hillcrawler

Whenever i push myself a little bit too much on the bike i'm having pain around my kneecaps following days, sometimes weeks. The pain is mainly above my kneecap, sometimes on the left and right sides as well. When i grab the kneecap with the palm of my hand and move it slowly i can feel it is rubbing the other bones. I know this is serious, i have seen doctors, had some mri scans but they didn't find a major problem. They just advised me to strengthen my quadriceps. I did those exercises for a period of time but not anymore. I wonder if anyone here had the same problems and by doing those strengthening exercises were you able to get over the problem?

KLiNCK

Sounds like your seat is too low.
Try raising the seat height of your bicycle.

gizzsdad

It is quite common to get knee pain from riding in too high a gear, which would correlate to a cadence that was too slow. Without seeing you ride, there's not much we can do other than make recommendations based on experience.

etw

Besides the suggestions for cadence and height, you might try moving the saddle back just a little. (which can also make it seem higher)

hillcrawler

I know how to adjust my seat height, i have seen some bike fitting videos and i think i set the height right. My cadence is not much high but i know it is not ridicilously low as well. I will try to pay more attention to it anyway, thanks for the reminder.

topflightpro

Doing strengthening exercises a few times and then stopping is not going to help. You need to continue to strengthen the muscles. They pretty much become weak again a few days after your last effort.

Camilo

Not a bad idea to see the doctor like you have.

However, I recommend seeing a Physical Therapist (most insurance don't require a referral from a doc, but you could check.... either way, an appointment shouldn't cost you more than $100 - $150 if you have to pay yourself).

Get a recommendation from some athletic or active people you might know so you get a PT who is attuned to athletics and activity-oriented therapy. This is in contrast to some who are more suited to, say, geriatric stuff, disability stuff, etc. and who might have a higher tendency to default to rest as opposed to activity, or might default to the methods and machines he/she knows rather than translating to your chosen athletic activities and training goals.

I just got back from an appointment and it is really worth while. I have a sore shoulder, sore knee and a sore hip. All problems that are transient, not getting worse, but bug me regularly. She did a great, thorough assessment and even though they don't happen to be "acute" right now and are pretty vague, she was able to pinpoint probable causes and prescribe specific strengthening and STRETCHING exercises, as well as teaching me how to recruit different muscles for different movements (in the shoulder especially) to avoid exacerbating the problem and begin to solve it. Very detailed diagnoses - many different positions and movements of the joints, assessing for range, flexibility, tightness, strength, and pinpointing pain according to causes and location vis a vis type of motion, resistance against the motion, etc.

Anyway, there's a lot of potential causes for pain around the knee cap and specific muscles that can be strengthed and / or stretched to make it better. I recommend this beyond what the doctor has told you. Doctors can be excellent in this sort of stuff, but their "bag of tricks" is much different than a good PT.

The fit thing as it relates to knee pain - if you're lucky you will find a PT that also knows bike fit, but it is more likely to be self-awareness on your part in teamwork with a good bike fitter (not bubba at the LBS), and a good PT, with you being the one who learns and interprets to make it work.

Elvo

One legged squats

xuwol7

I had the same problem and researched etc. until I was blue in the face.
I was in constant pain...

What finally worked for me was to simply put my pedal at 6:00 and place my heel on the pedal so my knee was locked then slam the seat all the way back.
Simple and old school but hey...
High cadence etc works but I mostly ride fixed(which is murder on the knees 'til you get your gear ratio and everything set perfect).

s-one

I also heard making sure during your cadence that your feet are pointing straight.

Carbonfiberboy 

So do the saddle height with locked knee thing as recced above, then raise the saddle another 5mm. Do "high kicks," where you hold the knee locked and kick as high as you can, 15 reps on each leg. Do a set every day. Take ibuprofen. Stop riding your bike. Temporarily try hiking. Or go to the gym and do squats, leg sled, and calf raises. After a week of this and taking ibuprofen, get on the bike with the new saddle height, and ride very easily 1/2 hour, no more. Zone 1. If that's OK, do it again the next day. Do that for a week, while continuing with the strength stuff. Then try a little more.

This is a three pronged approach: rebalance your quads, make the swelling go down, and lessen the knee bend while on the bike. After you've been pain-free on the bike for a couple of weeks, going very easily, you can try going a little harder, but ramp it up very slowly or you'll be right back where you started. Once you feel normal, you can drop your saddle down a hair, but many people ride with a small gap under the heel when the knee is locked.

