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  1. #1
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    1st Century report and knee question

    Hi,
    I have been following RBR for some time (but I have not posted much.) I completed my first century (Katy Flatlands Century) this past Sunday.
    Prior to the century my longest ride has been a few 45 mile group rides.
    Per my bike computer my ride time was 5hr 57min and a distance of 102.19 giving me an average speed of 17.16 mph.

    My shoulders and arms were pretty sore, but overall it felt good. One issue I am having (and the reason for this post) is pain on the outside of my right knee. From what I have read during my search is this appears to be an issue with the IT band. Per recommendations I went a purchased a foam roller. Before using the roller 2-4 times a day I could only go 5-6 miles before I had a good deal of discomfort in my right knee. Now that I am using the roller the pain does not show up for 20-25 miles. It starts out weak and by about 40-45 miles it is pretty intense.

    What are some recommendations to minimize this type of pain on longer rides 40-100? I have tried many stretches that I found online, but the only thing that seems to work is the foam roller. The problem is I do not carry a foam roller when ridding.

    To give a little more background:
    I am 33 years old, 5'8" & 170 pounds
    I try and keep my cadence around 85 rpm. On shorter rides (15 miles) I have tried using a higher cadence around 90rpm, but it did not seem to make a difference on the knee pain (although it was hard on my lungs.)

    I purchased my bike in April it is a CAAD 10 rival. I had a quick fitting when I purchased the bike. The guy at the lbs only adjusted the seat height.
    In June I took the bike to another LBS and purchased a new saddle (Selle SMP dynamic.) I paid this LBS to fit me for the bike. I am glad I did as they changed my cleat position, seat height, steam height, steam length, and the angle of the bars.
    With the new fit I feel really good on the bike (with exception of my right knee.) The new fit did not seem to have any impact on the knee pain. One recommendation the lbs made was to possibly try a shorter crank (165mm.) I am hesitant to try the new crank due to its cost and not knowing if this will even help my situation.

    Any recommendations on this type of knee pain would be appreciated. Also if anyone has any feedback if shorter cranks will make a difference.

  2. #2
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    When I started training for my first century I started developing knee pain in my right knee. Mine was caused by a leg length discrepancy. My right leg is shorter by almost 2cm. The quick fix was to adjust my saddle by my short leg. At least this kept my right knee from hurting.

    The long term cure was to get my right shoe shimmed. This brought my right leg closer to the length of my left so I could have a better saddle height for both legs and no more knee issues.

    Don't really know if that could be your issue but just putting it out there.
    "I like to ride my bicycle." - Lance Armstrong -

  3. #3
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    Try adjusting you cleat so your toes point slightly in.
    That's the longest I've ever ridden without a beer stop.

  4. #4
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    I will give that a shot and see if it helps, thanks.

  5. #5
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    Ice, ice and more ice.

    Once you irritate the ITB its very hard for it to calm down because its a ligament. After each ride I would ice it, take ibuprofen (take it regularly to combat the swelling as this is what is causing the pain) and take it easy. If it hurts at 40 miles so bad that you are changing your pedaling then you need to cut it back.

  6. #6
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    I'm a bit surprised that no one has suggested this...I would first see a doctor to really find out what your problem is. Self diagnosing and relying on an internet board is a prescription (pun intended I guess ) for more troubles.

    Go see a Doc!
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  7. #7
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    Re: 1st Century report and knee question

    No suggestions, but congrats on the century! I was on corner 10 directing riders.

    Side note, I had knee pain on the inside of the knee. Had my cleats shimmed, adjusted and the seat height adjusted and it fixed the problem for me. Good luck!

  8. #8
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    Quote Originally Posted by leadout_kv View Post
    I'm a bit surprised that no one has suggested this...I would first see a doctor to really find out what your problem is. Self diagnosing and relying on an internet board is a prescription (pun intended I guess ) for more troubles.

