How to fix knee injuries for cyclists

injury

#1

Knee injuries are common and SO frustrating! Please share what you’ve done to fix them in this thread.

DISCLAIMER: This post is LONG, but it’s meant to be a resource on what is working for me and a place for discussion on what is working for other folks. Cyclists and “knee problems” are as common a pair as shoes and socks, yet they are highly individual and in every scenario, an individual approach needs to be taken. What I am sharing in this post is what is currently working for me. I am not suggesting you do these exercises, and instead suggest you work with a knowledgable PT who has helped many cyclists through similar issues. In other words, this is not medical advice in any way, and please consult your doctor before undertaking any treatment.

Knee Injury History

This is a lengthy post, but I’ll keep this part short. I’ve battled with “knee issues” of one kind or another for the last 3 years. Over that time I have worked with eleven different Doctors, orthopedic specialists, physical therapists, coaches, and trainers to be pain free on the bike. Every one of them has pointed out something helpful, and in almost every case I had temporary relief.

In terms of diagnoses, I’ve had:

  • IT Band Syndrome
  • IT Band Friction
  • IT Band Tightness
  • Patellar tendonitis
  • Chondromalacia
  • Runner’s Knee
  • Chronic Inflammation Syndrome
  • Musuclar imbalances
  • Tight hips
  • Lack of flexibility
  • Inactive glutes
  • Neuromuscular blockage/interference
  • Ineffective hip control
  • Hip impingements
  • Ankle impingements

I’m sure there are others I’m forgetting. In other words, everybody will have a different opinion what is wrong with you, and they are probably right. Even if you are pain free, there is endless room for improvement in terms of biomechanical efficiency on and off the bike.

My "Solution"

The tricky part comes in when you latch onto a diagnosis and think there is only one thing that needs a simple fix, then you’ll be on your way. The painful truth is we are all different, and although it may be frustrating and seem unfair that you deal with chronic injury while others don’t, it’s simply the cards you’ve been dealt. You get to work extra hard for normalcy, but I reckon that struggle will make you a better person and more dedicated athlete, so there are perks :slight_smile:

There is low hanging fruit like a proper bike fit and proper pedaling technique, and I’m sure a fitter will be upset at me for this, but I am going to leave those two components at the following: Pedaling technique is individual, but if you are an outlier (extreme toe pointer or extreme heel dropper, habitually ride at a <70rpm or >110rpm cadence, inability to have your knees track straight) then you should address it. Bike fit is also very individual, but you will find commonalities across a range of proper fits. I don’t have any good bike fitters to recommend, but try to find one who has good reviews from athletes that are similar to you (discipline, experience level, etc.). Finding a good fitter is a tough and expensive process, but as silly as this sounds, I find Competitive Cyclist’s Bike Fit Calculator to be a great tool for a starting point.

Treatments/adjustments I have done:

  • Rest
  • Ice
  • Compression (I’ve tried all sorts of braces with little to no improvement)
  • Elevation
  • Heat
  • Stretching posterior chain (lower back, glutes, hamstrings, lower leg)
  • Stretching quadriceps and anterior hips
  • Yoga
  • Plyometrics (Great way to build durability, but tough to do when already injured)
  • Hiking and walking
  • Foam rolling
  • Dry needling
  • Acupuncture
  • Self-massage
  • Manual Therapy
  • ITB Flossing
  • Countless exercises to strengthen glutes and hips
  • Cortizone shots (Just a bandaid, and in some cases an illegal one depending on your organizing body and competition level)
  • Diagnostic MRI
  • Medicinal anti-inflammatory regime (Another bandaid with very detrimental side effects)
  • Homeopathic anti-inflammatory regime
  • Plant-based diet
  • Low carb diet
    • Low sugar diet
  • Gluten free diet
  • Cleat adjustment (shims, fore/aft, left/right)
  • Shoes/insoles
  • Pedal choice
  • Bike fit adjustment
  • Using rollers instead of trainer
  • Cadence adjustment
  • Pedaling technique adjustment
  • Reduction in high intensity training (No causation in my case with intensity and inflammation)
  • Reduction in low intensity / high volume training (Same as the previous point)
  • Changed time of day that I train
  • Meditation
  • Neuromuscular repatterning ( I used the Halo Neuroscience product for three months, but found no improvement)

