Yet Another Post About Knee Pain

Jun 18, 2011
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Okayama
#1
Hi all,

Hope we are all having a lovely Friday. There are a few threads around about this, but I was hoping for some personal advice.

I went for a big ride last weekend over three days, and did a few big climbs. I still had the standard crank, so I was grinding up these hills in 39/21 in a very low cadence. On the last day on the way home, I noticed pain in the inner side of my right knee. I hurt this snowboarding a few years ago, so I have just re-aggravated the injury I suppose.

I went for a 60km ride yesterday after work with 3 300m ish climbs and there was still pain, but not a terrible amount. I got a compact crank put on this week, which is making a huge difference.

I want to go on a big big ride the weekend after next which will involve a distance of over 200kms, with more than half of that in the mountains. At one point I will be going up to about 1500m, so it will be quite a challenge for me, but I think I am capable of it.

My question is: is there anything I can do to help heal/strengthen the knee before the weekend after next? Baths, stretching, whatever, I am willing to give anything a go. Not really keen on medicine though. Have any of you had this type of knee pain personally? If so I would like to hear what things you tried and the results that ensued. I will have some supplements delivered soon which supposedly help protect joints, made by SAVAS, so I will give that a try.
 
Jul 13, 2010
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Shinjuku
#2
Make sure that your saddle isn't positioned too far back. This is one of the things that can put extra strain on your knees. Maybe loosen the adjustment on your pedals to allow for some extra float?
 

kpykc

Speeding Up
Jun 13, 2007
804
4
38
38
Tokyo
#3
Some of the wise advice I picked up and tested on myself:
- Saddle position is important - not too high (so you don't rock in your saddle when pedaling), not too low (so you don't strain your knees).
- Don't run/jog/walk long distances before your big ride (unless of course, you're one of THEM :D)
- Use high cadence when pedaling, don't grind - better go faster with a high cadence, than with a heavy gear.
- Avoid overcooling and overheating your knees.
 
Jun 18, 2011
72
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Okayama
#4
Thanks, I got a professional fitting a few weeks ago, although the new crank I got is 175 not 170; however the pain developed from the 170, so I don't think it is that. I might have to lower the seat a little to compensate for the longer crank; but I don't want to mess up the settings from the fitting. (It was expensive)

I have been spinning high cadence and that has worked, but the niggling pain is still there a little bit.
 
Dec 31, 2009
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Matsumoto
#5
Its not set in stone

A fitting is a mere suggestion of where you should be. A large part of a of it is how YOU feel not how someone thinks you should look(unless you were in a wind tunnel and training for the pro peloton, LOL, wich many bike shops think they are fitting everyone for). I would measure your bike and mark it with a permanant marker then try moving your seat forward 2 cm OR down 2 cm.
Although, alot of knee problems do happen from over use.
You could try staying out of the mountains for a little while.
Just because you are now fit to your bike correctly does not mean your body is at all used to it! You should ease into a bike fit and work up your kilometers over several weeks to adapt, especially if there where drastic changes made.
Also, look at your knees when you are pedaling. Are your knees pushing out at the top of your pedal stroke? Try focusing on making your knees go perfectly straight up and down like a piston.
Did you get cleat wedges installed and did the person fitting you view your pedal stroke from the front of the bike. What is done is you place a vertically lined laser in the center of your knee cap at bottom dead center of your pedal stroke. your knee should stay within the laser around the entire pedal stroke.
I am quite skeptical about bike shops in Japan, just from my own experience and so many horror stories. A person I was riding with asked me to look at his derailleur and the hanger was clearly bent. He said he has taken it to several shops and no one could figure it out! Just silly! A bike shop that cant fix a bike! WTF! I do know that there are great shops but alot of bad ones too.
 
Jun 18, 2011
72
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Okayama
#6
I got the Specilaized BG fit, which included the cleat wedges and looking at the knees from the front with a laser. My knees are going up and down pretty straight now. The angles of my knees were also measured at 3 o'clock and the angle adjusted accordingly.

The guy also asked me what my goal was for cycling in the pre-fit interview and so I told him being able to ride longer distances and more climbing. I specifically mentioned also that I am not interested in racing.

I wonder if going from the 170 to 175 was a wise decision or not?

Also I am thinking of buying another saddle for the follow-up fitting, I heard that a new saddle moulds into the shape of your bum and supports better, considering mine is second hand, I thought it may be a wise thing to do.

