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Thread: Sharp Knee Pain

  1. #1
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    Sharp Knee Pain

    There are a few threads about this topic but none quite addresses my issue.

    I'm fairly new to road biking; have done 1,734km over about three months on my road bike.

    Yesterday, at km 84 of 119, I experienced a very sharp, intense pain in my knee. Probably behind my patella or just along the joint, seemingly straight through (not more on the left or the right - just all the way through).

    I had been riding on flat roads almost the whole time at an average cadence of 75 or so, but never in large gears.

    So I slowed it down and the pain went away. But when the next small hill came it was back, and it was bad. So I just took it really easy and kind of limped the next 35km home.

    On the way home I moved my saddle up about a quarter of an inch hoping that would alleviate it but it did not.

    The pain doesn't come when I stand, run, jump, or take stairs. Only when I push on the bike hard. But it was so bad I knew if I aggravated it it could be serious or long-term.

    I can't figure out what caused this or more critically how to get rid of it. Any thoughts?

    A few things to consider:

    • Besides the seat post adjustment, over the past 3 months I I haven't changed anything on my bike
    • I have never had such pain before
    • That distance is easy for me
    • I haven't been riding much lately and have no reason to think I have overused my knee
    • It is not cold here - I'm on the equator
    • I don't stretch
    • I haven't had a proper bike fitting
    • I am 38 and am in good shape


    The obvious: Go get a proper bike fitting. But that doesn't explain how this happened out of the blue.
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  2. #2
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    Strains occur from time to time and the pain may not even be related to riding your bike, per se. Your ride may have stressed/weakened supporting muscles that were keeping this particular strain from being noticed.

    Moving a saddle 1/4 inch is a lot for most people. A cadence of 75, unless a lot of climbing is involved, is quite low for most people. If I was riding on flat ground, I'd probably be trying to spin about 100.

    Give yourself a few days rest from cycling, and watch for reoccurrence off the bike. Front knee pain that you're describing is usually associated with the saddle being too low (which you apparently know), and riding in too big a gear (which may be a problem, based on cadence of 75).

    Others with better knowledge will probably chime in. Good luck!

  3. #3
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    Give your body a rest and make any fit changes in small increments. I'm talking .5-1mm at a time. 1/4" is a a big jump if the body is already telling you it is hurting. One at a time too. Usually these changes take time to dial in. It isn't like take a ride and change it again, it is an accumulated test that may take couple weeks for a single change to show if it is good or not.

    When in doubt, see a sports ortho for a proper knee diagnosis to make sure. That peace of mind is very valuable if you are a worrier about injury. Then you know you are ok before going in.

    IMO, this is a cleat position issue then getting proper leg extension/saddle height for your fit.

  4. #4
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    You sure you don't get pain going down stairs? I had a similar thing happened, and I noticed going down stairs, rather than up them, tended to set it off. I'd venture you probably are also looking at patellofemoral syndrome, but only a doctor can say for sure.

  5. #5
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    The majority of ppl who have not had bikefits, or who have been subjected to the "free" salesman bikefit have saddles too high rather than too low. Unless u know yr saddles too low, then I would be trying your saddle lower rather than higher...

  6. #6
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    You need to have your bike fitted to you by a qualified LBS. They will get you up on a trainer and dial in your seat height, and shoe cleat angles. Both of these can factor in to severe knee pain. Discontinue any riding until you are sure that these factors are adjusted correctly.
    With people like Peter P. around, I am done posting on this website. Mean people have driven me off after 9 plus years. Good luck newbies beware.

  7. #7
    Mad-one...
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    I am not a doctor so I share my experience as just my own personal experience. I rode for years with no knee pain whatsoever. I decided to move my saddle back on the rails to see if it would be a more efficient position for me. The day after I did this I had the same pain you are describing. I settled on a middle ground with the saddle that seems to work for me. You may be sitting in a slightly different position (forward or back) than you usually do without noticing? Just a thought.
    There is NO rehearsal - this is the real thing.

  8. #8
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    Look into ITBS. If this is the problem, and it is in most non-injury related running and cycling knee pain, then it is easily addressed with a foam roller. Stretching does not help with ITBS but rolling it out does.
    My cycle tour blog; raymoorerides.blogspot.com

  9. #9
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    Not stretching could be a factor. Especially if you jump right into a ride and don't pedal light to warm up. Obviously it could be something else.
    I had the same thing when I had about the same riding experience as you. I never knew for certain what the cause was but it's never came back since raising my cadence and being more diligent about warming up/stretching. I took a week off and then rode really light for another week to make sure it was fine then on the third week I was back in business.. hopefully you have whatever I did because you'll be fine. It does sound like the same thing because I didn't feel anything running jumping Ect but it really killed on the bike.