GT2R

You didn't mention how much you ride. If you are not 'seasoned' a small increase in riding can stress your weakest link. Some good advice so far and I would add:
Get on your bike and have someone take a pic with leg fully extended at bottom of pedal stroke. Make sure your heal is down so foot is flat. Measure extended angle with a protractor on your computer screen. Should be around 140-145deg (upper to lower leg).
Next time you ride, look down at your knee while you pedal. Does your knee 'track' in a lateral circle? It should not move in an out towards the top tube. This can also aggravate a knee and is purely a technique issue. Good luck and follow the RICE method. Rest.Ice.Compress.Elevate.

JonnyHK 

ITB syndrome? (illio tibial band)

Common enough in cyclists for many of the reasons mentioned above. Lots of standard stretches etc.

dm83

Like most non-athletic cyclists, you probably have weak hamstrings. Your quads continuously pull your tibia forward, wrecking your knees. This isn't fixed on a bike, spinning at a ridiculous cadence. You need strength training.

dalava

Knee pain, as described by OP, is almost always a result of overuse, but the actual reason for the pain is very complicated, and sometimes, not clear at all medically. I suggest you take a quick reading of this: https://www.cptips.com/knee.htm.

SirHustlerEsq

I have the same problem in my right knee, leaving it bent (at a desk) for an extended period causes pretty nasty pain when straightening. It's aggravated by climbing or mountain biking. I alleviate the pain by adding a 20mm setback post and slamming the seat back as far as it goes.

DM83 is right in my case, time for hamstring work. I avoid quad work all-together, including squats...sad, I know.

dpicare26

could also fall under the blanket diagnosis of PFS, or patella femoral syndrome, or chondromalacia. These are just general diagnosis' for: 'your knee cap is rubbing against your femur and it hurts'

This is typically from a quadricep strength imbalance. The patella should 'track' in a straight line through the femoral groove. If the lateral (outside) quaid is stronger than medial (inside) quad (I'm generalizing this muscle group), then tracking can be off causeing the patella to grind on the undersurface (think back to HS physics and recall force vectors). It's common that the medial aspect of the quads (VMO) is the culpret for being weak (it's responsible for the last ~15 degrees of terminal knee extension) which is not acheived on a bike if the seat is not adjusted properly (see above).

Best treatment from a PT standpoint is to try and isolate and strenghten the medial muscle of the quad. Also try a compressive sleeve or neoprene brace which helps reduce grinding of the patella.

cyclezen

frequent application of the 'chicken dance', Oktoberfest is just around the corner...
luv those old folk/wholistic remedies...

hillcrawler

Guys, i'm very glad to see you are coming up with great ideas to help me. These are sounding much better advices than the two doctors i have seen so far. I'll try to practice these exercises. In the meantime, it would be great if you could post videos of the exercises you mentioned. It's a bit hard for me to understand what i should do just by reading.

dpicare26

https://www.youtube.com/watch?v=sb_2OVC4TuM
https://www.youtube.com/watch?v=S5BDi8Oj5eM

snookanglr

I also suffer from knee pain in one of my knees. I think it's tendonitis that came about from trying to do too much too fast and my age (42). What's helped me is easing up on the mileage a bit, using the little ring a lot, pedaling high cadence (at least 85), and slant board eccentric decline squats. I try and do about 30 of those daily. I also switched to Speedplay pedals to allow for more float (I like 8 degrees) and of course make sure you have a good bike fit. For big rides I usually wear kinesio tape and ice it afterwards. I also wear a simple Ace knee brace during flareups but not when riding. Here's some links and videos that I found helpful:
https://www.youtube.com/watch?v=1_wbW0cea8E&feature=youtu.be
https://www.youtube.com/watch?v=ul09...eature=youtube
https://www.myfivefingers.com/knee-exercise/
https://www.fix-knee-pain.com/injurie...ee-tendonitis/

Pug

When was the last time you changed your cleats?

nadimk

OP, this is called chondromalacia. This is caused by excessive forces on your patella when your knee is bent. I have had it, and I have a few suggestions for you, some of which have been made here.
1. Move your cleat farther back on your shoe's outsole. Start with just 2-3 mm and see how that feels.
2. Achieve a more rearward position of the saddle on your rails, putting your body further behind your bottom bracket. Again, 2-3 mm back on the rails, then lower your seat by 1-2 mm.
3. Stay out of your large front chain ring for a while, depending on how often your ride, until the pain subsides.
4. Stretch your quadriceps muscles

Let us know how it goes after 3-4 weeks.

SirHustlerEsq

I converted to a stand-up desk at work and it significantly reduced the pain. This made the biggest improvement for me, made the pain only recur after mountain biking.

Clem von Jones

Saddle slightly too high is better than slightly too low, slightly too far back is better than slightly too far forward IMHO