Knee Pain - where to start?

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Postby GregPankhurst » 25 Nov 2012, 11:52

The last 4 or 5 decent rides I've done have seen me pull up with a lot of soreness in my left knee. The knee hasn't bothered me at all on the rides, rather the soreness has come on 6-48 hours after the ride, and it's actually at it's worst when I'm actually keeping the knee in a flexed position (such as driving the car).

The pain is localised below the kneecap probably more toward the inner/medial side. I've done nothing to the knee trauma-wise to think I've done something structural to the joint (though this is a knee that got re-coed in 1995), and it is still perfectly stable.

I've been doing some googling on knee pain (and 30 minutes later am of course an expert :lol: ) and was wondering whether it might be a bike fit issue? I've basically just ridden my bike as is aside, so there hasn't been any science putting in to setting it up per se. I've also been upping the intensity of my riding over the last couple of months (both total km and amount of climbing), which is perhaps why it's manifested itself now.

I just wanted to get people's perspectives on their experience with knee pain, managing and treating it, and the value of bike fits in dealing with the issue? (and any other suggestions). Also appreciate any bike fit recommendations - I know Steve Hogg is very well regarded, but I'm not paying $700 for a fit.

Last edited by GregPankhurst on 26 Nov 2012, 07:00, edited 1 time in total.

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Postby timothy_clifford » 25 Nov 2012, 13:33

Have had some trouble with a slight tear of the meniscus. This, I found out, was rather common amongst cyclists. I'm not sure my symptoms match yours (I have pain when riding, especially when the knee was under stress) but I'd recommend the same physio and chiro advice I was given.
Stretch. A lot. Stretch everything. Before and after riding.
Hamstrings and quads put the a lot of strain on the knee. They can pull the kneecap out of alignment, which caused my tearing. So now I lie on back with my bum flush against the wall and one leg stuck straight up to target those hamstrings. Then lunges whilst knealing - target the hip and upper quad. These are my main stretches.
Also focus on strengthening the knee - especially the muscles that don't get a lot of use, like those on the inner part of the leg. This will make your leg more stable when pedalling. Google these - bridge, clam, squats (try to work up to one legged squats), side and back leg lifts while standing. Get some resistance bands and slowly build up your knee and leg strength.

And see a physio - they'll help you a lot more than I can. I saw SOS physio in Rockdale, but my physio has since started her own business, PhysioFIX in Sans Souci.

Hope that's some help.

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Postby rhys » 25 Nov 2012, 14:00

The seat height and position (along with cleat position) would have a lot to do with it. Get it checked out by someone who knows what they're doing bike-fit wise, you won't know yourself afterwards.

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Postby Chris96 » 25 Nov 2012, 16:16

For a bike fit I'd recommend seeing Kane at Jet Cycles...

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Postby tedrobin » 26 Nov 2012, 06:46

Wow - that sounds exactly like what I had a year or so back: riding was fine but driving a car was a nightmare. It was a little tear in the meniscus, and the knee hated sitting there twisted as I drove. See a knee doctor, and with a bit of manipulation (and almost certainly an MRI for confirmation) you'll have your diagnosis. I'd probably torn mine falling on a tennis court several years earlier. They don't heal because there's practically no blood flow in that area of the body.

If that's what you've got, the bad news is that you'll probably need an operation. The good news is that with the march of modern medical science this type of surgery is now keyhole and pretty straightforward, although of course it's never nice to have to go under an anaesthetic. Further good news is that because your leg muscles are nice and strong from cycling, your recovery should be much quicker than normal. You can get back to riding pretty quickly, although no big hills should be attempted for a couple of months after the operation. I had my meniscus trimmed almost exactly 12 months ago and I'm 100% now, and have been for a long time.

Club medicos will be aghast at this half-baked online diagnosis, but since you asked...

