:

The Competitive Fit (cm)
-------------------------------------------
Seat tube range c-c: 55.1 - 55.6
Seat tube range c-t: 56.8 - 57.3
Top tube length: 53.7 - 54.1
Stem Length: 11.2 - 11.8
BB-Saddle Position: 72.8 - 74.8
Saddle-Handlebar: 53.0 - 53.6
Saddle Setback: 6.2 - 6.6


The Eddy Fit (cm)
-------------------------------------------
Seat tube range c-c: 56.3 - 56.8
Seat tube range c-t: 58.0 - 58.5
Top tube length: 53.7 - 54.1
Stem Length: 10.1 - 10.7
BB-Saddle Position: 72.0 - 74.0
Saddle-Handlebar: 53.8 - 54.4
Saddle Setback: 7.4 - 7.8


The French Fit (cm)
-------------------------------------------
Seat tube range c-c: 58.0 - 58.5
Seat tube range c-t: 59.7 - 60.2
Top tube length: 54.9 - 55.3
Stem Length: 10.3 - 10.9
BB-Saddle Position: 70.3 - 72.3
Saddle-Handlebar: 55.5 - 56.1
Saddle Setback: 6.9 - 7.3

I have; 54cm frame, ETT = 550mm, stem = 110mm, saddle height = 735mm with approx. 5mm setback, bars = 420mm

Last edited by cerealkilla; 08-09-13 at 12:17 PM.
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Old 08-09-13, 11:57 AM
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Not trying to be a jackass, but from my experience, if you're going to the internet to solve knee issues, you're going to have a bad time.

If you have consistent issues, always work with a professional bike fitter and/or physical therapist. My PT is provided almost free by my HMO.

Just my 2 cents.
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Old 08-09-13, 12:05 PM
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Me'beez, but its a nu'pain, was thinking tiz just IT Band stretching, that I need to adjust too... OR could it be the extra force needed for the 53/39??
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Old 08-09-13, 02:20 PM
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I suffer from knee pain in one of my knees. I think it came about from trying to do too much too fast and my age (42). What's helped me is easing up on the mileage a bit, using the little ring a lot, pedaling high cadence (at least 85), and slant board eccentric decline squats. I try and do about 30 of those daily. I also switched to Speedplay pedals to allow for more float (I like 8 degrees) and of course make sure you have a good bike fit. For big rides I usually wear kinesio tape and ice it afterwards. I also wear a simple Ace knee brace during flareups but not when riding.
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Old 08-10-13, 07:06 AM
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Same age here, 42. Also using speedplay with proper 4 hole shoes, Lake CX331s. Taking from the above comments it may well be the change to standard from compact.... Pains gone today, so will try stay off big miles for a few days
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