Feel free to ask questions on the above, but from that list, this is what I have found most helpful / am currently doing:

What's working right now

  • Rest
    (If inflammation arises, you simply have to respect it. Don’t pedal through it)

  • Stretching posterior chain
    (See more on this below)

  • Stretching quadriceps and anterior hips
    (See more on this below)

  • Yoga
    (Very beneficial at building control and stability. I don’t attend a yoga class, but regularly incorporate movements into my routine. See more on this below)

  • Hiking and walking
    (I’ve noticed a direct correlation between improved control in the pedal stroke and increased dog walking and hiking)

  • Foam rolling
    (I roll my quadriceps hamstrings, glutes, lower leg and feet every day. I don’t go crazy with it, but a 15-minute session is part of my every day routine when I wake up)

  • Manual Therapy
    (I have a monthly appointment with a PT that specializes in Manual Therapy. The goal is to diagnose any major imbalances or impingements in my body and reset everything back to “straight and balanced”. It’s expensive, but I find it irreplaceable)

  • Dry needling
    (Helped me initiate the process of regaining control and proper recruitment patterns with my glutes)

  • Countless exercises to strengthen glutes and hips
    (I feel like I’ve done darn near everything with this, but I’m always surprised by new movements. Dr. Jay Dicharry from Rebound Physical Therapy in Bend, OR provided me with the current routine that I find more beneficial than any other routine I’ve used. See below for images and descriptions of each movement.)

  • Homeopathic anti-inflammatory regime
    _(I take in a high amount of foods that are rich in anti-oxidants. Berries, turmeric, red/black beans, cranbarries, artichoke, apples, etc.)

  • “Low sugar diet”
    (I’ve noticed a correlation between periods of inflammation and binging on sweets. Why can’t chocolate chip cookies be more healthy!!?? :wink: )

  • Cleat adjustment (shims, fore/aft, left/right)
    (I’ve tried everything here. Only thing out of the norm that I have is that the cleat tends to be about 1cm toward my heel from center. Otherwise, I’ve found no correlation between a cleat adjustment and change inflammation. YMMV.)

  • Shoes/insoles
    (A big help was getting custom Surefoot insoles for my shoes. Helped me control knee tracking in the pedal stroke)

  • Pedal choice
    (The custom float of Speedplay Zeros is hugely beneficial on the road, and I dislike Crankbrothers on the dirt. The float always has some degree of resistance, and then the cleats, shoes or pedals wear, the pedaling platform becomes unstable. I like SPD-style cleats since they offer more “free” float and a stable platform)

  • Bike fit adjustment
    (Only correlation I’ve found here is that most bikes put me too far behind the saddle and that correlates with an increase in pain. This is getting better as brands are steepening seat tube angles and getting rid of setback seatposts)

  • Using rollers instead of trainer
    (Rollers have taught me to be extremely disciplined with my technique, and I had become a bit sloppy over the years with my bike locked in place. You can cultivate the same discipline on the trainer, but the rollers force it upon you :wink: )

  • Cadence adjustment
    (On dirt I usually average 85-90RPM, on road 95-100RPM, and this hasn’t changed. What has changed is my focus on being proficient outside of those ranges. I do plenty of cadence drills.)

  • Pedaling technique adjustment
    (I am very conscious of glute activation when pedaling. It’s not that my glutes are what is pressing my pedals, but I should feel my glutes engaging in order to stabilize the pedal stroke and let my quads put more focus on just making watts.)

  • Meditation
    (I use the time I do my stretching/mobility routine to get into a very focused and clear headspace. I’ll use controlled breathing techniques with a mantra to make everything beside my connection to what my body is mechanically doing melt away. I do the same when training. I’ve found this to be key in establishing a feedback loop with my body so that I don’t get sloppy without noticing.)

