# Knee pain from SS?



## cocheese (Jan 12, 2004)

I have recently gotten my first SS, a Pereira 29er to be exact. Super bike, love it. Anyway, I injured my knee racing back in 1997 and thought that the injury had fixed itself after a year or so off the bike. Well, I have been singlespeeding lately and it seems the left knee tightness and pain has come right back. Anyone else have this issue when riding singlespeed? If so, what did you do about it?


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## Nonracerrichie (Dec 20, 2005)

If you recently got the SS bug, give your body time to adapt. I would suggest gearing down to make climbing easier for now until you get some hours at it. Climbing on a SS is more like doing squats or deadlift. You really use your entire body. Ice your knee/s if it hurts bad, and/or take some ibuprofin after unless you have allergies, or meet any other restrictions...I wouldn't pre-ride-medicate so if things start to hurt you'll know sooner. You might consider doing some weight training and stretching to help strengthen/stabilize the knees as well.


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## Rainman (Apr 18, 2004)

*Stand a LOT..*

What he said.. :thumbsup:

You need time to get your SS legs, it doesn't happen overnight. 3 or 4 weeks of regular riding should see you ok.

Tip: DO NOT sit down and push hard on the pedals. Stand up a LOT and mash or just stand up and ride.

A lot of new SS riders make the mistake of sitting too much. This stuffs up your knees very quickly.

R.


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## CB2 (May 7, 2006)

I was reluctant to try singlespeeding due to a knee injury I had in 2002 (surgery in 2003). But it has not caused me any pain.
Make sure your bike's fit is really dialed in. The add physicality of SS's might be bringing out fit issues that were nt present with all those gears.


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## singlespeedsycip (Jan 30, 2005)

Definetly stand on the tougher climbs, much less stress on your knees.
Make sure you have the right cleat positioning.
If it is a tendon or ligament that is bothering you massage it a few times a day, apply cold compesses, and take an anti inflamatory drug....
Ease into alot of milage on the ss, if I'm off the bike for a while I always want to go out and ride for hours, but on the ss you will pay for it the next day if your legs are not conditioned for it...
This book has helped me out alot....it describes a bunch of knee injuries and a routine to help get back to health...
http://store.velogear.com/anprcomegufo.html


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## Linus81 (Mar 10, 2006)

I’m a physiotherapist. I’d say your knee pain can be related to the fact that you have begun a new type of physical load on your knees. The injured knee is your weak point. The fact that you got back the pain so soon is probably due to your muscles reacting to a new type of workload. A lot of the muscles surrounding your knee is secondarily attach to inner structures of the knee joint, such as the meniscus. Therefore can muscles tighten up if you don’t stretch them enough after this type of new load and cause the pain. My advice is to stretch your muscles, especially the gluteus muscles (aka your ass). Hope this can be of any help!


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## serious (Jan 25, 2005)

All good advice given, but the most important one for me was to make sure I get into SSing gradually. Before starting SSing this spring, I worked very hard all winter on the spinner. But after some real hard and rides and/or races, I still have some pain in the knees and my body is battered.

This is one of the main reasons I don't ride my rigid SS exclusively. Switching between the rigid SS and the geared FS bike lets my body recuperate and lets my knees get a break.


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## cocheese (Jan 12, 2004)

I'm running 32x22 which is a good gear I think. I could go lower but then it would drive me crazy on the flats. I'm actually headed to the dr. today to get his opinion on it. He will have to refer me to a specialist (typical insurance hoops). Hopefully it will be something can be solved with some stretching and strength training, but I am not so sure. I get these weird pains for weeks after I ride. Most of the time it is focussed on the lower inside of my knee, other times it is on the outside of the knee, and even radiating down or up the leg as well? It doesn't seem to have a single place from which the pain originates. I've had a couple of MRI's on it a while back and they found nothing. The dr. said, "Let's just scope it and I'll find out what is going on." I'm going to hold that as a last resort. 