I am pretty sure I just overdid it, climbing up 500-800m climbs three days in a row with a standard crank, when I was practicing on multiple 300m climbs. There was a lot of grinding going on. I was pretty tired on the third day, so maybe poor pedalling technique is also to blame? Anyway I had the time of my life and fell in love with mountains even more, so I don't regret it. I will just take it easy and I can spin high cadence now with the compact, so that helps a lot too.
 

FarEast

Maximum Pace
May 25, 2009
5,528
538
193
Yokohama
#7
My question is: is there anything I can do to help heal/strengthen the knee before the weekend after next? Baths, stretching, whatever, I am willing to give anything a go. Not really keen on medicine though. Have any of you had this type of knee pain personally? If so I would like to hear what things you tried and the results that ensued. I will have some supplements delivered soon which supposedly help protect joints, made by SAVAS, so I will give that a try.
Listen to Pro Race he knows his stuff! I extended my stem length by 10mm and it had a huge change, I got a sore neck and shoulders for the first few weeks and also theleft knee started to play up a little, but after a few weeks my body adjusted and the benifits of the position change paid off.

You may want to look at replace your cleats with a pair that have a larger float %. Keo and Shimano do 3 types. from zero play to 9 degrees play they may have fitted you this way and that but cleat adjustment is also a voodoo art that can take weeks to dial in with constant micro adjustments to get it just so. Something a 1 off visit won't sort out so the float will compensate for the micro adjustments.

Time iClic pedals are great for float but if you ride a lot you will go through cleats very quickly.

Suppliments for joints, all you need is glucosamine, I get the cheapest there is and it does the trick normally takes a few days to recover and I basically destroyed my knee and had to have it rebuilt so I know all about knee pain :eek:uch:
 

kiwisimon

Maximum Pace
Dec 14, 2006
2,658
477
103
Japan
#8
all great advice so far probably the best is take it easy for a few days, you have made a heap of changes to your biomechanics as well as stressing it all with some pretty strenuous cycling. Why did you switch to 175 from 170s? That alone is however only a 5th of an inch. Shouldn't make or break your knees. Whats your inseam?
 

GSAstuto

Maximum Pace
Oct 11, 2009
945
242
103
tokyo
www.roadfixie.com
#10
All this is great advise. One small tip - if the inside of your knee is painful - then try a little 'toe-in' on that side. If it's outside of knee, then toe -out a bit. Take a look at your saddle - if it's wearing uneven then its generally a sign of stroke length difference - so you need to compensate there a bit. Lastly, its pretty normal for knees to hurt a bit while you are doing long ride, in the hills or whatever. Just give yourself time and consistent training to build up the support muscles and most importantly for the body to compensate for the extra repition. Proper hydration is very important. Also - when you finish a ride - get ice on your knees ASAP. In fact get your legs chilled down as fast as you can. Then follow the ancient words of wisdom:

1) If you can walk, don't run
2) If you can sit, don't walk
3) If you can lie, don't sit

Ibuprofen or other NSAID often helps as well. Check with your doc. I usually take an aspirin before I ride and after,plus a very cold shower and ice my knees after I'm done. Then a protein smoothie. Put on some compression socks and hit the sack. I guess my body is trained to go into 'recovery mode' from years of this kind of routine - I will just about shut down fully and crash out within 60min of a hard ride - every time.

Def I would see ProRacer about a proper fit. Seen some very wonky fits on the road - especially on very expensive bikes ... bizarre.
 

FarEast

Maximum Pace
May 25, 2009
5,528
538
193
Yokohama
#11
The ePerformance camp on the 15th and 15th of October would be the perfect oppertunity to learn all about this and also sit down with two professional fitters (One whom worked for Mavic Neautral Support and the other head fitter for ePerformance and GURU bikes)
 

okayamaPaul

Speeding Up
Jun 18, 2011
72
1
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Okayama
#12
The ePerformance camp on the 15th and 15th of October would be the perfect oppertunity to learn all about this and also sit down with two professional fitters (One whom worked for Mavic Neautral Support and the other head fitter for ePerformance and GURU bikes)
Is this in Tokyo? When is the next one after that?

I would love to see PRM for a fitting and get in a ride up there while I am at it, but I live very far away from everyone, new job this year, not many holidays, yada yada yada. He was quite nice and offered me a free fitting if I made the trek up there, which is damn nice of him; but I just went for the local fitting in the meantime due to time constraints. The fitting took 3.5 hours, so it wasn't a bodge job or anything like that. I felt a lot better on the bike after getting it done too, more power and less fatigue, which is why I am hesitant to fiddle with it. I have a follow up fitting in the next month or so and I think it would be a good idea to let the body get used to the new setup before changing things again.