Disclaimer: All of this will likely change over time, and I’m sure I’ll have new struggles pop up over time. That’s how this works :slight_smile:

Mobility Routine

My current routine comes from Jay Dicharry of Rebound Physical Therapy in Bend, OR. I can’t recommend him and his office enough. They work with elite and professional athletes from all over the world, and Jay is a cyclist himself. He knows what he is doing.

The routine I am sharing here is what he prescribed for me. I am certain it would change for each person that visits him, so once again, please refer to a professional. I’m only sharing this due to the sheer number of requests I’ve gotten for it.

Part 1: Open Blocks

Before I started to build things back up, I had to clear any blocks out.


Ankle Dorsiflexion
My talus tends to drift forward in relation to my tibia, and this stops my knee from being able to track correctly. To address this I place a high resistance band in the bend of my ankle with as much tension as the band supports, then bend my knee forward while keeping my heel on the ground and resisting pronation of the foot.




Hip Internal Rotation
Even though you may think internal and external rotation of your hip has little to do with a pedal stroke since your leg is supposed to track straight, hip stiffness above the knee forces it to twist as it bends. What this looks like when I ride is the classic “hatchet and cut”, meaning my knee flares out at the top of the stroke, and in and the bottom of the stroke.

An approachable method to clear up this block is the 90/90/90 self mob. It’s called that because your knee, hips and knee are all at 90º angles on the ground. Start from a seated position, then let your right leg roll outward so the knee touches the ground. Then bend that knee to 90º. Now roll your left leg inward so the knee touches the ground, and position that leg so you have a 90º angle in your hips and the left knee. Your legs will resemble the Triskelion featured on the flag of the Isle of Man.

Once you get into this position, make sure your torso is position upright, then rotate your torso toward your left leg until you feel tightness in the groin and hip joint. Your left hand will be between your left heel and your glute, and if your can, your right hand will be just inside your right knee. This is really uncomfortable for some, and it feels more like something is genuinely wrong more than just a normal stretch. Take your time easing into this one.

At that point you are ready to actually start working. In this position, try to think of pressing your left knee downward into the ground for a couple seconds while keeping your left heel on the ground. You’ll do this almost entirely through glute activation. Then think of pressing your left ankle down into the ground for a couple of seconds while keeping your left knee on the ground. I alternate this pattern 30 times, then switch legs, then repeat that set three times.


Short Rectus
The rectus femoris is a deep muscle in the thigh that is really hard to target with standard quad stretches and even foam rolling. A short rectus causes excess tension on the knee cap, and that is less than desirable. :wink:

The Couch Stretch is a variation of a lying quad stretch. The difference is you want to be on a surface that allows the leg that isn’t being stretched to drop down and allow that knee to bend at a 90º angle (or as close to it as possible. Use a band to get the stretch, and spend a significant amount of time here. Time is what will really make this effective.

Part 2: Stability

It’s funny that we have to focus on making the knee track properly sometimes, because it should just automatically track straight. These are exercises I am doing to help increase stability.


Pigeon Pose Hip Extension
This is a great way to isolate glute activation, and a good way to get in some stretching while you’re at it.

For an explanation on Pigeon Pose, see the image below. Keep the toes of your back foot on the ground, and only extend your back leg backward as far as you can while still maintaining contact with your kneecap and toes to the ground. Your back knee will be slightly bent. Once you are in this position, using only your glutes, left the back knee off the ground.




Glute Rainbow
This one is extremely hard, and not because of it being physically strenuous. It’s an exercise that once again isolates the glutes, but even more than the previous exercise. It takes a lot of neuromuscular control and it will feel awkward at first, but persistence will make it better.

Assume the position you see in the image below (on all 4s with 90º angles in shoulders, hips and knees). From this position and while keeping your knees bent in their current position, left your left leg up so that you make a straight line from your shoulder to your knee on your left side. Your foot should be flat with the base pointing to the ceiling.

It’s very easy to let your back cave in this position and allow your belly button to get closer to the floor, but work to maintain a neutral spine. Any movement you do from here on out should have zero effect on the position of the rest of your body. If you want, put a foam roller on it’s end under your left knee to serve as a warning point when you are dropping your knee. You can do the same for your belly and chest if you really want to stay strict.

