Continuing pain in my knees .... help..please.

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pjclinch
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Re: Continuing pain in my knees .... help..please.

Postby pjclinch » 7 Nov 2017, 7:37pm

landsurfer wrote:My GP, a cyclist, said, " Your knees are 60 years old, what do you expect, take drugs ", does not fill me with hope for the next 20 years.

I Want My Knees Fixed !


Complicated things, knees. And GPs are not necessarily very well up on them.

I was having bad pain in my right knee, off to the GP, who said painkillers. I said that was the Wrong Answer, and he wondered if I'd like a physio referral? It turned out I would like a physio referral, and at my appointment it didn't take the physio long to work out the inside muscle supporting my left knee cap was a little weak, causing the knee cap to mis-track. Do the following exercises and it should get better... I did, and it did. An X-ray confirmed sone arthritis, but by making sure the muscles are balanced and in good order (it so happens cycling helps!) everything has got much, much better.

So while your problem may well be different to mine, check out the physio option because they know how knees work. I wouldn't be entirely surprised if bike fitters don't.

Pete.
Often seen riding a bike around Dundee...

pwa
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Re: Continuing pain in my knees .... help..please.

Postby pwa » 7 Nov 2017, 8:34pm

If you have already looked at saddle height and forward/backward adjustment, and crank length, pedals and shoes are next. Are your feet free enough to rotate a little? Are they rocking too much?

I'm sceptical about bike fits because self-professed experts seem to produce different "right fits". No bike fit would produce my position but I get no problems.

chris_suffolk
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Re: Continuing pain in my knees .... help..please.

Postby chris_suffolk » 7 Nov 2017, 10:21pm

TrevA wrote:What pedals are you using?

I've had knee troubles over recent years. I had to change back from SPD-SL to Look Keos, with red cleats, and I have my cleats set up so that my toes point slightly outwards. I can no longer used SPD's as they don't seem to have enough float..


Can second this. Started getting knee pain earlier in the year (after years using SPD cleats). Switched to Look Keo (red) with7 deg of float. Problem disappeared over night.

Thinking the knee was ok, tried SPD again, and only one ride of 10 miles - pain came back. Back to Look, and no pain again, Can only assume additional (and non sprung loaded) float is the solution.

Middle of the road
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Re: Continuing pain in my knees .... help..please.

Postby Middle of the road » 11 Nov 2017, 12:19pm

Hi Landsurfer,

Sorry to hear that you have got pain in your knees. I have had knee problems for some years (cartilage and ligaments caused by 30 years of rock climbing and running) and I now have arthritis (I'm 50) that has started in both.

I'd suggest start with going to see a physio about your knees. you may have done that already . The GP's that I have seen know very little and the honest ones admitted that. I may be very lucky but my physio was also a county class runner and now that she's a bit older, is a touring cyclist. She's got me to reduce the gearing on my bikes and now two bikes have 44/32/22 and 11-34 and the other two have 46/32/24 with 11-32. I find these work for me in the rolling Leicestershire hills and for all events, Audax, Touring etc. I've changed my cadence to spin up hills rather than try and push a higher gear.

I had achilles tendonitis in my left leg in 2011 which was diagnosed by my physio and she diagnosed the cause as a combination of tight and shortened hamstrings and calf muscles and a saddle that was set too low to accommodate my lack of flexibility. Lisa (the Physio) gave me a few stretches to do on a daily basis, which I have done ever since and recommended a bike fit and I found this guy, Mike at Leamington Spa;

http://bikedynamics.co.uk/

Mike's fitted 3 bikes for me and from those I've also used the measurements to fit myself to the 2 other bikes that I now have, including my Spa Cycles Steel Tourer which I picked up on the same day that you collected yours. He's not cheap but I would have no hesitation in recommending him as I've had no further (non-arthritis) problems. I've since ditched my SPD's for flat pedals and now use DMR V8's which suit me.

Whatever you choose to do I hope you can sorted.

robing
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Re: Continuing pain in my knees .... help..please.

Postby robing » 15 Nov 2017, 12:09am

I have been plagued by knee pain in one knee that has had several meniscal surgeries.
In the end I found the magic bullet was having a slightly lower saddle height than recommended.
Once I found this I never looked back and have completed many long distance cycling tours.
In fact, the more I cycle the stronger my knee gets. I have had occasional flare ups, not bike related.
I got some new shoes and hadn't quite got the cleat adjustment right and my knee blew up.
Once I adjusted it it was fine. It's amazing how small adjustments can make a profound difference.

landsurfer
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Re: Continuing pain in my knees .... help..please.

