Road Bike, Cycling Forums banner

Bike fitting for a knee injury

1K views 10 replies 6 participants last post by  Xcelerate 
#1 ·
Okay, I won't go into as many details as my first post on these forums, but basically I have Chondromalacia/patellofemoral pain syndrome in both knees (wearing away of the cartilage) caused by running. However, even when it has been extremely painful to walk, cycling has not caused any pain thus far.

From reading a few websites, it seems that the reason for this is that runners generally experience the pain/cartilage wear on the inner side of the knee (almost at the edge of it), whereas cyclists feel the pain directly behind the patella (kneecap). Can anyone confirm this from a cycling perspective? I have not felt any pain directly behind my kneecap, so I think my cartilage there is still doing alright.

As I am purchasing a new bike at the beginning of May, I went to my LBS a couple of days ago for a test ride. I'm pretty much settled on the CAAD10 4, however, the employee at the shop noticed that my knees bend in a lot when I pedaled. Of course, the pedals were made of disposable plastic used for test rides, but I think my knees bend in regardless.

Anyway, I am trying to minimize anything that could possibly cause further knee pain. I don't want to lay down a lot of money (from a college student's perspective anyway) for a bike just to get injured midway through the summer.

So I guess I'm looking for advice from anyone who's had a similar issue or is knowledgeable on this subject. One thing that I think will help will be getting a professional fit by the LBS when I purchase the bike, but more generally I think I need to err on keeping the seat higher, pedal at a higher cadence -- and should I get a compact instead of a standard so hills won't be as taxing? Before my injury I used to pedal-mash and stand up on the bike going up hills, but I have completely stopped this.

Are there any sorts of special pedals that can help to minimize knee injury? I have recently gotten orthotics from a podiatrist to put in my regular running/walking shoes, but can these be transferred over to bike cleats? And since I'd like to keep my aerobic fitness up the best I can, I'll be training about 4-5 hours a day over the summer (I don't have anything else to do each day). With this much time, is there something else I need to be doing to minimize injury from cycling?

Thanks a lot!
 
See less See more
#4 ·
1. Get professionally fit before you buy the bike.
2, Stop running
3. Don't overtrain -4-5 hrs / day seems quite excessive.
4. Try speedplay X's - pedals for max float.
5. Stay off hills for early part of training.
6. Compact - good
7. High cadence - good
8. Raise seat - good to a point.
9., do leg excercise - to strengthen quads
10. Watch seat angle on bike - too upright and you may put torque on kneed.
 
#5 ·
Just because you have a lot of time on your hands, doesn't mean you should spend it all on a bike. You are asking for injuries.

Because you are very fit (I assume) you will have the tendency to over train. Don't do it.
Just because your engine can go for hours, doesn't mean your body can, especially at first.

Get a cycling training guide. I would not do any more than the average cyclist is recommended to do. We're talking about probably 5 to 7 hours a week.

If you feel pain, especially knee pain, back off your training schedule. If it persists, stop. Recover before continuing.

As your body and especially your knees become accustomed to cycling, you can increase your hours in the saddle.

I would focus on light gears, at higher rpm, and ride with a heart rate monitor at a moderate heart rate. I believe if you take these steps, you will not end up with the kinds of injuries that has forced you to stop running.

Just because cycling is a non impact sport, it doesn't mean that you won't get hurt.
 
#6 ·
Thanks for the help! It means a lot to me.

I'll get those Speedplay X pedals and purchase that book on running injuries. I'm a little confused by what you mean about getting fitted before buying the bike. I assumed I would go to the shop and they would fit me for the appropriately sized bike before I bought it.

As for the running, I couldn't do it now even if I wanted to. It just hurts too much. And I've been doing physical therapy the last 4 months so I think most of my muscles have decent strength at this point. I'm still not sure why my knees bend in cycling; is this normal?

As for my last statement, that probably came off stronger than it actually is. The 5 hours a day of cycling isn't what I'm going to just jump into. That will be after about 6-7 months total of cycling. When I first got injured running 4 months ago, I slowly started building up the cycling volume -- starting with 5-6 miles every other day. Now I've slowly reached up to about 30 a day, however, this past week I have reduced cycling a lot until I get the new bike because I don't trust the one I'm riding on at the moment. So when I do get my new bike, I'll ease back into it (5 hours the first week) and give it about 2 weeks to reach where I'm at now (13 hours), and then only by mid-August will I be up to 5 a day. I think this is a sufficiently slow progression but I could be wrong.
 
#8 · (Edited)
Though I don't know for sure this sounds like the same thing my brother has. He's had it for over 15 years and he used to run competitively. Have you experienced any pain thus far while cycling? I'll ask him to be sure but he has never complained about knee pain while cycling and he has been cycling every since he first had his cartilage problem.
I am not a doctor but It seems to me that cycling wouldn't put as much strain on your knees as running would. Running is a load bearing exercise so every step your joints are taking the full force of your body plus gravity. Cycling is not a load bearing exercise so the only forces that your knee would be subject too are the force needed to move the pedals which would be far less than that of running.
 
#9 ·
15 years? Wow -- I was sort of afraid of that. I don't think my problem's going away anytime soon short of some experimental treatment. However, that's very very good to hear that he hasn't felt knee pain while cycling! If I couldn't run or cycle, I'm not sure I could stand to swim :(
 
#10 ·
Many of us are former runners that moved over to cycling because our knees couldn't take the pounding anymore. I used to run 8 to 12 miles every day, I have torn cartilage in my left knee.

I do have IT band syndrome in my right knee that flares up now and again on the bike from pushing large gears for extended periods of time, but I can resolve that with stretching and a reduced workout for a few days. But overall cycling is good for the knees as long as the bike is fit to you properly. Saddle height.. fore/aft, pedal Q factor, cleat position, pedal float can all be modified to custom fit and resolve just about any problem that might crop up.
 
#11 ·
heathb, how did you tear your cartilage if you don't mind my asking? Has the problem ever become better for you? I was reading one study that said articular cartilage could (very very closely) repair itself over time if it was a full chondral defect -- not to mention that cycling simulates a CPM.

I ask because even walking is painful and has been since I got injured, so it'd be nice if that at least felt better at some point.
 
This is an older thread, you may not receive a response, and could be reviving an old thread. Please consider creating a new thread.
Top