knee pain and touring

Cycle-touring, Expeditions, Adventures, Major cycle routes NOT LeJoG (see other special board)
grani
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Re: knee pain and touring

Postby grani » 7 Jul 2014, 9:36am

I have had problems with ny knees since I was a teenager. Exercise makes a huge difference for me and cycling and swimming seem the best.

Spinning in a low gear is much easier on the knees and I can really feel it if I push too hard on the pedals for too long. Building the muscles to support the knee helps but it only goes so far.

My commuter bike has Shimano Click'R pedals with lots of float and they are very gentle on the knees.

Gearoidmuar
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Re: knee pain and touring

Postby Gearoidmuar » 7 Jul 2014, 7:47pm

rualexander wrote:
Gearoidmuar wrote:
Does it hurt walking down the stairs?

I don't think that stretching will do ANY good...

If it hurts walking down the stairs then it's probably a touch of chondormalacia patellae.
To treat that, no big gears and stand while climbing.. no cleats.


Probably not a touch of chondromalacia patellae, this is what is sometimes diagnosed by people like GPs who are not experts in sports injuries. I was told this was my problem 24 years ago by a doctor, but reading up on chondromalacia patellae and subsequent visits to physios who do know about sports injuries ruled this out as a diagnosis.

Without knowing more about the OP's knee pain, location, etc. we are just guessing here, so best advice is visit a physio.

My knee pain has recurred several times over the years, most recently last summer, when I was treated by a physio with ultrasound, electrical muscle stimulation (ems), and kinesio taping, and stretching, a combination which worked very effectively.
I subsequently bought an ems machine for £20 and use it a couple of times a week to keep my vastus medialis muscle in good shape.

Look up quadriceps stretching exercises too, these were emphasised by my physio as very important.


There is no scientfic evidence for the benefit of stretching. It's often harmless, but if overdone can provoke injuries as achilles tendonitis. A scientific trial on the Australian Army showed no benefit in preventing injury.

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NATURAL ANKLING
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Re: knee pain and touring

Postby NATURAL ANKLING » 7 Jul 2014, 8:12pm

Hi,
Stretching before exercising...no benifit unless you ar a gymnast / 110 m hurdler.
Running - cycling - walking - swimming no.

But specific physio exercises following assesment by a qualified person will work wonders.

If you are over 50 and suffer tendonitous then see your GP for a referal.
Physio's will isolate specific muscle's and they know how to find them too.

General stretching, posing on a local park bench....what for........
If You Don't Try You Don't Do.....Don't Do You Don't Get...I'm Still Trying....Well Very..
You'll Find Me At The Top Of A Hill...............Somewhere...After Dark..

slowpeddler
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Re: knee pain and touring

Postby slowpeddler » 10 Jul 2014, 11:09am

I agree with Nuke, riding overgeared is to be avoided. I had knee pain on a European tour and the problem was solved by using lower gears and increasing cadence.

If it continues, ignore amateurs like me and see your doc asap.

John

andy_scot_uk
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Re: knee pain and touring

Postby andy_scot_uk » 10 Jul 2014, 12:38pm

On Hadrians wall cycleway now. Lower gears and higher saddle appear to be working. 35 miles before lunch with panniers.

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mjr
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Re: knee pain and touring

Postby mjr » 10 Jul 2014, 3:35pm

NATURAL ANKLING wrote:The problem with cycling with no device for feet is that your feet will creep around on the pedals and if they twist a little and you then continue to cycle this can then lead to knee pain.

I'm 90% convinced that this is a myth. If you have stout shoes and good grippy pedals, such as Vavert Leisure pedals or ye olde rubber blocks, then your foot will not creep around. Even if it moves out of place (unexpectedly hitting rough ground with one foot completely unloaded, perhaps), learn what's right, look occasionally and put it right - you can do that easily because it's not clipped in.

I feel you're as likely to suffer problems from getting the clips, cleats or straps set up wrong and holding your foot in a bad place; and infinitely more likely to hurt yourself by falling when you fail to get the foot out. Unless you're really willing to sacrifice a little efficiency for the tiny extra peak power (racing, in other words), I don't think they're worth it.

But I'd agree that saddle height and gear choice are more important.
MJR, mostly pedalling 3-speed roadsters. KL+West Norfolk BUG incl social easy rides http://www.klwnbug.co.uk
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NATURAL ANKLING
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Re: knee pain and touring

Postby NATURAL ANKLING » 10 Jul 2014, 5:12pm

Hi,
Its possible to use grippy shoes and pedals, but clips and straps, with straps loose not tightened, your foot position is assured, assuming you set it correct in the first place.