Also, it is ONLY in my left knee. My right knee is fine, no pain or tightness whatsoever. Wouldn't both knees be hurting if it was a conditioning type of thing?

I've been doing almost all of the riding standing. I simply cannot push the gear on any kind of incline while seated. I only sit very briefly on the short flats to coast and give my legs a rest. I'm kind of torn because I love singlespeeding but my knees don't.

Thanks for all the help here. I'll try the cleat positioning and let you guys know what the dr. says. Fingers crossed!


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## nogearshere (Mar 7, 2005)

cocheese said:


> Also, it is ONLY in my left knee. My right knee is fine, no pain or tightness whatsoever. Wouldn't both knees be hurting if it was a conditioning type of thing?
> 
> I've been doing almost all of the riding standing. I simply cannot push the gear on any kind of incline while seated. I only sit very briefly on the short flats to coast and give my legs a rest. I'm kind of torn because I love singlespeeding but my knees don't.
> 
> Thanks for all the help here. I'll try the cleat positioning and let you guys know what the dr. says. Fingers crossed!


cocheese: "my knee hurts when i ride"
Dr: "then stop"

i had a similar experience and i found that riding 'fixed' my knees, eliminating previous problems.

standing on tough climbs, mixing it up on long climbs both help keep my knee happy.

BUT the biggest thing for me is a good long warmup. i ride to the trails on most days while my buddies drive in, and it has made the world of difference. if i must drive, i get there a bit early and 'spin out' in the parking lot for 10+ minutes while the idgits get their shoes on.


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## cocheese (Jan 12, 2004)

Well, I'm back from the dr. He is ordering up several weeks of physical therapy to conclude with a visit to an orthopedic specialist, since it takes that long to get in to see one. I am very optimistic about this and the dr. is behind it 100%. He reassured me that I am simply too young to have these kinds of problems and that if I love to bike, then we need to do everything we can to get it fixed. He did say that it sounds as though it is something internal, but he is not sure.

One of the best things is that the orthopedic specialist I am seeing focusses on sports medicine. 

Again, fingers crossed!

Thanks for the help. I'll check back as soon as I get some physical therapy under my belt.


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## crankpuller (Feb 27, 2004)

The pain in my right knee was the result of keeping the same leg back while descending - it caused the IT band to tighten which lead the muscles on the outside of my leg to overpower the muscles on the inside of my leg. I have since learned to feel comfortable descending with either leg forward. The pain only occurs when biking - running and hockey ar fine. Weird - but maybe that could be the same issue with you?

good luck


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## CB2 (May 7, 2006)

nogearshere said:


> cocheese: "my knee hurts when i ride"
> Dr: "then stop"


We must have the same Dr.
Fortunately the Orthopedic surgeon felt differently.


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## Chiro75 (Sep 23, 2006)

One of the issues is seeing the right doctor for your problem. General family practitioners are pretty poorly trained in the neuromusculoskeletal system for things outside of pathology, and even then they generally refer them to other specialists. This isn't a knock against MD's, it's just that their NMS training is pretty limited and aimed at figuring out whether an NMS patholgy should be referred to an orthopedist, a neurologist, an oncologist, etc.

Orthopedists, too, generally specialize even further. You have guys who are knee guys, hand guys, shoulder guys, back guys. Their general perspective is also looking at frank pathology from a surgical/major intervention point of view. 

I have patient after patient with relatively minor problems go to orthopedists or their family MD's and the "diagnosis" is generally "Well, nothing is really wrong. Just stop running/biking/lifting/whatever for a few weeks and you'll be fine." The problem with this advice is that athletic people don't take time off, for any reason, because they don't want to detrain. Also, there usually IS a problem, just something that isn't frank pathology.

