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prevention of knee injury/pain?

Old 04-26-05, 02:50 AM
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prevention of knee injury/pain?

how do your knees feel? I have only been riding fixed for a month or so now. rode ss for six or seven months, but not as frequently. fixed is a f***ing blast, and I am riding daily now.

Alas, my right knee does not agree. it's not terrible, but I feel like it could become so. First, fixed has to be tougher on joints, no? Second, any thoughts on preventative care?
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Old 04-26-05, 08:26 AM
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use a lower gear ratio, to decrease impact on the joint. try to limit skids and skips b/c that adds a lot of torque to the knees. I ride with a bum right knee and use a brake, that seems to do the trick. Stretch and weight training could be beneficial too.
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Old 04-26-05, 09:11 AM
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Try moving your seat up. If you ride with clipless pedals, moving the cleat further back will take some strain off.

I just got over my knee problems, and that's what worked for me.
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Old 04-26-05, 10:25 AM
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Originally Posted by yonderboy
Try moving your seat up. If you ride with clipless pedals, moving the cleat further back will take some strain off.
I would say you need to look at where your seat is and get the height and position right. This may require moving the seat higher but you may need it lower. Same with horizontal position etc.

Getting the fit right is essential to riding fixed. Your knees and legs are constantly moving and under strain so anything wrong with position is quickly amplified.

Once you have the position right (plenty of fit guides on the web), would second that you look at your gearing. You have to start lower and work on your spin otherwise you'll never really get stronger.
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Old 04-26-05, 10:57 AM
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I had the same problems, had to stop riding for a while because of severe and sudden patellar tendonitis (first time in my life.) I stopped leaning on my bad leg (left) too much, which I think was the major culprit for me (when slowing down, stopping, etc.) Everything I read on med sites said that biking was actually often recommended as good physical therapy for knee problems--but these were all assuming normal, non-negative-resistence cycling. So maybe work on spinning more in lower gears on a freewheeled bike, too. I do think this helps to strengthen the muscles/tendons around the knees.

I've also started doing a few minutes of stretching before riding, and I lowered my gearing a lot. I ride a 44x19 gear with 175mm cranks and 27" wheels. I've been taking it slowly in getting back, but everything seems better.

OH, and one more thing, as said before, I raised my seat a bit more, maybe about a cm or two. Everyone suggested this to me, and I think it IS better for my joints. I was also considering going to shorter cranks, since I have a long femur.

But if you're having chronic pain, DO NOT keep riding or doing things that add to it. You'll just be injuring yourself more. Take anti-inflammatories and ice it every day, too--that helped me recover a lot quicker (packs of frozen peas work better than bags of ice.)

Good luck, ride safely.
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Old 04-26-05, 11:37 AM
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I've been doing lots of fixed gear riding. I'd get knee pain two ways... braking too much with the pedals and starting too hard from stops. I mainly use my brake now, with just minor speed adjustments on the pedals, and I start slowly from stops with my 44/17 gearing. No knee issues for over a year.

PS I also do all my climbs standing...
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Old 04-26-05, 11:54 AM
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I've had ACL replacement with serious cartilage damage and I actually feel that riding fixed makes my leg stronger than any other types of excercise. Once you get used to it, your spinning becomes smoother and negative resistance builds up the back of your leg. They grafted part of my hamstring which needed to be built up again. I ride brakeless 48 x 16 and don't have any pain. Start off slow with a low gearing and a brake and see how that helps.
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Old 04-26-05, 01:04 PM
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Stretch! before and after..
I was having crazy patella pain after riding 30 - 40 miles on 42x16
upping my gear to 42x14 seems to be helping.. I think too much spinning was wearing out my knee..
in hindsight i think 42x16 is was to light for a dude of my proportions (tall and husky)

after an injury I just ice my knees for 30 min or so and that really helps
or like 12 ibeprofin and booze

good luck! and try to take it easy when you start to feel tenderness
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Old 04-26-05, 01:12 PM
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Originally Posted by rattking
like 12 ibeprofin and booze

recipe for disaster, can seriously irritate your stomach and cause bleeding!!!
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Old 04-26-05, 01:30 PM
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Originally Posted by rattking
Stretch! before and after..
I was having crazy patella pain after riding 30 - 40 miles on 42x16
upping my gear to 42x14 seems to be helping.. I think too much spinning was wearing out my knee..
in hindsight i think 42x16 is was to light for a dude of my proportions (tall and husky)
I'm definitely not an expert, but this runs contrary to all advice anyone has given me when starting off. I was running higher gears initially, and that was definitely NOT beneficial: it flat out made my legs hurt, and not the good soreness kind of hurt. I believe you move up in gears ONCE you've gained enough leg strength initially. Anyone feel free to correct me on this. Stretching is ALWAYS a great idea.

Originally Posted by rattking
after an injury I just ice my knees for 30 min or so and that really helps
or like 12 ibeprofin and booze

good luck! and try to take it easy when you start to feel tenderness

IMO, if you're taking that many anti-inflammatories to relieve 'an injury', you're already at the point where you need to do some serious therapy. DO NOT just keep riding on that, unless, of course, you're gunning for reconstructive surgery as soon as you can get it. There's a difference between hard, challenging exercise and punishing abuse. The latter can get you into a LOT of trouble down the road.
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Old 04-26-05, 02:11 PM
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Riding a fixed gear bike can actually heal or cure knee issues.

