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So I've got a brand-new knee pain.

Today on a fairly long ride (65K), I started to have pain on the inside of my knees. It started very mildly in the left knee, but that went away, and it started on the right knee, also on the inside, and got worse. It only started on the right after about 50K, so I was on my way home anyway.

Since I've been home, the pain has persisted. It's very odd to me, because on the bike, the pain was worst when I was pulling up on the pedals. Mashing didn't hurt (and I wound up doing that a little on the way home to stop it hurting, and hopefully keep things from getting worse). Now that I've been off the bike a couple of hours (and I stretched VERY thoroughly), the pain comes when I lift my knee. It does not hurt to have a load on the knee and bend it, but if I just raise my knee, it hurts raising and lowering it. Very odd. I'm not used to pain that comes only from unloaded motion and not with loading.

I've been riding a fair amount this winter, but not a ton. I haven't changed anything on the bike, nor my shoes in the last 700 miles or so. Cleat position has remained unchanged for quite some time. I am pigeon-toed, so I have my toes turned in some--and I hear that the usual cause of medial knee pain is having your toes not turned in when you need it. Since I have them turned in, and they've been fine up to now, I'm not thinking this is the issue.

Here are the possible changes: I wore just shorts today for the first time in a while--I've been wearing tights and shorts. This seems like too small a change to create seat-height problems. I have been off the bike for two weeks, but routinely ride 60K or more on a weekend day in the winter. I had a full-body Thai massage last weekend--could he have upset some delicate muscular imbalance I was depending on? Finally, I experimented a little today with TT body position. No clip-ons, but I did try getting in the drops and getting forward onto the rivet some. Probably only about 15 minutes total out of 2.5 hours, though, and never more than five minutes at a stretch. No particular link between that kind of riding and the pain that I noticed.

Still, I suspect it was the TT position that might have caused the issue, but I'm not sure how. What changes that might effect the knee when I'm in the drops (I don't usually use them much) and on the rivet (sitting well forward). Maybe it wasn't that at all, but it would seem the best choice I've come up with.

Ideas? Explanation of how that TT position upsets my setup? I'm taking anti-inflammatories and taking it easy today, but I had hoped to ride tomorrow. Not looking so great at the moment.
 

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I'm sitting here with what sounds like a very similar condition. Though I wonder what you mean when you write the pain is occurring on the inside of the knee. Do you mean the side of the knee towards the inner seam of your pant leg?

I attribute my pain, which is relatively low intensity but almost constantly present and which gets worse when I try to lift my knee to pulling up much too hard during spinning class. Doesn't hurt to push down, but right now, pulling up ain't such a good idea. I've been taking aspirins but they're not helping. I've done this before on my road bike and for me, it's a result of pulling up much too hard on the upstroke.
 

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Fini les ecrase-"manets"!
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AnotherRedRyder said:
I'm sitting here with what sounds like a very similar condition. Though I wonder what you mean when you write the pain is occurring on the inside of the knee. Do you mean the side of the knee towards the inner seam of your pant leg?

I attribute my pain, which is relatively low intensity but almost constantly present and which gets worse when I try to lift my knee to pulling up much too hard during spinning class. Doesn't hurt to push down, but right now, pulling up ain't such a good idea. I've been taking aspirins but they're not helping. I've done this before on my road bike and for me, it's a result of pulling up much too hard on the upstroke.
Yep, pain on the inseam side. Sounds like yours is the same as mine. I got relief from one of the Naproxen Sodium (motrin?) generics from Safeway. They're way too strong for me to take many of, but a couple yesterday and one this morning seems to have me sorted. For anti-inflammation, nothing's better in my book (if your stomach can take them). And I iced it twice too.

I do have a tendency to pull up pretty strongly when climbing, but I've never had this one before. Certainly pulling up made it hurt worse. Right now, I'm imagining that my Floyd-Landis-on-the-rivet impression was probably what upset the apple cart. I'm taking the rest of the week off the bike, then I'll be back on next weekend, without trying to keep up with my pal who's training for a TT, and see if I'm back to normal.
 