Once you are in this position with neutral spine, it’s time to have your left foot make a rainbow. Imagine standing behind you and the left foot has a paintbrush in it. The following movement would cause that paintbrush to paint an arc.

The way to do this is to imagine your femur is a rotating spindle that can’t be moved off of its axis. While maintaining this position, rotate the left femur (without letting your knee flare out, drop or rise) so your left foot gently arcs medially until you can’t hold position, then retrace that path and go as far laterally as possible until you can’t hold that position. The lateral rotation in this case feels almost impossible for some, but you’ll get better at it with time. Add ankle weights to drop deeper into your range of motion.

Banded Hip Twist

(Heads up, we shot this one incorrectly. You should be standing on your left leg, not your right. You can tell which side is correct because you should feel resistance when opening up laterally rather than medially.)

For this and the remaining exercises, keep in mind that “rotational spindle” concept we talked about on the last exercise.

This one is simple. Anchor a resistance band to something in front of you, bring it around your left hip and hold it in your right hand while putting your right hand on your right hip. Then stand on your left leg and while keeping your hips, torso and shoulders aligned, imagine your body’s rotational spindle is your left leg and rotate slowly inward and outward. You’ll feel a lot of glute engagement when rotating outward.




Supine Hip Rotation in Half-Bridge

Another great one for isolating glute activation. Get into a bridge position, making sure your hips are high enough to maintain a straight line from your shoulders to your hips and finishing at your knees. From this position, extend your left leg skyward, keeping your left femur parallel with your right. You goal should be for this movement and any subsequent movement to not affect your position in any way.

At this point, consider your rotational spindle your right leg and rotate your hips around this axis. This one feels awkward at first, but keep at it.



Tippy Bird Twist
If your familiar with Yoga, assume a Warrior III pose but place your hands on your hips. Maintain this position despite all further movement.

From this position, Rotate your body outward and inward. This requires a ton of balance and it is really hard. Stick with it.



Banded Hip / Jack

Stand in an upright position with your feet comfortably place under your shoulders, hands on your hips, and a band around your knees with another band around your ankles. Their size should give you immediate tension if you were to widen your stance, and the knee band will have less tension than the ankle band.

In this position, balance on one leg and move it backward at a 45º angle, making sure to move only as far as you can control. This is a great one for more glute isolation.

You can make this one extra tricky by standing on a bosu or some sort of balance-challenging device.


Part 2: Quad Control

Standing Knee Extension

Put a large swiss ball against a wall and put the backside of your knee against it in such a position that without compressing the ball, your knee is bent. In this position, straighten your knee fully.

This one really puts a lot of emphasis on balancing out workloads across your quadriceps, which is something we are really bad at as cyclists.


Star Squats
This is similar to a single leg squat, but the focus is not on getting into a deep squat. Instead, the focus is complete control of the leg you are standing on.

This is a three part squat, with the first squat seeing your free leg go forward, the second squat seeing it go outward, and the third squat seeing it go backward. Your goal with this will be to keep your upper body in a similar position across all three squats. Remember, just go as deep/far as you are able to control.




Rock ‘N’ Roll Squats
Start in a standing position on a soft floor, carefully, and in one fluid movement, crouch down and roll backward onto your back before reversing the movement to get up to your feet and jump. Using momentum is good, and this all happens in one fluid motion. Your goal should be to move through this fluidly without needing to reposition feet or knees in order to get the strength/fluidity you need.


Summary

Once again, I have not clue if this is what will help you, but it has helped me. More specifically, getting many opinions and working through a lot of different professionals has led me to this point. I still have subtle twinges every once in a while, and tightness in my muscles and joints persists, but this is what I've learned in this process of managing the issue.

I think it would help if other people shared what they have done to alleviate or remove knee pain and regain control of the legs in the pedal stroke. Please share your insights below, and share this with anybody you know who is having these issues. Let’s make this the best thread for knee problems for cyclists! :slight_smile:


Knee Pain on Trainer
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#2

Thank you Jonathan for your post! I just had an MRI on both knees after some damage from the infamous Das Hugel ride in Austin. This very well will be a great aid!