First of all, although I have studied this one issue, that of knees and fixed gear bikes, for over a year with a world-class expert in body mechanics, I have no credentials, myself.
Although what somebodies describes sounds like a body mechanics problem, he may actually have something wrong with his knee, and he should temper whatever I have to say on the subject with a visit to a knee specialist.

That said, we human beings have several body-design properties that often escape our awareness:

1) we do not have symmetrical bodies, and we do not use the two sides of our bodies in the same manner or with the same movement patterns;

2) we have a more knock-kneed (knees towards the center) basic design than we think we do; and,

3) we over-use our thigh muscles and under-utilize our hip and buttock muscles.

Assymetric movement patterns explain why we would have one sore knee and not two sore knees.
We may do the wrong thing with both legs, but more of the wrong thing with one of the legs than the other, and the more wrong movement pattern side will get a sore knee first.

We males, especially, tend to pedal straight up and down, or even a little bow-legged, with knees out.
A light, taped to our knee caps so that we could see how they move, would generally show our knees moving vertically, straight up and down.
In the best of all body-mechanics worlds, our male knees should move in a little more knock-kneed pattern than they do, with our knees following two crescents bent toward each other in the middle.
The lights moving up and down on our knee caps would look like this: )( , but not so exaggeratedly so; and, in fact, they would follow a crescent so shallow that an observer may not see it unless looking for it.

Bookmark the above thought.

Continuing, we come to the issue of over-using our thigh muscles and under using our hip and buttock muscles.
Because of the mashing motion we learned riding bikes as children, we tend to straighten our legs by shortening the muscle in the front of our thigh.
Shortening this muscle, in order to straighten the leg, pulls the knee and the knee cap forcefully up into the bottom of the femur.
Our knee has to do enough work just supporting our weight during movement, and then we add to it by focusing all of the stress of straightening the leg with the thigh muscle into the knee.

Think about it.

In the normal manner of straightening the leg, the thigh muscle pulls the knee upwards into the end of the thigh bone and then forces the knee to rotate around the end of the thigh bone, much as the chain pulls on the rear cog and forces it to rotate around the axle; and sometimes that force will actually pull the axle forwards in the horizontal dropouts.
That same force pulling on the cog pulls on our knee cap.

So, what options do we have?

Well, we have buttock and hip muscles.
We can use them to push the thigh bone down and backwards.
If we had no thigh muscle at all, we could push the thigh bone down and backwards with our buttock and hip muscles.

In the case of bicycle riding, because of the foot's position on the pedals, when the thigh bone goes down and backwards it pushes the foot down and the knee/leg straightens.

Stop and think about this for a moment and capture the mental image.

With no thigh muscle at all, we could mash down on the pedal with our buttock and hip muscles alone.
If we could somehow so isolate the muscles, and use only the hip and buttock muscles, so that the thigh muscle remained relaxed during the mash portion of the cycle, the knee cap would never experience any stress at all.

Actually, we do want to use the thigh muscle to straighten the leg, only, not so much as we do when we experience knee pain.
We need to learn to recruit the hip and buttock muscles and take some the load off of the thigh muscle, and thus off of the knee cap.

How do we recruit the hip and buttock muscles so that they start carrying a share of the load and giving the thigh muscles and the knee a much needed break?

The knee that hurts has a movement pattern that uses less of the hips and buttocks than does the other leg.
If we could see our knees from the front or back, they might move like this: )l ; or like this )) ; except, not so obviously.
We want to make it look like this: )( , only, not so obviously so that we can actually see it.

How do we do it?

First, when the knee hurts, imagine a rubber band connecting the two heels of the two feet.
Imagine the heel of the foot of the knee that hurts as pulling on the rubber band connected to the other foot.

Secondly, put a slight outward, sideward load on the whole foot of the knee that hurts.

Thirdly, pick up a copy of the May issue of BICYCLING at the newstand (don't have to buy it), turn to page 73, and read about how to do exercise #6 on that page.

Fourth:

1) stand on the floor barefoot and align the feet so they both point perfectly straight ahead;

2) place the hand on the same side as the sore knee on the hip, just below the beltline;

3) step backwards, slowly, with the sore knee foot, and with the intent of placing that foot back on the ground still perfectly aligned to the front, but one step backwards; and,

4) do that backwards step, forwards and backwards with that foot, several times, and feel the muscle underneath the hand on the hip.

Visualize the muscle described and discovered above, and remember it.

When the knee hurts, while cycling, pull outward with the heel on that side, push outwards/sidewards with the whole leg, and visualize the muscle discovered above.
The knee should come in a little, perhaps not visibly, but enough to look like this: )( .
If done even half correctly, and if it actually involves a body mechanics issue, the knee pain should go away within a minute.

Otherwise, do all the other stuff recommended in this thread.