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Moving forward on the saddle will compress the knee angle. It would be like lowering your saddle about a centimeter or so. Depends on how far forward you were on the saddle. You may be on to something as far as defining what caused the pain. Forward on the saddle, pushing and pulling very hard at possibly a low rpm could result in pain. Especially early in the season when you begin to rack up the miles.

Normally moving back and forth on the saddle would never really make much of a difference. However, with a hard sustained effort early in the season, it doesn't take much to over do it.

Something to understand with fore and aft movement of the saddle. When the saddle moves forward, the saddle height is effectively lowered. Vice versa when the saddle is slid back. Do you ever feel like you can push more through the pedal stroke when you sit further back when climbing a steep hill?

Here's an example, on a steep seat angle TT/tri bike the main reason is to decrease the rider's hip angle and allow them to achieve a more effective position in the aerobars. If you compared the TT bike to a road bike, the seat heights would be much different. The TT bike would have to have a much higher saddle height because of the more forward position.

If you can, try to get out and ride easy at a higher rpm. Say between 90 and 100 rpms for about an hour. A nice easy smooth spin can do wonders for sore knees. Hope this helps you out!
Mike
 

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What were the temps when you were riding? If it was below 65 degrees your problem might have been riding without tights. Your knees can do strange things when exposed to a little cool air. I refuse to ride without knee warmers unless I start a ride in the mid 60s and know it is going up over 70.

If I was guessing I would say that riding without tights would be your prime suspect in your knee pain case.
 

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bigrider said:
What were the temps when you were riding? If it was below 65 degrees your problem might have been riding without tights. Your knees can do strange things when exposed to a little cool air. I refuse to ride without knee warmers unless I start a ride in the mid 60s and know it is going up over 70.

If I was guessing I would say that riding without tights would be your prime suspect in your knee pain case.
I'm not sure what the starting temps were, but 65+ wouldn't have been out of the question. It was pretty warm here this weekend (85 predicted for today!). I don't think temperature is a more likely factor than my monkeying with my position. I've worn plain tights on some VERY cold days this winter without problems (apart from being a little cold).

Aren't you in the DC area? You were on the DC RBR ride last fall, weren't you? I routinely see a guy in Rock Creek park on the weekends that fits the general description of the person I thought was you on the RBR ride. Is it you (would have been in a retro-style Bianchi jersey this weekend, and typically in the company of a 'bent or two)?
 

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Yeah, I am an hour and a half north of DC.

The reason I said that may be the problem is that it started out in the low 50s in the morning and then climbed to high 70s. If I ride in below 65 degrees my knees ache if they are not covered.

I was on the DC RBR ride but never frequent Rock Park and am not allowed to ride with bents because I don't have a beard. :)

If your knee problems turn out to be caused by the bike can I have it?:D
 

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bigrider said:
I was on the DC RBR ride but never frequent Rock Park and am not allowed to ride with bents because I don't have a beard. :)

If your knee problems turn out to be caused by the bike can I have it?:D
I'm not an engineer, so I too have to steer clear of 'bents. You need to be an engineer to explain how they're superior, even though you mysteriously avoid hills like the plague.

You get my bike from my cold, dead, fingers and like that.

I just gotta learn not to play around on it when I'm not physically ready for it.
 

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bikeboy389 said:
I'm not an engineer, so I too have to steer clear of 'bents. You need to be an engineer to explain how they're superior, even though you mysteriously avoid hills like the plague.

You get my bike from my cold, dead, fingers and like that.

I just gotta learn not to play around on it when I'm not physically ready for it.

Just gonna make the generic comments. I battle medial knee pain through the year. In general it's worst in the spring because of:

-Upper legs not as strong therefore more stress on knees
-Temps don't allow you to warm up as fast as you think (stated earlier)
-Pedaling in too low RPMs on hills because not in shape enough to spin out the normal gears (my major cause)

Early season on hills or when hammering I'll force myself to slide back furthur on the saddle than is comfortable to help this. Your problem sounds fairly similar to mine. Medial knee pain is rarely serious enough to need medical attention so you have that going for you.

The most common cause of knee pain is a condition called "medial plica" where the cart. has a "groove" or bump in it. This isn't serious. Just build up the low RPM high watt training slower.
 
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