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Weird knee "pain."

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Weird knee "pain."

Old 01-12-22, 09:54 PM
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Weird knee "pain."

I put the word pain in quotes, because it feels more like a muscle getting tired. It's like a pressure. I was on the trainer tonight, and after about 30 minutes of fairly hard cycling, the inside of the knee feels like a pressure, almost like it's getting tired, over stressed. if I stop pedaling, the pressure feeling goes away in about two or three seconds, like a muscle relaxing. It's the left knee, on the right side of the knee cap. It feels like the pain (or whatever you want to call it) starts directly adjacent to the knee cap, about 3/4 of an inch from the right edge of the cap, and extends down towards the shin an inch or so.

In looking at diagrams of the knee, muscles, etc, there doesn't appear to be a muscle in that location. I have no pain off the bike at all. Thoughts?
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Old 01-13-22, 08:51 AM
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Might just be your knee telling you to slack up on the resistance for a while. If you were grinding out a steady 800 watts for those 30 minutes at 50 rpm, that's going to be more pressure on your knee than a steady 800 watts for 30 minutes at 80 rpm.

You can substitute any number you want for the avg. watts. I just pulled that out of my ....
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Old 01-13-22, 09:23 AM
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Originally Posted by Iride01 View Post
Might just be your knee telling you to slack up on the resistance for a while. If you were grinding out a steady 800 watts for those 30 minutes at 50 rpm, that's going to be more pressure on your knee than a steady 800 watts for 30 minutes at 80 rpm.

You can substitute any number you want for the avg. watts. I just pulled that out of my ....
Since I posted, I've done some research and have come up with a hypothesis. There IS indeed a muscle in that very area of the knee and shin...the sartorius muscle. It's a long, thin muscle, not really strong, and it's possible it's being overworked because of a muscle imbalance. I have some funky shaped calves, bowed more than average, and I'm also quite pronated. That, combined with the narrow q-factor could be the cause. I ride a mountain crank wearing flats outdoors, and I don't think I have nearly the same problem. I've adjusted my cleats a little for riding the trainer, and threw in an additional washer on that side of the pedal. I think my foot prefers to point out a bit, like a duck, but with the narrow q-factor, it's not able to. I suspect a cleat adjustment won't be sufficient, so I will add a pedal extender. That will raise the q-factor to that of the mountain crank i use outdoors.
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Old 01-15-22, 12:39 PM
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Knees are complicated. There are many causes for this sort of thing. I encourage you to not pedal so pronated. Our knees aren't designed for that. Try to pedal with your toes pointed almost straight ahead, say no more than 5° of pronation. That'll take some practice/training because you've done it the other way for so long and sure enough, now you see the result. Could take 6 months of retraining. I also encourage you to supplement with off-the-bike exercise and stretching. The stretches I do every morning are here: https://www.bikeforums.net/road-cycl...l#post15372967 They help.

There's also a series of fix-your-knees videos on YT by the "kneesovertoesguy." I do a few of his exercises, very helpful. I walk up stairs backwards for 10 minutes (up and then down), do 3X25 reps of tibialis raises, and his split squats. That's been helpful for when my legs get out of balance. If you do the backwards walking, point your toes straight ahead, same with toe raises and split squats. It's therapy. You can search YT for the above terms.
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Old 01-15-22, 05:52 PM
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Originally Posted by Carbonfiberboy View Post
Knees are complicated. There are many causes for this sort of thing. I encourage you to not pedal so pronated. Our knees aren't designed for that. Try to pedal with your toes pointed almost straight ahead, say no more than 5° of pronation. That'll take some practice/training because you've done it the other way for so long and sure enough, now you see the result. Could take 6 months of retraining. I also encourage you to supplement with off-the-bike exercise and stretching. The stretches I do every morning are here: https://www.bikeforums.net/road-cycl...l#post15372967 They help.

There's also a series of fix-your-knees videos on YT by the "kneesovertoesguy." I do a few of his exercises, very helpful. I walk up stairs backwards for 10 minutes (up and then down), do 3X25 reps of tibialis raises, and his split squats. That's been helpful for when my legs get out of balance. If you do the backwards walking, point your toes straight ahead, same with toe raises and split squats. It's therapy. You can search YT for the above terms.
Thanks. I put flats on the trainer today and didn't have the problem. Outdoors I always ride flats on a Shimano XT groupset. I think the wider q-factor helped me there...175mm. On the trainer, the q-factor is 150mm. I think that's part of the problem. I nudged by feet about 15mm off-center on the wide flat pedal today, and I had no knee issue. I'm going to purchase a pedal extenders. and see how it goes.

