Pain in the front, inside of the knee... means?

All right... I had pain in my left knee... all in the front and around the back of it. It started at around 200 miles logged on my bike.

So, I take the bike in and get fitted.

We raised the seat about 1.5 inches. My seat was way too low apparently.

Yes, I spent time in the shop having him raise and lower the seat... then deciding on the higher seat height.

This past weekend I rode 80 miles (40, then 40)... and at the end of my 2nd 40... I started getting pain in my right knee, in the front, on the inside of the knee... ever so slight.

So, does this pain mean my seat it too high?

This really sucks if it is ... because it's a real pain to take my bike over to the shop.

Anyone have any advice on all that?

KSH, knees are such tricky creatures. I have found that the book Bicycling Medicine has the best discussion of all kinds of knee stuff. This book is an incredible resource for all kinds of aches and pains associated with cycling. I don't have my copy here at work so I can't look up anything but I think you'd find a good return for investing in the book. The fact that the pain is to the side could mean more than saddle height adjustment.

Quote:

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Originally Posted by KSH

This past weekend I rode 80 miles (40, then 40)... and at the end of my 2nd 40... I started getting pain in my right knee, in the front, on the inside of the knee... ever so slight.

So, does this pain mean my seat it too high?

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I just ran this by my resident mechanic :D who said from what you've described, your bike seat is too far forward.

To check for the correct seat position - put your cranks parallel to the ground (have the crank arms in the 3 o'clock and 9 o'clock positions respectively) while seated on the bike. Obviously you'll need someone to help hold you on the bike or in a trainer. When the seat position is correct, the front edge of your knee will be directly above and plumb to the axle of the pedal.

Generally speaking, pain in the front of the knee usually means that the seat is too far forward - pain behind your knee means that the seat is too far back.

You only need to make a minor adjustment - the seat probably got out of whack from raising and lowering the seat position.

Good Luck!

For the replies and advice ladies.

Yea, I rode 25 miles today and the knee pain popped up on my right knee, on the inside, again.

I loathe having to go back to the bike shop... but I can't ride in pain... and I have the MS 150 (riding 150 miles in 2 days, but I have heard it is really around 180 miles) coming up in May, and I need to get this fixed before that happens!

Could be a simple overuse injury...

How many days per week are/were you riding? Do a little RICE...

Rest
Ice
Compression
Elevation

Plus a little Advil and you might be surprised.

My raking leaves injury is getting better with RICE and Advil Liqui-gels (every 6 hrs) Should be in the saddle tomorrow, weather willing.

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Originally Posted by spazzdog

Could be a simple overuse injury...

How many days per week are/were you riding? Do a little RICE...

Rest
Ice
Compression
Elevation

Plus a little Advil and you might be surprised.

My raking leaves injury is getting better with RICE and Advil Liqui-gels (every 6 hrs) Should be in the saddle tomorrow, weather willing.

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I only ride 2 days a week... at the most. So, it's not overuse, that is for sure.

And, I know it's pain from my bike, and my positioning, because I can get on a bike, and my knee will hurt... and then I can go run and I have absolutely NO knee pain.

I am just going to have to take it back to the shop and have them refit me... AGAIN! UUGGGGGHHHH.

Thanks for the advice though! I will take some Advil tonight!

Just a thought - you might have someone different at your LBS do the fit this time. Or even look into investing in a professional fit. If you don't have any pain running - then I'm guessing it's something about either the bike Or the pedals. A professional fitter would probably be worth the expense in the end.
Ladies: any suggestions on where KSH could find a professional fitter?

Pedals: are you using clipins?

If yes - check the positioning of your cleats on the shoe. If they are scattiwompus then it's putting an "un-natural" angle on your pedal stroke.

When you run or walk whats the position of your footstrike?

Sample: Using myself - I toe in (from the hip)... when I first got clipins (SPDs of the LOOK or TIME variety), the cleats were installed "straight". It caused pain in several places for me; shins, knee... and my feet felt "wierd" in the pedals.

I had one of my infrequent brainstorms one night and fiddled a bit. I re-mounted my cleat so that the position allowed my feet to point the way they wanted to. End of problem... except I hated the pedals (but thats another story).

