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unusual knee pain

 
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mhester1
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Joined: 10 Sep 2008
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PostPosted: Wed Sep 10, 2008 12:46 pm GMT +0000    Post subject: unusual knee pain Reply with quote

I have pain in both knees (a little more in the right), but it's in a place where no cyclist I've met has ever experienced pain or discomfort. It's on the back side towards the outer area where the hard feeling tendon comes in (if a tendon is what that is). But it does not feel like it's that tendon itself. It feels more like it's just under it. I've googled until I'm blue in the face and can find no mention of pain in this particular area. I have a cyclist/phys therapy student friend who looked at it and confirmed that it's not the IT Band (which I had already determined). I went to an orthopedist several yrs ago and he said that I just need to develop more flexibility. Well, I'm more flexible than most cyclists I know. I have no problem in bending over straight-legged and touching the floor. I can't palm it, but touching is easy enough. I can ride up to about an hour or so without much issue but longer than that is not good. If I wear a neprene knee brace I can ride for long distances with usually no pain (maybe feel a bit the next day if it's a really long ride) but even 180 miles in 2 days straight is doable without much discomfort. Wearing the braces for our few months of "winter" in Houston is fine enough but most of the year it's warm enough for the braces to simply suck.

I don't think my seat is too high as I've had people look to see if my hips are rocking and they are not.

Any ideas?
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The Bike Doc
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Joined: 08 May 2003
Posts: 1398
Location: Corpus Christi and Warda, Texas

PostPosted: Thu Sep 11, 2008 3:52 am GMT +0000    Post subject: Reply with quote

mhester1:

Here is a copy of a posting from a few years ago regarding knee pain. Though not all apply to the location of your pain other readers who see the question regarding knee pain may benefit.

Look specifically at the section of knee pain on the outside of the knee and see if any of these are issues for you. If you have addressed all those issues listed, then get an evaluation by an experienced PT (no offense to your friend the PT Student, but you would not let a Medical Student manage a critical medical issue for you without close oversight from an experienced attending physician). The PT may be able to identify other issues or recommend an evaluation by an Orthopedic doctor.

Knee Pain Location as Indication of Fit Problems:

Location- Front of Knee
Causes: Correction
Seat too low: Raise Seat
Seat too Forward: Move Seat Back
Excess climbing: Reduce climbing
Big gear mashing: Spin at higher RPM in lower gear
Cranks too long: Shorter cranks

Location- Inside of Knee
Cause: Correction
Cleat malposition toes point out: Adjust cleats to bring toes in, use floating pedals/cleats
Excess pedal float: Limit float to 5 degrees
Excess exit tension: Lower tension
Feet too far apart: Move cleats out (moves shoes out on pedals), Narrower bottom bracket or Cranks with narrower Q factor

Location- Outside of Knee
Cause: Correction
Cleat malposition, toes point in: Adjust cleats to bring toes out, use floating pedals/cleats
Excess pedal float: Limit float to 5 degrees
Feet too close: Move cleats in (moves shoes out on pedals), Wider bottom bracket or Cranks with wider Q factor

Location- Back of Knee
Cause: Correction
Saddle too high: Lower saddle
Saddle too rearward: Move saddle forward
Floating pedals: Limit float to 5 degrees

Modified from: Arnie Baker, MD Bicycling Medicine 1995 Argo Publishing

Thanks,
_________________
Paul K. Nolan, MD
AKA: The Bike Doc
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mhester1
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Joined: 10 Sep 2008
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PostPosted: Thu Sep 11, 2008 4:47 am GMT +0000    Post subject: Reply with quote

Thanks. I'll try one at a time adjustments to see what may work.
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