#3

Thanks so much for summarizing your experiences. Glute activation is SO important! I recently have been making that a major emphasis and it has eliminated my nagging knee pains, taken stress off my hamstrings/quads, and made me feel much more powerful.


#4

Oof! What sort of knee pain do you have? Medial, lateral, below the kneecap? Would be interesting to see what you learn from the MRI as well.


#5

Yes! What did you do to work on your glute activation?


#6

Bookmarking this. I’ve been introduced to Jay Dicharry’s Running Rewired book and see some familiar exercises from there on your list.

My knee injury was caused by downhill skiing (diagnosed as an MCL sprain) and funnily enough cycling was about the only thing I could do without pain in the immediate aftermath. I wasn’t able to run though, not because I had pain when running but because the night-time pain was crazy. It took 18 months of physio to get back to a point where I could run and even now I tend to be super-aware of my knee.

The physiotherapy also sorted out chronic instability in my non-acutely injured leg. The biggest difference for cycling has been my cleat position is much more neutral now than it used to be!

I have also done lots of glute activation over the last 2.5 years now. Banded monster/prisoner, clamshells, side plank clamshells, fire hydrants, glute bridges of all sorts, banded ladder drills; I have an entire folder full of exercises.


#7

Several things:

  1. I’m usually a bit wary of chiropractors, but there is one guy I have gone to in the past who is great at releasing tight spots with various massage techniques. He worked on my hamstrings, hip flexors, groin, and low back, and after a few sessions glute activation was much more natural/easy.

  2. I got a bike fit that didn’t move my seat position much, but it flipped my stem making it much less aggressive/aero. I now realize I wasn’t nearly flexible enough to ride that way and will slowly work on improving flexibility.

  3. Got a new saddle, the Specialized Power Expert, which seems to make it easier to tilt my hips underneath me while pedaling.

  4. Have been working on hip bridges and other exercises similar to the ones you posted to further emphasize the action of engaging my glutes.

I’m glad things seem to be going well for you now @Jonathan…I’ve been listening through the old podcasts (5 stars by the way) and while it’s tough to listen to you deal with those setbacks, your journey has helped me analyze my own problems.


#8

Bookmarked.
Due to my soccer and American football background, I have had the following knee injuries over a period of 15 years (all on the right knee):

  • MCL tear (minor, three times spread apart)
  • Medial meniscus tear (minor, x2)
  • ACL partial tear (loose part removed but only half a ligament left)
  • Patella Femoral pain and tracking issues (x3, recurring, partially caused by ITB)

Cycling keeps everything in shape so long as I ensure I’m using my VMO and stretching my hip flexors, but this summer I tore a ligament in my right foot (soccer with my daughter! :roll_eyes:), and now I’m getting tracking issues again. I think it’s because I lost a fair amount of muscle mass when I wasn’t able to put weight through the foot (it’s 98% healed - I couldn’t play soccer, but I can run), and my VMO gets fatigued about 3/4 of the way through the TR workouts.
I’m foam rollering, stretching and I’m going to do more single leg squats (they are great, especially the tiptoe ones), but I think that focussing on my core is going to be the key to sorting it out as the right side of my back is fragile too (and pre-dates the knee).
@Jonathan - all the above exercises are hips down. I know you have mentioned core work previously on the podcast - do you think that the core also helps with your knees? If so, do you have any specific exercises you do for core, or is it just the ones that are on the TR youtube channel?
Thanks for sharing all your exercises - they are great.:grinning:


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#9

It is Thanksgiving week so it will be a little while till I get my results. Time to take up some swimming! My suspicion is a result of TFL (Tensor Fasciae Latae) tightness. I hiked the Highline Train in the Uinta Mountains (Utah) two years ago and blew my knees along the trail because of all the ankle/hip articulation while walking over the broken stones in the trail.
The TFL connects around the front of the hip to the glutes (which wrap from the back) to form your IT Bands. My doctor thinks my right knee is IT band related. Left, waiting for the MRI results.

BTW, coworkers had been telling me to jump on TR for years, but it wasn’t till I started to listen to your podcasts that I moved over. Also, not sure if your office knows, but Pete was in briefly in DCRainmaker’s videos last month, reviewing the new GoPro7.


