Iain is one of our regular questioners and he has been doing quite a bit of top class riding, but he has a problem with his knee after a particularly hard ride with a long climb. He has a few ideas of his own and he wants our thoughts on what might be going on?
Question:
Hi Samuel, I rode the last stage of the route the Paris - Nice takes on Sunday evening after a long climb at around the 65 km mark I began to get pain in my left knee. So can you advise what might be the problem, I assumed one or a combination of the following might be the cause.
1. Saddle too high, I lowered it 1 cm when I got home.
2. Left shoe might need pulled in at the heel which I will do today.
3. It was just a hard ride and I am not strong enough for the climb.
What do you think? Oh and thanks for the offer of the books, good advice in them.
Hi again Iain,
Good to hear from you, Monaco must be nice at this time of year? That last stage of this years Paris-Nice was a tough ride, so I'm not surprised that you have a sore knee. On a ride like that every part of your body hurts, but I'm sure you know the difference between tiredness and an injury?
OK let's answer your questions.
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On hilly stages Pro riders tend to raise their saddles, not much, a centimeter or so. Try lowering it and see if that makes a difference, if not I would put it back where it was for a little while then higher it by 1 centimeter and see if that helps.
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The left shoe may need pulled in; you are the only person that can tell if this is right for you. It maybe that your foot needs to be nearer to the crank. The other cause of the problem could be something going on in your lower back; this can put extra strain on the knee on one side. Have a physio check you out if the problem persists.
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Yes, it could have been just a hard day, or you were feeling tired for other reasons. Have you been training over these distances and similar hills? If so then you should be fit enough, if not there's the problem.
I hope this all helps, and keep us posted on how you get on. As to the books, yes there is lots of great advice and help on many different cycling topics.
First i would recommend that he wears a knee support, nowadays you can
find many light wieght, flexible supports that will not hinder his
performance.
Secondly, depending on whether it is the bone or the muscle and cartilage
there are ointments available to help reduce the pain. Also try cold
treatments, this will help reduce any swelling.
Thirdly, proper rest between racing is imperative. If you dont give your
body enough rest then you will just end up hurting yourself. Pain is our
bodies way of telling us there is something wrong. We need to work our
exercise programmes around our own bodies capabilities.
Hope i have been of help.
Sam
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
Good Luck
Jim Burgess
MJ
Lawrence
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 injuries
Replace 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
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 other
Cycling shoe foot lasts that are not wide enough
The need for Arch supports
saddle too high/ back knee pain
saddle too low/ front knee pain
do you sit or stand on climbs?
leg strength and length discrepancies
fallen arches (this really plays with the knees)
differences at the hips
Are 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.