Knee pain, bike set up!

[sone]

I'm experiencing some knee pain across the front of my left knee whilst riding my road bike. Only a recent problem but it doesn't seem to be getting any easier. I've changed none of the set up on my bike so I'm a bit loss as to what could be causing the problem.
This leads to the question would a proper bike set up be a good investment and could it possibly help my issue. I've never had this done before so completely ignorant of the benefits. I'm not a competitive rider but would like my gear to do it's job without causing me grief.
Opinions would be appreciated.

[anonymous-user]

Unless you're racing, i think bike fits are a bit useless. Get it comfortable and that should be the best fit for you. I switched to oval rings (absolute black), that's helped my knees. Help give you a consistent pedal stroke over round rings.

I'm sure there'll be some superstars along shortly to tell me i'm wrong though.

[lufbramatt]

Are your cleats set up at the right angle so the float is centralised? ie the angle of your foot isn't resting against the limit of motion of the pedal/cleat?

I recently saw a sports physio about a hamstring tendon issue with occasional knee pain and she demonstrated that one of the issues I had was the VMO (innermost quad muscle) wasn't firing properly which is affecting the way my knee tracks. She gave me some exercises to strengthen and activate it, fingers crossed it will sort it out.

[miniwill58]

Thornaby said:

Unless you're racing, i think bike fits are a bit useless. Get it comfortable and that should be the best fit for you. I switched to oval rings (absolute black), that's helped my knees. Help give you a consistent pedal stroke over round rings.

I'm sure there'll be some superstars along shortly to tell me i'm wrong though.

I think everyone can benefit from a bike fit to an extent. How much you benefit I guess depends on how much you ride. If you ride once a month to the local park and back, maybe it's not such a good use of money. if you're out there putting in the miles every week, even if you're not racing, a bike fit is worth while.

I had a bike fit recently (I don't race) to try and sort out some pain I was having in my neck/shoulders and arms. Much more comfortable on the bike now and makes me want to ride more.

[alock]

As my rides started progressing above 40 miles, I started getting some knee pain last year. I treated myself to a full bike fit at http://vankru.com/. I haven't had any pain since.

For me, the issue they found was that I was not sitting perfectly central on the bike, and hence my hips were slightly rotated. This put a sideways pressure through my knees.

[anonymous-user]

If you don't know the cause of the knee pain then, if you do nothing, it is less likely to go away than if you do something

Either a bike fitter that knows their stuff, or a physio with experience of cyclists could be as good a place to start as any

Hope you get it sorted quickly

[ChrisMCoupe]

With so many variables that could be causing your pain; saddle height, saddle fore/aft, cleat position, crank length or a combination of all of them, I would 100% recommend a good bike fit. It won't just make you more comfortable, but may enable you to ride faster/more efficiently.

It could also be down to technique, how's your cadence? Are you grinding up hills and putting too much load through your knees.

[keith2.2]

Thornaby said:

Unless you're racing, i think bike fits are a bit useless. Get it comfortable and that should be the best fit for you. I switched to oval rings (absolute black), that's helped my knees. Help give you a consistent pedal stroke over round rings.

I'm sure there'll be some superstars along shortly to tell me i'm wrong though.

Couldn't disagre more - Getting 'comfortable' is easy but having something not quite right can cause discomfort down the road. There are so many variables to the way a bike is fitted and because everything is interlinked, it isn't necessarily obvious what he cause is.

I recently had a bike fit on my TT bike and wish I'd done it years ago - the little niggles (tight ITB, occasional inner knee, occasional outer knee) all gone and the bike has never been more comfortable.

To give an example of the above 'interlinked' comment - I was getting ignorable knee discomfort after a couple of hrs on my left knee, but full on pain after 10-11hrs on the outside of the knee. It turned out I was pushing my hip out left to get proper extension on my right leg - that was causing lower back stiffness and twisting the left knee slightly.

"I've tried adjusting the left cleat in various ways and I can't seem to sort it"

The answer was to put 3mm shims into the right cleat, which brought my hips back to centre. I would never have arrived at that conclusion.

Price justification? Not here isn't not - I've booked the other bike in for next month and can't wait to get it done.

