# Knee problem...any idea what this is?



## Sellyb (12 Jun 2012)

The day after an endurance event, the back of my left knee to the inside, feels like something is twanging (feels like a vertical direction),, almost like a loose rubber band, just as I straighten that leg when walking down the stairs. When I do intense, shorter, rides, it starts to hurt in the same area as I ride.
Does anyone have any idea what this may be? It's not painful after the long distance rides, but not a pleasant sensation either.
I am a little nervous of a doctor or physio playing with it and making it worse, as that has happened before.
I think my saddle is a good height, my legs are almost straight when the pedal is vertical, and it doesn't feel uncomfortable riding. I would be grateful for any ideas and advice.


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## John_c (12 Jun 2012)

Sounds like ITB http://en.wikipedia.org/wiki/Iliotibial_band_syndrome
Are you using clipless peddles? I had the same problem, turns out the cause was my cleats where set wrong, in relation to my natural gate, (ten to two feet). A simple adjustment to bring my feet into a more natural postion while ride has cured the problem.

HTH


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## HLaB (12 Jun 2012)

If its ITB stretch, I find standing up, crossing my legs and leaning to the opposite side of the top leg works best (repeat for the other leg)


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## Sellyb (12 Jun 2012)

I have looked up that ITB syndrome, but my pain is on the inside at the back not the outside. I also find it happens without clipless, on normal flat pedals. Thank you anyway.


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## doctornige (12 Jun 2012)

That is probably not ITBS. I have that, and it starts laterally and moves medial and posterior. Involvement of the lateral ligament is the differential. I would start by doing some hamstring stretches daily and before a ride and seeing if that helps. If you are really worried, see a physio, but they can be 1. Unavailable. 2. Not really able to help.


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## Sellyb (12 Jun 2012)

Thank you


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## Crackle (12 Jun 2012)

Sure you saddle isn't a touch high. I've had what sounds similar after raising my saddle too high. Only in one knee as well as one leg must be longer that the other, not in a Quasimodo kind of way, just the usual manufacturing tolerances we're all born with.

Also take a look at this page http://www.cptips.com/knee.htm


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## Sellyb (12 Jun 2012)

Thank you again, that is most helpful


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## Manonabike (12 Jun 2012)

Knee pain:

Top of the knee then probably pushing too hard gears.

Lateral pain then probably the saddle is too far forward.

Front of the knee then probably the saddle is too low

Back of the knee then probably saddle is too high.


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## doctornige (12 Jun 2012)

Oh, without being impolite, how old are you?


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## Sellyb (13 Jun 2012)

I am over 30 but under 40!


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## doctornige (13 Jun 2012)

Yep. That's when my knee problems started. An active youth of mountaineering built big legs that went unused for a decade. Then the ligament trouble started, which I put down to muscles remaining powerful, but ligaments losing stretch. Stretch a bit and see what happens.


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## Sellyb (14 Jun 2012)

Thank you, I think it may be my hamstrings.


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## rdt (19 Jun 2012)

_"my legs are almost straight when the pedal is vertical"_


As Crackle suggests, this pain may well be due to overextension of your leg, caused in turn by your seat being too high / too far back. It may occur on the left leg due that leg being shorter than the right (leg length discrepancies are common).

I've actually had that problem myself. I'd had a "perfect" bike setup after a professional bike fit a few years ago that worked great. I eventually succumbed to the temptation to tweak this setup, the end result being a slightly longer leg extension on the pedal downstroke. The result was pain similar to what you describe (and in only one leg, due to a leg length discrepancy). Slight reductions (a few mm) to seat height/setback prevent the pain occurring; increasing the height/setback by a few mm causes the pain to return.

Make a mark on seat post to record the seat's current height, and then try reducing the height by a few mm at a time, over a number of rides, to see if the problem goes away.


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## doctornige (19 Jun 2012)

Oh, I missed that. Your leg should be slightly bent at the bottom of the stroke. I made a jig from two long bits of thin wood and a pivoting bolt. I set it at 15 degrees off straight and used that to determine the seat height by having my wife hold the jig against my leg a the bottom of the stroke.

Having a straight leg causes a pull on the back of the knee and makes your hips tilt as you pedal.

fix that, but continue he stretches too.


