Advice needed. Help a paracyclist to continue cycling.

[Eoin Scollard]

Hi Guys,
I have lower limb Cerebral Palsy and I've been cycling a trike for nearly a year now and for most of that time its been great. I've been touring done TTs, triathlon and a even a criterium. Recently however I've been getting knee pain on the outside of my right knee at the top of the stroke and cant cycle more than 5 km without pain. Ive been to the physio and massaged foam rolled (ITB, outer calves) stretched (quads, hamstrings) and strengthened (quads glutes). Fiddling with the bike fit lowering the saddle and a putting the foot straps closer to my feet helped but knee pain still occurs. Because of me condition my feet are at awkward angles on the pedals and my right leg goes inward on a downstroke. I am in the process of shortening my cranks to 160 from 175mm and hoping that will help. This process has been a drain of finances and I'm not comfortable paying for a bike fit, spd pedals or much more physio. Are there people out there that could advise me? What should I do?

 

[ttcycle]

This sounds quite specialist, where are you in the country? There might be a disability cycling organisation that can help you but depends on location and even then they may not have the required expertise.

 

[Jon George]

I have to say that the crank reduction length seems quite a transition and, IMO, if you haven't already made the purchase, I'd invest in a bike fit at your LBS. I'm sure they'd do a basic set-up at an affordable rate anyway, so I'd make enquires. My only other thought is, if you have any engineering friends, why not try bracing your right leg further to stop the twisting?

 

[Crackle]

You don't mention the timescale of all this. A lot of what you described is currently familiar to me, especially the exercises. I haven't continued cycling or running, the most I've done is a few gentle spins on the turbo. I can slowly feel things improving but I'm not attempting to make a slow comeback until it's all settled down and everything I've read says that it takes time.

There's a good website here: http://www.knee-pain-explained.com/knee-pain-diagnosis.html

Of course it doesn't deal with your particular condition, for which you might need more specialist help but it does explain a lot about knee pain and recovery.

The other person who might truly be able to help with setup is @mickle

 

[fimm]

Eoin - just to clarify, I'm assuming you are riding a conventional upright tricycle?
Also, are you saying that in the past you have been able to go further? Can you think of anything that might have changed with your bike set-up?

 

[Sharky]

I have to say that the crank reduction length seems quite a transition and, IMO, if you haven't already made the purchase, I'd invest in a bike fit at your LBS. I'm sure they'd do a basic set-up at an affordable rate anyway, so I'd make enquires. My only other thought is, if you have any engineering friends, why not try bracing your right leg further to stop the twisting?

Just a note about crank lengths. After researching on the net about short cranks and the claimed advantages in power output and aero position, I decided to experiment with a pair of 150mm cranks. I was able to get a more comfortable position by raising the saddle about 2cm and now feels really good and you hardly know the difference from the 170's. I've since converted my stable from N to N-3 to using short cranks. Some bought (SINZ cranks) and some re-drilled by http://www.highpath.net/. Highpath also do a device to attach to normal cranks to achieve multiple crank lengths, which might be an option to experiment with. One of my stable is now on 145mm cranks and feels good on the turbo.

Cheers Keith

 

[mickle]

Where are you Eoin? I can help if we can find a way of meeting up. Im based in york but i get around.

 

[Eoin Scollard]

Hi Guy wasn't notified of your replies as i had, so I was pleasantly surprised when checking it again. I'm located in Dublin, and cycling one of the only decent upright trikes in the country. I've change trike from a mobility trike to a Longstaff in December and pain started in Early February. The cranks were shorter on the mobility trike so I'm hope shorter ones will do the job but it had different saddle position aswell (horizontally). I have not cycled much and been attempting get me knee strong since. A brace is something i hadn't thought of I was working on my adductors to try and keep my leg out. Thanks for the link crackle its a good source. Mickle obviously me being in Dublin meeting might not be possible but any advice you could give me if I send photos etc would be much appreciated. Thanks guys.

 

[mickle]

Its a small world Eoin. You bought your Longstaff from my colleague Andrew. He and I have been discussing your knees. Or should I say kneeds? I'm pretty confident that short cranks are the answer.