What to adjust first for knee pain

[snobetter]

Been building up my cycling over the last few months after not doing any for a long time (used to be on a mtb).

I'm on a hybrid now, did my first big climb and have had quite bad pain in my left knee since (10 days), didn't hurt on the climb, only noticed when nearly home. Thinking I need to adjust something to overcome this in the future? What to adjust first? Not in cleats and saddle is at the correct height I believe, slight bent knee when extended on pedal, no hip rocking.

The pain seems to run down the inside of my kneecap, no longer tender to the touch but pain when walking / steps.

Any suggestions welcome.

[Magic919]

Is it possible that you just over did it?

[snobetter]

Magic919 said:

Is it possible that you just over did it?

Possible, but I didn't push too hard and have built up mileage. Don't tell me this is another getting old thing! Adjusting things is far more an appealing idea...

[WaferThinHam]

Get a proper bike fit?

Otherwise I'd say cleat position.

[Julietbravo]

If it's on the outside of the knee, it's likely to be your illiotibial band. It's really common to have one leg longer than the other. Have a look at an old pair of jeans, and see it the hem is worn worse on one leg than the other. If so, that's because your legs are different lengths. What this means is that your shorter leg stretches at the bottom of the pedal stroke and aggrevates the knee.
It's not normally noticeable unless you do something repetitive like cycling, and the cure is to put an extra really thin inner sole in the sole of the shoe with the shorter leg. Cut one out of the side of a cereal box. I have one in the left shoe of my cycling shoes (100m plus rides) and the pain went straight away.
There are loads of resources available; google the stretches you should be doing.

[Herman Toothrot]

Too short reach? Sure I read having your saddle slammed back can mess with your knees.

[anonymous-user]

snobetter said:

I'm on a hybrid now, did my first big climb and have had quite bad pain in my left knee since

...

The pain seems to run down the inside of my kneecap, no longer tender to the touch but pain when walking / steps.

Any suggestions welcome.

First thing: where exactly is the pain. You say "inside" of your kneecap. Do you mean underneath your kneecap, on the same line as one from the base of your quad to top of your shin? Or do you mean "inside" in the sense of inward - so where your knees would contact one another were you to knock them together?

The cause is likely to have been the big climb. But it's pretty safe to discount any diagnosis until it's clear what actually hurts.

BTW: are you right footed?

[Magic919]

snobetter said:

Possible, but I didn't push too hard and have built up mileage. Don't tell me this is another getting old thing! Adjusting things is far more an appealing idea...

I'd like to think it's not a 'getting old thing'. My own experience is that they need to adapt to the use, but you seem to have done that. I keep them warm now I'm not so young and that helps me.

Given the lack of cleats it's hard to suggest an adjustment. I'd say feet too far apart if you had cleats. Look at too big a Q factor and you'll probably see this. Foot separation (Americans call it stance width) covers the functional parts.

Might be worth a look at _the_ bikefit guy's site https://www.stevehoggbikefitting.com/bikefit/2011/...

[snobetter]

Greg66 said:

snobetter said:

I'm on a hybrid now, did my first big climb and have had quite bad pain in my left knee since

...

The pain seems to run down the inside of my kneecap, no longer tender to the touch but pain when walking / steps.

Any suggestions welcome.

First thing: where exactly is the pain. You say "inside" of your kneecap. Do you mean underneath your kneecap, on the same line as one from the base of your quad to top of your shin? Or do you mean "inside" in the sense of inward - so where your knees would contact one another were you to knock them together?

The cause is likely to have been the big climb. But it's pretty safe to discount any diagnosis until it's clear what actually hurts.

BTW: are you right footed?

Right footed.

The pain follows the inside (left hand, inward, side) of the knee cap not under the knee cap, but still on the top of the knee.

[snobetter]

Magic919 said:

Might be worth a look at _the_ bikefit guy's site https://www.stevehoggbikefitting.com/bikefit/2011/...

I'll read that later thanks

[anonymous-user]

snobetter said:

Greg66 said:

snobetter said:

I'm on a hybrid now, did my first big climb and have had quite bad pain in my left knee since

...

The pain seems to run down the inside of my kneecap, no longer tender to the touch but pain when walking / steps.

Any suggestions welcome.

First thing: where exactly is the pain. You say "inside" of your kneecap. Do you mean underneath your kneecap, on the same line as one from the base of your quad to top of your shin? Or do you mean "inside" in the sense of inward - so where your knees would contact one another were you to knock them together?

The cause is likely to have been the big climb. But it's pretty safe to discount any diagnosis until it's clear what actually hurts.

BTW: are you right footed?

Right footed.

The pain follows the inside (left hand, inward, side) of the knee cap not under the knee cap, but still on the top of the knee.

Based on what you've said, my money is that you've strained (rather than torn etc) something. If you're right legged, your left leg will usually have worse fine motor skill and lower strength. So a sustained effort will tire it more than the right side, and you will lose both strength and control. That usually means that load gets transferred to connective tissue which is not well suited to cope with it.

The culprits sound to me like your medial patellar retinaculum or perhaps less likely your medial patellofemoral (knee) ligament. Overloading, possibly rolling your knee in towards the top tube during the power phase of the pedal stroke (that's the lack of control).

What I'd do: rest, ice/anti-inflams such as ibuprofen/elevate for a few days. Massage it with your fingers to increase blood flow, but don't work the area too hard. Next ride: maybe raise your saddle fractionally, but better: go easier, don't try to kill yourself. Work up to big efforts by doing plenty of easy base miles over time. Concentrate on how your knees track through the pedal stroke - up/down, and not in a crescent towards the top tube. Maybe use some cleats with a decent amount of float (they will stop your feet moving around if nothing else).

The trouble with a strained connective tissue, if that's what it is, is that it is very hard to feel it happening as you do it. It will show up over the following 24 hours, then feel worse before it gets better. You can usually ride on it but it will feel stiff to begin with then ease off. IME riding on it when it's in that state will usually (at best) delay its recovery and (at worst) make it worse - unless you've managed to eliminate the particulate repetitive movement that caused it in the first place.

Sorry not to be more precise. I think it's a case of take it easier, and play it a bit by feel.

[snobetter]

Greg66 said:

useful stuff

Thanks for that, makes sense.

I've started to ride again today only a 2 mile commute though.

I've inquired to a local shop who do bike fitting, asking the question about getting cleats and pedals before or after bike fitting (they might recommend a particular make / type which would benefit me?).

Sounds like me trying to do what I could many years ago, shame as legs and lungs stood up OK and my knees are one of the few things I've not had a problem with before!

[IroningMan]

snobetter said:

Greg66 said:

useful stuff

Thanks for that, makes sense.

I've started to ride again today only a 2 mile commute though.

I've inquired to a local shop who do bike fitting, asking the question about getting cleats and pedals before or after bike fitting (they might recommend a particular make / type which would benefit me?).

Sounds like me trying to do what I could many years ago, shame as legs and lungs stood up OK and my knees are one of the few things I've not had a problem with before!

Your knees will be fine, I'm sure: just concentrate on your pedalling form, as Greg said, and focus on keeping them tracking in a straight line.

[1ians]

Just want to add please rest and build up slowly. I started cycling recently, carried on through the first signs of knee pain and its still painful over a year later.

Make sure you stretch before and after riding. Maybe a few exercises to strengthen the surrounding muscles too. I find a few minutes on a foam roller to be the only thing to bring relief.

A bikefit is probably a good idea, and possibly changing pedals to something like speedplays which give you more float.

[scherzkeks]

Impossible to say from this description ofc, but pain in that area can be related to pedaling too big a gear at low rpm. Quite stressful for the knee.