Free Play pedals have I think oddles of settable free play :?: I dont like the idea................

Grippy pedals and shoes yes that is what I use too.

And here's the Secret I.M.O. once the pedal is loaded with foot on the main power segment of crank angle, the foot should not twist / rotate at all , with exception of the give of the rubber sole of shoe.
You can have clips without straps, this just positions the ball of foot in the correct (predetermined by user) for and aft to the pedal spindle.
Much climbing out of saddle over say 50 / 100 or more miles, it will be dificult to garentee foot to pedal position for and aft, even if you ignore any other errors that might creep in like rotation of foot , the pedal crank will act as a stop for sideways position though..................
Last edited by NATURAL ANKLING on 9 Sep 2014, 11:01am, edited 1 time in total.
If You Don't Try You Don't Do.....Don't Do You Don't Get...I'm Still Trying....Well Very..
You'll Find Me At The Top Of A Hill...............Somewhere...After Dark..

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mjr
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Re: knee pain and touring

Postby mjr » 10 Jul 2014, 7:51pm

Sounds like a different style of riding than touring. Maybe I'll start a poll asking who rides out of the saddle while touring, as this is not the first suggestion of it.
MJR, mostly pedalling 3-speed roadsters. KL+West Norfolk BUG incl social easy rides http://www.klwnbug.co.uk
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skicat
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Re: knee pain and touring

Postby skicat » 9 Sep 2014, 10:34am

A bit of a cry for help here.

I've been increasing my ride distances and frequency over the last 6 months. I currently try and get out every 4-5 days and do something like 40-65 miles. In the last 6 weeks or so I've experienced very bad knee pain, only the left one, just above and just below the patella. It starts within a few miles of setting off, twinges a few times during the ride, then after the ride it is very painful for the rest of the day, almost seizing up. It then takes 2-3 days to get back to normal. I've found ibuprofen gel helps ease the problem a bit. I've also applied as much advice as I can glean from these forums - moving saddle height/position, high cadence and low effort etc.

The 'cry for help' stems from the fact that 2 weeks today I set off to do a JOGLE - 14 days of 60+ miles and I'm very worried that my knee isn't going to get beyond 2 days. I think the long term solution is probably a physio and careful exercising - I suspect I've increased my training too abruptly and too quickly and my muscles are out of balance. But what can I do to maximise the chances of completing the E2E?
The hurrier I go, the behinder I get

LollyKat
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Re: knee pain and touring

Postby LollyKat » 9 Sep 2014, 10:58am

Stretching and exercises should help - get a copy of Knee Health asap. If you use clipless, maybe set them to allow more float?

I have had a dodgy knee for years but two things have helped enormously: a regular ten-minute stretching and exercise regime, and using shorter cranks. I'm 5'6" and used 170mm for most of of my adult life, but switching to 160mm (Spa XD) has made a massive difference.

Unfortunately you don't have much time left, and depending on your age you may be risking long-term damage if you persist. I'd definitely consult a sports physio if you can find one.

Merry_Wanderer
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Re: knee pain and touring

Postby Merry_Wanderer » 9 Sep 2014, 12:33pm

I'd suggest get a bike fit (assuming you haven't already) and if you use SPD's or similar, to check the position of the cleats and see a sports physio too just in case there is an underlying problem. I have permanent (non-cycling cause) damage to my left knee and having the bike set up properly removed the pain that I previously had. I would also suggest applying ice to the knee if any swelling. All the best, Andrew

Psamathe
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Re: knee pain and touring

Postby Psamathe » 9 Sep 2014, 12:45pm

skicat wrote:A bit of a cry for help here.

I've been increasing my ride distances and frequency over the last 6 months. I currently try and get out every 4-5 days and do something like 40-65 miles. In the last 6 weeks or so I've experienced very bad knee pain, only the left one, just above and just below the patella. It starts within a few miles of setting off, twinges a few times during the ride, then after the ride it is very painful for the rest of the day, almost seizing up. It then takes 2-3 days to get back to normal. I've found ibuprofen gel helps ease the problem a bit. I've also applied as much advice as I can glean from these forums - moving saddle height/position, high cadence and low effort etc.

The 'cry for help' stems from the fact that 2 weeks today I set off to do a JOGLE - 14 days of 60+ miles and I'm very worried that my knee isn't going to get beyond 2 days. I think the long term solution is probably a physio and careful exercising - I suspect I've increased my training too abruptly and too quickly and my muscles are out of balance. But what can I do to maximise the chances of completing the E2E?