In my personal experience with knees, when there isn't something wrong with the joint itself, ligaments, etc, it almost always boils down to a patellar tracking issue. Your patella (kneecap) should have a specific pattern of movement as your leg does its thing. More often than not people have a problem with a muscle called the VMO (vastus medialis oblique). The VMO's job is basically to keep the patella from tracking laterally too much. Retraining the VMO is easy, but it would take forever to explain it and about 5 seconds to demonstrate it. Certainly get a proper dx before you just assume your VMO is detrained, but I see it in nearly every knee problem I take care of. I hope this helps!


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## cocheese (Jan 12, 2004)

Yes, the pain is only caused by biking and more specifically the motion of pushing the cranks I think. I can hike, run, play soccer, and surf with no pain whatsoever. I'm hoping that the orthopedist doesn't give me the "Well, don't bike."-thing. I don't think he will as I have a good friend who is an avid kayaker who had his shoulder scoped and fixed by the same dr. He understands that as an athlete, life is too short to be unable to do the things that you enjoy. Sure, when I'm older my joints will be too tired and worn out, but not yet.

My wife had terrible knee pain when she started a rigorous expercise class, eventually becoming an instructor. It turned out that after some physical therapy, there were muscles on the inside of the leg that were weaker than the muscles on the outside of the leg. The net effect of this was pulling the knee towards the outside rather than keeping the proper alignment. After a few weeks of physical therapy, she was all but cured. She also gave us these red squishy dics things that she was supposed to stand on and keep her balance as a way to strengthen and train the muscles to do equal amounts of work when standing. Kind of cool if you ask me!

Thanks for the help crankpuller and Chiro75. I'm setting up my first physical therapy appointment this coming Monday.


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## Chiro75 (Sep 23, 2006)

Cocheese, it sounds like your wife had VMO weakness, exactly as I described. It's terribly common and super easy to rehab.


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## cocheese (Jan 12, 2004)

Yes, I agree, It sounds just like what you described. She hasn't had any trouble out of her knees since. I hope I am as lucky!


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## cocheese (Jan 12, 2004)

Well, it's been several months and, with some scheduling mishaps with the specialist's office, I am back at the knee issue. I went to have the MRI and they say that nothing is wrong with the knee. Everything looks totally normal. Tthe orthopedic specialist says that he needs t scope it too see first hand what is going on in there. I'm in limbo, waffling between going in and trying other avenues. I've tried a full regimen of PT and it did nothing whatsoever. I am going to a pro bike fitter this weekend who does fittings and work for seeral pro cyclists, both road and mtb. I am going to get a full fitting as well a work up on my knee and the issues that could be causing the pain. After this, if there is no relief then I am going for the scope. I just want to exhasut all of my avenues before resorting to surgery.

Thanks for all of the help that everyone has provided here. Ice, Advil, and streching are my friends. I've also found that the geared bike doesn' hurt my knee nearly as much. Still hurts though.


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## sonoranbiker (Dec 31, 2006)

I had some knee pain when I started singlespeeding (still do, intermittently), and all of the previous suggestions are great. Warm up, stand more, make sure your bike is fitted correctly, correct gearing ( I live in the Tucson area, and I ride 32/17).

Another suggestion is to seek out a kinesiologist. I happened to find a chiropractor who specializes in kinesiology, and he's really helpful. They focus on the muscle groups around joints rather than the joints themselves, and are really helpful with strengthening, maintenance, and rehab. They're also a lot cheaper than surgery.

Good luck!


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## SlowerThenSnot (Jul 16, 2004)

*Cleats?*

Don't know if your clipless or whatever.....

I had issues a few years ago when I started riding fixed offroad.... Played with my left cleat postion could not get it to go away...

went to platforms and it went away..... Now just looking for a platform that well last longer then 800 miles =)

I'll use powergrips sometimes if it isn't to techy but i'll sometimes have a tiny bit of soreness after a long day with them.

just my .02


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## G-reg (Jan 12, 2004)

SS seems to be a scapegoat for lots of knee pain. But dude, you have a brand new bike. If it was a new geared bike you would immediately think that any pain on the new bike was due to fit issues, the SS should not be any different. Your previous injury may make that knee more sensitive to a poor fit, but don't assume it's just due to SS.