#10

Jonathan- From a guy in rehab for Patellar tendinitis- thanks for this!! I’ve been dying to know how it is going for you. Totally agree on all of these lessons you’ve learned, right down to speedplays and hip strengthening.

Question 1: how do you incorporate those strength/stability exercises into your training week? Before a hard ride? After? On easy days?

Question 2: I can see a path back to road racing, but MTB or CX seems like the slightest tweak from a maneuver would set me back months. Have you changed anything around MTB riding other than the routine above? Your stretching routine sounds better than mine


#11

I don’t (normally) believe in “magic” fixes, but the Cali Lift Glute Developer is pretty darn close. Full disclaimer: I am not sponsored by Cali Lift, nor have I ever worked for them. I bought this product with my own money.

The Cali Lift does something special - it activates your glutes in a way that is so instantaneous, simple, and significant, I thought there was no way it would work. But 9 months later, my knee pain has disappeared on the bike, and I have noticed significant improvements in both lower body strength and on-the-bike power.

Instead of doing countless, precarious, and complicated glute-activation exercises, the Cali Lift has been a “one-exercise-does-all” for me.

My background: I had two serious knee injuries & surgeries when I was 14 and 15 while playing soccer. I started cycling at 17, and made it four years before serious knee pain returned. I had a TTO (tibial tubercle osteotomy) at age 21. But the biggest difference has been using the Cali Lift for the past 9 months. My knee pain has gone away, despite my racing and training load being higher than ever. Hope this helps.


#12

Thanks for all the information, nice to see a mix of some ‘classic’ exercise plus ones that are new to me.

I did have a few questions though, some I am fairly confident of the answer but I just wanted to double check and it may help someone else in the future.

  1. The ankle dorsliflexion, is this a hold the position or are you ‘squating’ while resisting the band, how long/how many reps?
  2. Can you elaborate on the difference between the banded stretch and the couch stretch? What do you consider a ‘significant’ amount of time?
  3. Pigeon pose - when you say lift the back knee off the ground, presumably the toes of the back leg are sitll in contact with the ground?
  4. Making a rainbow - this is a left to right rotation movement, right? Reps?
  5. Banded hip twist, Supine rotations in half bridge, tippy bird banded jacks - Reps? I understand that perhaps ‘more is better’ but as a ballpark, what is a good starting point?
  6. Star squat, do you come back to standing between the 3 points or do you crouch with your free leg forward then remain crouched while you move the free leg from front to side to back? Again, rep recommendations?
  7. As a whole routine, what is an effect dose of this? Every day, 2-3/week? once a week?

Thanks!


#13

If I’m totally out of shape or in really good shape I have knee pain, mostly in my right knee. When I was in grad school, I got really fat and didn’t exercise. I could barely carry my son upstairs when he was an infant. I went to PT, and they mostly got it more inflamed. I started swimming, and that fixed it. I hurt my knee this year and started swimming again, and tried to figure out why. I think it is pushing off from the wall twice a lap. Partial squats are supposed to help knee issues too.

I have a lot of problems with patella tracking in my right knee, so I either use a strap or KT tape. If you search on youtube, “IT band KT tape” that’s what I do. I also use bandage prep so that it lasts longer, usually about 4 days. When I had inflammation in my left knee this year, I used the same scheme but not as tight. The inflammation was keeping the patella from tracking properly, which caused more inflammation. What I found out with that was that if I didn’t stand up on the bike, it didn’t hurt. There was inflammation above the knee because of repeated hyper-extension.


#14

Thanks Jonathan. For me, it has been the incorporation of stretching, yoga and leg days from Beachbody’s 80 day fix program for strength training that has made the difference for my back and my knees.

Btw, I’m a long-time listener to the the podcast and had an image of you, chad, and the other guy :slight_smile: in my head. But based on the pictures in your post here, I was way off on what you look like.


