# Knee pain while cycling but not while running.



## bcwall (Jul 4, 2011)

So at the end of May I did a 80 mile race with around 5000 ft of climbing. I really was not prepared or able to train for this race so I suffered bad!

I took a week off after the race and the following week got on the road bike for a quick spin. Not a few pedal strokes out of the drive I started to feel a sharp pain on the outside of my right knee. I thought "Im just stiff I will ride it out" but by the time I had made 10 miles it had stared in my left leg also. Hurt so bad I about called the wife to come get me.

Took another week and a half off before I tried to ride again but the same thing happened after a few miles. Sharp pain on the outside of both knees.

After this went to my GP and he prescribed a steroid pack and some high power NSAID. He told me to take two weeks off and come back if the pain didn't go away. Three weeks later Im back in his office with the same problem.

But before I went back to see him I wanted to know if jogging would cause the same problem. It did not. I can jog as long as I have the wind to do it. So I stayed off the bike for a while and just jogged a couple miles every other day.

I have been back on the bike once since then with on problem. The day after I rode a I went for a two mile jog still no problem. But that night at work after being on my feet for a few hours and climbing a lot of stairs the pain come back.

I have been to a PT and a othro knee doctor also. the PT said I had no pain so she could not do nothing for me. The othro said it was probably IT band syndrome.

All the Drs I have been to have pressed on the outside of my knee looking for a pain response. but I do not have this. When the pain comes on its quick and sharp. Almost like a bad cramp. The pain feels like its on the outside of my knee but the inside of my knee feel extremely tight and for a couple days after this happens I can feel soreness only when I pull my leg up behind to stretch my quad.

Sorry for being so long winded but has anyone on here experienced this?
Any suggestions on what I need to do? Any comments? thanks


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## AndrwSwitch (Nov 8, 2007)

Can you ride easy for a half hour without pain?

I was plagued with knee problems for years after college and before finally fixing it. For me, the fix was correcting my bike fit, fancy insoles, and really taking my time ramping up again.


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## Kajjal (Dec 14, 2013)

That sounds about right. If you have no history of knee pain and it only happens on your bike then it is likely your bike setup is off.

Start with getting the saddle at the right height so your legs are slightly bent but your hips don't rock due to over stretching. Then get the saddle in the tight fore / aft position on its rails, look up KOP's for a good starting point. If you use flat pedals your feet will find their own position , if not then you need to set your pedals up properly. This should if do be right remove knee pain etc and give you greater , smoother power delivery.

After that your bar height and reach are up to you as on mountain bikes you move around a lot more than road bikes.

Good luck


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## bcwall (Jul 4, 2011)

Hey guy thanks for the comments. One of the doctors I have seen recommended getting my bike fit checked. Which I have been fit to my road bike but not my mountain bike.

The way it works out all our mountain biking is a couple hours away so I did not have much time on the bike. All flat around where I live so really no hills of mountains to climb even on the road bike.

Can your seat be to high? When I was fit to the road bike the fitter lowered my seat. He recommended that I do not raise it higher than he set it. But on the mountain bike I run the seat higher, right before I can feel my hips start to sway, feels like I have more power with it set there.

So maybe having a seat that was too high, riding a bike I haven't put much time on and a lot more climbing than Im used to(around 6000 ft) my knees couldn't handle it?


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## Kajjal (Dec 14, 2013)

Climbing 6000ft on a bike that you are not used to and haven't had a chance to setup properly is likely to cause you problems of some sort. When I first got my road bike, the saddle was too low, too far back and not wide enough. This caused me knee, seat and ankle pain. After a few adjustments on test rides and a proper fitting saddle I can now ride for hours with no problems.


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## AndrwSwitch (Nov 8, 2007)

bcwall said:


> Hey guy thanks for the comments. One of the doctors I have seen recommended getting my bike fit checked. Which I have been fit to my road bike but not my mountain bike.
> 
> The way it works out all our mountain biking is a couple hours away so I did not have much time on the bike. All flat around where I live so really no hills of mountains to climb even on the road bike.
> 
> ...


I had my saddle too high for years. That was part of my problem. I often suspect that mountain bikers running their saddles too high is part of why dropper posts are so popular...

It's funny how sometimes formulating a question for an email or a forum post can make things clearer. I bet you're rereading your post and thinking, "What was I even thinking signing up for this race?"

What kind of pedals do you use on your MTB?

I only ever paid for a fit on my road bike. I just dial in my mountain bikes, and my current road bikes, actually, by feel. I try to match the pedaling feel. Handlebars go wherever is comfortable for my back, and if I'm on the right size bike in the first place, I end up with good handling too. At this point, I'm pretty set in my riding position. All my bikes feel fairly similar to me to sit on, though of course they have really different handling personalities.

