Yeouch! Knee problems.

[LoisLaneinIND]

Girlies -

As I've been riding, I notice that a few miles in (which, for the newbie that I am, equals about half way) one of my knees gets tight -- kind of like a rubber band that's been pulled too tight. It's only on the outer side of my knee cap, and if I pull my leg off the pedal and flex it a few times, it seems to get better -- kind of like I'm unkinking it. (Sorry to be so inelegant in my explanation, but it's the only way I can describe it.) It doesn't happen every ride, but when it does, that feeling of "tightness" continues for a bit.

Since it's only one knee, I don't think it's a problem with my saddle height, but I don't know. Any thoughts? Maybe I'm just a weirdo. :-)

Gracias!!

[KnottedYet]

Howdy!

do a search for "ITB" or "iliotibial band". There have been a few threads, and it sounds like that's what you're dealing with.

Probably not related to saddle height, more likely it's an imbalance you deal with all the time, but which is more noticeable on the bike.

Pretty common for those of us with "real" hips. (men don't have real hips...)

:D

Edit: I should've said "not caused by saddle height". Thanks, songlady. I lowered my seat to make mine better, too. Still got ITB issues, but I do what I can to minimize them.

[songlady]

Actually, I would double check that seat height. I am currently suffering from ITBS and lowering the saddle is one of the most significantly beneficial changes I have made in the past few months.

[yellow]

ITBFS sufferer here. Pedals with float are ESSENTIAL. Without such a thing, I wouldn't be riding!

[bikerchick68]

I also had an ITLB issue... got a professional fit by John Howard (I'm lucky he's local!) and he did SO much to change my fit I was floored... RAISED my saddle 3/4 inch, changed my cleat position, moved saddle forward, put shims in my cleats cause I was riding like a duck, and told me I had to go to NO FLOAT pedals! I am the exception to the rule, but I need pedals that prevent float or I splay my feet and overpronate badly... I had been off the bike for 2 months with the SAME issues you described... got fit and rode my first century the next month! Fit was in Jan last year, first cent was Tour de Palm Springs... and NO pain!

Good luck and whatever you do, DON'T ignore it and assume it's normal like I did...

[emily_in_nc]

I was diagnosed with ITB Syndrome in my left leg after my third century in five weeks (yeah, stupid, I know, but it was a flat century!!) a few years ago. I pedaled for 80 miles in pain. Doc had me lower my saddle (I had raised it a bit a couple of weeks prior), and even though it's now lower than the "books" say it should be, I have never had a recurrence.

He also started me on a regular program of ITB stretches, and I still do the standing one regularly. Here's an example (http://www.triathloncoach.net/itb_Stretches.htm) of some ITB stretches.

Never had a problem since.

ITB is usually associated with upping your mileage rather quickly -- it's normally an early-season injury. Sounds like this is the case with the OP.

Don't increase your mileage too fast, make sure your seat is not too high, and stretch!!

Emily

P.S. For me, the float of my pedals was not an issue - I was riding unlimited-float Speedplay X series when this happened. I can ride pedals with less float without recurrence.

[Cassandra_Cain]

I'm obviously not a doctor and it is impossible to say what you have over the internet.

However, I did have ITBS once and actually, it was from one thing above all others......too low a seat height. One thing I noticed about having it, was that climbing stairs was painful/tender. Perhaps your symptoms are different.

Anyway, I would raise the seat up until the point where you start bouncing in the saddle when pedaling. Then from that point, I'd lower it just enough to eliminate the movement and no more.

[spokewench]

Don't know if this is your problem, but ITB Syndrome is rampant among cyclists. Men and Women alike. Without seeing your fit, it is difficult to tell you what to do on your fit, but often times, dropping your seat a tiny bit will help. Unless your seat height is WAY OFF, never change your seat height by more than 1/4 inch at a time! You want to slowly change the height or you may find that you have other problems crop up.

I find that yoga helps a lot - basically, you get to stretch that IT band and loosen it up and that is all it takes. Do yoga regularly, try to get your seat height figured out and you should be doing great! The pigeon position in yoga really helps the ITB tightness.