Thanks for the advice everyone, in the fitting they actually raised my seat by about 15mm at a guess, which reduced a lot of knee fatigue. I was getting it on both knees around and towards the bottom of the knee cap, but there was no pain. The angle before was 40 something before at 3 o'clock and it was reduced at the fitting to closer to 30.

I feel a slight bias when riding, but my legs were measured and there was only 2mm difference, which doesn't seem to be too bad. Poor technique most likely.
 

okayamaPaul

Speeding Up
Jun 18, 2011
72
1
28
Okayama
#13
all great advice so far probably the best is take it easy for a few days, you have made a heap of changes to your biomechanics as well as stressing it all with some pretty strenuous cycling. Why did you switch to 175 from 170s? That alone is however only a 5th of an inch. Shouldn't make or break your knees. Whats your inseam?
I have to go and look up what inseam is now:eek:

I switched to a 175 because I thought a longer crank would be better for the size of my legs, plus lots of people seem to have 175mm cranks. Basically an uninformed decision. The guy who I bought the bike from had short legs and so that's why I figured he was using the 170mm and I should get a longer one.
 

GSAstuto

Maximum Pace
Oct 11, 2009
945
242
103
tokyo
www.roadfixie.com
#15
I use a pretty standard formula to calculate the optimum crank arm length - then tweak more or less like you have below - though - you have some interesting riding techniques:

1) You tend to be high cadence climber - therefore shortening crank slightly would benefit you in terms reducing your anaerobic load. So - I can see where you choose the shorter crank for climbing!

2) Your middle choice makes sense - as you need to constantly switch up from climbing and attacking or recovery sections. And you can draw on your mega-torque more effectively.

3) This makes sense for TT to get you on long cranks. You don't need to worry about pedal strike, and your TT might benefit by slightly lower cadence. However - I'd be concerned about pedal strike in a Crit - and also 'spin up' for attacks or sprints where you want to get as high revs as you can quickly.

Anyway - try this formula and see where you are:

2.2 x your Inseam = proportional crank arm length. For example - I have a 77cm inseam - and using the above - I get a 169mm crank. I use:

170mm - for most everything and i works fine.
165 or 160mm - track / crit
172.5 - feels best for sustained climbing and /or TT (what I mainly use now)

As a side note - none of these changes affects my knee 'health' one way or another - as the angle of motion is not changed so much ... however, it does change the muscle groups I will focus on and provide some benefit in terms of not only the rides - but also the terrain. I certainly do not want to be swinging some big axes on a 40 degree track curve!

I really don't see how changing your crank even 1cm from your 'norm' will affect your knee health. If your range of motion is so severely limited - yes, I could understand - but I suspect other issues first - and foremost is just simple 'ride time'. My knees ALWAYS hurt when I'm coming off a rest period - it takes me several hundreds of kilometers of LSD to build up the endurance qualities which is largely associated with conditioning the joint and the surrounding supporting muscles. After that - I can increase loading and repetitions with no problems.

I used to argue this alot with a very famous Seattle framebuilder who swore that using long cranks and pedaling less than 90rpm would kill your knees faster than anything. Well - sorry - but 20yrs later my knees are the strongest they've ever been and I've been through a very damaging accident which literally sheared my left leg at the knee! I rehabbed carefully , increased range of motion and used a fixed gear religiously to 'bring up' my conditioning in a scaled, 360 degree manner using macro and micro cycles. Nothing secret - this is just the normal training that is recommended by the Italian Cycling Federation from back in the 80's.


I use 172.5 for climbing 175 for rolling terrain and 180 for TT and crits.

The Camp is being held in Nagano.
 

GSAstuto

Maximum Pace
Oct 11, 2009
945
242
103
tokyo
www.roadfixie.com
#17
Yes - right up to perineum in the center of the pubic arch. By using the proportional formula - your optimum crank length would be 187mm. However, not many makers provide cranks in this length and we need to provide a scaling factor - so practically - your ideal crank length would be in the 175-180mm range. So - try to get cranks arms that are 175mm. As a note - some of the higher end mfg have cranks arms up to 180mm (like Dura Ace) and you may even be able to find an older DA crankset on auction for a good price. Depending your riding style you may find either 175 or 177.5 to be good starting points.