    Go see a Doc!
    ITB injuries are fairly easy to diagnose and fix usually. Rest and ice is the only thing that will help and the rest has to come rather fast or it can actually damage the ITB. I've gone through it on both knees and I've treated it a lot while I was medic in the Army.


    I didnt catch the toe-in comment until just now. You do NOT want to do that. It will put your leg at an inward angle and put more pressure on the outside of the knee. If anything, you want it to toe-out. You could also try raising your seat a little to get you less leg angle on the upstroke so it wont rub your lateral condyle as much.

  9. #9
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    Quote Originally Posted by leadout_kv View Post
    I'm a bit surprised that no one has suggested this...I would first see a doctor to really find out what your problem is. Self diagnosing and relying on an internet board is a prescription (pun intended I guess ) for more troubles.

    Go see a Doc!

    It could be something different, but I am pretty sure it is the IT band. When it is sore and acting up I have no pain when walking. When I bend my knee to sit down or do a squatting motion I get a sharp pain. If i use the foam roller for 2 min. I can immediately do a few squats with zero pain or discomfort. After a few squats the pain returns.

    thekarens- Thanks for helping out it was a great event. I guess that means you are
    with the Northwest Cycling club. I have been going out to Zube park for the Saturday group rides (3 out of the last 5 rides.) Seems like a great group and I now spend all week waiting for Saturday morning.


    bballr4567- When you say rest how long are we talking? Am I just waiting for the pain not to be present under normal day to day activities, Or should I rest longer? I have been dealing with this issue for about 5-6 weeks. The most rest I have had without riding has been 3 days (obviously this has not been enough rest.) During the weekdays I try to ride 3 nights (mix of 15-20 miles per ride, or 1-2 hrs on a trainer.) During this I can feel a small amount of discomfort in the knee, but it does not make me change my position or pedaling technique. On Saturday i do a longer group ride (45 miles) at a faster pace. I do not think i change my pedaling but I do curse to myself for the last 15 miles . I will try to raise the seat height and see if that helps.

    Thanks everyone for the suggestions.

  10. #10
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    Rest means like two weeks. It sucks to be off the bike that long but with ITB injuries it literally just takes time to recover. Its the same as an ankle sprain.

    The reason the roller works is it gets out a lot of the extra fluid. Once, it comes back, it hurts again.

  11. #11
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    Quote Originally Posted by bballr4567 View Post
    Rest means like two weeks. It sucks to be off the bike that long but with ITB injuries it literally just takes time to recover. Its the same as an ankle sprain.

    The reason the roller works is it gets out a lot of the extra fluid. Once, it comes back, it hurts again.
    Thanks, I guess I will force myself to take a few weeks off. In your experience is this going to be a reoccurring issue, or only re-occur if I over stress it?

  12. #12
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    I have been dealing with knee pain on the inside of my right knee for well over a year. I have been seeing a sports chiropractor, which has helped a whole lot, but it still occurs sometimes. I needed a shim under my cleat. Maybe a shim angling the other way will help you. I'd recommend seeing someone about it

  13. #13
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    Quote Originally Posted by Bmusick View Post
    Thanks, I guess I will force myself to take a few weeks off. In your experience is this going to be a reoccurring issue, or only re-occur if I over stress it?
    I've never had it pop up again in either knee once I let it heal.

    I did have a couple guys who kept having issues but they had gait issues that would cause them to be a little bow legged so they would get it reoccurring.

  14. #14
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    Quote Originally Posted by leadout_kv View Post
    I'm a bit surprised that no one has suggested this...I would first see a doctor to really find out what your problem is. Self diagnosing and relying on an internet board is a prescription (pun intended I guess ) for more troubles.

    Go see a Doc!
    +1

    Not like it costs anything besides a few minutes of your time.

