Sorry, another aching knee.....

[Willo]

Conscious that this a common topic raise and, in any case, it's impossible for a forum diagnosis given the variables involved. However, would welcome the sound views of others on this forum (especially as I've probably stretched my work health insurance to the hilt with previous running aches and sprains!).

While in France a couple of weeks back I went on a few early morning rides between 10 and 20 miles. After clipping out my right foot at a mini-roundabout to let a lorry pass, when I continued I started to feel an ache on the outside of my right knee. I initially thought I may have twisted/pulled something when clipping out but the timing could be coincidental. Anyhow, 2 weeks on, when I cycle the dull ache comes on after a while, always in the same place on the outside of the right knee and starts to worsen/spread a little the further I go (but never so much as it becomes really sore, just an annoying ache). I will have a play with the cleat positioning ( I use shimano touring pedals with SPD cleats and Sidi shoes which have otherwise been okay for the last few months). The ache doesn't appear at all when I run, so it's definitely aggravated by cycling. I'm wondering whether a) when checking my cleats a few weeks back, I inadvertantly repositioned the right shoe slightly and the affect showed up when I done a bit more cycling than normal in France (I will adjust it, but always find cleat positioning a fairly random science) or b) I somehow pulled/twisted something when I clipped out just before first feeling the injury. Anyone have any ideas - is pain on the outside of the knee a typical symptom of cleat positioning etc. or am I barking up the wrong tree?

thanks

 

[montage]

Knee pain is a department which I can shed some help on

Cleat position could be an issue, so it could be worth seeing who is local to you that can get that checked.
I would also go to your GP and get the ball rolling incase it is something more serious - prevents you having to wait for a long time if the knee does get worse.

Give ITBS a google (Illiotibial Band syndrome) - there is some good stuff on the internet about it, enough to make a possible self diagnosis.
Does any of the knee hurt if you massage it?
Is it the kneecap that is hurting, or more on the side of the knee?
How much float does your kneecap have? (can you almost poke underneath the kneecap or is it really hard to move?)

 

[ASC1951]

Give ITBS a google (Illiotibial Band syndrome) - there is some good stuff on the internet about it, enough to make a possible self diagnosis.

ITBS is a real problem for cyclists, isn't it, Montage? All that repetitive load, in a position which never fully stretches all the leg muscles and linkages.

I had a sports massage a couple of days ago, for the first time ever. Physio took one look at my jodhpur-like legs and warned me that I might find deep ITB massage "a little uncomfortable". It was the most excruciating voluntary experience I have ever endured. "Well", she said, "if you are going to get all your exercise on a bike, that's what you can expect if you don't do remedial stretches and have an occasional massage".

Still, at least my kneecaps have come round to the front again.

 

[montage]

ITBS can be a huge problem, as can short/very tight hamstrings. I'm lucky in that I get both!

 

[Willo]

Thanks for the replies. From a quick search online, ITBS certainly fits the bill in terms of symptoms. However, it doesn't seem to hurt when running (which I would've thought would aggravate it if there's an actual injury), but just the cycling so maybe it is the foot position (one cause cited is having the feet "toed in" to an excessive angle during cycling). Taking that definition literally, I'll check the position of the cleat to make sure my toes are not pointing inwards.

On a short cycle home from the station tonight, it immediately ached on the bike, where there's no pain otherwise, before or after, which makes me think it is the foot positioning. Anyhow, will try and resist the bike for the rest of the week and will look at the foot positioning at the weekend.

 

[Norry1]

When I started cycling a few months ago, I started getting pain on the outside of my kneecap. I read on here about the Iliotibial band and did some stretches. Magically, the pain went away. I do them every now and again and have had no further problem. The stretches are a bit weird, but do the trick

Martin

 

[HLaB]

Willo as well as the angle of the cleat (as explained by Park) the lateral position of cleat can also cause a pain, this BRadar article is quite good in showing you how to move the cleat to alleviate it.

 

[montage]

I'm surprised a dodgy cleat angle would make your knees hurt straight away. Try cycling with flat pedals for a bit - if there is no pain then cleat angle is the issue. Having said that, your knees may be inflammed which can take a while to go down - ice at least once a day to try kill any inflammation.

Hopefully, it is ITBS - easy to cure. If you are unlucky it will be something like a maltracking kneecap, which may or may not be solved easily. A slight maltracking kneecap may hurt whilst cycling, but not whilst running - please get to the GP and get the ball rolling on this incase you are unlucky and it is something more severe than ITBS

 

[montage]

Also, get your saddle height right - splash out for a professional fitting if you can, it is worth it

 

[Willo]

Many thanks again. Reading the links (thanks HLaB) realise I've been a little blase with my positioning. I did tweak them some time back as my foot was scraping the crank every now and then. Will have a proper check over the weekend but suspect I twisted it inwards rather than move the cleat position across but retain the same angle. Given I was doing some more riding in France it may have only then showed up as a problem. Will be sensible and avoid the bike until next week and then test out as Montage says. Will look around for someone localish who can do a proper fitting (fairly limited in terms of cycle shops in my part of Kent)

 

[Willo]

Does any of the knee hurt if you massage it?
Is it the kneecap that is hurting, or more on the side of the knee?
How much float does your kneecap have? (can you almost poke underneath the kneecap or is it really hard to move?)

Montage, I've been browsing via my blackberry for the last couple of days, so missed your questions above.

To answer:

Doesn't hurt if massaged
Aches on the outside of the knee
It's hard to move my kneecap

Thanks again for all the helpful advice.

 

[Willo]

Sorry for the running commentary of my creaky legs, but in the gym this morning I tentatively tried the spin bike without being clipped in and, with everything feeling okay, done 25 minutes without any problems. Therefore, may well be the cleat angle so will have a look at the weekend and see how that works next week. Thanks again for all the advice - really helpful.