# re-occurring knee niggle



## Doyleyburger (12 Nov 2013)

I got this knee niggle about 40 miles into my ride a few weeks ago. Was quite uncomfortable to say the least. 
Weather has been crap for the last few weeks so I haven't managed to go back out till today. This time it happened about 3 miles into the ride.
It's to the side of the knee and today it was a bit more painful. 
Has anyone experienced this before ? ....perhaps it could be that I still haven't had a proper bike setup yet or maybe I'm using that leg too much when I'm riding compared to my other leg ????
I know that you guys aren't all gonna be doctors but I am going to assume that this could be a common issue with newbie cyclist like myself. So hopefully someone can help me out here


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## Dusty Bin (12 Nov 2013)

Doyleyburger said:


> It's to the side of the knee



Can you be more specific - like which side?


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## Doyleyburger (12 Nov 2013)

Right leg. right hand side of the knee.


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## vickster (12 Nov 2013)

Look at saddle height and cleat position

Also, rest it. Was it a very hilly ride that aggravated it?


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## buggi (12 Nov 2013)

i have this from time to time. I'm gonna guess that its a cartilage problem. See a physio, she will give you some exercises.
in my case one side of my quad is slightly underdeveloped bcoz my right knee is very slightly turned inwards (i can't really tell but her trained eye spotted it immediately) so wasn't supporting my knee properly when i bent it. I think the common term is knock knee'd. She gave me some exercises to strengthen it, which did the job at the time (pain was sharp, to the right of my knee cap, and tight and felt like something was going to snap when I knelt down and tried to stand up)
the problem came back last week in a slightly different place (sharp pain through my knee when pushing down) so I've got an appointment tomorrow. Although I've been pain free for a few years. I suspect its the same thing.


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## 400bhp (12 Nov 2013)

buggi said:


> i have this from time to time. I'm gonna guess that its a cartilage problem. See a physio, she will give you some exercises.
> in my case one side of my quad is slightly underdeveloped bcoz my right knee is very slightly turned inwards (i can't really tell but her trained eye spotted it immediately) so wasn't supporting my knee properly when i bent it. I think the common term is knock knee'd. She gave me some exercises to strengthen it, which did the job at the time (pain was sharp, to the right of my knee cap, and tight and felt like something was going to snap when I knelt down and tried to stand up)
> the problem came back last week in a slightly different place (sharp pain through my knee when pushing down) so I've got an appointment tomorrow. Although I've been pain free for a few years. I suspect its the same thing.



I'd suggest getting a bike fit by someone that knows what they are doing.


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## vickster (12 Nov 2013)

Note that there are two types of cartilage in the knee - articular and meniscus - they are very different


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## buggi (12 Nov 2013)

also, i should add that my friends always said i cycled with my right knee in. I was constantly trying to correct it, which just gave me knee pain and was tiring. A few years ago i had the opportunity to cycle with a British cycling coach and he pulled me to one side and said "you cycle with your ankle out". Of course i corrected him and told him it was actually my knee "in", but at home i thought about it, and the exercise the physio had given me years earlier when she encouraged me to turn my foot out. I took heed, corrected my ankle, which brought my knee back in line and voila.
i think my most recent issue has been caused by the "travel" on my SPD allowing my foot to turn out again.


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## Pedrosanchezo (12 Nov 2013)

I think this time of year increases the risk of Knee injury and niggles. It takes longer to warm up properly when riding and the cold temperatures can also mask or numb the feelings in the legs/knees. 

As a general rule try to start out with a higher cadence than your normal and allow yourself time to warm up sufficiently before putting any real power down. Some suggest you could even increase cadence throughout the whole of winter in an effort to stave off knee troubles. 

Just thought i'd mention this seen as some people are mentioning that the pain has just started recently. There is quite a bit of research indicating that knee pain can flare up in the winter months due to dropped temperature and changing pressures - directly affecting the joints. This is more keenly felt in any existing past injuries. I had tendon damage and a dislocated knee cap on my left knee from a football collision. In winter i can sometimes feel a slight niggle which can be alleviated with some specific stretching. These days though if i have any hint of pain in the knee i make sure to ease off and if necessary take some time off to rest. 