Remember, that in winter and summer sometimes you have to change your seat height a little. I always have more trouble in the winter with ITB Syndrome. One reason is the muscles are tighter, one reason is that I'm wearing tights which makes me sit higher on the saddle, and one reason is that I'm not riding as much as it is that first of the season settling in and getting fitter. So, I drop my saddle in the winter a 1/4 of an inch or so.

Hope it gets better for you. :D

[Bron]

This very useful advice. Thanks everyone. I went to the sports doc today and he said that this is what I have got too. However, as he mainly sees runners and footballers, he couldn´t say a lot to help me with my bike set up.

My question is: how long did any of you have to stay off the bike to allow the pain to clear up? I´ve been told at least two weeks of no serious exercise :eek: , plus physio sessions to loosen things up and then an analysis of my gait to check if I need insoles in my shoes. Seems like overkill to me, especially as the pain is only there on the bike.

Oh well, maybe I will have time to tackle the ironing pile/mountain:D

Bron

[spokewench]

Ice your knee where the attachment of the ITB is. This is an inflammation. Like any inflammation take an antiinflammatory - i.e. ibuprofen. Stretch, do yoga, go to a Physical trainer to get stretching, etc. moves that you can do at home. Easy cycling only. Looking at your gait off the bike will do no good; doing orthotics for off the bike will do no good. Every once in a whie a cycling orthotic will help (but it needs to be a cycling orthotic not one for walking or running, they are different) As your doctor said, he knows nothign about bikes.

[BleeckerSt_Girl]

I have my own bike on order and should have it by a couple of weeks. Meanwhile, I've been riding a grilfriend's loaner hybrid. fits ok, but a little small but feels fine and been riding for weeks now.
The other day I visited another friend and borrowed HER small hybrid for a 20 mile ride. Her bike and seat were even smaller, though I managed ok after raising the seat an inch- still too low though. My point is that after that one ride my knee hurt and is still a bit sore after 2 days. I haven't gotten this on the other slighter taller bike at all. I suspect it was because the bike was too small or too short.

[emily_in_nc]

I have my own bike on order and should have it by a couple of weeks. Meanwhile, I've been riding a grilfriend's loaner hybrid. fits ok, but a little small but feels fine and been riding for weeks now.
The other day I visited another friend and borrowed HER small hybrid for a 20 mile ride. Her bike and seat were even smaller, though I managed ok after raising the seat an inch- still too low though. My point is that after that one ride my knee hurt and is still a bit sore after 2 days. I haven't gotten this on the other slighter taller bike at all. I suspect it was because the bike was too small or too short.

Just don't confuse front-of-knee (or back-of-knee) pain with ITB Syndrome. It is often the case that a too-low seat can cause front-of-knee pain, and a too-high seat can cause behind-knee pain. What we have been talking about here is a pain on the outside side part of the knee; it's actually an inflammation of the Ilio-tibial band, which runs along the outside of the leg. But yes, seat too high or too low can definitely cause knee problems of various types.

Here's a good website (http://www.cptips.com/knee.htm) with lots of information on cyclist's knee pain and how to prevent/alleviate it.

Good luck, all!

Emily

Emily

[emily_in_nc]

My question is: how long did any of you have to stay off the bike to allow the pain to clear up? I´ve been told at least two weeks of no serious exercise :eek: , plus physio sessions to loosen things up and then an analysis of my gait to check if I need insoles in my shoes. Seems like overkill to me, especially as the pain is only there on the bike.

Bron, I was told by the sports orthopedist I went to to do no cycling for two weeks, then to spend a couple of weeks riding only the trainer or (if outside) flat or very gently rolling climbs and staying in very easy gears (i.e., granny gear for all climbs, no matter how easy), and keeping mileage low as well. The first few rides back, the pain started at about mile 17 or so, so that's all I did. Eventually I upped my mileage and added hills and within ~8 weeks was completely healed. I continued doing the ITB stretches throughout this time (and still do them), but aside from lowering my saddle slightly, that's all I had to do to prevent a recurrence.

