Knees.... not the bees knees...

[chrissiedakini]

So I had a question regarding knees.

We are currently on the second leg of a 10000m trip arou nd the us, canada and mexico. On the first leg of the trip, my right knee was bothering me, quite possibly as I had started out with toe clips and climbing Yosemite and Sierra Nevada mountains, and then after getting rid of the clips my knee started getting better. I took it easier too.
Then we stopped for about 6 weeks working in Montana.
First day back in the saddle, on the 11th of septemeber, my left knee started hurting. At first it was on the outside, just to the left of my knee cap, then the inside, then above then below and so the pain keeps moving about. I put my saddle up, then down, then further down, then up, etc. Currently, for the last few days, the pain is on the inside part of my knee, slightly above the knee cap and can get way too intense, where I can;t put any pressure on it. So I spin along, and thankfully we are on relatively flat land. At times it feels worse, then it gets better, then all of a sudden, the pain just shoots through my leg. I am putting tiger balm on it and taking advil. But of course can't really continue with that. Does anyone have any suggetions? On what to do  - other than stop peddling? My hopes are that it is the height of the seat and that I am off by just a couple of mm one way or another. I believe I am cycling with my leg moving straight up and down Are there any excercises I should be doing? I have never had any issues with my left knee prior to this.

Any recommendations would be so helpful! What have you guys done when you have experienced knee pain?
Thank you for any advice!

 

[bogiesan]

Asking for medical advice here is, Umm, not a good idea. Your symptoms, as I read them, could be a meniscus tear or iliotibial band inflammation or just the result of inadequate knee care for several years.
Or you just might need a few days of ice and rest.

 Severe damage from which you might not recover is easy to do on the road. Hate to say it but you really need to see a sports medicine doctor who understands bikes. Even if it's just to rule out all worst cases and to get some good meds.

[paddleboy17]

I agree that you should get yourself checked out at an appropriate medical facility, right away.

It might be a good idea to go to a good bike shop and make sure that you and the bike fit each other.

Lastly, are you riding with good technique?  If you ride with a cadence below 80, you could be doing soft tissue damage.  Yes,  I know that a famous racer rode with a slow cadence  (Eddie Merx?), but for most of us, a cadence of 80 - 90 is what you should maintain.  If I climb hills with too slow of a cadence, I get pain similar to what you describe.

[Pat Lamb]

Just speculation (not medical advice), but are you using clipless pedals and is it possible the cleats are maladjusted?  One of the reasons I went to Speedplay pedals is that I could never get the SPD cleats lined up right, and finally figured my biomechanics were too goofy to use with even the "multi" cleats.

[zzzz]

The way I read the original post was that she started the ride w/ cleats and then stopped using them when her knees started to hurt. Although if she was clipped in that would certainly narrow the possibilities as a maladjusted cleat is more likely to put your knee in a bad way than the seat height being off.

Not to make this a chorus but the advice to see a doc is spot on. If you're on a 2 or even 4 week trip and somethings hurts and you decide to bull through it, that's one thing. You're on a 10,000 mile trip, that's completely different. That's a bad sign that you were off the bike for 6 weeks working and the first day back riding your knee was hurting.

The other point I'll make is just how subtle these things can be. I was having some small amount of foot pain shortly before I left for my trip in September (also in the Sierras). I went to a podiatrist and he thought it was too close to my leaving to do anything permanent to my insoles so he put a little piece of adhesive foam, maybe an 1/8" thick under my insole where he thought it would help. I went riding and it felt good. A week into my ride my knee started hurting in a way it had never hurt before. The only thing I knew that was different was that 1/8" thick foam. Pulled it out and the pain went away within a couple of hours. If you make a change to your position, ride with it for a little bit unless the pain is getting specifically worse. Be very cognisant of changes that made things slightly better (or worse) and slowly dial it in.

I'm sure this is very frustrating for you. Good luck getting it right.

Pete

[chrissiedakini]

Thank you all for your advice and taking the time to write! Yeah, not so fun, hope too, I get it down pronto.

The one difference on that first day back was that I was wearing different shoes to what I normally wear (I was wearing boots as it was damn cold that day), which weren't as sturdy as the normal shoes I wear when I cycle (just a pair of running shoes, but sturdy), and we did an 88 mile day that day. So I wonder whether that set it off (as never had a problem prior with my knee). Also: I notice I walk funny in that in shoes that I have worn for a long time, they are worn out on the inner side of the shoe first, so i guess i walk pretty lopsided with the tendency to lean in. I wonder whether that has anything to do with this also.


I am going to go ask at a bike shop first about positioning etc; I do a lot of spinning and so am certain that my cadence is within that range. I never did have spd's, but was in toe clips, which I took off and immediately made a difference.

Will play around with the seat height some more and try to get it right. I adjusted it a couple of days ago (after writing this entry) and it was awesome at first: then got some more pain: this time underneath the top part of my knee cap... which is new. Very frustrating indeed. And I will do more stretching. That seems to really help. When the pain starts, I stop, stretch the legs and can continue again for a while. 

Fingers crossed....

[mmike74]

I have similar pain. I got it checked out and the doctors explained it to me this way. I've over developed the muscles in my outer thighs and those muscles were pulling my knee cap off track. I've done physical therapy the last few weeks and it's helped. Good luck and hope you're able to get through your tour.


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[dayjack119]

The solution to my bicycle knee problems that got so bad I couldn't drive my car, was to use a prescription anti-inflammatory drug called Naproxen.  Maybe there is an over-the-counter equivalent.  After 2 pills the pain was gone and a month later I did a 7,000 mile ride without so much as a twinge.  (The first doctor had said that I had a torn meniscus.)

I would hope everyone would be so fortunate.