6 months of sore knees - Eureka?

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tcdev
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6 months of sore knees - Eureka?

Postby tcdev » Thu Feb 19, 2015 11:25 pm

I've been riding for just over 6 months now and it wasn't long after I began that I started to get sore knees. When it started to become debilitating I adjusted my seat height and it abated for some time, but slowly over the months the pain increased until it all came to a head last week and I was left crippled from pain in my right knee. Whilst I seldom feel the pain during an actual ride, it's apparent during day-to-day activities, most noticeable when squatting. Last week I couldn't get into my car without actually grimacing in pain, and for 2-3 days I was walking with a significant limp. I knew I had to so something. Next step was a proper bike fit.

Of course I was out of the saddle until I could walk again, more-or-less pain free. Fortunately that only took about a week. During that time I read the article on knee pain by Steve Hogg which someone on this site - and apologies for losing the reference - linked to. Of course there being 102 different causes of knee pain I wasn't exactly sure of my particular issue(s), but it at least gave me some ideas.

Before getting a fit though, I had a chat to my riding buddy (a fellow novice) about some of the most likely issues and he commented on 2 in particular; my seat height and my knees being angled outwards quite noticeably! So my 3rd seat height adjustment since getting the bike saw it raised even further, and my subsequent 38km ride had me concentrating absolutely on placing my feet ever so slightly wider on the pedals (no cleats yet) and - more significantly - keeping my knees as close as possible (it did tend to increase the chafing a bit though). I think I did a pretty good job at keeping that focused for the entire ride too, but it was a significant mental effort! My riding buddy commented that my technique definitely looked different!

I'm loathe to jump the gun here, but some 2 days later I can only say that my knees haven't felt better since I started riding. I would think that straight off the back of such a debilitating injury, another ride with bad fit/technique would only flare it up again immediately. Although there is some residual pain from 6 months of abuse - and I don't expect that to be cured with a week off the bike - I'm pretty confident that I'm no worse off than when I mounted the bike before my last ride. Eventually of course I'd like - and expect - to be completely pain free, and I'm hoping that now I'm finally able to achieve that.

I will of course need some discipline in correcting my technique (knees together). My question is, is this something in particular that others here have struggled with and have had to consciously correct? Will it eventually come natural to me?

As an aside, when grinding up hills (seated) on that last ride I actually felt like I had a bit more power than previously. Is that likely, or am I just imagining things so soon?
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cyclotaur
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Re: 6 months of sore knees - Eureka?

Postby cyclotaur » Fri Feb 20, 2015 9:08 am

"Keep your knees together" - always good advice ! [emoji51]

Correcting the seat height and improving pedalling technique are the two simplest improvements you can make. Just watch the good riders and mimic their pedalling technique.

True, it won't help the chafing but if you're naturally large of thigh you'll just need to work with it. A little chafing is far preferable to busted knees.
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Re: 6 months of sore knees - Eureka?

Postby Calvin27 » Fri Feb 20, 2015 9:20 am

I know how annoying these things can be and great to hear you've resolved it!

Sore knees is one of those things the bike industry has not yet resolved. If you are having to find yourself putting your feet wider then the q factor (pretty much distance between two pedals) is too narrow for you. Unfortunately bicycle part manufacturers still haven't gotten around to q factor adjustability mainly because this affects chain line so much. If this is serious enough, you're probably not gonig to find a solution short of MTB cranks which have a wider q factor.
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foo on patrol
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Re: 6 months of sore knees - Eureka?

Postby foo on patrol » Fri Feb 20, 2015 10:01 am

You don't to be pushing your feet out wide on the pedals, if that will cause you to push diagonally through you natural pedal motion. You need to be pedalling to the perpendicular line not from one side to the other. :idea:

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kb
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Re: 6 months of sore knees - Eureka?

Postby kb » Fri Feb 20, 2015 10:10 am

I'd say get a fit anyway. You may have some habits to overcome but I don't think they should require a "significant mental effort" if you're set up well. What sort of cadence do you pedal at?
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Re: 6 months of sore knees - Eureka?

Postby RonK » Fri Feb 20, 2015 11:21 am

It's a pity it took 6 months for somebody to point out that your saddle was too low. With your knees pointing outwards it should have been obvious.

Other points to observe:
- make sure the saddle is not too far forward, if your knees are in front of the pedal axle with the crank horizontal they'll likely be overloaded
- that you use flat pedals indicates that you are likely a pedal masher, you need to lift your cadence to reduce the load on your knees, maybe time to go clipless and focus on cadence.
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Re: 6 months of sore knees - Eureka?

Postby Nobody » Fri Feb 20, 2015 2:41 pm

As a person who has focused on trying to reduce knee soreness after rides for about 7 years, I'll write what I think works. My knees were so sore that I gave up cycling about 9 years ago after restarting cycling for only a couple of months. Now I can ride on consecutive days or not notice the knee soreness much the next day. Fixing the problem is usually about a lot of small steps adding together. I'm not cured, but at 47yo I don't expect to be.

Saddle height. Do a Google search and find out the various techniques for getting the correct saddle height. To summarise, your saddle height may end up somewhere in the range of 1.05 to 1.09 times your inner leg length measured from pedal top to top of saddle along the seat tube. Best to do your adjustments < 5mm at a time and keep a log how you feel the next day. Also give yourself a week or two to adjust. My log dates back to Nov 2008 and my ideal worked out to be 1.07 times inner leg length.

Saddle setback. Usually measured with a plumb bob and comparing front of knee to axle and referred to as KOPS. Unscientific, but it at least gives you a measurable reference point. Most people aim for knee over pedal spindle. Mine is 15mm behind the spindle currently. More saddle setback (as said by RonK) is often better for your knees.

