I have a small knee ache and just came up with a theory why it happens, so I want to hear what you think.

First to specify the pain. It's just a slight pain I feel in my right knee, at first it was above the knee cap, now it moved to the right, it occurs after longer rides (around 100+ km), more often if it's hilly terrain.

Also, generally, even now when I'm sitting at my desk, I feel a slight tension in my right knee, I feel the need to straighten my right leg.

Now, for my theory. I think I am using too low of a gear on flats, or, comparatively, too high of a gear when going uphill, so my legs are under too much stress when climbing hills, which wouldn't be the case if I trained them by pedaling in higher gears in flats.

To be more specific, when riding flat terrain, My favorite gearing is 32/14, if the ride is short (30-50km), I can maintain speeds of about 30km/h (about 18 mph), which I believe is at a cadence above 100. If I am doing longer rides, my speed on flats is maybe 25,26km/h (about 16mph), maybe 28km/h on a good day, which is I think something between 90 and 100 cadence wise.

Then, when I hit the hills, for instance there is this 5km climb which averages something between 5% in 7% in grade, and I will climb it 32/21 or 32/24 with cadence I would say about 80, maybe higher if I am in the mood, but it's a considerably tougher effort and I feel and tolerate a slight but not numbing leg burn all the way.

But then, there is another hill, near my house, much steeper, maxes out at about 14%, most of the time it's between 7% and 10%, and I usually try as hard as I can to ride it in 32/24, and I really don't know the cadence because I'mt out of my breath there. I try to do it because I like to maintain at least some speed when going uphill, switching to the granny chainring (22), I drop to a lousy speed, even though I try to raise my cadence, but it's hard for me to maintain a proper pedaling motion when my heart rate is so high.

(Of course I do switch to granny gears when I'm tired but that's my last resort, just short of walking)

So, my question is, would it be reasonable to start riding flats in a higher gear (while still keeping cadence above 90), in order to develop more muscle or muscular endurance or whatever, so my hill climbing wouldn't be so stressful for my legs, or would it just further aggravate my slight knee problem?

Also when riding for errands around my neighborhood, I always go up short hills in high gears, practising out of the saddle climbing etc.

I understand there is a third option of riding hills in granny gears, and maybe it's the soundest for my knee health, but I just don't like superslow climbing.

Btw, I'm 24 years old, 193cm height, weight about 83-4kg, if it's of any importance.

And for the sake of discussion, let's assume my saddle height and all of that is correct, which it is by all standards, and I don't ride clipless, just regular platform pedals.

I've been dealing with a knee injury myself and the doctors have diagnosed it as patellar tendonitis. One main cause they say is pushing too hard rather than spinning up hills or even on flats. I'm having to adjust how I've ridden my bicycle for 20 plus years. Like you, I'd rather pedal hard than pedal a lot of times in circles and go nowhere. It's been a struggle to change, but I know my knee will be better off.

Lets not. The title of your thread is "knee problem developing". Stop that development ASAP by getting a medically-based professional bike fit to figure out why your knee hurts. I'm only 25 and just went through this whole ordeal (chondromalacia) with my knees. Once you know you aren't going to damage your knees by riding hard, then you can work on riding those big gears at 90-100 RPM on flats to get stronger.

Unfortunately there's no place which offers such services around here. So you reckon practising with big gears now would be a wee bit risky huh?

+1. If you can't get professionally fit then at least do some experiments with your seat height to see if it provides any improvement. I fixed a similar knee pain that you are describing by adjusting the height of my seat. You might find some tips here: https://www.cptips.com/knee.htm

Well, I'd sure recommend clipless. You're just pushing down with platforms, so that concentrates all the effort on your knee. I'd recommend learning to do one-legged pedaling with clipless pedals. That'll reform your pedal stroke, probably get rid of the problem if your saddle height and position is indeed correct.

^ good one, thanks, I'll see what I can do.

As for adjustments, after reading what rdkopp said I spent a bunch of time measuring myself, my bike, reading various fitting advice, and came up with a bold decision to try and raise my seatpost just by a cm, ended up with pain in the back of my knee after just a short spin xD

But, I used to ride with a higher saddle (aproximately that, heel rests on pedal when leg straight position) for most of the time, but this year I lowered my saddle a bit, as I found it to be gentler on me, plus I can keep a higher cadence. These all are very moderate adjustments of course, and the knee issue has not started this season but the previous. So, I'm off for a 150+ km ride now, and I'll return my saddle to it's pre yesterday tweaking height.

