"Another" newbie, with problems...

Hello Girls!!

I bought a bike about a month ago from my local bike shop. I had it custom fit since I have an existing knee problem (IT band syndrome). I have being very careful not to hurt my knee. I have so far done close to 100 miles (only run one time a week, 20 miles each time since I don't want the monster to wake up -the pain). I use very low gears for climbing to keep the beast asleep (knee pain) and also because I am out of shape :o . I wish I could go faster but when I increase gears my knee starts acting up. I have a few questions 1) Should I consider "clipless" pedals? Is it true it might help my knee? Which ones should you recommend? Shoes? 2) Am I doomed for having IT band syndrome? 3) Those with preexisting knee injuries or problems? How you do it?
I am tired of putting off exercising because of my knee and I want this to work for me. I am so ready to get more active and lose weight!! I have a Specialized Sirrus road/commute bicycle and I love it. I am still getting used to the shifting gears, etc. One thing I noticed is that when I pedal having my legs almost touching the upper pole (like in the Tour de France) I do not feel any pain when accelerating or using a higher gear!! You don't know how happy I was, I was flying today! Of course, I am concerned since I do not know if this is the proper way to pedal. The weather was windy and cold which made my knee hurt a little but I know to use longer cycling shorts next time. As soon as I am done using the bike the pain stops (and the heartache starts, I LOVE MY BIKE!!! :( ) Please, somebody help!!

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Originally Posted by Hell-uv-a-job

One thing I noticed is that when I pedal having my legs almost touching the upper pole (like in the Tour de France) I do not feel any pain when accelerating or using a higher gear!!

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I'm not sure what you are describing. Is this the seat tube (the frame tube in which your seat post is inserted)?

The frame tube, the one between the saddle and the handlebars... I tried pedaling with my knees inwards, almost rubbing my knees against that pole.

Ah ha! That is called the top tube. So, if you consciously keep your knees close to this tube the pain goes away and if not, it comes back?

What kind of shoes and pedals are you using? And do you hae a double or triple crank?

IT band issues can be horribly hard to fix.

I have now regular running shoes :o since I use pedals with clip and straps. I want to get shoes and new pedals but not sure if they could help with my knee problem. About having a double or triple crank... you lost me :o . But I think you are asking me about the front crank right? Where the pedals connect? It is a triple, the back crank in eight if i am not mistaken.
I normally use the 2nd gear in the front crank and between a 3 and 4 for normal or leveled road in the back.

I can ride all day at this level in a straight road but of course not if i take a hill (even if is very small) or accelerate to say cross a road quickly. I have to be very gentle when I accelerate. When this happen I feel discomfort. Lets not say pain, I have not gotten to that point yet and I am fighting hard not to get there. I used to be a runner and developed IT band during a 50 mile ride in Germany (since I was a good runner I never thought I needed training for that long ride). I used a friends bike. Now I know that good friends don't let friends ride Huffy Bicycles. After that, i could not run anymore :mad: .

To answer your question: If I intentionally keep my legs close to the top tube I noticed that I do not feel any kind of discomfor at all while climbing (while seated) or during descends using high gear and I can even accelerate and have a very decent phase for a 23 mile ride without ever stopping (except for the Hiny stretching of course). It usually take me like 2 hrs for the 23 miles (I am a newbie!! What do you expect!! :o) IT bands are a you-know-what to fix and are very painful if you push yourself. Even with ultrasound therapy and stretching it did not do much, I just learned to live with it by becoming a couch potato. But hopefully that is about to change.

You mentioned stretching. I assume you did PT for the IT band issue too? Keep up the stretching so at least you stay flexible and it doesn't worsen. As far as having knees close to top tube, that is a very good position to ride. If you find it comfortable, most definitely do it.
I suggest you get a cadence monitor. You are supposed to be between 75 and 110. I am guessing your knees would like the higher end. You may find you spend too much time mashing (the lower end) and that will be much more likely to give you knee problems. If you're a newbie, you probably don't know what your cadence is. Mashing all the time is a common newbie mistake. Spin at the 90-100 end all the time and you may find your knees last a whole lot longer.
G'luck

Have you thought about more frequent, but shorter rides? I, too have knee issues related to my IT band. I know if I ride several times a week, but only 5-10 miles each ride, that my knees 'warm-up' to the idea of riding. I also try to keep my gearing light so I am literally 'spinning', as the harder I have to pump my legs the more my knees scream. I literally pushed it too hard one day, after having not ridden for a while, and had to call for a ride home. Good Luck, and don't give up yet.

Another thought - have you talked to your doc or PT about how to approach this? Not if its a good idea or not, but how to set up a training schedule to get you where you want to go, and still be able to ride in 10years.