Pedal choice. I found this made a significant difference. I've tried most pedal types out there, various flats, SPD, SPD SL and now Speedplay. If you have knee issues, don't muck around like I did, go straight to Speedplay Zero CrMo version (cheapest). They are expensive, but IMO most people with knee issues report improvement with them. They have no/minimal heel sideways float resistance.

Pedal cleat wedges and cleat placement. Positioning the cleat so the foot is more forward on the pedal helps.Vulgas/varus wedges can help, but didn't appear to make a big difference in my case. I still use them, along in insole arch support.
http://www.stevehoggbikefitting.com/bik ... h-support/" onclick="window.open(this.href);return false;

Cadence. Keep it high (> 90). If it gets low, stand on the pedals instead. Standing up hill can improve you leg strength and therefore your knee support. I'm on a 1 X 9 setup these days as the Q Factor is better for me and standing is better for my knees on hills.

Crank length. Shorter is usually considered better. I found an improvement, but it was small in my case.

Q Factor. You are trying to keep your knee tracking vertically over your foot with less than 25mm of side movement during the pedal cycle (once you saddle height is close). If your pedal system doesn't have enough side to side range of movement to get this right, then you'll either need pedal spindle extenders or longer pedal spindles for wider. Or in my case a narrower Q Factor crankset. As said, you shouldn't need to concentrate hard on keeping your knees in place.

Diet. Has to be mentioned because it made a significant difference over time in my case. You may be eating something that is helping to inflame the joints. Whatever you change, give it a month or two to see a change. I went whole food plant based about 17 months ago and losing the 16Kg of body weight has helped my knees.

Stretching, ITB and muscle (self) massage. These usually help after a ride as everything gets tight. They can make an instant difference to my discomfort. As you fit improves, the tightness should be less of a problem in theory.

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Re: 6 months of sore knees - Eureka?

Postby Top_Bhoy » Fri Feb 20, 2015 7:44 pm

I'd opt for a bikefit done by someone who is also a qualified physio.

You may not necessarily get a better fit than that done by a non-qualified physio but if you have unknowingly done any damage to your knee from using your current set-up, in theory, the qualified physio should be better able to identify it and provide appropriate remediation advice.

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Re: 6 months of sore knees - Eureka?

Postby redsonic » Fri Feb 20, 2015 10:15 pm

Nobody wrote:As a person who has focused on trying to reduce knee soreness after rides for about 7 years, I'll write what I think works...
Some great suggestions here Nobody. You have obviously done a comprehensive self assessment!

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Re: 6 months of sore knees - Eureka?

Postby tcdev » Sat Feb 21, 2015 12:01 am

A big thank you to everyone who has chimed in here! I will definitely be continuing to experiment to improve my fit and technique! Will definitely check out seat/knee placement as a priority! 49 here, so my body is not going to be very forgiving if I abuse it too much longer. Never had knee issues until I started riding, even doing squats (ass to grass) for the last few decades. Recently squats have become unbearable. Always had big thighs, squats and cycling only reinforce that, so it's cream for me I guess if I'm modifying my technique (never had to use it before, perhaps I was unknowingly compensating with wide knees).

I had also intended to graduate from flat pedals at some point, and I guess now it's time I bit the bullet. I have been concerned though that it would just add a few more variables into the equation that has to be solved to avoid knee pain; i.e. complicate the issue. But perhaps if fitted properly it could be part of the solution! If you see some idiot falling off his MTB at the lights, it could be me! :oops:

Have to admit I'm a bit of a grinder, preferring a lower cadence not just on hills, but flat as well. I started really attacking hills after a couple of weeks on the bike, and it has done wonders for my leg strength, but obviously at the cost of my knees. I also suspect my technique goes to hell in a hand basket when I get out of the saddle (which I try to avoid generally). I've never measured my cadence, will have to do that as well.

Again, thanks everyone - much appreciated!
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Re: 6 months of sore knees - Eureka?

Postby TheWall » Sat Feb 21, 2015 3:33 pm

I too suffered knee trouble but a good bike fit has me much more correct on the bike with knees moving very straight. I can now walk up and down steps without pain! Awesome!

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Re: 6 months of sore knees - Eureka?

Postby flashpixx » Tue Mar 10, 2015 5:49 pm

can highly recommend a bike fit from a physio. All the issues you have described were addressed and resolved by the physio I go to. had an initial fit and a second one 6 months later. About to go again this week to have the new bike set up.

Since the initial fit I have never had knee pain, neck pain, shoulder pain, or numb hands ... only thing he didn't fix is my inability to ride :P

Out of interest the second fit was to drop the bars and get me into a more aero and efficient position.
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Re: 6 months of sore knees - Eureka?

Postby BraddAU » Tue Apr 21, 2015 9:23 pm

Nobody wrote: I went whole food plant based about 17 months ago and losing the 16Kg of body weight has helped my knees.

Stretching, ITB and muscle (self) massage. These usually help after a ride as everything gets tight. They can make an instant difference to my discomfort. As you fit improves, the tightness should be less of a problem in theory.
:shock: :shock:

Great post. Yes to everything from someone who has had a knee op and previous pain etc. Getting the bike right, managing your own recovery/stretching (ITBs and Glutes) could see you riding into your 90s. Remember... spin, spin spin.
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Re: 6 months of sore knees - Eureka?

Postby Kev365428 » Sat May 02, 2015 11:07 am

You may want to look at orthotics in your shoes.

Go see a podiatrist to check for pronation.

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