[gazza285]

Thornaby said:

Unless you're racing, i think bike fits are a bit useless. Get it comfortable and that should be the best fit for you. I switched to oval rings (absolute black), that's helped my knees. Help give you a consistent pedal stroke over round rings.

I'm sure there'll be some superstars along shortly to tell me i'm wrong though.

Thinks bike fits are useless unless racing, uses oval rings...

[Treb0r]

I had long-term knee problems, partly caused by cycling.
Cycling makes your hip flexors, IT bands and piriformis get incredibly tight. In my case it was causing problems with patella tracking which meant my VMO "switched off" and even appeared noticeably smaller. I couldn't go straight into VMO strenghtening exercises because it was not "firing".

The solution for me was eventually prescribed by a good physio and involved regular stretching and foam rolling.

The routine that works for me is:

Piriformis - stretch and foam roll
Hip flexor - stretch (lunge with raised rear leg)
Seated hip and lower back stretch
IT band foam rolling

You can find most of these by googling - a few of them are here:
https://www.verywellfit.com/best-stretches-for-cycling-3120553

I also have a book called "Strength and Conditioning for Cyclists" which has some good progressive routines to help mitigate the effects of spending a lot of time on the bike!

Hope this helps.

[anonymous-user]

gazza285 said:

Thornaby said:

Unless you're racing, i think bike fits are a bit useless. Get it comfortable and that should be the best fit for you. I switched to oval rings (absolute black), that's helped my knees. Help give you a consistent pedal stroke over round rings.

I'm sure there'll be some superstars along shortly to tell me i'm wrong though.

Thinks bike fits are useless unless racing, uses oval rings...

Here he is

[gazza285]

Thornaby said:

gazza285 said:

Thornaby said:

Unless you're racing, i think bike fits are a bit useless. Get it comfortable and that should be the best fit for you. I switched to oval rings (absolute black), that's helped my knees. Help give you a consistent pedal stroke over round rings.

I'm sure there'll be some superstars along shortly to tell me i'm wrong though.

Thinks bike fits are useless unless racing, uses oval rings...

Here he is

Show me a peer reviewed scientific study that shows how an oval chainring relieves knee pain, or one that shows they increase efficiency throughout the pedal stroke.

[Treb0r]

There is also a very good page that gives an introduction to fitting - it's a good overview if you are not familiar with the concepts:
https://www.peterwhitecycles.com/fitting.php

Steve Hogg goes into more depth on his website.

[anonymous-user]

gazza285 said:

Thornaby said:

gazza285 said:

Thornaby said:

Unless you're racing, i think bike fits are a bit useless. Get it comfortable and that should be the best fit for you. I switched to oval rings (absolute black), that's helped my knees. Help give you a consistent pedal stroke over round rings.

I'm sure there'll be some superstars along shortly to tell me i'm wrong though.

Thinks bike fits are useless unless racing, uses oval rings...

Here he is

Show me a peer reviewed scientific study that shows how an oval chainring relieves knee pain, or one that shows they increase efficiency throughout the pedal stroke.

I had knee pain, switched to ovals, now dont have any. No power gains etc as some of manufacturers claim though.

[bigdom]

Thornaby said:

gazza285 said:

Thornaby said:

gazza285 said:

Thornaby said:

Unless you're racing, i think bike fits are a bit useless. Get it comfortable and that should be the best fit for you. I switched to oval rings (absolute black), that's helped my knees. Help give you a consistent pedal stroke over round rings.

I'm sure there'll be some superstars along shortly to tell me i'm wrong though.

Thinks bike fits are useless unless racing, uses oval rings...

Here he is

Show me a peer reviewed scientific study that shows how an oval chainring relieves knee pain, or one that shows they increase efficiency throughout the pedal stroke.

I had knee pain, switched to ovals, now don't have any. No power gains etc as some of manufacturers claim though.

So you had an issue...and tried a self-help approach. Whilst you've cured one issue, you may not be seeing the claimed power increases, as your overall positioning is still not correct. You're unlikely to be extracting the full pedal stroke, so efficiency will be lost.

Don't get me wrong, it's pure cost benefit ratio. The idea of paying someone to adjust your bike or buy some new shiny bits

I don't race, and don't plan to at my age. Although as my mileage increased, I regained a few issues from my back (operated over 25yrs ago), and also previous sporting activities.