I switched to Speedplay (X2's) which are free floating and I don't worry about it anymore.

spazz

Quote:

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Originally Posted by SadieKate

KSH, knees are such tricky creatures. I have found that the book Bicycling Medicine has the best discussion of all kinds of knee stuff. This book is an incredible resource for all kinds of aches and pains associated with cycling. I don't have my copy here at work so I can't look up anything but I think you'd find a good return for investing in the book. The fact that the pain is to the side could mean more than saddle height adjustment.

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Front of knee:
seat too low (raise seat)... seat too forward (move seat back)... climbing too much (reduce climbing)... big gears, low rpm (spin more), cranks too long (shorten cranks)

Back of knee:
saddle too high (lower saddle)... saddle too far back (move saddle forward)... floating pedals (limit float to 5 degrees)

Page 214 of Arnie Baker's "Bicylcing Medicine"

Well, I walked into the LBS today... and I asked for the best guy in the shop to fit me on the bike.

This guy did some measuring the other ones had not done in the past.

So, he lowered my seat some and moved it back some.

I am going to ride some on Tuesday... and I will find out if the problem is fixed.

If not.... it will hurt to pay someone... cause I am so broke! But I know I may have to do it.

Thanks for all the assistance!


OH... PS... about the climbing reference... since I have no clue how/when to change gears... that might be an issue too.

Spin honey... SPIN.

If you're gruntin' to turn the pedal you're working too hard for your level right now.

Spin means pedaling with the most speed you can without bouncing in the saddle and still having a minimal amount of resistance in the pedals. A little resistance means you're still moving.

It's like power walking... you never quite break into that run.

Where do you live (town, state)? We're all over the place, someone may be in your area... Plus some shops give lessons. Cycling is way different than when we were kids. It's not out of line to get some help.

Hell, I started on a pee-wee herman boys bike that belonged to my cousin. Too big... first crash - WAAAAYYY owie! but still. Only thing I wish is that I still owned that bike (could make mucho mula on Ebay now)?

Get the kids on your street to show you the ropes a little. They know how to shift and it'll make them feel important.

Use every source... you never know what you'll experience or learn.

the "philosophic" spazz

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Originally Posted by KSH

OH... PS... about the climbing reference... since I have no clue how/when to change gears... that might be an issue too.

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While climbing, change to a lower gear BEFORE you absolutely NEED to. Anticipate the climb, look ahead. What you don't want to do is power partway up the hill and then - poof - out of energy, you're done. I see so many new riders do this. They charge the hill, fly by me, and then die and I ride by at about the same pace I started out on. Better to have some energy left at the top and pick up the pace than to start too quickly. Pacing is SO important.
When you're learning, it's better to use lower gears, let your knees and muscles and ligaments and tendons become accustomed to the extra work. You then have a base to build on without causing yourself injury.

Good luck with the new fitting. Hope It helps.

annie

Eh... well... I went on a ride tonight with a faster group.

I got my butt handed to me on a platter... and by the end my knees were HURTING SO BAD!

I think this goes beyond my bike fitting properly. We lowered my seat a tad after the ride.... but that was it.

Honestly, I have no clue how to pedal that darn bike. I muscle through it... I smash the pedals.... sure, I make it up a hill fast, but my knees aren't up to the ride at the end!

Thanks for all the advice... I need to learn how to ride that stinking bike now.

PS- I had 2 very kind people who hung with me at the back... and they looked at my form and all that. One assisted me with trying to tell me when to shift. They were really fabulous!

KSH... if you make changes to your bike, don't expect instant results in pain or discomfort.
Sometimes the "right" change will feel uncomfortable for a few rides until your body gets used to the new position.

Also, when you sit on the bike and go over bumps, you get minor bruising, and if your pain thresh-hold is low this may lead you to believe it is more than it is.

After being "fitted" you should make all changes to your bike small ones, and only change one thing at a time. Go for shorter rides til every thing starts to feel ok.

Good luck

I was reading my ProRoad Tips this AM and thought of you KSH. I was reading a section on cadence and at the end of the chapter there was an alert!!