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    Thanks for the good advice.

    24 hours after it happened I didn't feel anything so I got on my full-suspension MTB and rode it in the parking lot and up a slope to see if there would be any pain. To my amazement it was all gone.

    Incredulous, I thought I should try the same on the same road bike I experienced it on, with the same shoes obviously. Same story. I could mash up the slope in a big gear and not feel anything.

    I would have ridden today but I'll rest more just to be safe, and I'll get a proper fitting.

    I was worried it was long-term, and while it still could be, it isn't persistent (as far as I can tell).

    Thanks for your replies.
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  11. #11
    BT, wishing you ride safe
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    Quote Originally Posted by HarryV View Post
    The majority of ppl who have not had bikefits, or who have been subjected to the "free" salesman bikefit have saddles too high rather than too low. Unless u know yr saddles too low, then I would be trying your saddle lower rather than higher...
    +1!

    I had different problems (sore back, numb hands) and finally listened to the top dogs in the cycling club who recommended a profit (in our case a Retul fit at a bike shop that was quite a ways away, but had a top reputation for fitting)

    After my fit I no longer had the pains and had more power and comfort. And the guy said "Your bike is really close. You would not believe how far off most bikes are."

    After about a year and a half I replaced my seat. I knew the seat height, but for got the tilt and set back. I just guessed. On a metric I had the same problem. The next day I spoke to a sports doctor friend and he speculated that I suffered from "hyper extension" from not having my seat in the proper position.

    I got a "refit" later that week, and have never looked back. Or had any other problems. YMMV.
    BT

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  12. #12
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    Out of the blue my right knee started hurting ... I moved the seat aft (back) 2-3 mm and the knee returned to normal. The fit was pretty much knee over pedal before I move it. Also, just that slight amount of saddle movement improved the bike handling.

  13. #13
    Cycling induced anoesis
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    Quote Originally Posted by Patterson View Post
    Thanks for the good advice.

    24 hours after it happened I didn't feel anything so I got on my full-suspension MTB and rode it in the parking lot and up a slope to see if there would be any pain. To my amazement it was all gone.

    Incredulous, I thought I should try the same on the same road bike I experienced it on, with the same shoes obviously. Same story. I could mash up the slope in a big gear and not feel anything.

    I would have ridden today but I'll rest more just to be safe, and I'll get a proper fitting.

    I was worried it was long-term, and while it still could be, it isn't persistent (as far as I can tell).

    Thanks for your replies.
    I'm not going to play dr, but what you've offered leads me to think you may be experiencing Chondromalacia. See the attached link for more info. Once there, scroll 3/4 of the way down for the section that applies.
    CYCLING PERFORMANCE TIPS -

    If you notice, the second bullet states, "Spin at a higher RPM. Pushing big gears at a low RPM puts a tremendous load on the knee", so you may want to up your cadence. The beginning of the article talks about the importance of maintaining a cadence of at least 80-90.

  14. #14
    cmg
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    don't push big gears, learn to spin. up your cadence.

  15. #15
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    I can't say for sure, but this sounds exactly like the pain I was having in my knees when I first started riding. The problem was too low of cadence, I think I was around 70 on the flats and less than 60 on the hills. As soon as raised my cadence it went away. But it did come back one day in the middle of a ride when I was stuck in the big ring with shifter issues so be careful.

  16. #16
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    See a Doctor

    Take it easy for a few days, ice your knee and take an anti-inflamitory. If it still hurts see a doctor -- it's the only way you'll know what the problem is -- a ligament/tendon strain or actual injury to the joint.

  17. #17
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    you have bad knees. strenghthen your leg muscles, then do a lot of stretching. then get a proper bike fit.

    even if you crank on high gear if your musclesare strong it will have no pain. low gear is when you get tired or when you want to conserve energy on uphills.
    every 3 seconds, a child dies of hunger. how much did you spend on your bike?

  18. #18
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    +1 The IT Band Tendinitis. I got this while doing a century a few years back. It hurt so bad I almost cried real tears. It comes from not stretching properly before/after. I would run it buy your Dr. thats what i did. It took a month or so of foam roller and serious stretching. It hasn't bee back since.
    You might want to check it out before you do major setup changes to your bike. A professional fitting is definitely a good thing though.

  19. #19
    classiquesklassieker
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    Quote Originally Posted by Patterson View Post



    The obvious: Go get a proper bike fitting. But that doesn't explain how this happened out of the blue.
    The obvious is that you should go see a medical professional. I hope you are not relying on advice from Teh InterWebs. Getting a proper bike fit is secondary to making sure your injury isn't serious, or recurring.

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