#15

Thanks for sharing @Jonathan! Out of curiosity, did your PT have you working on both legs or just the trouble maker? If only one, did they have you switch to start working on both at some point? If so when?
Tim


#16

Hey Jonathan … I’m currently recovering, on the build back from petella tendonitis and pre petella burstitis. Its been awful, but since having it all surgically drained and cleaned up its been getting better.
Why did this happen ? I do not know … perhaps over training as I had ramped up my training for a full ironman distance triathlon - which I’ve since deferred to 2019.
BUT - one suspicion I have is poor gut health. Whilst recovering I have been exporing poor gut health and yes I have some food intolerances and confirmed ‘leaky gut’ - both of which can lead to auto-immune issues. I’m still exploring, not trying to resolve why I have these issues as Ive never had anything like this for the previous 45 years … I’m now looking at what’s the root cause of all this - next I’ll be looking into gut bacteria
So - I’m sharing all these details because i also believe that all the good stuff and correct fit and good training etc etc. can still go bad and you can still get injured if something else is not right - for example your gut health.
( I also have some tendonitis going on in right shoulder and left elbow from swimming - so I have issues not just in the knee - all of which I’ve never experienced before - hence my holistic approach to examining why may be causing them all to blow up )
Michael


#17

I have bad knees, trust me they are bad!! Walking any distance I get impact pain but cycling is great and can manage distance and hills, my consultant give me credit for getting where I am by keeping going and cycling and if I don’t I get more pain (the arthritis sticks!!) Anyway after a knee replacement I had a revision of my bike fit and shorter cranks were recommended. I know loads of people who have had reputable bike fits but cranks aren’t usually mentioned.

I’m 5`4’’ so why would I have cranks the same length as someone 6’4" even on a smaller framed woman bike?! The difference has been good to great. The theory is that I don’t have to crunch up my knee when flexing on the up… it generally stops me twisting - it was marginal but my hip would twist to make a bit more room as I flexed - plus I used to get groin/hip flexor pain but don’t get that any more.

While the physic theory is longer crank more power I don’t feel I have lost any and am way more comfortable on the bike and knees are good (or as good as they will be)!!! Might be worth thinking about particularly those with shorter height/legs/possibly the ladies out there if they have a problem in this area. There was an article this year in one of the cycling mags this summer about this and the argument was good towards considering this, after all we fit most of what else is on our bikes saddle up/back/handlebars tilted, we buy a bike for our size but the cranks are generally one size fits all.


#18

So it appears that 2 weeks in to HV SSB2 I’ve developed a patella-femoral issue, basically runners knee. Not awful but a dull ache that got worse as Sundays session went on, right behind the kneecap. I’ve tried cycling a few times this week but can’t put any power down. Trying to get a physio appointment and foam rolling twice a day on quads, ITB, glutes etc. Aside from that does anyone have any advice on how I can recover well, and crucially how long before I’m back on the bike? No pain walking or on stairs, only if I sit and push my foot against the floor hard.


#19

Hmm -
Knee injuries are so individual, it is difficult to discuss.

In the summer of 2017, I was experiencing knee pain while riding (Right Knee), and it only got worse as the summer went on. The pain got to a point where I stopped riding for two months, and was looking for answers on how to fix. Rest, and PT did not solve the issues, and I got an MRI during that time also. I finally found a surgeon that was confident about my knee pain that it was “Plica Syndrome”, and that an arthroscopic surgery would fix the pain.

Plica Syndrome: https://en.wikipedia.org/wiki/Plica_syndrome
Basically - some tissue in the medial part of my knee got inflamed from overusing it (cycling!). Surgeon goes in and removes the inflamed tissue, and resolves the issue.

Flash forward to fall of 2018, and my right knee is perfect. No issues, not a bit of pain. Unfortunate thing is, that my LEFT KNEE is having the same issue! I was quicker to the gun with getting surgery, and it will be 3 weeks post operation tomorrow. I’m still in the recovery phase, and am able to ride, but its about every other day to keep the inflammation down.

Anyways, I wanted to share my experience. I could be a minority, but it seems like the more cycling friends I meet, the more I hear about Plica syndrome. Hope this helps. :slight_smile:


#20

I’ve had to take some 3 months off bike due to patella tendonitis and work travel and among physical therapy exercises purchased a powerdot and run the knee programs and quad massage and have started seeing some promising results.