Rmember that strong and flexible hamstrings do wonders for easing knee pain on the bike too. I don't know if your IT band problems would keep you from doing this, but low/no weight hamstring curls ( I think that this is what they are called - the one in the gym where you lie on your stomach with the pads at the backs of your calves and bend your legs back towards your butt) are great.

I wonder if your running shoes are putting your knees at an odd angle since good running shoes address all kinds of pronation or supination issues. Also, the sole is wide increasing the Q-factor (which is the distance from one pedal to the other). Women are the most sensitive to Q-factor probably because we are also so prone to knee issues. I use clipless pedals and have the cleats set up so that my feet sit towards the inside edge of the pedal. Crank Bros makes a shorter pedal spindle to address the same issue. Your cage and strap approach could be exacerbating the foot position problem. What happens if you take the cage off? Do you feet want to sit closer to the frame?

Some people who use Rx orthotics for running do not use them for cycling so you can see that angles for your feet may be sport-specific. Did the LBS measure body angles when they fit you? You need to go back and talk to them again. It is only a month later. They'll want and need the feedback. So, you have two things to consider, foot position (inwards and outwards) and foot angle (there is even a wedge made by LeMond for this). Aggressive hip angles can cause problems also. I told you there were a ton of possible issues!

Doc is right about cadence, but it sounds like you are paying attention to that already. Mikki touched on the warm-up issue. I watch loads of cyclists start out way too fast without a proper warm up time, but if you watch a racer they sit on a trainer for a long time before a racing just spinning a high cadence with little resistance. I find that if I mimic the same thing on the road I don't develop knee (or fatigue) issues later in the ride.

I also have IT band problems and it really helps if I roll the side of my leg on a giant styrofoam tube. I also used Kinesio tape last summer when I was training for my tri and during a Grand Canyon trek. I got it from my PT and it worked miracles.

Glad to read that you are off the couch and getting back out there, one step, er, pedal at a time!

My suggestion for knee pain and problems, is to buy clipless pedals that allow motion - and do not severely restrict your movement. I believe this is referred to as "float" in a pedal. The clipless pedals will allow you to pedal in a true circle - lifting on one side while pushing on the other - all the way through the pedal stroke. The float in the pedals will allow your knees to naturally position themselves in a comfortable position. As you are getting in shape, stay in easy gears (big rings in the back) and little rings in the front and increase your cadence as your strength and stamina build. I would work on cadence before speed and bigger gears. You can also buy a stationary trainer to place your bike on - to spin at home on days that you cannot get out on the road. Even 20 minutes a day will help. I think this is better than going to spin class - you don't have to find a comfortable position on every new machine you find yourself on. Talk with several bike shops about pedals - ultimately - you need to buy what feels comfortable to you - everyone has a style choice and pedal choice depending on the level of cycling they are doing. :)

Although there is alot of expertise and experience on this Board - and listen to what all have to say - the best way to deal with your problems is to 1) work with your doctor and 2) work with your bike shop.

I'm assuming your doctor is aware you are cycling. I'm also assuming your doctor has recomended certain exercises to address your knee problems. Most likely you need to strengthen your hamstrings or inner thigh muscles in order to off-set/allieviate the IT Band issue. Your doctor should help you address these issues and I would even think about joining a gym and working with a licensed trainer.

As to riding, make sure you regularly check back in with your bike shop to make sure your fitting is working. Usually "fine-tuning" is needed. I'm alittle confused about the reference to the top tube. You should be riding with your legs as close to the bike frame as possible. If your knees are sticking out, you will have knee problems. But if your legs or knees are hitting the top tube, your seat is too low. This should not happen. You will have knee problems if your seat is too low.

Since you are a newbie, try not to do too much. Start out with short rides. Work on form. Learn how to "spin" this relates to the rpm or rotation of the crank arm per minute. Proper form is 80 - 90 rpms. If you fine yourself pushing the pedal and turning at less than 80 rpms, your gear is too hard and you will have knee problems. Remember cycling is an aerobic sport. Also make sure you don't spin too much. That will also cause knee problems. Learn how to swift the bike correctly (your bike shop should assist with this). You need to prevent "cross-chaining". Again ask the bike shop to explain.

I would start out ding 10 - 15 miles max. Get comfortable with that and then increase mileage. Work on flats first then add hills when your legs start building muscle and strength. Good luck. Give yourself time to built up strength and expertise before pushing. Nothing worse then investing money in a bike you can't ride because you caused further problems to your knees.

Good luck and have fun!

PS: Definitely go clipless! For knee problems I recommend Speedplay. Good pedal to learn getting ina nd out of. If you buy the road version, make sure you also get the cafe covers. Well worth the investment! All of the Crank Bros. pedals are good as well.

