Sore right knee after riding

[CalgaryCommuter]

For a number of years I was able to ride 3-4 times a week 40 kms return distance commuting to work. After each ride I felt fine. However, two years ago I developed severe pain and stiffness in my right knee. The pain was worst under the knee cap and toward the inside of the knee, in the area where the bones meet. The stiffness was in the back of the knee in the "leg pit" area, if you will. It was very painful to walk afterward.

I had an MRI where a minor 5mm meniscus tear was identified and subsequently cleaned up via arthroscopic surgery. Prior to surgery I had visited the PT for various stretches and muscle massages techniques, none of which helped at all.

The photos the surgeon took of the knee while she was in there and her comments indicated no arthritis or cartilage problems aside from the tear she fixed.

My left knee has zero pain. Playing ice hockey does not cause any pain. Using the elliptical machine is pain free is well.

I really like to ride. My office recently moved which made my commute 10 kms each way vs the 20 km each way before the move. Even riding that distance once caused significant pain within an hour of getting to the office. By 2:00 pm it was fine but I elected to have my wife pick me up instead of riding and making it sore again.. It has been 10 months since my surgery.

Are my riding days over? I have cages and wear running shoes as I have always done. I have never gone clipless. I have been riding the same bike for the past number of years and the setup appears to be correct.

Do you have any suggestions or advice?

Thanks.

[GeorgeET]

Sorry to hear this. However bear in mind that there have been changes in your knee so the old set up may benefit from adjustment to compensate for knee problems. Max power position may not be the best for your knee.

Take a ibuprofen and Ice the knee when it hurts. I take a ibuprofen before the ride to keep inflammation down. Ice is your best friend....

Consider adding some weight/ resistance training to build up the strong parts of the knee to support the weak part.

[CalgaryCommuter]

Maybe I should get properly fitted due to my condition? However, I don't want to lay out a bunch of money to convert to clipless if it won't help. Methinks I should be able to ride with cages if the seat is properly fitted. Unfortunately my employer doesn't have a freezer so icing my knee at work isn't an option.

Thanks for taking the time to reply. I appreciate it!

[GeorgeET]

You can try taking the cages off. That will allow more movement and reduce upward stress. Changing of the foot position will load different areas and may help.The 10K ride is not that long so just comfortable pedals may be enough. Experiment with Lowering the seat a bit it may help. Knee brace? Talk to a sport doctor especially one that works with bikers.

I have some shoulder and elbow problems and changing my grip and using flexible straps or rope in the gym allows me to find a position that allows me to do the exercise. Its like a crane lots of pulleys and cables pulling and strength varies with angle..

Ice it when you get home. Two lb bag of frozen peas works great and is reusable.:-)Get aggressive with treatment..........

[nfmisso]

I get severe knee pain from standing, and a bit from walking. Bicycling reduces my knee pain - we are all different. My orthopedist said to do whatever helps, and that I will be having a knee replacement in the future - my knees are worn out.

I have found that my saddle height must be high enough not cause knee pain and low enough not to cause hip pain. There is about a 6mm (¼") "sweet spot". My saddle is higher than most "experts" think it should be, but it works for me. The set back of the saddle and handle bar position is also critical. AND most importantly, the ideal set up changes over time.

I do not use straps (clips) or clipless - I use platform pedals. My favorites are MKS Lambda http://www.amazon.com/MKS-Lambda-Pedals-16-Silver/dp/B001GSQVEE/
my second choice is Avenir ATB http://www.amazon.com/Avenir-ATB-Pedals-Black-Inch/dp/B00165OKYU/

The Avenir is a bit wider which is nice at the end of the day, as my feet swell a bit through the day. They are both relatively light pedals. I have tried several other pedals, so a bit pricey, none of which worked well for me.

[cny-man]

I don't believe that removing toe clips will help, could just as well cause problems. You do need to make sure the clips are of the correct length so that the ball of your foot is close to the pedal axle, almost always over it or to the rear very slightly.

Yes, of course you can ride safely and efficiently without clipless. Clipless pedals will require a specific foot rotation and fore-aft position, which could help but also could hurt if not set properly.

Have your physician check relative leg length. Different leg lengths can cause problems if your seat height is set so the longest leg is comfortable

Next make sure you are using the lowest comfortable gear at all times. RPM rate of 80+ is best.

Finally do see if someone can evaluate your saddle fore-aft position and height. Too far forward a position can especially cause problems. I naturally pedal with a flatter foot than most people, so I take a lower saddle position as a result, so there's no one "right" height.

[GeorgeET]

Yep, its all theories do not doubt anything, try different things till you find what works best.......

[cny-man]

(05-12-2014, 08:56 PM)GeorgeET Wrote:  Yep, its all theories do not doubt anything, try different things till you find what works best.......

Huh? It's not "all theories," but rather based on experience and biomechanics. Trial and error is never very effective, and is a flat-out bad idea when it can make things worse.

[GeorgeET]

Lots of good suggestions were made based on the theories of biomechanics.
Not all will work some may. One way to find out.......

[cny-man]

Which things one tries need to be selected and applied in a logical manner based on the OP's situation. The fact that he can play ice hockey and use an elliptical machine point to a problem specific to the bike and his interaction with it. The location and type of pain can give clues as to what is best to try. A sports medicine specialist may be able to assist, or someone very familiar with bike fitting, but my suggestions above are likely to provide some relief.

One additional note is that a shoe meant for bicycling may help, as they typically have a stiffer sole to provide a more stable platform. Shoes that take SPD style (2 hole system) which use a recessed cleat can be used with standard pedals and toe clips or with clipless.

If a clipless system is used particular attention should be paid to positioning on the pedal, and a cleat should be used that provides "float" so that the foot can relax into the best rotational position. I would advise against going without a retention system entirely, as doing so encourages lower rpm and offers less ability to smooth out effort over a longer arc.

[GeorgeET]

Absolutely. I agree you make some good suggestions too. Proper set up is important. All our suggestions, are based on personal experience . Do not know how old you are but I have lots of experience working around pain.:-)
I set up my bike by what feels good to me.
I take a ibuprofen before a ride as my doctor suggested. Some things cannot be fixed but worked around to get the best results. Do not take medicine without discussing it with your doctor.

The reversed and cut off handle bar experiment worked out great and the bars are very comfortable . I like a larger bike than the theories suggest and I like to set the seat back. I like to stretch. I am not a racer , for racing set up may be different.