Good luck!
Emily

[Bron]

Thank you everyone for the great advice. It was good to know that other people have managed to deal with this without taking too long off the bike.
My physiotherapist was a lot more helpful than the doctor with regard to suggestions for the bike setup to stop this happening again. I have been a good girl and stayed off my bike for two weeks; my reward is to be allowed to cycle again - low gears only, no hills and short rides only. The physio is also going to take a look at me on the bike. She also agreed that the running analysis wasn't going to help (so I've cancelled it) as I never have any pain while running.
Thanks again,
Bron

[BleeckerSt_Girl]

Just don't confuse front-of-knee (or back-of-knee) pain with ITB Syndrome. It is often the case that a too-low seat can cause front-of-knee pain, and a too-high seat can cause behind-knee pain. What we have been talking about here is a pain on the outside side part of the knee; it's actually an inflammation of the Ilio-tibial band, which runs along the outside of the leg. But yes, seat too high or too low can definitely cause knee problems of various types.

I agree, Emily- my pain was indeed in the FRONT of my knee, and was probably caused by that too-low bike seat.

[Pascale]

I agree, Emily- my pain was indeed in the FRONT of my knee, and was probably caused by that too-low bike seat.

I've raised my seat height twice and am still experiencing front of the knee pain. Are you supposed to be able to touch the ground with your toes when still seated? Because I no longer can - I have to jump off when I come to a stop and then try to jump back on and get moving when it's time to move (very intimidating when I'm battling traffic at intersections cuz sometimes my shorts get caught on the seat and it's just so clumsy looking). I'm not sure how high I should raise it? Keep going until there's no pain? Get a step-ladder? LOL

[BleeckerSt_Girl]

An update since I got my OWN bike last week:

I had some significant front of knee pain appear just that one time when I rode a too-small loaner bike for 2 hours one day. The pain lasted several days afterwards, then faded away.
Now I've been riding for days on my new bike that fits me just right, with no sign of any knee pain so far.
For what it's worht: If I stop at an intersection, I simply cannot stay on my saddle and keep balanced with my toes touching the ground. I HAVE to hop off the saddle, or else fall over to one side. I slowly brake to a stop, then I simultaneously hop forward off the saddle with my right foot on the pedal in the down position, while putting my left foot solid on the ground. Then I adjust right foot on its pedal in the front up "ready' position. When ready to go, I sort of hop up slightly onto the saddle while pushing on the right pedal to get going forward. I am pretty unsteady still, but this doesn't take TOO much skill. Every day I get better at it.
Other people use different methods. Probably more graceful and more efficient methods! :rolleyes:
Try practicing starting and stopping in an empty parking lot or empty street. You are not supposed to be able to stand on the ground with your feet while in the saddle, is all i know. I was professionally fitted when I picked up my bike, and my husband knows a lot too and helped me get the saddle height just right. It "seems" too high at first, but I can see why a lower saddle would not be good.

[Pascale]

Lisa - thanks for sharing that.

I was told at one bike shop that I should be able to reach the tips of my toes to the ground at least, but that just isn't happening, at least on this frame of bike!

[Bikingmomof3]

I was told at one bike shop that I should be able to reach the tips of my toes to the ground at least, but that just isn't happening, at least on this frame of bike!

I cannot touch from my saddle. My saddle height is adjusted so my leg is in the correct position when pedaling. I do not have a problem balancing though. so I was of no help.

[Veronica]

You should not be able to touch the ground with your feet when your butt is on the saddle, not even tippy toes. Unless you have some really huge feet -like size 19s or something.

When you're sitting on the saddle, your leg should just about fully extend at the bottom of the pedal stroke.

V.

[BleeckerSt_Girl]

Instead of adjusting your seat height based on being able to touch the ground while in the saddle, I would think it's MORE important to create the best distance between your "down pedal" and your seat. Nothing to do with where the ground is. In other words- maybe it's more important to create a good leg postion when your at your extended (pedal down) leg position. Just a thought: Riding all the time with your knees bent too much so that you are able to balance on your toes at a stop light has little to do with being a pain free biker for hours on end while riding. I'm not saying that's what's causing your problem, but it seems to me you are basing your saddle height on ground level instead of on good leg/knee angle. Maybe I'm wrong. But all angles are worth persuing!

[Bikingmomof3]

Yay! It is good to know I was fitted properly.