I can appreciate the idea of doing some off-the-bike training to work other muscles....I think it's generally a good idea, as one can develop muscle imbalances anywhere...even the upper body. Cycling is a pretty artificial activity, unlike walking, i think it promotes imbalances.
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Old 01-31-22, 08:39 PM
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I like to get my cleats centered under the ball of my foot. Then sitting on a counter I see which direction my feet point. Whatever direction that is, the cleats are angled in the same.
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Old 01-31-22, 08:53 PM
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Originally Posted by Greg161 View Post
I like to get my cleats centered under the ball of my foot. Then sitting on a counter I see which direction my feet point. Whatever direction that is, the cleats are angled in the same.

I think I need a shim.
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Old 02-02-22, 04:48 AM
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Originally Posted by Wattsup View Post
Thanks. I put flats on the trainer today and didn't have the problem. Outdoors I always ride flats on a Shimano XT groupset. I think the wider q-factor helped me there...175mm. On the trainer, the q-factor is 150mm. I think that's part of the problem. I nudged by feet about 15mm off-center on the wide flat pedal today, and I had no knee issue. I'm going to purchase a pedal extenders. and see how it goes.

I can appreciate the idea of doing some off-the-bike training to work other muscles....I think it's generally a good idea, as one can develop muscle imbalances anywhere...even the upper body. Cycling is a pretty artificial activity, unlike walking, i think it promotes imbalances.
I listened to a TrainerRoad podcast a few months ago and they were discussing how some riders are far more sensitive to bike fit than others. Some people can just ride in pretty much any position, while others have to be in a very small window (a few mm off and they have issues). One of the coaches suggested that some of this "sensitivity" may stem from lack of mobility i.e. simply not doing enough off-bike strength and mobility work. So his suggestion was to work on mobility off the bike to become less sensitive to small positional changes on the bike. I think this makes a fair bit of sense. For whatever reason I've always been insensitive to things like Q-factor and saddle height (within reason), but I do make an effort to do off-bike training and other sports. I do think it makes a difference. I never even notice the Q-factor difference between my mtb, road bikes and trainer. But I do set my cleats slightly toe-out because that's how my feet naturally stand. I use Shimano +4 mm extended pedals so my heels don't rub the cranks.
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Old 02-19-22, 06:56 PM
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In case anyone's interested... I think I need a cleat wedge on the left foot. How do I know? I started using flats to see if I could figure this thing out. One thing I've noticed is that I can't engage the hamstrings and butt on the problem leg as much as I can on the right leg. I thought maybe I have quad dominance on that leg, and the hams just got lazy and won't fire. In addition, the inside head of that quad is significantly bigger than the one on the right. That makes some sense, but.....I think the thing that causes it all is my left leg pronation, the foot wanting to tilt to the inside. Using flats, I found that by riding a little on the outside of the left foot, (with the foots slightly tilted, like a wedge would do) I could easily engage the left hamstrings and butt. This was after a long hard ride that tired that "muscle" or whatever it is on the inside of the knee, which is the main issue. My point is that, even after that muscle got tired, when I changed the position of my foot, I could continue cycling, without the muscle getting tired again, That, and I could engage the hamstrings and butt more.
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Old 02-20-22, 08:40 PM
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Originally Posted by Wattsup View Post
In case anyone's interested... I think I need a cleat wedge on the left foot. How do I know? I started using flats to see if I could figure this thing out. One thing I've noticed is that I can't engage the hamstrings and butt on the problem leg as much as I can on the right leg. I thought maybe I have quad dominance on that leg, and the hams just got lazy and won't fire. In addition, the inside head of that quad is significantly bigger than the one on the right. That makes some sense, but.....I think the thing that causes it all is my left leg pronation, the foot wanting to tilt to the inside. Using flats, I found that by riding a little on the outside of the left foot, (with the foots slightly tilted, like a wedge would do) I could easily engage the left hamstrings and butt. This was after a long hard ride that tired that "muscle" or whatever it is on the inside of the knee, which is the main issue. My point is that, even after that muscle got tired, when I changed the position of my foot, I could continue cycling, without the muscle getting tired again, That, and I could engage the hamstrings and butt more.
just a suggestion - Before going exterior wedge/cant, you might wanna try a hard shell footbed like the Superfeet, and put a 'wedge' under the inside heel area. Pronation is very common, especially as we age.
Depending on how marked it is, you might be able to deal with it with an interior heel wedge.