Postby landsurfer » 19 Nov 2017, 3:36pm

robing and quite a few others; I seem to have had an improvement.
I used colin531's guide as a basis for a basic set up and also read Michael Veal's DIY Dynamic Bike Fitting pamphlet ( he charges £3.99 colin531, maybe you should charge as well ? ) to get a few ideas to add to the advice given in the post.
This morning i adjusted the SPA as follows; Seat back by 10mm, seat pin drop by 5mm, nose of saddle drop by 1 click on angle adjuster.
I also moved my cleats back to the rearmost position.
Normally i am in a very low level of discomfort from the off but to-day after 2 miles there was no discomfort at all and so it continued for the first 10 miles ... there was a twinge at 10 - 12 miles but it very quickly disappeared.
It was just a 16 mile trial ride .... on Tuesday i will go up to 30 miles and see how i get on ....
The best wave of my life is still out there.

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531colin
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Re: Continuing pain in my knees .... help..please.

Postby 531colin » 29 Nov 2017, 10:16pm

How's it going now?......some thoughts....
Moving cleats back moves your foot forward on the pedal, and this has the effect of increasing the reach to the pedal; so does moving the saddle back.
Sitting well behind the pedals seems to me to make it easier to "get your heels down" if you are a toe-down pedaller, and also to "keep your knees in" if you tend to pedal "knees-out".
Dropping the saddle nose may rotate your pelvis further forward, and this will alter which part of the range of contraction of your glutes, quads and hamstrings (at least) that you use, as well as letting you ride with a straighter back.

Of all the above, "keeping your knees in" is a definite bonus for your knee joints.
I don't like too big a reach to the pedals, I set saddle height so that when I'm forcing the gear I slide back a bit in the saddle to increase the reach a bit for more power.....most of the time I'm happy to have a comfortable bend in my knee when the pedal is at the bottom, I think this makes me smoother at high cadence, or when I'm tired or stiff.

landsurfer
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Re: Continuing pain in my knees .... help..please.

Postby landsurfer » 2 Dec 2017, 5:46pm

So 110 miles later ... the cleats went back to the original position but every thing else stands .... however i offset the seat pin 2 mm to the chainring side of the bike and the occasional "trapped nerve" pain in my groin has also disappeared.
No one ever seems to mention "saddle rotational offset". (pat pending) ..... lol
But in all my 40 years of competitive and recreational riding it's something i have always been aware of .... Just lining the saddle up with the top tube seems daft considering all the other changes and adjustments we appear to need.
The best wave of my life is still out there.

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531colin
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Re: Continuing pain in my knees .... help..please.

Postby 531colin » 3 Dec 2017, 5:35pm

I think very few of us are perfectly symmetrical. My right shoulder appears to be about 2 inches lower than the left.....buttons need altering on suit jackets.
I think I probably ride with the bike leaning (slightly) to the left, because my right bum bone makes a bigger dent in the saddle than the left does, and despite being left eye dominant I see (predominantly) the right side of the front wheel. I once tried to ride tandem with a lass who wanted to lean the bike the other way, and it simply wasn't going to work, although I have ridden tandem with several other people without difficulty.
I may have differing leg lengths for all I know, I have never investigated.
If you offset the saddle (nose?) 2mm to the right, I would expect the back of the saddle to move less than 2mm to the left. I'm not sure my ass locates on the saddle with that degree of accuracy, but if it works for you, then I'm happy for you!

landsurfer
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Re: Continuing pain in my knees .... help..please.

Postby landsurfer » 3 Dec 2017, 6:52pm

Colin531, I set the saddle inline with the top tube, plumb line from the nose of the saddle.
Marked the seat pin and clamp at the leading edge and off set the seat pin by rotation to the right as viewed from the rear of the saddle, by 2mm.
There was no science around the amount of offset just a "suck it and see" approach.
Which seems to have worked.
So far.
The goal was to reduce the pressure on the area between my left hand glute and my upper thigh muscles.(Adductor and Gluteus ??). I am not feeling any additional pressure on the right hand muscles.

The bike is my SPA Steel Tourer. Which is the best bike i have ever owned or ridden ..... Buy one ..... you know you want too ..................... :D
The best wave of my life is still out there.

QUIST
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Re: Continuing pain in my knees .... help..please.

Postby QUIST » 6 Dec 2017, 1:31pm

I've found the following to be very helpful in terms of relieving aching knee pain.

Wearing knee supports

Ensuring the saddle is not set too high and lastly much to my surprise ensuring my chair at work is not set too low (When it was previously my knees ached beyond belief and I really was wondering wha t the hell was the cause of them aching like god knows what)

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531colin
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Re: Continuing pain in my knees .... help..please.

