Hi everyone,
I'm a guy with banged up knees. I'm trying to decide if it is worthwhile for me to splurge for a high-end bike fitting or go with a more ordinary fitting or skip getting a fitting altogether. Here is some background. One of my knees is missing a whole lot of articular & meniscal cartilage. I'm experiencing knee pain while going for relatively short distances (at the beginning of the ride & after 10-12 miles). I ride with Speedplay Frog pedals. I'm turning 49. I haven't had a fitting since January 2012. I don't race or do group rides. If my knees were solid, I'd like to do social rides or even go touring. I ride a Surly LHT & use it for commuting & shopping. It is more accurate to say I "used" the bike for those purposes. I'm pretty much not riding now because doctors have told me that knee pain=fresh damage. I have the option to get 1) a run of the mill fitting similar to the 2012 fitting from a well-regarded bike shop or 2) get a fitting from a physical therapist who works with racers, triathletes, etc. I've been to a lot of physical therapists & surgeons without much result at this point. (Most seem have expertise with runners but none have any background with bikes.) My last fitting was useful but I can't say it was ever quite right. I had joint issues back then which likely made the fitter's job impossible. I went back to the fitter a few times without much success. I mean, there are only so many adjustments you can make to the seat position right? At this point, I'm looking to avoid throwing more good money & time after bad. Maybe I should just get platform pedals? I keep seeing posts pointing to clipless pedals as causes of knee issues. Perhaps I should just get a recumbent to limit knee strain?

Very. Get the option with the physical therapist.

Even if the result is that they tell you to stay off the bike for the rest of your life to avoid further damage, it will be money well spent.

I used platform pedals for about a year or so after a nasty ankle break. It really helped. I did notice one thing recently, is that my spikey platforms + fivetens actually give me less float than my SPDs, so it might not be the right thing for your knees. (OTOH, maybe too much float is hurting your knees. I don't know. A competent fitter hopefully would.)

Clipless pedals are not the cause of knee issues. If anything, it's the other way 'round. If you can only push down on the pedal obviously you have to push harder in that quadrant than you would if you could put force on the pedal in other quadrants, thus clipless is better. Higher force is bad. Some people do better with more float, some with no float. Both are best achieved with clipless.

Go for the PT fitting.

Your joint issues may very well make it painful for you to ride no matter the fit. The PT can answer that question better than I, obviously. But older athletes I know who have lost joint tissue still ride, but it hurts.

The biggest thing you can do to help with joint pain, other than that fit, is to use small gears and pedal higher cadences. Learn to climb at cadences over 90 and run 100+ on the flat. i.e. reduce the force on your joints. I don't think a recumbent lessens joint strain. You still have to push on the pedals.

Yes ... get the PT fitting!

This is really helpful information & advice. Thanks!

Is it possible that the knee pain is caused by the ankle being too close to the crank and hinging the knee? It was for me. I could ride about 5 miles and then the pain was overwhelming.

The bike shop added a peddle spacer after the notice me ridding and checked it with the laser during a fit.

"Is it possible that the knee pain is caused by the ankle being too close to the crank and hinging the knee? It was for me. I could ride about 5 miles and then the pain was overwhelming.

The bike shop added a peddle spacer after the notice me ridding and checked it with the laser during a fit."

Hi Flatbroke,
In other words, your spindle was too short & you resolved your problems by lengthening the spindle?

A fitter and physical therapist? That's an excellent combo IMO. I've had a few knee issue where the knee cap wasn't tracking right due to muscle imbalance. I've started using my hamstrings more as in pulling the pedals up more while cycling and strengthning my hamstring which in 3 days i've already seen a difference.

I'm in my late 40's and have always thought that professional fittings were for pro racers looking to eek out every watt of efficiency or noobs who couldn't figure out how to make their own adjustments. Yet it sounds like several very experienced cyclists on this thread think it's a good idea. Is this something that becomes more important as we get older?

I think it becomes more important the more hours you're putting in on the bike; it's not really about being a racer or even really fast. Little things like less than optimal saddle height or bar reach that aren't too big a deal on a short ride can cause a lot of discomfort when you're on the bike for hours at a time.

While that's true, it can't just be a distance thing. I'll ask the regulars in my randonneuring club in the spring, but based on past conversations about comfort and fit, none of those guys use bike fitters either. We're all making micro-adjustments throughout the season to dial-in the comfort for long rides. For example, a new leather saddle will take several adjustments to get right, and as it breaks in, it requires even more fine tuning. Eventually it will wear out, and you have to get a new one and start over. Similarly, what's comfortable for me right now at the end of the season, might not be comfortable next spring when I'm not as fit as I am right now. And what about people with a lot of bikes, do you need a fitter for each one? I'm not trying to discourage anyone from getting a professional fitting, more just wondering if there will come a time in my life when it's something to consider.

Some randonneurs do get professional fits, especially if they're having some sort of physical problem. Most however, do not. I've never had a fit. It's probably quicker to get a good pro fit than to learn by trial and error what works for you.

OTOH if you work it out yourself, you'll know what to mess with if you start to have a problem on a long ride.

Be that as it may, the OP is having physical problems and a fit with a bike physiologist is the way to go. I have several friends who rave about how much it helped them.

Thanks, [MENTION=78894]Carbonfiberboy[/MENTION]. I will keep an open mind about fitting when I start to develop problems that I can't sort out myself.

+1 on everything here.

Only if you ride a lot without many issues AND have a willingness to experiment, tweak away. You will eventually arrive at a good fit. Otherwise, a good professional fit is a wise investment in your future health. Don't skimp on the fit.

I think it's really critical to have your bike fit you very well, but that isn't necessarily the result of going to a fitter or even a fitter/PT. I think those micro-adjustments you talk about are the real fittings, especially when you have experienced long-distance riders to discuss them with.

It's also true that what worked well in the fitter's studio might not prevent the problems you will discover on your first few metric centuries of the season, or the build-up rides to them.

I've had perhaps four fittings in the past dozen years, and the only one that really rocked my world was the first. I was left with a real good saddle height but too much weight on my hands. Perhaps the fitter had intended to modify that as I developed, and I think he also thought I would take him on as a coach and buy a more setback frame from him, but those things didn't happen. Other fitters did not do the basic setup as well as he did. One said that I need more setback than this bike can give you. Now with a bike or two that has more setback and hence can better accommodate my upper body weight, I'm riding much easier. But there was no "magic fitter moment" that resolved all my problems. Except for the first and that more recent one, they have not done ME that much good.

But I did learn valuable things from them all. I'm glad my path has been what it has been.