There is some good reading out there on the inner workings of the knee

http://www.wholeathlete.com/assets/documents/winter_knees_01-09.pdf

And some decent thoughts on how to keep them in the best possible shape throughout the seasons: "An overuse strain is more likely to occur if a tendon is tight due to cold conditions; the exposed positioning of a cyclist's knees makes this a potential hazard"

http://www.livestrong.com/article/528877-bicycling-cold-weather-and-knee-injuries/


A thread about the subject here:

http://www.bikeforums.net/archive/index.php/t-319832.html


As a side note i also find that using foam rollers as a poor mans post ride massage very useful. Working the IT band especially, hurts in a good way.


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## Berties (12 Nov 2013)

Bike set up maybe,do you warm up slowly,do you warm down and stretch you leg groups out,a good Physio will point you in the right direction,not just in relieving the pain but finding the cause


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## Doyleyburger (12 Nov 2013)

vickster said:


> Look at saddle height and cleat position
> 
> Also, rest it. Was it a very hilly ride that aggravated it?


Hilly where I live, but to be fair I did a relatively flat route today and it was apparent within 15 mins or so. I will definitely look into my cleat position. Cheers


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## Doyleyburger (12 Nov 2013)

Thanks guys. I will look into the physio side of things. I remember injuring this knee whilst playing basketball in my teens. Perhaps this new found exercise that im doing these days has just flared it up again.


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## vickster (12 Nov 2013)

Are you making sure your knees are covered now it's colder as above and that you warm up and down properly with some good stretching of all of the leg muscles after


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## Doyleyburger (13 Nov 2013)

vickster said:


> Are you making sure your knees are covered now it's colder as above and that you warm up and down properly with some good stretching of all of the leg muscles after


Guilty for not covering the knees yet. ....but always warm up and down


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## vickster (13 Nov 2013)

Cover the knees. Do you stretch after too? If doesn't improve with correct saddle height and cleat positioning, maybe see a sports physio. Normally around £40-50 for an initial session, depending on where you are based


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## Doyleyburger (25 Nov 2013)

I went for a 19 mile ride today and the knee was much better. I kept it strapped up as well as wearing base layers which kept the legs warm. Also turns out I had my saddle about 2" too high. Browsed YouTube this morning and found a video which showed me how to give myself a basic bike fit/set up. All good, no aches and pains .....happy days !


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## Doyleyburger (21 Jan 2014)

Well the knee pain has flared up again. I think im fitted well to my bike but haven't had a pro fit done as I can't really afford it. Just had some experienced friends and YouTube help me out. I have looked into my cleat position and that seems fine also. Have booked in with docs to get it looked at, (doctor himself is a cyclist so that will be handy). Goes without saying that I have kept it warm and covered up during these winter months.
I can feel the pain when cycling but nothing compared to when I finish the ride and walking about the house. Trying to get up the stairs is a joke !
Might be worth adding that the pain happens when the leg is bending


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## vickster (21 Jan 2014)

Do you stretch and ice after riding?


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## Dusty Bin (21 Jan 2014)

Could be fibula related - have you whacked your leg on something recently? Maybe a partial dislocation - I had that once and the pain sounds similar...


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## vickster (21 Jan 2014)

Could be a kneecap issue? Where's the pain? Stay off the bike until you've seen the doctor


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## Dusty Bin (21 Jan 2014)

vickster said:


> Do you stretch and ice after riding?



Stretching and icing will only treat the symptoms, not the cause...


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## vickster (21 Jan 2014)

Dusty Bin said:


> Stretching and icing will only treat the symptoms, not the cause...