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## jmw (Feb 25, 2005)

sounds like your gearing isn't particularly to blame

other things to check:
crank arm length? (different from what you're used to?)
pedal float not enuf?
placement of cleat on your shoe?

do you wear a brace or support on your knee? if not, maybe you shoud to keep it warm


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## RemfSS (Jun 22, 2006)

Knee brace works for me.


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## Chest Rockwell (Mar 21, 2007)

When I first started riding my SS Inbred, my knee hurt too.

I dropped my saddle 2mm and all was well after that. Perhaps your saddle is just a touch too high?


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## cocheese (Jan 12, 2004)

Thanks for the input guys.

STS, I tried some platforms and it was actually worse?! I thought it would be a cure-all but it turned out the opposite.

G-reg, I'm not blaming the SS entirely. It does bug me after rides on my geared bike, just not as much as the SS rides. The odd thing is that I'm starting to get the same pains in my right knee now, which up to this point I had assumed was uninjured.

jmw, crank arm length is the same (175). Pedals are Shimano 959. The cleat placement I have tweaked to the best of my ability so far, but this weekend that will probably change. I am heading to Herriott Sports Performance to get a professional fit workup to my bike(s). The PT over there, Russell Cree is also going to do an evaluation on my knees. I'm hoping that he can give me some things to work on that will alleviate some of the discomfort I am experiencing. 

RemfSS, I have never worn a brace but I wouldn't have a problem doing so if it would help things. What kind of brace is it? What is the exact reason, alignment or strength?


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## RemfSS (Jun 22, 2006)

cocheese said:


> RemfSS, I have never worn a brace but I wouldn't have a problem doing so if it would help things. What kind of brace is it? What is the exact reason, alignment or strength?


My weak knees stem from too much running and volleyball through the years. I have a brace that I bought from the local drug store that has whole where the knee cap goes. Holds the knee cap in place and I don't have any pain. Without the brace, my knee hurts when going up and down stairs. If I wear the brace, I can ride every day, if I want.

I am sure there is something wrong with it. I smashed it after going OTB in November and subsequently developed a blood clot behind my knee. Just started riding again and I don't have any problems, again as long as I have the brace on. Also, I am wearing knee and shin guards to prevent any additional injury to my knee.


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## cocheese (Jan 12, 2004)

I'll look into that knee brace. That could be a really nice and cheap solution. I'll try dropping the saddle a bit too. Thanks!


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## ferday (Jan 15, 2004)

> I'll look into that knee brace. That could be a really nice and cheap solution. I'll try dropping the saddle a bit too. Thanks!


brace = good idea (helps the patella track)

but i also highly recommend going to a *good* chiropractor that also does soft tissue work. there are some strange muscles in the knee (paplitious for example) that are often ignored by orthopods, but affect the knee in a large way. a *good* chiro will work these odd little guys.

this is coming from a guy who has had 2 full knee reconstructions and well over half-dozen scopes. please, please use surgery (including scope) as an absolute last resort.


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## datako (Aug 27, 2004)

I second the saddle suggestion.

Try getting a proper bike fitting.


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## cocheese (Jan 12, 2004)

Thanks a ton for your input ferday. I have been exhausting every resource and using surgery as a last resort. I always hear that surgery comes at a cost. That is amazing that you have had that many surgeries and still ride. The thing that I find perplexing is that cycling is supposed to be good for your knees. For me it is just the opposite? Well, after a good fitting and some PT work on the knees, I may look into a good chiropractor. I must say (and I mean no offense to any chiropractors out there) that I have always felt that chiropractors can do more harm than good. I don't really consider them doctors I guess. That may stem from my own misconceptions about them because I have no first hand experience with them at all. 