I'd suggest seeing a physio. Privately they can often fit you in pretty quickly (given your timescales) and they don't cost much (the ones I see occasionally cost around £35 for appointment). Whenever I've had to see a physio they have seen me next day; and given your 2 weeks timescale I suspect they could fit you in pretty quickly.

Of course get bike fit right, but until you know what the problem is it is difficult to go about correcting it. If it happens to be caused by saddle height, pedal clip fittings, etc. and you get them right then no doubt it will solve. But it could be caused by other things. In my own case my knee problems were caused by a weak VMO muscle (as diagnosed by a 2 physios), and they gave me exercises to help and showed me how to tape my knee appropriately, which for my problem helped massively (the knee taping and support band). And, my symptoms are not unlike yours (though not so extreme) - so may or may not be the same problem. And I suspect that getting bike fit right might not solve the problem if it is caused by e.g. weak VMO (or other issues I don't know about).

I don't know how quickly muscle imbalance can be rectified, but IF it is something that can be helped by knee taping (and there are different ways for different problems - I believe), then that helps immediately. Certainly, if I ride without my knee tape I get pain and if I tape them up I'm mostly ok and can manage. But a lot must depend on knowing what the problem really is.

Ian

andy_scot_uk
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Re: knee pain and touring

Postby andy_scot_uk » 9 Sep 2014, 2:46pm

Since I raised my saddle my knee has been fine. I know have tried that. It seems to me that maybe something simple will cure your problem. I hope so as I was worried about my coast to coast when I had my knee issue. Good luck.

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531colin
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Re: knee pain and touring

Postby 531colin » 9 Sep 2014, 4:44pm

"skicat"...
Straight-leg isometric quads. exercises will tone up the Vastus Medialis very quickly, this would be my preferred option over taping, and can do no harm at all.
I find stretching beneficial.....stretching after exercise means I am less stiff next morning, but you should relax into the stretch, not use it as (another) form of competition, eg see how low you can go. God alone knows what extreme form of stretching would damage the Achilles tendon.....ever watched a high-jumper? that tendon is the thing that launches them.
If riding alone, I would stop, stretch, and self-massage as soon as the knee started hurting.....with the leg straight and the muscles relaxed, just gently move the knee-cap around....practice on the un-injured leg.
I rode for maybe 40 years with clips and straps, and I wouldn't give up my SPDs for anybody. Despite what the SPD-haters say, there is more float in SPDs (etc) than in flat pedals, and it really is FREE float. Random ridges on rubber soled shoes will hold your foot at a "wrong" angle, set SPD cleats precisely so the "right" foot angle is "in the middle" of the float and the system is much better. In the old days of nail-on shoe plates http://www.classiclightweights.co.uk/components/shoeplates-components.html I had to file out the slot like a trumpet-mouth so my foot could move.
Set your saddle as this thread http://forum.ctc.org.uk/viewtopic.php?f=5&t=74985, use low gears, also short cranks if you are short-legged.

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mjr
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Re: knee pain and touring

Postby mjr » 9 Sep 2014, 5:08pm

531colin wrote:Despite what the SPD-haters say, there is more float in SPDs (etc) than in flat pedals, and it really is FREE float. Random ridges on rubber soled shoes will hold your foot at a "wrong" angle, set SPD cleats precisely so the "right" foot angle is "in the middle" of the float and the system is much better. In the old days of nail-on shoe plates http://www.classiclightweights.co.uk/components/shoeplates-components.html I had to file out the slot like a trumpet-mouth so my foot could move.

I guess you may mean me by "SPD-hater" but it's more that I hate all the myths pedalled by SPD-fanatics, such as it being more efficient or somehow better and that I must be imagining all these people who fall off their bikes from failing to unclip quickly enough.

SPDs are indeed better for positioning than old style shoe plates, but most people will find it easier to put the ball of their feet over the pedal axle (IIRC, but the bike's downstairs and I forget easily) correctly with flattish shoes on a flattish rubber pedal. Just check your feet occasionally and move if needed. If you notice that a particular shoe has sole ridges that hinder correct positioning, try another shoe that doesn't. It's not like you're restricted to expensive special shoes... ;-)
MJR, mostly pedalling 3-speed roadsters. KL+West Norfolk BUG incl social easy rides http://www.klwnbug.co.uk
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