I had a fit, and can comfortably ride all day long now, and do the same the next day. Were the overall changes dramatic, no. Would I have got there, maybe. Although it would have taken a significant amount of time, and more pain/time of bike to do so, and chuck in physio etc, a lot more expensive for me anyway.

A bike fit is merely a starting point, not a means to an end. It adjusts.

[MiseryStreak]

You don't necessarily need a bike fit to eliminate knee pain (straight away).

Loosen the bolts on your (presumably) floating cleats. So there is no restriction on the angle of your feet on the pedals, they can rotate freely. Do a long ride like that. If you're not experiencing knee pain, or it's not made worse, then your cleat was set at the wrong angle. You can get this right by loosening off the cleat bolts slightly so they're tight but can twist a bit, riding for a few minutes then stopping and removing your shoes carefully. Tighten the bolts and they should be set at the correct angle.

You say the pain is at the front of your knee, which could be patellar tendonitis or runner's knee. This could be caused by your saddle not being high enough which is loading up the patellar tendon due to the higher sheer angle from your quad across your patella (kneecap), but this would generally affect both knees.

You may have just sprained your patellar tendon, so you have an injury. This can take weeks to heal. You may need to rest it or just make sure you're stretching it adequately before a ride. I'm not a doctor (obviously), so if it persists or is painful you should see one.

[anonymous-user]

bigdom said:

Thornaby said:

gazza285 said:

Thornaby said:

gazza285 said:

Thornaby said:

Unless you're racing, i think bike fits are a bit useless. Get it comfortable and that should be the best fit for you. I switched to oval rings (absolute black), that's helped my knees. Help give you a consistent pedal stroke over round rings.

I'm sure there'll be some superstars along shortly to tell me i'm wrong though.

Thinks bike fits are useless unless racing, uses oval rings...

Here he is

Show me a peer reviewed scientific study that shows how an oval chainring relieves knee pain, or one that shows they increase efficiency throughout the pedal stroke.

I had knee pain, switched to ovals, now don't have any. No power gains etc as some of manufacturers claim though.

So you had an issue...and tried a self-help approach. Whilst you've cured one issue, you may not be seeing the claimed power increases, as your overall positioning is still not correct. You're unlikely to be extracting the full pedal stroke, so efficiency will be lost.

Don't get me wrong, it's pure cost benefit ratio. The idea of paying someone to adjust your bike or buy some new shiny bits

I don't race, and don't plan to at my age. Although as my mileage increased, I regained a few issues from my back (operated over 25yrs ago), and also previous sporting activities.

I had a fit, and can comfortably ride all day long now, and do the same the next day. Were the overall changes dramatic, no. Would I have got there, maybe. Although it would have taken a significant amount of time, and more pain/time of bike to do so, and chuck in physio etc, a lot more expensive for me anyway.

A bike fit is merely a starting point, not a means to an end. It adjusts.

I tend to set my own bikes up, like I always have. Tape measure, plumb line, mirror. I tweak my cleats if I need to etc etc. Bike fits on a TT bike, yes. Bike fit to do a sportive? set your own up so it’s comfy.

[bigdom]

Thornaby said:

I tend to set my own bikes up, like I always have. Tape measure, plumb line, mirror. I tweak my cleats if I need to etc etc. Bike fits on a TT bike, yes. Bike fit to do a sportive? set your own up so it’s comfy.

Each to their own. I tend to work on prevention rather than cure, I'll ignore your advice.

You might be doing it the same way as you've always done, although it would appear you need to revisit what you're doing.

Something would appear to not be correct, as you've changed your crank rings to try and solve a setup issue?

[ALawson]

Has the OP suddenly upped the mileage with the improving weather? Knees are sensitive things and just doing this with everything remaining the same (maybe some loss of muscle definition over winter if not having done much riding) could give some pain.

I have a partial tear to left ACL and no left MPFL. (Underside of patella is a mess)!

[nethers66]

My brother in law Tim does bike fitting tell him Leigh recommended him.

https://www.speedhub.co.uk/bike-fitting/

You'll be surprised what little adjustments can do for comfort and performance.