  15. #15
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    Quote Originally Posted by DCash View Post
    Try adjusting you cleat so your toes point slightly in.
    this may be entirely coincidental, but here's my story. i have had pain on the outer part of my right knee since forever. through two fittings, several seat height adjustments, and new shoes. nada. my doctor thought it's my gout--it lingers in my joints, and that cycling was an activity that particularly heightened the pain in that area. medical tests otherwise show nothing wrong with my knee.

    anyway, last week before my group ride, i angled the cleats of my right shoe so that they pointed inward. went for a 43 mile ride on saturday, followed up with 22 on sunday.

    bingo! no right knee pain.

    not sure if it's the cure for the OP, but it certainly worked for me.

  16. #16
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    Quote Originally Posted by dnice View Post
    this may be entirely coincidental, but here's my story. i have had pain on the outer part of my right knee since forever. through two fittings, several seat height adjustments, and new shoes. nada. my doctor thought it's my gout--it lingers in my joints, and that cycling was an activity that particularly heightened the pain in that area. medical tests otherwise show nothing wrong with my knee.

    anyway, last week before my group ride, i angled the cleats of my right shoe so that they pointed inward. went for a 43 mile ride on saturday, followed up with 22 on sunday.

    bingo! no right knee pain.

    not sure if it's the cure for the OP, but it certainly worked for me.
    I heard this is also a legit fix for the lateral knee pain. I ride with the Shimano Dura-ace PD-7810 pedal and cleats with no float adjustment (the red ones). I was told by a pro fitter that I should try the Speedplay Zero pedals as they have up to 15 degree's of float. You see, my right leg points out slightly when I walk and being clipped in to a fixed parallel position to the bike, was damaging my ITB (I think).

    I ordered up the Speedplay Zeros which should be here Thursday. I have an appt. with the pro fitter the following Friday. Crossing my fingers that this solves the problem. After my Century last Sat. it kinda bummed me out with the amount of discomfort

  17. #17
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    Update.

    I was going to take a full 2 weeks of and see if it would heal. Time off the bike actually seemed to bother me more. To be honest what hurt my knee the most was sitting on a toilet. I guess the hard seat pressing into my right hamstring caused my right knee to hurt. I started doing intensive hamstring stretches and within a few days I could ride with almost zero discomfort in my knee. My hamstrings have never bothered me, but I am also very inflexible.

  18. #18
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    Get a nice pair of heat moldable shoes. If you have flimsy poorly fitting shoes they can screw up your pedal stroke and cause discomfort (that's what happened to me). I fixed it by buying a pair of bonts.

  19. #19
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    Quote Originally Posted by Bmusick View Post
    Update.

    I was going to take a full 2 weeks of and see if it would heal. Time off the bike actually seemed to bother me more. To be honest what hurt my knee the most was sitting on a toilet. I guess the hard seat pressing into my right hamstring caused my right knee to hurt. I started doing intensive hamstring stretches and within a few days I could ride with almost zero discomfort in my knee. My hamstrings have never bothered me, but I am also very inflexible.
    Well, that actually makes a lot of sense. Hamstrings have a lot to do with how well you bike. If yours are pulling you tight then it can change your pedaling motion. Taking the time off the bike took the time you stretched them out of the equation so they just kept getting tighter.

  20. #20
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    I have a similar issue as you do, Bmusick, although mine is on the left knee. The first time I felt it was during the second day of AIDS/LifeCycle (7-day, 545-mile ride) I had already completed 3 centuries previously, but this was my first time of long back-to-back rides. I managed to make it through the event, saw a doctor after the ride, and was ordered off the bike for a minimum of 2-3 weeks.

    My doctor's diagnosis wasn't just an irritated ITB, but extremely tight quads and hamstrings as well. The overall recovery suggestion was: rest, multiple sessions of deep tissue massages, and then stretches and exercises.

    Daily foam rolling has helped, but I'm much lazier with the stretching and strengthening routines. I'm close to "normal" now, but I try and incorporate the stretching immediately after rides.

    During actual rides, when taking rests/breaks, I try to stretch as much as I can. That's helped to stave off ITB flare-ups during the actual ride, but I do feel the onset of those every now and then.

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