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Severe ‘Getting Off Bike’ Knee Pain

Old 10-24-21, 10:19 PM
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Severe ‘Getting Off Bike’ Knee Pain

For a while now, I’ve always been told that my knee pain is minor and I need to “suck it up”.

I know I can’t find answers here but I at least want to find common ground with others who also experience the most frustrating thing possibly when you’re just trying to get some miles in.

I’m 27 riding typically 100 to 150 miles a week depending if I want to wake up early or ride at night. By mile 30, it feels like someone has placed shards of rocks into the side of my inner knee. This leaves me another 10 miles to pedal back home with my left leg. I rest, stretch and go back out with a good couple ride ins and before I know it, I feel that right knee start binding up as if there’s not enough oil or grease and then the absolute horrid pain of broken glass mixed with someone with a fish hook plucking at tendons and nerves.

I needed to get this off my chest. I’ve been to multiple doctors, multiple steroid injections under the knee cap and a lot of stretching. On top of finding different frames sizes(6’2”), cleat positions and saddle height.

Is it just a simple, “you may have arthritis.”?

It’s one of those selfish things where you feel like you’re the only one not cut out for the sport as the group of athletic cyclist on their Madones and S-Works fly by(with most being above the age of 40). I can’t be the only one.

Thank you if you finished all this.

Last edited by Yelbom15; 10-24-21 at 10:23 PM.
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Old 10-24-21, 10:42 PM
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My wife is experiencing this kind of thing, and what she found is that you need to get an MRI and a competent doctor to figure out what is going on. You should stop riding or at least take it very easy until you get this sorted, as you want to avoid permanent damage. At age 27, you still have hopefully a long life ahead of you, and need to get this sorted out, whether or not you ever touch a bicycle again.
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Old 10-25-21, 09:48 AM
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Originally Posted by Yelbom15 View Post
For a while now................................
+1 regarding having a Dr. (Sports Orthopedic) check you out.

Personal experience so not even worth 2 cents --- I have BOWED LEGS. Had knee issues until I read some 40+ years ago that setting cleats for a TOE IN position and keeping knees close to Top Tube could resolve. Did it and it worked. NOW AT 71yo with decades of arthritis and medial bone on bone knee joints the pain reminds me of my age often. Should have had knees replace many-MANY years ago but didn't.

GOOD LUCK and please post how you resolved the problem.
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Old 10-25-21, 10:29 AM
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Agree on a visit to a sports orthopedist, also after that I would seek the help of a bike fitter who can get your position worked out. Getting the biomechanical position wrong (especially your lower legs) can cause many issues.

I had battled knee pain for a long time, and my left knee finally blew out this year without warning. Still recovering from surgery to remove a destroyed lateral meniscus, and was diagnosed with pretty significant arthritis in same knee. To paraphrase the surgeon, if I had the issue looked at years ago, this surgery would not have been required, I would not have the level of arthritis I d0 (I am 56 and have had issues with this knee since an injury in the 80's) and we would not be discussing when (vs. if) knee replacement will be the logical next step for me.

I'm hoping to be able to resume riding my bike in a couple of weeks.
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Old 10-25-21, 11:26 AM
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Foot position is important with knee pain. Changing the angle of your toe to heel can make drastic changes with knee pain in walking or cycling. I constantly have to change my foot position on the pedal so I use loose toe clips. 5° to 10° can make a big difference in just in a short ride.

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Old 10-25-21, 12:23 PM
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If it's real pain, I wouldn't think you just need to suck it up and endure it. Especially if it doesn't alleviate itself after a few rides.

You mentioned you've changed cleat positions which I assume means different angles of which direction your foot is on the pedal. I have one foot that is more heel-in toward the bike than the other. Recently had a cleat get loose on my shoes and when I tightened it up, I had my foot ever so slightly at the wrong angle. Fine at the bottom of the pedal stroke but making my knee twist a tad at the top of the stroke. Painful after just a few miles. So fixing that quickly let me continue the ride. Had similar when I bought new shoes, but a change in the angle of the cleat made an immediate difference.