I actually had a supination issue in my younger days, and it's swung over to pronation. But whatever footbed you try, the base needs to be solid, not a cushion. That slight buildup under the heel is often just what's needed to align the ankle bones and eliminate slight pronation. I've been using the Superfeet Black for some years to take care of my pronation. I've found that up to a 2 degree cant can be effected on a good footbed.
You wouldn;t think that heel canting would make a difference in cycling, where the contact is at the BallOfoot - but it does.
Otherwise, if the pronation is more than mild, a podiatrist may be able to make a footbed which can fit into your cycling shoes.
Canting/wedging the cleats can be a process...
Ride On
Yuri
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Old 02-20-22, 09:38 PM
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Originally Posted by cyclezen View Post
just a suggestion - Before going exterior wedge/cant, you might wanna try a hard shell footbed like the Superfeet, and put a 'wedge' under the inside heel area. Pronation is very common, especially as we age.
Depending on how marked it is, you might be able to deal with it with an interior heel wedge.
I actually had a supination issue in my younger days, and it's swung over to pronation. But whatever footbed you try, the base needs to be solid, not a cushion. That slight buildup under the heel is often just what's needed to align the ankle bones and eliminate slight pronation. I've been using the Superfeet Black for some years to take care of my pronation. I've found that up to a 2 degree cant can be effected on a good footbed.
You wouldn;t think that heel canting would make a difference in cycling, where the contact is at the BallOfoot - but it does.
Otherwise, if the pronation is more than mild, a podiatrist may be able to make a footbed which can fit into your cycling shoes.
Canting/wedging the cleats can be a process...
Ride On
Yuri
Thanks, I'll give it a try. My left knee is the problem knee, but actually, my right foot is more pronated than my left, and yet I have no issues with the right. I think what I have going on on that left leg is the pronation, but also my calf is more curved, bowed more than the right. I guess it'll be just trial an error.
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Old 02-21-22, 12:58 AM
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Originally Posted by Wattsup View Post
Thanks, I'll give it a try. My left knee is the problem knee, but actually, my right foot is more pronated than my left, and yet I have no issues with the right. I think what I have going on on that left leg is the pronation, but also my calf is more curved, bowed more than the right. I guess it'll be just trial an error.
Other thing which has a great effect on both leg vertical alignment and muscle actuation is cleat rotational alignment. In a big way.
You can't assume that both legs need the same rotational alignment.
Idea for most riders is to have the shoe/foot in a 'natural' posture for that leg - very individual to each leg of any person.
This assumes that your leg muscle actuation is balanced when your foot rotation is what it normally falls into when standing/walking/running... not always true, but true for most/many.
There are a number of ways to determine cleat rotation.
my method is now a little unconventional/old school... because I've used since my earliest days, riding with leather nail-on cleats and just modified the methodology as newer stuff was used.
I'll tell you what it is, but don;t be surprised if you don;t get it to work for you.
If it's a 'new' shoe (not replacement of same shoe model and size).
Make sure there are no cleats on the shoes. I put in whatever footbed I'm planning t use. I put oldschool rattrap pedals onto the cranks - same cheapish pedals you current get on a new bike, when you buy the bike - metal cage though... Wellgo pedals... preferrably with 'teeth'... LOL!
Put 3 layers of duct tape on the shoe sole approximately in the area where the REAR cage of the rat trap pedals might strike when the ball of foot is over the spindle.
Get on bike, go ride, get your shoes/feet placed on pedals with the Ball O Foot over the spindle. ride around the block 3 or 4 times, approx 1 to 1.5 miles, in a moderate gear where you're putting light but consistent pressure on the pedals.
In that time, your foot rotation will fall naturally to what your leg is accustomed to. THIS DOES NOT COMPENSATE FOR ANY MISALIGNMENT YOU MIGHT HAVE - DO TO Biomechanical issues, muscle imbalances, knock knee or bowleggedness - those need specific attention not addressed by this method.
Back to pedal rotation... in the short ride time, the rattrap pedal cages will 'mark' the tape (cages MUST be straight and parallel to spindle).
Peel up the front edge of tape to where you can cut the tape across the cage marks - leave the back part of the tape on the shoe.
Place the cleat onto the shoe and align the Ball O Foot to where the pedal spindle would be (you can figure that out).
Then rotate the cleat until the cleat aligns with the marked/cut edge of the duct tape. Cleats like SPD-SL, LOOK, are a very easy job to do this alignment.
Tighten screws. Go ride/test... Modify as needed. Pull off tape when you're satisfied...
Ride On
Yuri
EDIT: Not forgotten, but other BIG consideration in the whole foot/leg alignment and muscle actuation is 'Q' - can be very complicated and is very important.
ANother Ball of wax -
'Q' is pretty much set by your equipment - but many people really need something other than what they have... and may/can/will have a great effect on pedaling performance/strength/comfort/injury for many...
also great discussion...