Oh, and by the way, if this works, send me a check for $140.
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Old 04-26-05, 02:27 PM
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Ken this is awesome! For the past month or so I have been doing exactely that on descents - using my buttock/hip muscles. For me it worked by imagening that I was pedalling just with my upper legs (picturing your foot where your knee is). This takes away all that knee pressure on descents. Feels weird at first but then it becomes normal. The other thing I have been doing is pedalling with my feet/calf muscles. Making nice round circles. Especially when riding in flat terrain I step a little bit out of my clips (pull my feet out a bit) and pedal in a more paddeling way (if that makes sense) this in combination with hip and buttock pedalling should largely reduce any knee pain. STRETCHING is key too. I spend at least 5-15 minutes after every ride stretching. Saddle position is crucial too. If your knees hurt in the front put your seat up if they hurt in the back lower it.
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Old 04-26-05, 02:31 PM
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Kick-ass post, Ken! ::

This stuff reads like a class I did in the Feldenkreis method with similar goal for running: take the load off of the knee and transfer it to the stronger muscles around the hips, buttocks and torso. I'm heading down to B&N for a gander at May Bicycling magazine. Where'd you learn about this stuff?
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Old 04-26-05, 03:58 PM
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Wow! thanks for the writeup Ken
Im paying attention

if you're taking that many anti-inflammatories to relieve 'an injury'
last time I did go to the doctor for my knee pain he prescribed me 800mg ibuprofen and said to stay off it.. at the time the whole thing seemed like a waste of money
that was before i started cycling.. this runs in the family
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Old 04-26-05, 04:37 PM
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Originally Posted by fixedpip
I would say you need to look at where your seat is and get the height and position right. his may require moving the seat higher but you may need it lower. Same with horizontal position etc
I found this only completely confusing. Only just so. Can you explain? Or am I just (165 stay out) stupid?
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Old 04-26-05, 06:41 PM
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Great post Ken, thanks. I've been struggling with knee pain for a month or so, with some--but not enough--improvement. I'm sure this stuff will help.

To the original poster I would say that, once the gearing and saddle are worked out, if you still have pain, just rest. That's done the most for me. Don't go out 7 days a week, and you shouldn't be riding with pain. That will end disasterously.
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Old 04-26-05, 07:38 PM
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Originally Posted by 46x17
Ken this is awesome! For the past month or so I have been doing exactely that on descents - using my buttock/hip muscles. For me it worked by imagening that I was pedalling just with my upper legs (picturing your foot where your knee is). This takes away all that knee pressure on descents. Feels weird at first but then it becomes normal. The other thing I have been doing is pedalling with my feet/calf muscles. Making nice round circles. Especially when riding in flat terrain I step a little bit out of my clips (pull my feet out a bit) and pedal in a more paddeling way (if that makes sense) this in combination with hip and buttock pedalling should largely reduce any knee pain. STRETCHING is key too. I spend at least 5-15 minutes after every ride stretching. Saddle position is crucial too. If your knees hurt in the front put your seat up if they hurt in the back lower it.
Congratulations. You've just discovered what roadies ride fixed gears for, to develop a smooth spin .
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Old 04-26-05, 07:43 PM
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yer kiding, people were -not- using glutes? ou never be fast off the mark w/out training the big ones to chunk yer ass forward, and don't even talk about climbing. If girls aren't talking about what a tight round ass you have review your training regiment
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Old 04-26-05, 08:44 PM
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yeah, I really appreciate everyone's input. Thanks Ken for taking the time. I guess I will leave back pain from practicing trackstands for another post. My body is most likely just resisting getting in shape. Its been a awhile.
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Old 04-26-05, 08:49 PM
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Originally Posted by glowingrod
If girls aren't talking about what a tight round ass you have review your training regiment
Um, ahem, er. I don't think that many of us can afford to employ a full regiment for training purposes, let alone a single sergeant.
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Old 12-31-05, 08:13 AM
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Great post and very informative. I was a runner for years and had to stop because of worn out knees. I sat around for about 6 years putting on the pounds because everything hurt my knees. I finally got off my fat butt (and I do mean fat) and tried cycling. BINGO! I was concerned that my knees couldn't handle it but much to my surprise, not only did they handle it but they felt stronger then they had for years. My knees used to sound like rice crispies when I walked up steps. Now they are much quieter and feel great.

While watching the TOUR this past summer, I noticed how close the riders kepted their knees in relation to the crossbar. I then realized that I had been riding with my knees in more of an outward position. I started experimenting with my knees closer in and it seemed to make my pedling smoother and added more power.

I also started going to the gym and doing leg extentions and seated leg curls. I feel this has stregthened those muscles that don't get worked in cycling especially the quads. I feel this added conditioning has helped prevent any nagging injuries.

Two years ago I had the knees of an 80 y.o. Now my actual 54 y.o. knees feel 20 years younger.
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Old 02-01-09, 05:34 PM
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Holy Cow! Ken I think you may have just saved my fixed gear riding. I thought I was going to have to give this up and now I feel great every time I step off the bike. Thanks Ken. This post should be a sticky.
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