"don't ride in high gear with low cadence if you have bad knees!!"

I immediately thought of you! Hope the spinning is working for you and your knees are getting better!

Quote:

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Originally Posted by KSH

Honestly, I have no clue how to pedal that darn bike. I muscle through it... I smash the pedals.... sure, I make it up a hill fast, but my knees aren't up to the ride at the end!

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someone else mentioned it: SPIN! peddle fast! do you have a bike computer with cadence? keep your cadence at 90 or higher (except when going up a hill.. then shift to lower gears to keep it up as high as you can even if you shift to your lowest gear!)

if you are a masher.. that may be a BIG part of your knee issues if it's not fit....

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Originally Posted by caligurl

someone else mentioned it: SPIN! peddle fast! do you have a bike computer with cadence? keep your cadence at 90 or higher (except when going up a hill.. then shift to lower gears to keep it up as high as you can even if you shift to your lowest gear!)

if you are a masher.. that may be a BIG part of your knee issues if it's not fit....

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Well, I rode today (with a lady off the board in fact!), and I was SPINNING... I kept in the LOWEST GEAR 90% of the time. I would only knock it up a gear if I was spinning too fast, and I was bouncing (typically down a hill).

By mile 20 I had really bad knee pain again. Now, I did let my knee rest for 3 days... before riding again. And today, I averaged about 12 MPH.

I might get a candence sensor... maybe that will help?

I just don't know if I should stay off it a week... or keep riding... I do have the MS 150 coming up in 15 days... and I need to be ready for it! And I need to get how to peddal down BEFORE that!

UUUGGGGGGHHHH..... this is so frustrating.

PS- The knee pain only happens ON the bike. If I get off the bike and run, my knee is FINE!

I don't know grrl... it really points to position/fit on the bike/pedals.

Front of the knee is the patella (knee cap) with the patellar tendon running down the front and retinacular tendons to each side.

I found this site www.bikefitting.com which has some great (though VERY detailed) info.

This link specifically speaks to knee issues: http://bikefitting.com/English/FAQ/KneeFemur.aspx

Also, this link: http://www.coloradocyclist.com/BikeFit/index.cfm

scroll down to item D to see the proper "neutral" position, though the entire page is quite informative.

Secondarily, are you taking some sort of anti-inflammatory? Speaking from experience, the rest part is important, but you need to take an anti-inflammatory. Knees have some of the worst circulation because its such a complex joint. So, when you ride take some tylenol, advil (name your poison) pre-ride. When you return, sit down and ice the knee and take the meds.

It takes a long time with knees... trust me. I'm the proud recipient of 2 knee scopes.

spazz

Actually - Tylenol has no anti-inflamatory action whatsoever. Advil/Ibuprofen/Motrin or Naprosyn/Alleve would have anti-inflammatory action.

When treating a minor injury or inflammatory process, in order for anti-inflammatorys to be effective, they have to be taken pre-activity if possible, and then every 4 to 6 hours (or every 12 hours in the case of Alleve) for 2 to 3 days following the strain.

They do help reduce inflammation in acute pain, but are best if taken on a continual basis for a couple of days, rather than sporadically.

If there is inflammation, the area should also be iced for 20 minutes every 2 hours, then after 2 to 3 days heat should be applied for 20 min every two hours. If you apply heat within the first 48 hours of an injury you will increase the swelling, thereby worsening the injury and/or increasing the pain.

Rest and compression by way of an ACE wrap wrapped comfortably but not tighly are also helpful.

In your case - there is no actual inflammation post ride though - it is unlikely either of these measures would be effective for you.

Thanks Spazzdog and Techno-RN!

Well, I went to the bike shop... AGAIN... today... and my cleat needed to be fixed... it wasn't aligned right.

I went to ride and then had NEW pain in my right knee.

At that point, I said, "SCREW THIS"... went back to the bike shop and bought the speed play peddals and new shoes to go with them.

Now, I need to get use to the speed plays.... but that should fix the knee pain... because I won't have ever to worry about my knee being "locked" in the wrong position again!