Yes but he is waiting to see the doctor for a diagnosis of the cause. Ice will help with inflammation in the meantime

He doesn't say whether he has stopped cycling while this is going on. Given he is happy with the fit of the bike and this is reoccurring, this would seem wise


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## Doyleyburger (21 Jan 2014)

Dusty Bin said:


> Could be fibula related - have you whacked your leg on something recently? Maybe a partial dislocation - I had that once and the pain sounds similar...


Not that I recall. Earliest appointment at docs is 10th Feb. I ride weekly at the moment so ill let it rest til Sunday or Monday depending when I can get out next. I do a little stretching after the ride, probably not as much as I should tho.


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## vickster (21 Jan 2014)

Ice too whatever dusty says. If you have pfs, the symptoms are congruent with the cause, ie inflammation. Do you have pain when bending but not weight bearing, is there clicking with pain, swelling?


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## PpPete (21 Jan 2014)

It *could* be ITB
I occasionally get soreness in same area, just outside of one knee.
Foam roller soon cures it, where other forms of stretching don't help

Might not work for you but I'd say unlikely to do any harm.


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## Doyleyburger (21 Jan 2014)

vickster said:


> Ice too whatever dusty says. If you have pfs, the symptoms are congruent with the cause, ie inflammation. Do you have pain when bending but not weight bearing, is there clicking with pain, swelling?


No clicking or swelling. Terrible pain when putting weight on it yes !
I have to keep that leg dead straight when going upstairs. Got a 12hr night shift tonight, will be interesting


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## vickster (21 Jan 2014)

Can you bend it and straighten it when sitting or lying? Where in the knee is the pain?

Have you taken some anti inflammatories, paracetamol and iced with some peas wrapped in a tea towel? If it's that bad, surely you can see a doctor sooner than 3 weeks? Call into work sick if you can't stand. Don't want to make it worse. RICE first for knee injuries. Hard to do if working on feet


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## Doyleyburger (21 Jan 2014)

Yes I can bend and straighten as normal , but with some discomfort at the moment. Normally eases off a day or two after riding. I'll see if I can get an earlier appointment I think, as I'd like to get it seen to ASAP


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## vickster (21 Jan 2014)

Good stuff. If it is that bad and has been going on a while, best not to ignore. Could be tight itb, muscle imbalance. Physio may help. Good sports physio about £40-50


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## Dusty Bin (21 Jan 2014)

Doyleyburger said:


> Yes I can bend and straighten as normal , but with some discomfort at the moment. Normally eases off a day or two after riding. I'll see if I can get an earlier appointment I think, as I'd like to get it seen to ASAP



Go for one of the 'turn up and wait' appointments, usually in the mornings.


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## vickster (21 Jan 2014)

My practice has open morning appointments, can't specify who you'll see though, depends who is covering

Or phone now for a cancellation


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## Doyleyburger (22 Jan 2014)

Just a thought. ......not sure if this is going to solve the problem. .....I currently use spd m520 mtb pedals and of course the relevant shoes. 

I keep coming back to the cleat issue.

Although I feel my cleats are positioned correctly I can't help feeling that a more fixed pedal & shoe combination would help me !? 
Less movement/rotation etc...... 

Like I said....just a thought


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## vickster (22 Jan 2014)

As this has been bugging you for two months and sounds troublesome off the bike, why not see the doctor and stay off the bike for a bit before spending lots of money on pedals and shoes?

What angle are your knees at when clipped in? What angle are they at when sat on a table with feet dangling? Are they the same? Try flat pedals / pedals with toe clips and see if that helps? But I'd still favour staying off the bike and seeing the quack


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## Doyleyburger (26 May 2014)

So I have been riding with my knee problem for months now. Doctor provided me with some anti-inflammatory tablets which work well in between rides. 
The wife bought me some new spd-sl shoes and pedals as I have been using spd's since I have started cycling almost a year ago. The new pedals and shoes seem to have done the trick.....yesterday's sportif event is proof enough I would say. 117 miles with 10,500 ft of climbing and no trouble at all !
Such a relief to not have to put up with the pain


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