How about warm up exercises? Rotating the knee joints as karate practitioners do, especially prior to sparring. Do you have an old knee injury that’s coming back again? Is it possibly the onset of arthritis? What about wearing a knee brace? I’m no physician. Maybe, you should consult with a sports physician.

On my first 120-km (without preparation), I also had a left knee pain after about the half-way mark. Perhaps my legs are not symmetrical, so the weaker left leg send a pain signal first. Later along th route, both knees hurts. Pain finally subsided after some isotonic drink. On the eve of a second such ride, I read of hyponatremia and prevention against it. Happy painless cycling all the way for me Now I check with each organiser if such isotonic drink available for more than 60-km ride, before participating (local climate has this preparation requirement) Best regards,Lee Joo Mong

In the past i have the same pain as you, i let it be and after 6 years i was stopped for 1 full year recovering for a cirurgic intervention on booth knees, my advise is to contact a doctor.

Hi there,First i would recommend that he wears a knee support, nowadays you canfind many light wieght, flexible supports that will not hinder hisperformance.Secondly, depending on whether it is the bone or the muscle and cartilagethere are ointments available to help reduce the pain. Also try coldtreatments, this will help reduce any swelling.Thirdly, proper rest between racing is imperative. If you dont give yourbody enough rest then you will just end up hurting yourself. Pain is ourbodies way of telling us there is something wrong. We need to work ourexercise programmes around our own bodies capabilities.Hope i have been of help.Sam

You did not say how old you are or where the pain is in your knee. If you are 50 plus then probably very little can be done except to rest it. Usually, if the pain is in the front then your saddle is too low, if it it is in back then your saddle is too high. If the pain is on the inside or outside then then probably you need to adjust your cleat. Also, if one leg is stronger than the other this could lead to unconsious overuse and result in knee pain. Lastly, you did not say whether you stand or sit to climb, so this has to be factered in as well. Unfortunately, most ordinary doctors are not experts, and you are probably left with trying different things.Good LuckJim Burgess

I got back into cycling after a total knee replacement of the left knee. I usually get pain in the non replaced knee but I find that if I use a rotating pedal stroke rather than mashing down on the pedals it helps put more power and thus less strain on the knees. While the front foot is rotating forward, the back foot is pulling up and over. Try it in lower gears, it might help. Good luck,MJ

the seat height as well as fore and aft adjustments mentioned earlier is great place to look, but have you considered the canter(valgus and varus) of the shoe in the pedal cleat as well as leg length discrespencies.Andy Pruitt has done some extensive medical research in chapter 4 & 18 of his book entitled complete medical guide for cyclist. I got my copy from velo press.. also check out bikefit.com Hope this helps!! and happy climbing ..don

I’m using the wedges to help with alignment. You may try those. Read about them here: http://bikefit.com/

Right back of my knee and both top and bottom muscles get stiff (tight) hard to stand and sore to walk on after 65 K’s any idea’s of what to do. Thanks.Lawrence

Change your cleats and pedals regularly when doing high mileage!I had the same problem over twenty years ago and the cause was worn cleats and pedals – I had actually worn the pedal cage in the same way that I wear my shoes out (flat footed) – result 6 months off the bike and recurring problems even now with the need to click my patella back in to place.Pedals and cleats tend to be “fit and forget” for most cyclists but particularly walking on plastic cleats causes accentuated wear on the edges of the cleats and when they go off square results in rocking, repetitive strain injury when pedaling at a high cadence – the same applies to a saddle not being “square” with the top tube – a deviation of 1 -3 degrees can result in back, knee and ankle injuriesReplace your cleats on a very regular basis – the pros do and also check that each pedal is free running on it’s bearings – any play can cause problems – unfortunately left hand pedals due to the assembly process tend not to run as smoothly as their right brethren

A long climb on the Paris/Nice route is probably hard on a lot of people, but if your knee seems likely to often bother you, then you are going to be looking at all kinds of positioning possibilities. Over the past few years, I have had the good luck to be working part time in an Orthotics/Prosthetics business. Common knowledge in those places is that, most people are not symmetrical, but most people naturally and subconsciously compensate for it. Right and left hips are often not the same height off the floor. Feet are not mirror images of each other, etc, etc, etc.Shoes almost never fit without some kind of modification.So:Wedges at the pedal, Cycling shoes that don’t fit, or fit one foot and not the otherCycling shoe foot lasts that are not wide enoughThe need for Arch supports saddle too high/ back knee painsaddle too low/ front knee paindo you sit or stand on climbs?leg strength and length discrepanciesfallen arches (this really plays with the knees)differences at the hipsAre you a heavy rider or a light rider?Do you naturally tend to push, or tend to spin? ie do you ride better with the saddle back in the rails and the ball of the foot ahead of pedal rotation, or do you ride better with the saddle forward and the ball of the foot right over pedal rotation, or even behind.All of this stuff can give you a clue of the problem.What I have found to be the biggest help in any problem in the knee area is too make sure the knee has enough free left/right rotation on the pedal, and make sure that the leg and foot joints rotates in a more or less straight line when seen from behind and above. I have always wedged my pedals to more or less bring about a straight line machine/mechanical kind rotation at all joints involved, and I get the impression that a large number of people should have the inside of the pedal higher than the outside of the pedal, but there are exceptions and opposites. (one is called pronation and I forget what the other is called)(the Fit Kit used to have a two pencil pedal kind of thing that would show when things were not in-line)If it is related to the shoe and pedal and not to things like seat height, conditioning, technique, electrolytes, etc…then try to just feel the foot through the rotation and say to yourself, is this set of mechanical levers off angle or off kilter? Does my foot feel like it imparts full force with no hot spots where the foot (or knee)compensates and rotates to follow through.That website http://bikefit.com/ seems to be getting at all of this stuff,and it can get really complex.Most of the fitting systems out there can only guess, based on generalities, and that’s why they are only a start to positioning. If this becomes a real problem you should find out what is unique about you… Are your feet huge compared to your legs? Is one leg shorter than the other and where is this difference? Do you have fallen arches, or just one fallen arch? Are your torso and legs proportioned in a way that is not the norm. All of this junk is worth knowing about yourself, and all of it can affect the weakest link, which is often the knee.