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Postby Richard » 26 Nov 2012, 07:30

Sounds like a medical justification to buy another bike

Bound to sort out the knee and move the pain to the hip pocket nerve

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Postby JoTheBuilder » 26 Nov 2012, 09:32

I had a similar story but luckily escaped with no serious injury. My first road bike was a Cell and I didn't have it fitted properly. I didn't know anything about bikes at the time so ended up with a frame that Cell promised was a 'great price' but ended up being more suited to a 6 foot male (it was a 56cm). Over the ensuing months I suffered back and knee pain and originally thought it was simply as I hadn't ridden a bike much before. It was only when I took the bike to a different shop to be serviced that they asked if the bike was mine or my boyfriends (which didn't exist at the time). The penny dropped.

I eventually bought the Avanti I ride now and Burwood Cycleworld did a free bikefit where I bought it from. I'm not sure they go quite to the nth degree that Steve Hogg does but I've never had any knee or back pain since.

I believe Burwood Cycleworld do bike fits regardless of where you bought the bike but I'm not sure how much they are.

And for the record, I gave my Cell bike away (as I felt I couldn't ask for any money for it) to a 6 foot friend of mine. :-)

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Postby weiyun » 26 Nov 2012, 09:45

I think the interesting bit about the history is that the onset of pain is 6-48 hours after riding, one that suggests a reactive phenomenon.

I think that it's premature to call it a bike fit issue without knowing a lot more about the Greg's health and activity background. Irrespective, a decent bike fit is a basic requirement to minimise the risks of injuries and trial and error should be your starting course. As such, it's logical to have one's bike fit checked (even within the club, some of our experienced hands can spot obvious problems). Following which, it's only logic to pay a visit to a health professional (physio or GP with knowledge on cycling related issues).

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Postby GregPankhurst » 26 Nov 2012, 09:56

Off to the physio today and will look at bike fit options. Will let you know how I go on both fronts

Interestingly enough this link touches on getting knee pain off the bike: ... ?aeid=2825

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Postby Peter T » 26 Nov 2012, 10:43

Greg - it must be knee season, I am seeing my physio tomorrow. Thanks for the interesting link above. Had an informative chat with Gi last Saturday at Cent Park on these issues.
Hope it went well today for you.
Look forward to comparing notes.

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Postby timothy_clifford » 26 Nov 2012, 12:51

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Postby GregPankhurst » 26 Nov 2012, 13:41

Diagnosis is in:

Hamstring stretches, ice and voltarin gel are my new found friends. Also need a bike fit - happy to hear more recommendations on that front. Jo - how did you rate the Burwood experience?

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Postby JoTheBuilder » 26 Nov 2012, 15:44

As I mentioned, I rarely get knee or back pain. I get some back pain if I haven't ridden for a while or if I do over 100kms but I don't think they are necessarily bike fit issues (more fitness issues!). However, I also think I've been very lucky with my knees despite years of netball.

Regarding Burwood specifically they were great. They did a full measure of me (legs, torso, height etc.), ordered the bike based on my measurements, called me in once it had arrived, sat me on the bike for an hour or so making adjustments and then waved me on my merry way. Easy! Now that I am a bit more bike savvy my only negative comments on the experience are:

1. The handlebars are too wide for me. Instead of replacing them they pulled the brake levers in. It doesn't impact my riding but illustrates they weren't prepared to make it quite perfect.
2. They fit a compact crankset without asking which one I would prefer. Again, it doesn't impact the bike fit as such, but to me it's another example of bike shops not educating new riders with their options.

Overall, however, they were very knowledgable and the bike they sold me is the sole reason I got so interested in cycling in the first place. The fixie and the boys came later... ;-)

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Postby geoffs » 30 Nov 2012, 09:58

Hi Greg
All you ever wanted to know about knee pain may be found here ... knee-pain/
Any shop that does a bike fit using numbers and formulas such a Burwood, BG Fit etc is guess work at best.
Have a read of this ... n-fitting/

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