Last edited by cyclezen; 02-21-22 at 01:29 AM.
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Old 02-22-22, 02:06 PM
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Originally Posted by cyclezen View Post
Other thing which has a great effect on both leg vertical alignment and muscle actuation is cleat rotational alignment. In a big way.
You can't assume that both legs need the same rotational alignment.
Idea for most riders is to have the shoe/foot in a 'natural' posture for that leg - very individual to each leg of any person.
This assumes that your leg muscle actuation is balanced when your foot rotation is what it normally falls into when standing/walking/running... not always true, but true for most/many.
There are a number of ways to determine cleat rotation.
my method is now a little unconventional/old school... because I've used since my earliest days, riding with leather nail-on cleats and just modified the methodology as newer stuff was used.
I'll tell you what it is, but don;t be surprised if you don;t get it to work for you.
If it's a 'new' shoe (not replacement of same shoe model and size).
Make sure there are no cleats on the shoes. I put in whatever footbed I'm planning t use. I put oldschool rattrap pedals onto the cranks - same cheapish pedals you current get on a new bike, when you buy the bike - metal cage though... Wellgo pedals... preferrably with 'teeth'... LOL!
Put 3 layers of duct tape on the shoe sole approximately in the area where the REAR cage of the rat trap pedals might strike when the ball of foot is over the spindle.
Get on bike, go ride, get your shoes/feet placed on pedals with the Ball O Foot over the spindle. ride around the block 3 or 4 times, approx 1 to 1.5 miles, in a moderate gear where you're putting light but consistent pressure on the pedals.
In that time, your foot rotation will fall naturally to what your leg is accustomed to. THIS DOES NOT COMPENSATE FOR ANY MISALIGNMENT YOU MIGHT HAVE - DO TO Biomechanical issues, muscle imbalances, knock knee or bowleggedness - those need specific attention not addressed by this method.
Back to pedal rotation... in the short ride time, the rattrap pedal cages will 'mark' the tape (cages MUST be straight and parallel to spindle).
Peel up the front edge of tape to where you can cut the tape across the cage marks - leave the back part of the tape on the shoe.
Place the cleat onto the shoe and align the Ball O Foot to where the pedal spindle would be (you can figure that out).
Then rotate the cleat until the cleat aligns with the marked/cut edge of the duct tape. Cleats like SPD-SL, LOOK, are a very easy job to do this alignment.
Tighten screws. Go ride/test... Modify as needed. Pull off tape when you're satisfied...
Ride On
Yuri
EDIT: Not forgotten, but other BIG consideration in the whole foot/leg alignment and muscle actuation is 'Q' - can be very complicated and is very important.
ANother Ball of wax - 'What is Q factor'
'Q' is pretty much set by your equipment - but many people really need something other than what they have... and may/can/will have a great effect on pedaling performance/strength/comfort/injury for many...
also great discussion...
Want more Power (How to Respect Cycling Q-Factor)
Thanks for the input. It's all very complicated. I am aware of q-factor. I'm riding a Kicker bike indoors 150mm, and an XT Groupset outdoors, which is 172mm. I've always used flats outdoors, and look pedals indoors on a spin bike with 168mm q-factor. It's with the new Kickr Bike I've noticed a problem. Actually, I think I have the same probelm outdoors, but outdoors there more coasting, which gives the interior knee muscle a rest. I experimented yesterday outdoors, and I think the wedge or the innersole is the best way forward. By just putting more pressure on the outside of the foot using flats,I could feel I was engaging my hamstrings more, like the right leg, I think another factor might be that the left is just very slightly longer.

Last edited by Wattsup; 02-22-22 at 02:13 PM.
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