Knee pain (stupid f#$%king knee pain)

A light bike doesn't replace good fitness.

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Milese
Posts: 224
Joined: Wed Mar 17, 2010 12:04 am

by Milese

Hi guys,

As I'm sure you'll appreciate, I'm frustrated by some knee pain and want some reassurance and advice please!

I'm 37, have ridden 7000+ miles a year for the last 10 years.

Since working from home I've been doing a lot of riding on my training bike on the rollers on zwift, clocking up around 200 a week in about 10 to 13 hours across zwift, road and mtb.

Everything was rosey.

Then about 3 weeks ago I started getting some knee pain. Which....

Central in knee behind knee cap
Both sides, but mostly right
More of an ache than sharp pain
If I hyper extend my leg it creates the pain
Doesn't actually hurt much to ride, but I'm aware of it.
I've previously had similar knee pain from running, which I've never done much of and don't do any now.

This changed in that week before pain started...

Bought a new mtb that I rode for about 8 hours in the first week, at the end of this week I realised the saddle was too low and put it up about 15mm.
Weather improved and I rode a lot more outside
Had a harder, 15 hour week

Since pain started ive had two easy weeks (about 5 hours each)
Started foam rollering ITBs
Started stretching quads (been doing a lot of yoga through lockdown which does a lot for hamstrings and pelvis but nothing for quads)
Ice the knees a few times

They don't seem to be getting better.

It feels like that week, extra load, low saddle and increased pedal pressure riding outside have pushed them over the edge, and I now need to let them recover.

Am I on the right lines? What else can I do? I dont really want to do a 3rd easy week but it feels like I need to?

Is more hours easy better or worse than fewer hours harder training, from a knee perspective?

Thanks.




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by Weenie


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TobinHatesYou
Posts: 12444
Joined: Mon Jul 24, 2017 12:02 pm

by TobinHatesYou

See a doctor. I would suspect your new MTB’s raised saddle position since your knee pain started around time.

Andrew69
Posts: 593
Joined: Thu Feb 19, 2009 10:52 am
Location: ɹǝpunuʍop

by Andrew69

Whats the crank length on your MTB vs your road bike?
I know people say you cant tell any minor difference in crank length between bikes, but my kness simplay arent happy with anything over a 170mm crank length
I currently have 172.5's on a new bike and am awaiting shorter cranks that Ive ordered because while I cant feel the difference in riding between the two lengths, my knees certainly can
Defintly worse on my left knee that I suffered patellar tendonitis (which is the pain you desceribed) due to a hyperextension injury suffered many years ago

Cord1138
Posts: 35
Joined: Tue Nov 10, 2020 8:26 pm

by Cord1138

I'd recommend a bike fit. I previously had a lot of knee pain as well, and the bike fit solved it. My issue was saddle height, my quads were doing all the work and my hamstrings not enough. My quads got tighter, which put strain on my kneecaps which caused pain in my knee caps. Setting the saddle to the right height and offset, along with stretching solved it for me.

Milese
Posts: 224
Joined: Wed Mar 17, 2010 12:04 am

by Milese

Thanks for the replies.

The cranks on all my bikes are 170mm. I'll double check saddle heights and positions across all my bikes.

Neillp
Posts: 156
Joined: Mon Jan 06, 2020 4:22 pm

by Neillp

I have a similar problem from riding on my turbo all winter with a low seat height, I had this before and rest plus strength exercises have been the way forward once I have my seat height corrected.
This video is the best I have found for strength exercises but don't try and work through any pain.

https://youtu.be/gW1RdkwsWOw

Neillp
Posts: 156
Joined: Mon Jan 06, 2020 4:22 pm

by Neillp

Oh and look up how tape up your knees using KT tape, it does work to help protect but not a long term cure

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Mr.Gib
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by Mr.Gib

Research petellofemoral pain syndrome. Basically, when the lateral quad overpowers the vastus medialis, it can lead to pain behind the knee cap (patella) because the patella is no longer tracking nicely in the femoral saddle - it is being pulled laterally. The solution is to loosen all of the lateral structures and to build the vastus medialis. There are a number of specific physio protocols to acheive this. Be careful with taping (McConnel protocol) as this can increase downward pressure on the patella.

