LCL Pain

[aicabsolut]

ITB = iliotibial band. http://www.kneepaininfo.com/kneeITBand.html

While it attaches to the tibia at the bottom end, it runs along the outside of the knee and next to the top of the fibula.

If by pain on the fibula you mean a little more lateral-posterior pain (while the LCL is just lateral), or attachment point pain, there are some other things to consider.

For example, the biceps femoris (hams) run just under/behind the ITB, and tightness or strain of the muscle can hurt on the lateral-posterior part of the knee. This kind of strain is often caused by too much reaching--cleat too far forward, knee tracking inward (toward top tube) too far, saddle too far back, and possibly saddle too high.

An example on the other side of the knee is a strain of one of the longer adductor muscles. These attach at the medial side of the tibia, and tightness can cause a deep pain below the medial knee at the attachment point. But it is unrelated to knee ligaments.

It is pretty uncommon to hurt the LCL, but ITB or ham strains are pretty common and can show up as knee pain. Ligament injuries are often accompanied by heat and swelling. If it's ITBS, there might be hot spots along the band 1/3 of the way up the thigh. You may not notice the hamstring problem until you do something like get a massage. You might be able to stretch the same as normal, but a massage could burn.

If it's only on one side, check cleat placement, knee alignment, and pelvic symmetry. Is this by any chance on your left side? Many cyclists tend to drop their right hip, which creates a functional leg length discrepancy (I drop my left because of some biomechanical issues). This leads to all sorts of overreach problems with the other leg.

For some info on pelvic symmetry: http://www.cyclefitcentre.com/pdf%20...ETRY_final.pdf

[Wahine]

+1 what aicabsolut said.

[Mr. Bloom]

Thanks. THis is very interesting. The pain is identical on both sides, so I'm leaning toward overuse, or seat height, but not pedal float (since I wouldn't expect this to be a problem on both sides...)

After reviewing the links, I'm inclined to think it's not ITB since the pain is right on top of the fibula "bump", specific to that area, and not following a band.

No pain when the leg is extended straight; pain peaks on stairs or when I'm reclined to sit.

I spoke to the owner of a local health club for a sports medicine specialist today and will pursue that if the pain extends into next week.

[aicabsolut]

Could still be the hams. Could also be the peroneals (lateral calf muscle). Any lateral foot pain (5th metatarsal area)?

Look at how much of a heel drop style you have, knee tracking, and fore/aft position as well as height. Too far back strains the backs of the legs, too far forward usually cases quads or medial/anterior knee pain.

You can strain the peroneals if you pronate (or supinate if there's too much stretching), and that can be a lateral cleat position thing (foot too close to cranks, for example). You can also strain them if your cleat is too far forward (pedal axle should be a few millimeters behind your first metatarsal joint). Look to see if you have any forefoot abnormalities or anything else that would affect your knee alignment. If that's ok, then look at your saddle adjustment.

I find it hard to believe that you've blown out both LCLs. Despite all my blabbing, I'm no expert (just frequently injured), but something muscular on both sides goes more with the odds.

[Wahine]

No pain when the leg is extended straight; pain peaks on stairs or when I'm reclined to sit.

This would strongly suggest that it is not your LCL. I'd epect a muscle balance issue. Do you get a sharp paon when you sit in your recliner, with the knees bent 30 to 60 degrees and push your heels into the foot support by trying to bend your knees? That would indicate tight hamstrings irritating the joint that I spoke of earlier.

Otherwise it may be the peroneii as aicabsolut suggested.

[Mr. Bloom]

Once again thanks.

The human body is amazingly complex! The pain comes while bending with a 'lateral twist'. Like climbing steps, or squatting to sit down (where my feet aren't necessary straight as I'm squatting).

I'm getting the refitting today to see if LBS can see anything obvious. I'll let you know what comes from this.

I'll also visit my chiropractor on Friday.

[aicabsolut]

ITBS also flares once knee bend is past 30 degrees in a squatting motion.

Having your feet pointed inward or outward doesn't just affect knee alignment but also which of the contracting and stabilizing muscles fire more.

I read something on lack of float (plus improper cleat angle position) where feeling the "need" to rotate your heel somewhere the cleat position won't allow can strain the biceps femoris tendons, which attach at the head of the fibula. So there, float may be the problem. But its' still not the LCL, though over time, you can strain the knee.

What kind of pedals do you have? Do you have any new calluses on your feet, such as under your 5th metatarsal? Do your knees track straight (with someone watching in front of you) or do they wobble?

Of course the greatest strains on the biceps femoris are caused by saddle too high and/or too far back. Have you evaluated whether your knee is over the pedal spindle (or how far off it is)? Do you tend to be a little short in the femurs?

[Mr. Bloom]

OK went to the chiropractor - he confirms ya'll are right. It's the ITB.

Had bike readjusted and we're going on a 36 mile ride tomorrow. Will let you know how it goes.