Had to stop halfway with knee pain (V. Dissapointed)

[maximillion]

Set off from Lands End on the 16th May. Made good progress on the infamous A30. I didn't find it as bad as people said.
Stopped at St. Austell ( bugger of a climb getting out of there), Crediton ( hilly getting out of there as well), Glastonbury, Monmouth and Shrewsbury. Weather was atrocious especially over Bodmin Moor.
On my last day going to Shrewsbury I could only push the pedals around with my left leg. The pain around the front of my right knee was intense. The knee had swollen so much I couldn't carry on. Even dosed up with codiene, paracetamol and ibuprofen.
Went to the A&E and they said the tendons around my kneecap were very inflamed and to rest for at least two weeks.

Going to try to get from Hoylake to JOG in 3 weeks time.
Anyone got any suggestions on how I can minimize damage to my knee tendons in future?

Cheers
Max.

PS I would like to say a special thanks to a bloke called Gary who helped me out with directions in Bristol. He had done LEJOG and gave me lots of good advice and £20 for my charity Claire House. He owns a cycle shop in Bristol called GARYS BIKES. So if you need anything bike related in Bristol check out his shop. He definitely knows his stuff.

[amaferanga]

You need to get your bike set-up right. Knee pain usually means somethings not right with the set-up or you have some kind of muscle imbalance.

Cleats and saddle height are the things I'd check first.

[boink]

Sorry to hear about that, but glad you're picking up where you left off in a while. I had knee pain due to my having cleats positioned too far forward in my shoes and also not angling them so that I could replicate my slightly duck footed walk/leg rotation whilst pedalling. Changed the set up and didn't have a problem threafter. I did hear that placing the cleats further back takes pressure off the knee. useful advice for the over 40's.

[thirdcrank]

This seems to be something that is there all the time, but only bad enough to start to hurt when you have ridden quite a few miles. I presume the hospital could not say what sort of action might have caused the injury.

If you are using cleats, I'd second boink. There do seem to be shops ('cycleries') in the US that provide a fitting service for cleats but I've never seen it advertised here. I've seen various bits of advice on here. My own way is to copy the position of the marks formed by a quill pedal on a flat sole, but that's no use at all to anybody without a bike with quill pedals.

Another possiblity is a bent pedal spindle, if the bike has been in a tumble of some sort. It's not easy to detect because after a very short while, your leg no longer detects it - until knee pain occurs. Campag used to make a testing device which consisted of a couple of large discs, each threaded to take a pedal. A suspect pedal could be screwed in and spinning the disc would show a bent spindle as a wobble. I don't know if something like that is still available.

[gbnz]

On occasion, I've found too high a gear, sometimes combined with insufficient warm up has caused the damage. It really is worthwhile taking the first 30 minutes at slow speed, in an abnormally low gear, walking up the hill rather than cycling at the start of a days cycling, or at the slightest twinge adopting to a lower gear for the days cycling (Or taking a rest day)

On returning from the hebrides the other week, I did my knee in after catching the first morning ferry from North Uist to Harris and then foolishly "bombing" up the hill from the harbour (Couldn't help it, there was a struggling fat scotsman on a super lightweight road bike in front and the temptation to cruise past on a fully laden tour bike, c/w tatty shorts, shoes, rusting brake calipers was overwhelming ). Ended up having to cycle from Ullapool to Glasgow at half speed the following week, my left knee being out of shape. Having recognised the damage I adopted a low gear from Ullapool to Glasgow without any further damage. Being prone to short, fast days, its surprising the distance that can be done even when limping along - I was still managing 80 miles a day through the Highlands, even at half speed (Though today is going to be yet another "half day", as I'm still waiting for a fully functioning knee )

[jasps]

On occasion, I've found too high a gear, sometimes combined with insufficient warm up has caused the damage. It really is worthwhile taking the first 30 minutes at slow speed, in an abnormally low gear, walking up the hill rather than cycling at the start of a days cycling, or at the slightest twinge adopting to a lower gear for the days cycling (Or taking a rest day)

Sound advice gbnz. I suffer from 'weak' knees and I have found doing what you mention in your posts to be very beneficial. I am planning a LEJOG ride next year and my knees are my biggest worry. They are giving me grief at the moment so I have gone back to flat pedals for a while, which seems to help.

[Mick F]

I seem to have a strange affliction.

I have Bad Knees, but only when I walk. Cycling seems fine, be it in high gears or low gears. Walking can be a pain, especially down hills or steps, but cycling is fine!

I saw the nurse a while back, and she looked at them, comparing one against the other, and could see and feel no problem. She suggested I saw the doc if it felt too bad. Then she winced when I said I'd limped into the surgery but had ridden 30 odd miles on a bike only that morning! She just didn't understand.

Any road up, my knees don't seem to be a problem too much, so I ride rather than walk.

[Si]

I have Bad Knees, but only when I walk.

I got that on the end-2-end. By the time I got to Tiverton (strong head wind all the way) I could hardly walk ten yards without excruciating pain in my right knee, yet as soon as I got on the bike I was fine apart from a little twinge now and then.

Things that I found cause knee trouble:

no longs on cold days
trying to puc]sh too big a gear, esp when sitting.
saddle too high/too low.
saddle too far back.
rapid gaining of strength (muscles get strong faster than tendons and thus tendons get strained)
pedal spindle bent causing foot to constantly change angle - side to side
just plain, good old overdoing it.

[Mick F]

Good post, Si.

I reckon that's what's wrong with my knees - my muscles are too strong for them! Joking apart, it makes good mechanical sense to me, that's why it hurts more walking downhill, the tendons are being pulled to hold me back and the slope.

The pain never seems to be inside the knees, more on the surface, so it isn't cartilage or worn-out bones.

[Gearoidmuar]

There are numerous aspects to knee pain on a bike.

Height MUST be correct. The best way is that sitting square on the saddle your fully extended leg's bare heel should be just shy of the pedal (5mm or so) with your foot parallel to the ground and the crank fully down. To get this fiddle around with height until your heel just touches and then raise 5mm.

You must have the muscle. When training initially, standing up a good bit develops this, so stand and sit.

If you use cleats the angle may not suit your knee. Try uncleated pedals for a while and note what angle your foot naturally takes. You actually do not need cleats at all. I've cycled in the winter for years without them as I wear waterproof walking boots which keep my feet much warmer. I use cleats from March onwards.

Being unfit. Doing too much too soon.

Pushing too big a gear. Don't grind huge gears. There's no point and it helps neither back nor knees.

I've almost never had a significant knee problem since early problems with saddle height and cleats.

If your muscle (vastus medialis) is properly developed, when you straighten/tense your knee, the muscle on the inside and just above your kneecap will be good and hard. If it isn't you risk getting chondomalacia patellae which is a roughening of the cartilage on the kneecap, a condition which typically causes pain while walking downstairs.

I'm doing the CTC tour at the beginning of July. I wouldn't dream of doing it without getting properly fit. I'm recovering from a broken thumb which stopped me cycling more or less for 5 months. Back one month. Did 100m on Saturday on hilly route. 4700ft climbing. I'm no chicken (59). I reckon you've got to get into good shape for a long tour. Not as easy at my age and I've a couple of stone on me which I didn't have in my thirties!

[maximillion]

Thanks for all the advice folks.
I can only conclude that the pain must have been caused by my saddle being too low. I only have short legs and had put the saddle to its lowest possible position. My knees are just staring to feel ok again so I will try a few miles like this. I was fine muscle wise during my halfish trip so I think I was fit enough.
Thanks again for all the advice.
Max