Anyway, try matching your leg extension on your mountain bike to your leg extension on your road bike.

Do you use a cadence sensor on either? Lowering the saddle on your mountain bike is going to require a bit of a change in technique. On the bright side, it'll be in a better position for more dynamic riding, no dropper post required.


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## bcwall (Jul 4, 2011)

Yeah. Not the smartest thing I ever did! Paying for it now for sure. 

I use the double sided mtb shimano pedals on my mountain bike and regular one sided shimano road pedals on the road bike. Use cadence on my road bike. I coulduse cadence on the mtb but lo lazy to the cadence sensor and magnet off my old road bike.


I beginning to thing it has something to do with my foot being locked into one position. this morning went to the gym. I was finishing up a very light workout and put a 45 lb bar across my back and after a few squats the pain showed back up. Maybe like not having enough float in your cleats. Does that make sense?

Im sure I have the tension backed all the way out no both sets of pedals. The road pedals feel like they have more float. I use the yellow 6 degree cleat.

Anyway Im going to the bike shop my next off day and let them check it out.


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## AndrwSwitch (Nov 8, 2007)

Part of the puzzle for me is letting my cleat angle float. I'm naturally pretty duck-footed. If I allow my foot to settle on a natural angle, I'm fine. If I force it to be in line with the bike... I'm not fine. I always put my cleats on my shoes pointed inward as much as I can. In other words, so that the float in my pedals centers around my relatively duck-footed natural position. The cants in my shoes help too.


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## bcwall (Jul 4, 2011)

AndrwSwitch said:


> Part of the puzzle for me is letting my cleat angle float. I'm naturally pretty duck-footed. If I allow my foot to settle on a natural angle, I'm fine. If I force it to be in line with the bike... I'm not fine. I always put my cleats on my shoes pointed inward as much as I can. In other words, so that the float in my pedals centers around my relatively duck-footed natural position. The cants in my shoes help too.


Im duck footed myself. When I read you post that got me to thinking about cleat angle. I just got home and looked at my mountain shoes and the cleat angle is straight across. Now at one point I had them rotated in just like you were describing. Took me a bit to remember when I got fit to my first road bike I was using mountain cleats on it and the fitter is the one that straighten them.

So If im setting down and raise my foot off the floor about 6 inches I feel pressure and pain in the middle or inside of my knee. Now if I rotate the front of my foot inward the pain gets worse. Rotate the front of my foot outward and it doesn't hurt as bad. This is all with my foot off the floor about 6 inches with my knee at 90 degrees. Also there is no way I can pull my ankle to my butt to stretch my quad.

Is this similar to the knee pain you experienced?


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## AndrwSwitch (Nov 8, 2007)

For me, it was worst under my patella. Both deeper and more toward my foot. I also had pain in my IT band, right where it gets to my knee. And, the pain around my patella was biased toward the outside.

The explanation I had from my PT was that my patella was being hauled out of its track by one of the heads of my quadriceps. The IT involvement was kind of a bonus. 

Definitely stuff freaks out if I try to engage my muscles when I have bad alignment through my knee. I try not to do that.  I also haven't been able to get my heel to my butt since 1999, before I hurt my knee. That's not an ability I care about. Though being able to handle a deeper squat would be nice. I can do the exercise if I only go to where I have a ninety degree angle. But if I'm going to where my thighs are parallel to the floor, I'd better not have anything on that bar. I guess that's supposed to be bad for everyone, though.


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## perttime (Aug 26, 2005)

bcwall said:


> So If im setting down and raise my foot off the floor about 6 inches I feel pressure and pain in the middle or inside of my knee. Now if I rotate the front of my foot inward the pain gets worse. Rotate the front of my foot outward and it doesn't hurt as bad. This is all with my foot off the floor about 6 inches with my knee at 90 degrees.


I think you are onto something with this.

I've always used Time pedals and they allow for some float without any manual adjustments. With Shimano, you need to set it where it works for you best.


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## bcwall (Jul 4, 2011)

Thanks for the replies guys. I just have to figure out what Im doing to hurt it. It started out to only hurt if I got on the bike. Then It started to hurt when I would climb a bunch of stairs at work. Now I do a few squats and it hurts.

It definitely hurts when my knee is around or goes past 90 degrees with my foot anchored in one spot.

Its sore and hurting this morning so Im going to try to get in to see the PT tomorrow. Maybe with it hurting she can twist around on it till she finds something.


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