Thank you so much for all the replies. I see this board is very active!! I did not expected the amount of information that was given... that is priceless:) . I like you all already!!! Thank you so much!! I need to prepare a budget of course and see my physician. Thank you, Thank you, Thank you!!!!:)

As Pam said, work with your doc.

I have been through IT band hell (running-related). Thing is, it's not really a knee problem...it's a whole band problem that typically mainfests itself as knee pain. And because it's not your knee, per se, many of the typical "knee" solutions don't apply.

Work with a sports medicine doc. I did this and ended up going through lots of testing. My solution was pedals with as much float as possible and lots of use of the foam roller. I've not had problems with cycling, but I've been a good girl! Go easy and get a good doc!

Welcome to the wonderful world of cycling, I hope your knee pain doesn't slow you down too much. Can I ask how you know its IT band syndrome you have? (I ask because I am an Orthopaedic surgeon) There are lots of causes of knee pain, you see and it depends if its the IT band or not. If you do have it and you are most comfy with the knees close to the top tube it may be that you have some hip anteversion as the underlying cause. Don't worry that's not a disease! Its when your neck of femur (the bit attaching the ball of the ball and socket joint, to the rest of your thigh bone sits pointing more forewards than some.) Sometimes it results in in-toeing, but sometimes the shin bone adapts and grows with a twist to keep the toes pointing forewards. Either way this is all part of the rich variety of body shapes and biomechanics that we blessed with and what makes us all different! If either is the case you will be more comfortable with your knees inwards and to fight it may also add hip pain to your troubles!
If you are an "in-toeing" individual you just have to make sure that any cleats you have put onto your shoes for clippless are pointing right for you - forcing the foot out will definitely make your knees hurt.
Clipless are brilliant and you will love it once you are used to it. You will go faster and fatigue less..... You might consider pedals that allow some "float" which means there is some give in the amount of twist your foot can do and its not rigidly fixed.
I hope this helps. Good luck.

It was diagnosed 5 yrs ago, while in the military (I am currently out). The doctor asked me to position my legs in weird ways and that would agravate the pain on the lateral side of my knee. After that I was placed on PT (for Ultrasound Theraphy) but did not do much after 2 months of stretching and therapy. I was told pretty much to "stretcht" or to consider steroid injections (yeah... I keep the discomfort, thank you very much!! :rolleyes: ). I got discouraged since I did not see any results then and of course, did not took stretching very seriously. As embarrasing as it sounds I just said "screw it" and never went back to jog again. Now I am too heavy to run, but I welcome some bike riding. I do use the elliptical machine and walk on the treadmill at a decent phase (3.5 to 4.0) without a problem, a couple times a week. I just decided to join my husband during his bike rides (he was bitten by the Tour de france bug). ;)

Hey Helluva... I'm just piping up re the steroid injections.

I had problems with my shoulder for a bit a few years ago and was offered a steroid injection (I have since had another for the same prob) and when I came out of the doctors surgery and told my partner he congratulated on being so brave. Puzzled, I asked him why (it was just an injection after all) and he told me steroid injections can really hurt. I had no pain from it and the relief in my shoulder seemed almost instant.

I had no side effects (two injections over a few years) and I would strongly recommend them if you are offered again - however, if I had to do a course of injections, I would reconsider... don't want too much steroids in ones system...

Wishing you a positive and healthful outcome from your lifestyle descision - great to be doing it with your husband - thats what I love most about cycling... it is another passion both my partner and I can share.

You might look around your area for cycling-specific sports medicine clinics. Locally, we have Max Testa and Eric Heiden. Solutions for cyclists can be very different than those for runners.

http://www.ucdmc.ucdavis.edu/sportsm...al_tests.shtml

I had pretty bad ITB problems a few years back. I got rid of it completely with PT centered around weights. My PT bascially explained that when the quad is not strong enough to do the job that it is being asked to do, it will, shut down and the ITB will bear the brunt of the imbalance. The problems is gone. No shots, no surgery..gone.
See a good sport medicine doc, get some good PT going, strengthen and balance your leg muscles. I know everybody is different, but I betcha it will work.

Ruth

I would also suggest you join the Bike Journal. www.bikejournal.com.

There are some riders from Florida that you might get some good feedback from as well.

I also recommend clipless "float" pedals and carbon sole cycling shoes. I have arch supports in mine and have had few problems with my arthritic knees.

Yes the IT band is a difficult one to cure. I have a cycling friend (on the Bike Journal as RoboRider) who has terrible IT band problems. He says the only remedy is rest when it flairs up. He also takes Ibuprofren when he rides long distances. This guy is 61 years old and still doing long rides. In fact he is planning to do RAAM this year with 3 other riders. So with care, you to should be able to ride!