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## Sellyb (19 Jun 2012)

It is definitely better with my saddle lower, thank you. I guess that was the problem.


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## Badgeroo (20 Jun 2012)

This describes the same issue I've been suffering for the last few weeks... Didn't notice it on the first ride when I'd raised the saddle, felt it on a longer ride (halfway through) but continued on, and then it comes on quickly in the last few rides, meaning I've cut them short 

I'll be dropping my saddle a bit as a result of this thread!


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## Sellyb (21 Jun 2012)

It has made a huge difference to me! I did the longest ride I have ever done last weekend, a good 25 miles over and above what I'm used to, only a week after suffering with this knee problem. I was really worried about the knee, but with a lower saddle, not even a twinge!! It's such a relief, thank you all for your advice.


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## rdt (21 Jun 2012)

Generally, the first thing to check if you have a "straining" pain at the back of (and "inside") the knee is that the seat is too high. But be careful that you don't lower the seat too much, else you'll potentially swap one type of knee pain for another on the front of the knee, and lose power also. Lowering the seat by small increments at a time (e.g. 2-3 mm), and marking the post with (say) insulation tape so that you have a reference point to work to is the way to go about it. Once you have a height that works, mark that point so you can return to it without future trial and error.

If your budget ever stretches to it and you can justify it, consider having a professional bike fit such as that offered by Adrian Timmis @ Cadence Sport
http://www.cadencesport.co.uk/bike-fitting/

(no connection, except v satisfied customer a few years ago; some of the best cycling money I've spent)


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## Sellyb (9 Jul 2012)

I am now very confused. I joined up with the local road cycling club yesterday for the first time, and towards the end of the ride, a guy, who I have to say looked like he would have been in the road cycling world for some years, told me that my saddle looked a little high, and I was pedalling toe down, and suggested lowering it a 1/4 inch. He looks like he would know what he was talking about.
However, I have had no more problems with my hamstrings, but today the front of my knee is hurting, so I am a little worried about lowering my saddle any more.
However, I did go further yesterday at a faster pace, so could it be that my knee is just not used to going that far? I am a little bit worried about lowering my saddle any more, as I did put it up a few mm a week or so ago, as I thought I was getting twinges in the front, so was taking the advice as above..


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## dellzeqq (9 Jul 2012)

if your saddle is too high your btm will move a bit - as your left foot goes down, your left buttock goes down a bit, and the same with the right. The difficulty is that you might not know you're doing it, and it might pay to get somebody to follow and observe - and, trust me on this, there's be no shortage of volunteers on Cycle Chat.

But.....there's a difficulty here. Saddle height is no less a fashion thing than anything else in cycling. The oldies in the CTC tend to have their saddles a little lower than the more sprightlier items who started cycling in the seventies and eighties (sprightly is a relative term in the CTC). Road cyclists tend to have big thigh muscles, and can cope with a lower saddle - if I move my saddle down to the level that most road cyclists employ my knees would pack in after twenty miles.

Then again.....it might be that you're putting too much on the back of the bike and not enough on the handlebars. Your saddle may be at the right height but too far back - again, road cyclists with big muscles can manage this, but mere mortals struggle.

Worse still - you're a woman, which makes your geometry different. And, for what it's worth, I wouldn't rule out the cleats, because the only time that I have the kind of difficulty you describe is when (like now) I find myself using cleats with 'float' - and switching back to 'no-float' cleats cures it instantly. So....while all the advice you can get on the internet is worthwhile there's no substitute for having someone with an experiecnced eye look over the entire set-up.

My advice - go out with this mob http://www.horshamandcrawleyctc.org.uk/ - they're not superspeedy and they come in all shapes and sizes, and, better yet, both genders. And they've been doing it for a while.


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## HLaB (9 Jul 2012)

I think my saddle is set quite high, efficiency wise for me it works, it was determined by a bike fit (based on 172.5mm cranks) but at the same time I was riding an older bike with 175mm cranks and gradually I felt my calf (not sore, just weird if you know what I mean); I decided to drop the saddle by 2.5mm and forward by 2.5mm and the feeling went away. IMO its amazing what a small difference can make. My fit was in a shop but I've also out of curiosity tried an on line one and it broadly agrees, I used www.wrenchscience.com .


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