I use SPD's. I'm slightly under the impression that they allow your foot to move more freely than SPD-SL or other road cleats. However not ever having used proper road cleats, others will have to say more on this.

At risk of starting a crank length war, I will say that on a large frame bike you might have a really long crank which is going to put your knee through a greater range of motion. I'd think that bad knees will show themselves more when they have to bend more, so a shorter crank might keep you out of that part of your knee that gets irritated. Also, a low saddle height might put your knee into angles your knee doesn't like too. So is your saddle height really correct for you?

My oldest son has a knee issue that's affected him off and on since being a teen. He has been to many doctors in the past and none saw anything on any of the various types of imaging they did. The last doctor he saw specifically for it thought he saw something on an image. And put him in PT for a time which actually helped considerably. The doctor suggested that the main reason he and other couldn't see anything definitive on the imaging was that his knee was straight in all the images made. And that if in a bent position, the reason may have been better exposed. However 15 years ago in this area, there wasn't the imagine equipment available to make an image with it bent enough.

So since then, my son pretty much relies on spinning an easy gear to keep him cycling. When we ride lots of hills that are steep enough to keep his cadence low and power high, I can pretty much be assured he'll be complaining about his knee in a few days. He's a little stubborn and reluctant to go back to the doctors to look into this more. Though I think he should.
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Old 10-25-21, 12:23 PM
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Knee pain is the commonest complaint we hear from cyclists, especially high mileage cyclists like yourself. The commonest thing is muscle imbalance. Attaching to your kneecap, you have your vastus medialis and vastus lateralis.

Your medialis is probably stronger than your lateralis on that side. So the cure is to strengthen that lateralis and probably in both legs. As post 6 says, it makes a difference how you point your toes on the bike. In your case, try pointing them in. You might have to change your cleat orientation to facilitate this. There are also exercises: https://www.setforset.com/blogs/news...alis-exercises

i recommend that you stay off your bike for a couple weeks and do the exercises. When you start up again, try just 30' rides in zone 1 every day. You could also raise your saddle maybe 5mm for a month to reduce the compression force on your kneecap a little.

For some really odd reason, cyclists report these imbalances only on one leg. I haven't a clue why, but there it is. In most cases, it's the vastus medialis (VMO) which is too week, don't know why that would be either.

I very much doubt that it's arthritis, though it could be the result of an injury..
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Old 10-27-21, 06:41 PM
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I know you're just a kid, but over in the 50+ forum there's "Prehab and Rehab" thread. "Prehab" is what you're supposed to do so you don't need rehab: https://www.bikeforums.net/fifty-plu...hab-rehab.html

You might go on YT and search for the kneesovertoesguy's other videos. Here's a video from an orthopod who thinks maybe the kneesovertoesguy knows what he's talking about:

I agree.
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Old 10-29-21, 06:41 AM
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This is a story of one so may have zero relevance to your situation.

I started developing what I would call an ache in my right knee typically around 45 to 60 minutes into a ride. I went to an orthopedic surgeon who is 'activity oriented' by reputation (which was correct). He did x-rays and on coming into his treatment room to review them with me he asked 3 TIMES "it is your right knee and not your left knee that hurts - is that correct?". And I confirmed that.

Then he showed me the x-rays. The left knee looked like some kind of erector set mistake where the areas where bones came together were not parallel, etc. The right knee (problem knee) looked pretty decent. There was not an obvious issue with the right knee per the xray, but there was a moderate level of osteoarthritis. So we did an MRI where he could see more detail and see exactly where the issue was.

He told me 'we are going to try hyaluronic acid injections and a custom built knee brace'. I will give this a 50% chance of working but it is far simpler than the alternatives (which I assume to be some form of knee replacement). I was lucky and that worked although I think that I have some level of distance riding limitation here. I have trained for and ridden several centuries since then (2016) and do encounter knee discomfort on occasion, but it doesn't take a superhuman effort to get through it. If I were doing 70 mile training rides 3 days a week - not sure that would work.

That is my story - and then there was the hip pain where I was treated for a tendonitis problem for about a month and it only made things worse. Another MRI revealed that is really was a back problem (with completely different treatment).

This all my have no relevance to you.

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