Knee Pain - Suggestions?

[Penny4]

I've been pretty comfortable on my road bike all spring and summer. Just the past 2 Saturday's when I rode, I had a terrible pain on the outside right knee. Today it started after about 10 miles. I haven't changed anything on my bike lately. It did seem better if I kept my cadence really high, but I'm not used to riding that way. Also, on some of the hills, I end up in my lowest gear and spinning isn't always an option. I usually keep my cadence around 80.

I have clipless pedals and I double checked to make sure the cleat wasn't loose or anything.

Thoughts on why it just now started? How to fix? I am supposed to do a 60 mile charity ride next weekend, so I don't want to fiddle iwth things too much, but this pain could make it pretty unpleasant.

[radacrider]

Have you increased your workouts or mileage? May be simple overuse. You can read this article, http://www.livestrong.com/article/399870-outside-knee-pain-from-cycling/. Outside knee usually indicates a saddke too high or too far back, though you said you have not made any changes.

[Penny4]

Thx Radacrider, that was a good article. I was thinking my seat might be too low if anything. But it might possibly be too far back. The article also mentioned weakness in the knee and hip muscles, which could be factors here. I'll keep icing it and try to do more stretching. Maybe move the seat forward.

[FlyingScot]

Have you checked your cleat? If I got some grime in my SPDs it decreased the already small amount of float I had and sometimes locked my foot in too tight which does cause knee pain for me. I finally changed to Speedplay X's just for the incredible amount of float they have.

[OakLeaf]

Pain on the lateral and especially anterior lateral knee - where the kneecap meets the femur - is often because a saddle is too low. That can happen "on its own" - the seatpost can slip in its clamp, or you can lose enough weight to put your pelvis closer to your pedals. First thing I would do is check whether your seatpost has slipped. Did you have the original height marked or written down? It's a good idea to do that anyway. If you decide you want to try raising it, no more than 2 mm at a time.

Also, doing some self myofascial release on your IT bands with a foam roller, Stick, tennis ball, etc., is never a bad idea.

[Penny4]

or you can lose enough weight to put your pelvis closer to your pedals. First thing I would do is check whether your seatpost has slipped.

I am sad to say this most definitely not the cause :( I did not mark the original height on the seat post but I'll take a look at it. I will have to look up what "myofascial release" is :) I am not familiar with foam roller, etc exercises, but have heard about them.

[Rubylvr]

I second Oakleaf's thought on foam rolling. It hurts like crazy,
but our IT Bands are really stretched tight riding and need release.
I love/hate deep tissue massage and try to get one every other week.

[Dogmama]

+1 on foam rolling the IT bands. Feels so good...when you quit!

[bluebug32]

Here's a primer on foam rolling for cyclists and the IT band: http://www.bicycling.com/training-nutrition/injury-prevention/iliotibial-band

The cause of IT band pain often stems from adding too much intensity (you suddenly add lots of high tension pedaling or climbing) or adding too many miles before your body can adjust. Pain or not, a foam roller is one of the best tools you can utilize as a cyclist. Just be sure to roll slowly and allow your body to sink into the sore areas. You should be uncomfortable, but if your body is tensing or resisting, you're going too deep. Work into it.

Myofascial release works the body's fascia. This article does a great job of explaining what that is and why athletes should pay attention to it: http://runningtimes.com/Article.aspx?ArticleID=23045&PageNum=1

The muscles you'll want to stretch to relieve IT band pain are glute max and the TFL.
Glute max: http://www.youtube.com/watch?v=1TXWJ96l6vY
I can't find a good TFL video. Basically lie on your back on the floor. Wrap a rope or something similar around your right foot near the heel/ ankle, with the end of the rope extending from the medial (arch) side of your foot. Keep your right leg straight and hold the end of the rope in your left hand, bringing your right leg across your left one and out to the side. Extend the left arm away from your body as you stretch the leg out. Don't bring the leg high into the air, but keep it close to the height of your left leg. Hold the stretch for 2 seconds, release and repeat. You should feel the stretch in the hip/side of butt area.

The last time I had IT band pain, these stretches cleared it up in a couple of days. Good luck! And if the pain persists despite backing off on intensity/miles and stretching, I would get a good bike fit done.

[Penny4]

Thanks for the info BlueBug and all!

[dottigirl]

I've had a similar pain, having recently started with SPDs. I found changing the cleat angle so my toes were pointed slightly outwards has fixed it straightaway.

[Wahine]

I agree with some of the above posters, sounds like it's your IT band. Foam rolling is a good thing. Stretching as mentioned above also helps, here are two the the stretches I prescribe to patients for this problem:

Hip flexors/TFL (http://www.youtube.com/watch?v=WRb3W-94QLA)

Piriformis/glute max (http://www.youtube.com/watch?v=2qZ517Rw7ME)
Just note that the video above emphasizes the piriformis stretch but this strech does hit the glute max also and for a lot of biomechanical reasons that I won't get into here, it's a great stretch for cyclists in general but especially those with IT band pain.

As for bike fit, a saddle that is too far forward can cause this type of pain just as readily if not more so that a saddle that is too far back. In fact in women I think it's more common to have IT band pain if the saddle is too far forward, not the other way around. Saddle height is a factor too. You probably should be thinking about a bike fit sometime in the near future.


I hope that helps.