Bike Fit Question -- Knee Alignment
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  1. #1
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    Bike Fit Question -- Knee Alignment

    Hi, I've always been a little skeptical of professional bike fit but am slowly realizing I might have a fixable problem.

    On all four of my bikes -- flats and clips -- my left knee is always valgus throughout pedal stroke. My right leg is straight and aligned. With flats I can play with my Q-angle and the result is always the same unless I make a conscious effort to move my left knee outward, presumably by tilting my foot mostly.

    Whenever I ramp up my miles or do a tour, I'm limited by left knee pain.

    Should I try to use wedging under my cleat to align my knee or would that be a band-aid for some underlying MsK problem I should identify and fix with physiotherapy?

    I've wondered about a leg length discrepancy -- the valgus left knee appears to be closer to aligned when I lower my seat. When I measured it appears I had a slightly short left leg functionally, but legs were equal when I used bony landmarks (structurally normal). I've been working on my hip flexors...


  2. #2
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    Go for the wedge for the left shoe.

    You've already educated yourself on varus/valgus and have good observations of what ails you.

    If you can't do it yourself with a mirror, find a fitter who will merely assist you with WHAT YOU WANT, rather than prescribing to their methods or solutions.

    When using wedges, give them at least 500 miles or increasing pain, before giving up on the experiment. It takes time for the body to acclimate to changes.

    If the left leg is short functionally, you could always move the cleat forward on the left leg and rearward on the right leg, but I would think when you ride on you flats your feet are naturally compensating for this discrepancy and positioning the ball of the foot to accommodate the difference.

    I wouldn't change both the valgus and address the LLD at the same time because of the golden rule; only change one variable at a time.

  3. #3
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    This is my opinion, so take it for what it's worth.

    I always start inside the shoe, with a footbed that properly supports the arch. If your arch is collapsing expanding during a revolution, it can make your knee in ways that are not productive. Sometimes shimming the shoe without addressing the arch only partially corrects the issue, and can often make for more problems. Your knees should be tracking straight (not bowing out) through the pedal revolution, parallel to the top tube. You want your bones stacked up in a way that does not put strain on joints/ligaments/muscles.

    Specialized and Trek sell footbeds that work well. Ski shops sell them as well. Hell, you can get them from the drugstore and Walmart these days. As long as they are fit relatively well, they do the trick.

    From there, I look at cleat alignment and angle.

  4. #4
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    Quote Originally Posted by eb2143 View Post
    Hi, I've always been a little skeptical of professional bike fit but am slowly realizing I might have a fixable problem.

    On all four of my bikes -- flats and clips -- my left knee is always valgus throughout pedal stroke. My right leg is straight and aligned. With flats I can play with my Q-angle and the result is always the same unless I make a conscious effort to move my left knee outward, presumably by tilting my foot mostly.

    Whenever I ramp up my miles or do a tour, I'm limited by left knee pain.

    Should I try to use wedging under my cleat to align my knee or would that be a band-aid for some underlying MsK problem I should identify and fix with physiotherapy?

    I've wondered about a leg length discrepancy -- the valgus left knee appears to be closer to aligned when I lower my seat. When I measured it appears I had a slightly short left leg functionally, but legs were equal when I used bony landmarks (structurally normal). I've been working on my hip flexors...

    Dude. Get a bike fit.

  5. #5
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    Thank you all. I will start with wedging and then consider professional bike fit if still having issues.

  6. #6
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    Quote Originally Posted by eb2143 View Post
    Thank you all. I will start with wedging and then consider professional bike fit if still having issues.
    Actually I'd second what was written before and start with proper arch support. I've experimented a lot and found out that I need both arch support and wedges, and much ore of both on my right leg.

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  7. #7
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    Quote Originally Posted by eb2143 View Post
    Hi, I've always been a little skeptical of professional bike fit but am slowly realizing I might have a fixable problem.

    On all four of my bikes -- flats and clips -- my left knee is always valgus throughout pedal stroke. My right leg is straight and aligned. With flats I can play with my Q-angle and the result is always the same unless I make a conscious effort to move my left knee outward, presumably by tilting my foot mostly.

    Whenever I ramp up my miles or do a tour, I'm limited by left knee pain.

    Should I try to use wedging under my cleat to align my knee or would that be a band-aid for some underlying MsK problem I should identify and fix with physiotherapy?

    I've wondered about a leg length discrepancy -- the valgus left knee appears to be closer to aligned when I lower my seat. When I measured it appears I had a slightly short left leg functionally, but legs were equal when I used bony landmarks (structurally normal). I've been working on my hip flexors...
    One thing to check is that your saddle is correctly aligned left-to-right. I found my left knee not tracking straight this spring and if finally dawned on me to de a detailed check of my saddle and sure enough, it was off by a little bit to the left. When I put a straight-edge on it and tweaked it just a fraction, my knee straightened out.

  8. #8
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    functional short leg means your sacrum is misaligned, a bike fit or wedging would not solve the underlining issue, time to see PT or doctor

  9. #9
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    Quote Originally Posted by eb2143 View Post
    Thank you all. I will start with wedging and then consider professional bike fit if still having issues.
    I use the external wedges. I started by videotaping myself pedaling on the trainer and that started small with the wedges and compacted the videos with different levels of wedging. That proved helpful. Put a dot on you knee with a marker to make it easier to observe

  10. #10
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    Quote Originally Posted by Kerry Irons View Post
    One thing to check is that your saddle is correctly aligned left-to-right. I found my left knee not tracking straight this spring and if finally dawned on me to de a detailed check of my saddle and sure enough, it was off by a little bit to the left. When I put a straight-edge on it and tweaked it just a fraction, my knee straightened out.
    If I were the OP I’d do this first. I say that because no one understands the mechanics and science better. It isn’t uncommon for me to spend days to learn what Kerry Irons already knows. I am incapable of false praise. Check your saddle.
    To date, philosophers have merely interpreted the world in various ways. The point however is to change it.

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