Postby 531colin » 12 Jan 2018, 7:17pm

Just found this in my "drafts" folder, so here it is.....
Whenever I get out a bike that I haven't ridden for months it sets off a little burst of tinkering with the riding position.
So, getting the winter bike out and riding it round the block, I wasn't surprised that I found the saddle felt too high. I was a bit surprised that it felt much too high, but I dropped it about 5mm and put it away ready for the club ride next day. Next day, I rode to the start, and dropped the saddle another few mm.....when I got back home, I dropped it again. So that must be at least 10mm drop in total, and I was staggered.....that's a lot, for me. (I'll explain.....I have a pair of cycling boots, and I'm driven to use a different saddle height to account for the thicker sole compared to my shoes....its all of about 3mm, and I tell myself over and over that it can't matter, I must be imagining it, and all the rest of it, but I'm still driven to make the adjustment......unless I get somebody else to randomly alter my saddle heights, I'll never know if its real or a case of the "Princess and the pea" delusion......)
So, why the change to my saddle height? Its not the difference between boots and shoes; because the seatpost has to come out to get the bike in the car, all the bikes have a bit of tape round the seatpost.....the post goes back in down to the tape if wearing shoes, a bit above the tape wearing boots, simple when you are obsessive......
I had forgotten that (like "landsurfer") I moved my cleats back in the summer, and hadn't got round to adjusting the winter bike to suit.
Moving the cleats back will take some load off the calf muscles, and it also increases the reach to the pedals. Its difficult to say how far I moved the cleats, somewhere between 5 and 10mm, so I still don't see where a 10mm drop in saddle height has come from.

reohn2
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Re: Continuing pain in my knees .... help..please.

Postby reohn2 » 12 Jan 2018, 7:58pm

New to this thread (must've missed it somehow :? )
Landsurfer
From your posts over the years you appear to do a lot of driving miles,which involves sitting in the same position in tension,though you may not realise it driving is a tense activity,from my own experience it doesn't do the knees, hip joints and lower back much good however comfortable I feel.

On the bike,spinners are winners,no cash for mash
Mashing big gears and needing to get it of the saddle to climb isn't good for old knees that have seen a lot of use,especially if their owner weighs in at 100+kgs,(not to mention stress on the heart).
You've mentioned a few times you ride a 1(36t?)x9 or 10sp(11-34t?) gearing system which is OK for flatish slightly rolling terrain but would kill me in the hills even when I'm fit at 85+kgs when I was 59?(I'm now 65)ridng 7 to 8K miles a year regularly.

So if the riding position is right and the pedals are set up well,and you've nothing really badly physically wrong with your knees other than some degenerative age related Osteo Athritis(I'm riddled with it) look at what I've mentioned above.
My 2d's worth,hope this is of some help.
Last edited by reohn2 on 13 Jan 2018, 12:32am, edited 1 time in total.
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crazydave789
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Re: Continuing pain in my knees .... help..please.

Postby crazydave789 » 12 Jan 2018, 10:10pm

pjclinch wrote:
landsurfer wrote:My GP, a cyclist, said, " Your knees are 60 years old, what do you expect, take drugs ", does not fill me with hope for the next 20 years.

I Want My Knees Fixed !


Complicated things, knees. And GPs are not necessarily very well up on them.

I was having bad pain in my right knee, off to the GP, who said painkillers. I said that was the Wrong Answer, and he wondered if I'd like a physio referral? It turned out I would like a physio referral, and at my appointment it didn't take the physio long to work out the inside muscle supporting my left knee cap was a little weak, causing the knee cap to mis-track. Do the following exercises and it should get better... I did, and it did. An X-ray confirmed sone arthritis, but by making sure the muscles are balanced and in good order (it so happens cycling helps!) everything has got much, much better.

So while your problem may well be different to mine, check out the physio option because they know how knees work. I wouldn't be entirely surprised if bike fitters don't.

Pete.


Patello femoral maltracking a simple x-ray shows it up and a few weeks of doing nothing then starting over is the only way to sort it out. I was advised that the surgery of cutting the ligament is under 20% effective. mine came to light when walking downhill as it felt like the knee was full of glass. it came back after physio following an athroscopy so I was told to sit still for three weeks then start again but this time ignore what the physios had told me.

without knowing the location of the pain it is hard to give the OP any help on the subject. spinning a low gear in a high cadence just gives different problems. cycling builds up muscle strength and that can supply 60% of a joints stability helping with many common issues but it also tightens the joint causing others in its place so some flexibility is required and different exercise to use muscles you miss when cycling. a bit of tai chi type exercise can often help as can changing how you cycle. if you ride clipped in with a pull push action instead of a purely push push.

fiddling with your fit can help, up down front and back and the amount of toe in you ride with. usually people have slightly different positions for each foot as the legs are often half an inch different so one leg is always stretching, similar there is usually one foot larger than the other so a cleat adjustment could be all it takes.

mattsccm
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Re: Continuing pain in my knees .... help..please.

Postby mattsccm » 14 Jan 2018, 8:37pm

Both my knees are screwed. Arthritis in both, bugger all cartlidge left in one and that's the good one. I'll second all of the above with one qualifier. Don't spin too fast. If you lose a rhythm or get jerking it can make things worse. Sonetimes a silly high gear standing up eases my knee pain. I suspect that its the change of movement more than anything and maybe the downwards pressure is more controlled. Not a universal cure but it has its moments.