Most people consider 1 cm. a lot. I find 4mm very noticeable.

So I was riding with a (for me) fast group, and I had to spin higher gears for my standards, 44/16 to be precise, much more efficent. The whole ride was entirely flat, about 75 miles long. Did a thorough strech after, I have no problems now.

I was kind of brainwashed from all the pro high cadence talk I read on the web, so I guess I was tripping I have to ride like Lance or something. Spinning somewhere between 90 and 100 on flats is quite adequate I think now, going over 100, especially without clipless pedals is not so efficient it seems. So I guess some more miles in my new favorite gear will develop my legs enough that I won't be killing my knees when suddenly lowering cadence on climbs (because it won't be dropping so much now).

So I saw a doctor,
Chondromalacia Patella

is what I have.

To the search button!

No more hilll repeats for me it seems :I

Yeah, but probably half of serious riders have had that at one time or another, including me. Next step is fixing it. It's usually caused by a muscular imbalance in the thigh, which pulls the kneecap off center. Corrective action is to correct that imbalance through exercises. The other major recommendation is to raise the saddle until you have a slight gap under your heel when your knee is locked out. You can lower it back down a hair after the problem is fixed. Also, as I said before, go clipless. Ride heel down as much as is permitted by this saddle height. Don't point your toe, rather relax your ankle. Ignore doctors who say you have to stop riding. Just ride easy on the flat, and not long rides, until these correctives take effect. I'd keep it to 1/2 hour at a time until it stops hurting, then increase very gradually.

There are many threads about this on this forum. The most effective exercise therapy seems to be straight legged high kicks. Look for that.

The biggest deal for me in resolving my chondromalacia was valgus/vargus correction using the corrective shims included in Specialized's insoles. It basically made my femurs align with my tib/fibula immediately so my legs were in a straight line from my hip to my ankle.

Carbonfiberboy, thanks for your advice.

Between now and my last post, I've done physical therapy, lasers, ultrasound, electrotherapy, combined with some static exercises, and straight leg kicks with a u lock around my ankle. During that time I abstained from my regular long rides and just kept casual spins around town. The knee ache is not completely gone, but is significantly reduced.

Now, today, on my last visit, my therapist told me to start doing seated leg lifts like this



with some weight added.

Which is interesting because the whole internet says one should avoid such knee flexing exercises when dealing with chondromalacia.

Any thoughts?

Yes, it's true that anyone except bodybuilders are enjoined not to do leg lifts like that, at least not as they are usually done on seated machines with weight. And I never did them after my first bout with this. So I don't think they're helpful. I suggest squats instead. You don't need a gym, just a sandbag, either on your shoulder or held in front of you or some of each. You might get back to your therapist and ask about their thinking on these issues. I've not had good luck with therapists. Too often they have too little training and too little experience. There are good ones out there, but they're tricky to find, and even trickier to get access to in today's medical machine.

What's the thing with lasers? Eh? Electrotherapy should be very helpful if done right.

Lasers and ultrasound, all done with one machine, it's just this laser thingie the therapeust holds and presses against seemingly random spots around my knee cap. After that, she puts some gel and proceeds with the ultrasound, these two last about 15 minutes, and then about 15 minutes of electrotherapy with vacuum units that look like this:



It gives a tingling sensation around and inside the knee area.

Yesterday I talked to another physio, and he told me that the 10 sessions I had were not enough (the one where I did them told me about 10 is sufficient), he said that about 10 is enough for lasers and ultrasound to take effect, but for effective electro therapy I should have done at least 20 sessions.

Anyway, yesterday I played soccer on some pretty bad astro turf, it was very slippery, like running on snow, every time I tried to change direction at speed I would slide out. An hour was enough to kill my right knee I wouldn't have described my previous condition as pain, merely as a kind of higher sensitivity or something, but after that game, it feels really sore, I feel as if I destroyed all that I gained with this therapy just with an hour of running on bad surface.

I bought a knee brace, it feels comfortable, a really simple one, when I do google image search for "knee brace" I get all these kind of high tech braces with various belts and stuff, I don't know about that...

Oh yes, I tried clipless today, it was fine, I will probably get them by the end of the month.

Take care to adjust the cleats so your feet are in a natural position.

saddle height and fore aft position AND Cleat position is key along with good pedal form. Wedges in your shoes or under cleats might be needed. Cross Friction massage and ice can help with the patella tendon pain. In short, this is one big science experiment and you are the lab rat.