If you have PFS be advised that it is on of the more enigmatic knee issues. Getting the treatment right is tricky but the good news is that it is very curable with the right approach. Also, having PFS treatment, even if you do not have the affliction, won't hurt the knee and is likely to be helpful for overall knee comfort. And never, ever surgery for this problem.

Here is a thread with some photos of specific exercises: viewtopic.php?t=11620
wheelsONfire wrote: When we ride disc brakes the whole deal of braking is just like a leaving a fart. It happens and then it's over. Nothing planned and nothing to get nervous for.

Cord1138
Posts: 35
Joined: Tue Nov 10, 2020 8:26 pm

by Cord1138

Mr.Gib wrote:
Fri Mar 19, 2021 3:32 am
Here is a thread with some photos of specific exercises: viewtopic.php?t=11620
Excellent thread, thanks for sharing

eeney
Posts: 88
Joined: Sun Apr 30, 2017 10:09 am

by eeney

Indoor training magnifies any issues due to the very fixed position. I've had similar problems, was fixed with a bike fit, but need a good fitter. For me it was a case of adjusting cleats and float, but the solution is very personal.

In the past I experienced pain due to incorrect knee cap tracking, solution was stretching the IT Band regularly, I found an easy method where I would lie down and use a wall/door frame.... if you search knee pain cycling and it band you can see if the symptoms are similar.

Alexandrumarian
Posts: 795
Joined: Mon Mar 28, 2016 6:34 pm
Location: Romania

by Alexandrumarian

Milese wrote:
Sun Mar 14, 2021 10:38 am
Hi guys,

As I'm sure you'll appreciate, I'm frustrated by some knee pain and want some reassurance and advice please!
So how are you now? I recently developed a patella problem too, I currently think from having the saddle too forward, too low, likely both. 3 months ago I had artroscopy cleaning up the meniscus. After that when i returned to cycling my saddle height seemed too high (hamstring end pain behind the knee, also Achilles inflamation) I kept messing with my position until i improved the hamstring part only to develop stings in the quad end. Noticeable when climbing stairs, or rising from a low sitting position, or when pulling hard on the bike. Eventually the day after a very hard climb it "snapped", I could barely walk, sharp pains, locked knee and all. I researched how to tape it and it has been marvelous - it quickly allowed me to walk again (horizontal across the patella then a C with the opning towards the inside)

Milese
Posts: 224
Joined: Wed Mar 17, 2010 12:04 am

by Milese

Sorry to hear about your knee, sounds worse / different than mine.

Mine is fine now, not sure what the particular cure was, but I think the approach of doing everything that might help, will help.

So time, rest, ITB bands, stretching are the obvious ones.

iheartbianchi
Posts: 680
Joined: Sun Mar 24, 2019 9:17 am

by iheartbianchi

Newbie comment, but remember to adjust fore/aft position of saddle to correspond with any changes in saddle height!
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2000m2
Posts: 60
Joined: Wed Apr 07, 2021 11:28 pm
Location: SF Bay Area

by 2000m2

Crank arm length caused me significant knee pain. I bought a used bike with 175mm crank arms and had a lot of pain below my kneecaps just after riding. I switched to 172.5's and knees are good now. Amazing what a difference 2.5mm makes.

eeney
Posts: 88
Joined: Sun Apr 30, 2017 10:09 am

by eeney

Update, my bike fits helped as explained. However, I went to see a bike fit physio, but for an assessment not a bike fit.

He found that my quads were not firing properly, and my calves not strong enough. Two muscles that provide stability to the knee when applying pressure, therefore my knee was not tracking correctly and the kneecap not tracking properly. After 3 weeks of resistance band work, the type of exercises you see for bikini butt shaping, and my knee pain is gone. I've actually slackened off a lot of the bike fit restrictions we had implemented to address the issue.

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