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constant knee pain - what to do next???(13 posts)

constant knee pain - what to do next???dupe
Aug 22, 2001 7:26 PM
i have introduced a friend to the sport of cycling and he has lapped it up and is doing more miles than me after only two months. but he is suffering pain in both knee's.

the pain is on the outside of the knee's and to the side close to where the quadracep muscle ties in.

we have adjusted seat height and angle. we have checked his cleat alignment (he has look's that allow float). he has rested for 8 to 10 days at a time and this hasn't worked. i rode his bike to see if i could feel anything untoward. he has good shoes. he is active and very fit and in his early thirties. he used to ride a excersize bike in the gym before taking up road cycling and never experienced this pain.

i watch him as he is riding and feel the fit is pretty good. he doesn't experience any pain after a ride.
ive got him to start spinning more - higher cadence, as he liked to crank big. has this stuffed his knees up. he says that the knee pain is lessened when he is out of the saddle on a climb.

as he is fitter than myself he started at a fairlly brisk pace. usually quick tempo's for around 40 - 50 kilometer's. 3-5 times a week.

i dont know what to look at eliminating next as he has fallen for the sport of two wheels on blacktop and now feels that he may have to give it away. he is tall and lanky - 6'3" and 168 pounds.

he is riding a frame that is slightly smaller but the seat post is both out an has a lot of setback. i have swapped the stem for him and added a longer stem for him to stretch out properly.

i really dont know what else to think of. any advice would be appreciated as he is really talented and is now a keen cyclist as well as a good friend - ie i enjoy our rides .

ciao, ben
Check saddle fore/aft...Mike Prince
Aug 23, 2001 12:09 AM
You have adjusted seat height and angle, but have you checked that the saddle position is correct from back to front? My experience is that as a starting point the KOPS (Knee Over Pedal Spindle) method is not a bad starting point. This may not be the answer, but I have found that having the saddle too far forward causes knee pain for me.

Seatpost setback will only play a part if he adjusts the saddle either all the way forward or back and still can't find a good position.

After writing this I think your friend should go to a good shop and get fitted. If he really likes cycling and the pain is that bad, the $50 or so should be a good investment. Sounds like he may be on a bike that fits less than great. Best to have a shop check this out.
re: constant knee pain - what to do next???girodebirdman
Aug 23, 2001 12:17 AM
Pain in that area, according the the guy who owns the best shop in Bend, is related to a too-low saddle, the leg constantly being compressed throughout pedaling motion. I had that problem, got my saddle height fixed, rested a couple of weeks, and was fine. It sounds like you may already have checked out saddle height, though. Good luck, hope it helps.
Check saddle fore/aft...Mike Prince
Aug 23, 2001 12:28 AM
You have adjusted seat height and angle, but have you checked that the saddle position is correct from back to front? My experience is that as a starting point the KOPS (Knee Over Pedal Spindle) method is not a bad starting point. This may not be the answer, but I have found that having the saddle too far forward causes knee pain for me.

Seatpost setback will only play a part if he adjusts the saddle either all the way forward or back and still can't find a good position.

After writing this I think your friend should go to a good shop and get fitted. If he really likes cycling and the pain is that bad, the $50 or so should be a good investment. Sounds like he may be on a bike that fits less than great. Best to have a shop check this out.
re: constant knee pain - what to do next???pjkad
Aug 23, 2001 3:55 AM
I am right in the middle of this problem myself. After having no problems for years, I got a great new bike and right away had pain on the outside of the right knee. I have been really reading up on this and there are 25 possible causes it seems. Most likely is overuse that comes from the quads putting too much pressure on the patella and causing tendonitis (the book Bicycle Medicine is great on this). Solution is a lot of rest (no stairs even) for a few weeks. Hard to do when you love to ride and just got your dream bike. Then check saddle height, fore/aft as a starting point. But by the book calibration is not the answer for anyone. I'm tall too and a forward position (2cm) from KOP is improving things for me. Also, an orthodic in my shoe seems to have corrected a bad angle my foot must have had. I'm better but not cured yet as I still get too sore in the quads and have knee pain after 2 hour rides. So I'm taking it easy, very high cadence (which is good anyway), and working myself up to greater mileage/speed slowly. Next thing I may check is my BB axel width and may add a spacer between the crank and pedal (see the book). Go (as I did) to orthapedist to be sure there is no fundamwntal problem. Finally, make adjustments a little at a time to be sure the body has time to adjust. If he's like me, we will do whatever it takes to preserve the enjoyment of this sport.
re: constant knee pain - what to do next???mlbd
Aug 23, 2001 4:09 AM
pain in that area could be iliotibial band syndrome. tell him to stretch his ITB more.
how do you stretch an iliotibial band?dupe
Aug 23, 2001 4:45 AM
i appreciate all the info from everyone.

thanks
iliotibial band syndrome (&stretch)Kevin M
Aug 23, 2001 6:45 AM
http://www.runnersworld.com/injuries/iliotibi.html
iliotibial band syndrome (&stretch)azdave
Aug 23, 2001 7:28 AM
I had the same problem with knee pain that started last month as I ramped up my miles. I had a professional fit done, and the fitter used lasers to verify that my knees were going up and down on a vertical plane. At the top of my pedal stroke, my knee was 2 inches further to the outside than it was at the bottom of my stroke. Raising my seat helped some, but I am now seeing a physical therapist to improve my flexibility. I had thought that my seat was too high, because people said that was the probable cause of my hips rocking. As it turned out, it was just that I wasn't flexible enough through that IT band. I have been seeing my physical therapist for 2 weeks now, and my flexibility is getting better every day.
One more possibilityDCP
Aug 23, 2001 5:11 AM
I was having a problem with pain on the outside of a knee and cured by adjusting the lateral position of my cleat (in my case, moving the cleat so that my foot was further away from the BB). May not be the problem here, but it may be worth a try.
Nextgrzy mnky
Aug 23, 2001 8:34 AM
See a sports medicine doctor to gain an understanding of exactly what's going on. It could be as simple as "too much too soon" or there could be a real problem with his fit, or all of the above. Most likely it's a matter of fit on the bike - have you used the plumb bob from the knee to get correct fore and aft. Also recognize that if he pronates either way he's going to have problems until his biomechanics are correct - usually custom orthotics.
re: constant knee pain - what to do next???jonny dee
Aug 23, 2001 12:55 PM
HI guys,
This ones easy. Put the saddle up until the pain goes. Try one cm clearance between heel of shoe and pedal when pedal is at lowest point. The pain should go to the tendons in the back of the knee, so you can go from there to find a happy medium!
If this fails, and you use look style pedals, loosen the tension screw on the pedal so that the foot floats more. this did it for me.
thanks to all respondees - will keep trying on itdupe
Aug 23, 2001 11:52 PM