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  1. #1
    RoadBikeReview Member
    Join Date
    Apr 2011

    Knee Pain Related to Handlebar Adjustment, Is It Possible?

    Hi all,

    I have recently been hit with pretty bad knee pain that is keeping my cycling limited. The pain is just above/under the knee cap on inside portion of the knee, basically right where the inside quad hits the knee cap.

    Here is the back story. Keep in mind this is my cross bike so does not see near the amount of miles my road bike does, nevertheless I did put in a fair amount of rides on it in the past 6 months. Back in September of 2014, I had the bike fit by a trusted individual with a great reputation. I have not had any issues on the bike and rode 3-4 100 mile + rides without pain. In mid April, I saw the fitter again to adjust the handlebars to position where I was more comfortable in the drops. The result was the bars were brought closer to me by about 10mm and raised up about 23mm. The new bar position felt great. My first ride with the new bar position was a 125 miler. Probably 80 miles in, my knee really started bothering me. Being the stubborn idiot that I am, I continued on through the pain and finished the ride despite barely being able to ride at the end. Needless to say, I am still dealing with the injury.

    My question is this: Could the knee injury be related to the handlebar change that I made?

  2. #2
    RoadBikeReview Member
    Join Date
    Apr 2012
    Quote Originally Posted by ChuckDiesel View Post
    My question is this: Could the knee injury be related to the handlebar change that I made?

    So you brougght the handlebars up almost an inch and brought the stem back almost 1/2". And the first ride you did out of the gate with this setup is/was a 125miler? Wow, ok. So could this be related to position changes, possible. Could it be just something that would've cropped up no matter what, equally possible. But let's address the former, and go with it.

    I am sure you already know, the body is an adaptive machine. You change something somewhere in your position, it is pretty much going to affect a lot of things. Bringing the stem back and the bars up, has this biomechanical effect on your body (this is a general rule, some people it may not apply too)

    1) you are now sitting a bit more upright

    2) equally, you have limited the distance you used to use to stretch out on the bike

    3) when most people are faced with a shortened, more upright cockpit than what they are used to with regards to their on-the-bike normal position, their natural tendency is to start arching their lower back ever so little as the brain/body attempts to stretch out like it is used to & be in the pedalling position it is used to

    4) next thing that happens as the lower spine arches is that your pelvis begins to rotate back & down a little (due to the force of the spine arching). As the pelvis rotates back & down, it forces your legs with it by fact that they are hooked together at the hip socket.

    5) as your pelvis brings your legs, you've just effectively shortened the reach your lower body has to perform to reach the pedals like it is used to all because you've made your legs longer by arching your lower back.

    6) since the reach to the pedals have been shortened by you making your legs longer with arching your back (try it at home in a chair, arch your lower back, and watch your knees move even further out), something somewhere is going to have to compensate as your brain/body attempt to do the pedal stroke that is ingrained into its system. Guess one of the places that takes a hit on a majority of people when they shorten their reach to the pedals and don't allow a sufficient break-in period to allow everything to adapt? The inside of their knees, as the leg flops to do the same pedal stroke, and since it is now a bit longer, the leg collapses to the inside just a bit as it feels increased pressure, and puts pressure on the interior patella track and also where your VMO attaches it ligaments on the inside right in the same area.

    I know you don't want to hear it, but i equally know you've heard it and just chose to ignore it: when you make bike position changes, and they are bigger than a few mms, then give your body some time to adapt. Don't just go out and crank an 125 miler right out of the gate. Use your noodle and allow your body to adapt, then when you've given it time (start easy and short, then over 3-4 weeks get progressively harder by sprinkling in pushes and allow the longer rides to come naturally), then you should be good. I can pretty much guarantee you that anyone, young and/or old, that makes significant on-the-bike position changes, and tries to crank it & ride it long immediately, is going to run into some quite painful areas on their body that they never experienced before.

    Good luck.

    P.S. Excuse any grammar errors, pounded this out fast, will be back in a bit.
    Last edited by BelgianHammer; 05-13-2015 at 08:49 AM. Reason: Change the lengthen to shorten

  3. #3
    RoadBikeReview Member
    Reputation: ibericb's Avatar
    Join Date
    Oct 2014
    It's possible, but a bit unusual. What may have happened is that in the more upright position you've slid forward/or backward a tad, and are now able to apply more force on the pedal in the power phase of the circle, or at least apply more at a different knee angle. The resulting pain may be temporary as you adjust and adapt to the changed position, rather than an enduring injury. After changing a saddle not long ago I developed knee pain similar to what you describe, but probably less severe. The fix in that specific case was to raise the saddle 5mm to reduce knee flexion about 4 at the top of the circle.

    First, you need to heal and recover. Second, you need to see that fitter again, or at least talk with him/her about a follow-up adjustment.
    "When man invented the bicycle he reached the peak of his attainments."
    -Elizabeth Howard West

    Never use your face as a brake pad.
    -Jake Watson

  4. #4
    RoadBikeReview Member
    Join Date
    Aug 2009
    Yeah I agree with BelgianHamm. You need to let the body adapt to any changes that you do to your bike big or small. Anything else different in the last ride? Average speed about the same + or -

  5. #5
    RoadBikeReview Member
    Reputation: looigi's Avatar
    Join Date
    Nov 2010
    Agree with above that physiologic adaptation is a huge factor so it's best to take a gradual approach to changes.

    In moving your bars up and back what value does a having a fitter do it add over doing it yourself or having a mechanic do it?
    ... 'cuz that's how I roll.

  6. #6
    RoadBikeReview Member
    Join Date
    Apr 2015
    anyone who gets knee pain, no matter what fit problem they have, i am 100 percent sure that they could fix the problem by strengthening the hamstrings and gluteal muscles, without this, your kneecap gets unequal tension front/back. it worked for me.

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