I will buy a brace for sure, get the fit up, follow the advice of the PT, and then go from there. Again, I really appreciate everyone's help here. The collective depth of experience here is staggering. Hearing people talk about their experiences and share ways that they have overcome the a similar problem is simply invaluable.

The most troubling thing to me is that I absolutely LOVE to ride my SS! If I could get this knee thing whipped, my geared bike would more than likely get very lonely.


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## cocheese (Jan 12, 2004)

datako said:


> I second the saddle suggestion.
> 
> Try getting a proper bike fitting.


Ok datako. I'll lower the saddle a little and I'm actually already scheduled to head to Seattle this weekend for a bike fit.


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## Paulie (Jan 23, 2006)

cocheese said:


> The cleat placement I have tweaked to the best of my ability so far, but this weekend that will probably change.
> 
> I had orthroscopic surgery to repair a torn meniscus about 15 yrs ago and can no longer run or edure impact type exercise or twist/pivot sports as a result. I can bike for 25-35 miles usually without great pain, except for extended multi-day trips. I noticed that "toeing in" my cleats a little (that is heels further away from chain stays) has helped reduce pain in both of my knees, but I stil need to take ibuprofen every day. You might try it (the cleats I mean. . . or the meds, or both?) Good luck.


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## cocheese (Jan 12, 2004)

Paulie said:


> cocheese said:
> 
> 
> > The cleat placement I have tweaked to the best of my ability so far, but this weekend that will probably change.
> ...


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## 0gravity (Mar 9, 2007)

I wish I could time-travel a decade or so into the future and see how everyone's knees are holding up after this first big wave of SSing. I'm no SSer (nor an orthopede) but common sense says that SS does put a lot more stress on the knees than a geared bike. I just has to. 

I used to have some bad knee issues. I'm interested in trying SS but I don't want to bring any knee pain back. I want to be on the trail for the long haul. I'll probably try SS out within the next year or so, but if get recurring pain, I won't hesitate to drop it. I'd rather be out there, regardless of geared or not. 

So my advice to those with recurring or worsening knee pain and who SS: your body is trying to tell you something; that the SS takes a heavier toll and maybe it's worth chilling out for a bit with gears. A faster, easier spin on a geared bike has to be better for your knees. And at least you're out there. Sorry if this gets the SS'ers :madmax:


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## pisiket (Sep 19, 2006)

0gravity said:


> ... common sense says that SS does put a lot more stress on the knees than a geared bike. I just has to.
> 
> ... A faster, easier spin on a geared bike has to be better for your knees


But an SSer does most of the climbing standing with a more straight knee angle on the power phase, as opposed to a gearie's granny grinding with a more bent knee position.

Do we know the effects of putting power down at different knee angles? I don't. What I know is that it is much more natural and comfortable at least for me when I'm climbing standing.

For the record, I had a "knee feeling" when I first started SS'ing 6 months ago. I don't even remember when the feeling vanished.

Ali


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## thebigred67 (Mar 29, 2005)

Seat to far forward to far back to high. The fitting is a great idea. You can use it to set up all your bikes!


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## cocheese (Jan 12, 2004)

thebigred67 said:


> Seat to far forward to far back to high. The fitting is a great idea. You can use it to set up all your bikes!


That's what I'm thinking. I'm taking my geared bike but they said that the measurements would work on any bike.

I'll let you guys know how it turns out.


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## datako (Aug 27, 2004)

Most of the strain on your knees comes when you're grinding uphill no faster than a walking pace. I get off and walk when it's faster to walk. It's amazing how this helps recovery.

A couple of other points - try a lower gear setup. I have found that dropping my gearing a couple of teeth does not make any difference to my speed on a local circuit, it just means I have to be prepared to spin more on the easy bits.

I use platform pedals and have never had knee pain. I suspect anything less than a perfect setup on clip in pedals is going to cause damage.