Also as FE points out, dialing a 'fit' can take weeks cause you need to accustom to each change - and the changes should be very very small. riders who just rack their saddles up and down by 10mm or so are just asking for trouble. Same with cleat adjustment. And his suggestion of cheap glucosamine is also something I'm familar with - it does make a difference to me, too. Without taking it I start to get 'twinges' and tightening in the knee - when I take it, my knee opens up and feels much better even after long hard rides. Everyone is different - but it certainly helped in my case.

So inseam is just the measurement up to your crotch right?

Mine is 85cm then.
 

okayamaPaul

Speeding Up
Jun 18, 2011
72
1
28
Okayama
#18
Thanks for the good advice, this is all good study.

Anyway I took it easy this week and the pain has gone. I will go a little bit harder this week and hopefully the pain will stay away and I can do a big ride on the long weekend.
 

Sikochi

Maximum Pace
Sep 13, 2010
1,144
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Kochi
#19
I mentioned the Steve Hogg site before, but there are some intriguing articles on this. I can`t remember which one I linked to before (and too lazy to check!) but certainly the top one is recent, and the second and third one have been updated. There are many others to read as well.

https://www.stevehoggbikefitting.com/blog/2011/09/perspectives-on-fitting/

https://www.stevehoggbikefitting.com/blog/2011/02/seat-height-how-hard-can-it-be/

http://www.stevehoggbikefitting.com/blog/2011/06/how-to-avoid-bike-fit-hell/

Well done for taking it easy. Ultimately, without the option of internally examining your knee, any diagnosis is pretty much guess work (less so for an experienced sports physiologist), so the safest option is to wait for the pain to go away, as always lurking is the risk of long-term damage which will put you out of action for months/years. Basically, it does sound like a case of too much too soon. I usually only do 2 hard days back to back.

Reading back through the thread (haven`t logged in for a while) the other thing that comes to mind, is were you sitting when you were grinding? I usually sit, but if I can`t maintain cadence due to the gradient even at full effort (high pedal torque), then standing takes pressure off the knees. Climbing with low cadence/low torque is fine but I wouldn`t advise seated low cadence/high torque climbing.
 

GSAstuto

Maximum Pace
Oct 11, 2009
945
242
103
tokyo
www.roadfixie.com
#20
Guys -

1) Recovery .ne. repair. There is a big difference between slacking off to allow an injury to repair and managing your training schedule so you have sufficient recovery time between hard sessions.

2) In short - you should think of your overall cycling pattern in terms of macro cycles and micro cycles. I know this is OLD FASHIONED - but it's an easy way to pace your self and train effectively without really doing anything special.

3) Important to get sufficient LSD base - so you should concentrate on pedaling form, low effort cycling just to get the billions of RPM's required to condition all the joints without stress and get your whole engine smoothly functioning.

4) Then, on top of that, increase effort in small iterations. Raise the levels incrementally and consistently to provide agnostic stress to your conditioning. Don't over- exercise , just consciously manage your incremental intervals increasingly.

5) Ride every day - even if it's only 5km.

6) If you are planning a big ride or event, then focus train increasingly to that event so you will peak for the event especially. This could be sprinting, hill, attack or simply high steady state TT. But, you will develop conditioning momentum that results in a peak for that event.

7) After you have base conditioning, nothing builds conditioning faster than intervals. And you can do them in so many ways. Big Gear / Low Cadence, Small Gear / High Cadence, Hill repeats, etc. It's not so much about how many k's you put on the tires at this point - its more about the quality of effort. If your knees are tender - then work on intervals that cause less stress . for example if the pain is due to hard exertion at low cadence, then do some sets at lower gear and higher cadence, and vice versa. Start with just 30s interval and a few sets and then progress up from there. Get your workout done quickly - especially if you have some tenderness or need to build up some strength - warmup slowly, intervals, cool down / ice. Stretch and rest. 1.5 - 2hr max is enough. If you want more , then do it 2x a day.

Anyway - all this is laid out in many real training guides. Just pick one you like and follow it. Reading blogs and bbs' and such is great - but soon, so many opinions will just over-season the stew as everyone has different opinions and experiences.

I disagree, for example, about waiting for pain to go away. There is bad pain and good pain and just annoying pain. Know your pain - then decide to wait. If pro cyclists waited until their pain went away before they jumped on the bike, you'd be watching a bunch of sadly out of condition riders trying to race. Part of cycling is also increasing your base tolerance to discomforts that mere mortals find intolerable. It's gaining a dose of HTFU that is necessary to carry you through the rough spots.

I'm not saying you should be completely masochistic, but sometimes you need to work through those discomforts to get to a level up whereby the riding becomes naturally more efficient and fun.