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## JMac47 (Apr 23, 2004)

*Q factor?*



cocheese said:


> Thanks for the input guys. I am heading to Herriott Sports Performance to get a professional fit workup to my bike(s). The PT over there, Russell Cree is also going to do an evaluation on my knees. I'm hoping that he can give me some things to work on that will alleviate some of the discomfort I am experiencing.


I didn't see anyone mention this. I just built up another SS and had to run a 118 Ultegra bb (112.5 XTR on my other) to get the spiderless crankarms off the chain stays. I have an old cartilidge injury that's come back to haunt more now plus an inside pain to my good one after about 3 hrs into a ride. I have a feeling that the wider spread might be it. I have to admit I sat abit too long in the saddle yesterday on some of the sections I usually stand that probably didn't help much either. 

Maybe mention that to the PT and let us know what he thinks. I'm also thinking on the same lines as you to see a pro and get some proper fitting for my 50 y.o. body, to my bikes, so I can extend some years enjoying this crazy passion of ours.

Best wishes on your knee rehab.


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## connie (Mar 16, 2004)

datako said:


> Most of the strain on your knees comes when you're grinding uphill no faster than a walking pace. I get off and walk when it's faster to walk. It's amazing how this helps recovery.
> 
> A couple of other points - try a lower gear setup. I have found that dropping my gearing a couple of teeth does not make any difference to my speed on a local circuit, it just means I have to be prepared to spin more on the easy bits.
> 
> I use platform pedals and have never had knee pain. I suspect anything less than a perfect setup on clip in pedals is going to cause damage.


I've had 4 knee surgeries (mainly from skiing), and my beat up knees definitely prefer clipless pedals. Get something with a good amount of float and it's actually much better than using platforms. On platforms, my shoes get stuck in the position I set them in and you basically have zero float. If you didn't happen to line your foot up on the pedal perfectly every time, your alignment is off and it's putting strain on the knee when you pedal. I don't use platforms unless I'm riding DH on a really technical course and therefore won't be spending much time pedaling.

Not to mention, as far as knees go, one of the issues most people have is that you overdevelop your quads in relation to your hamstrings. If you don't have clipless, you're not able to pull up and let your hamstrings do their share of the work, which would make that problem worse and make your knees more prone to injury.

I think the biggest key is to make sure your bike is set up correctly and you're not overdoing it. Build up to longer and steeper rides gradually and don't push through symptoms of tendonitis or other pain or they'll just get worse.


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## cocheese (Jan 12, 2004)

I went yesterday to Herriott Sports Performance in Seattle. http://www.herriottsportsperformance.com It is located right next to the ferry dock in downtown Seattle. I decided to take my geared bike since I will be riding it until I can get my knee to behave. Then I will move back to the SS to see whether or not is it actually the SS that is aggravating things or not. I met with Russell Cree who was incredibly knowledgeable and helpful in every way. His coworker was away helping George Hincape prepare for an upcoming race. Their clients include an impressive list of world-class cyclists and one of Lance Armostrong's early bikes from his win at the Tour of Flanders hangs above the large flat panel TV in front of the trainer platform.

It was obvious from looking at their website that I was way out of my league in this place. I am not a pro level racer nor will I ever be; nor do I want to be. Russell assured me that they do plenty of work for "serious recreational" cyclists. They use the Wobble-Naught system of fitting and Russell took all sorts of measurements and input them to the computer. He took some video of me pedaling with my bike. After some analysis and the help of this laser gun thing, we moved the seat up and back quite a bit since my position before was very cramped and not making efficient use of the full range of my legs. After the changes I got back on the bike and video taped from different angles. He then played back the two sections of tape showing how the new saddle height and fore/aft measurements had changed my leg extension. He also adjusted the cleats on my shoe by having me stand of a piece of paper and tracing my foot.

There were a lot of things that went into the fitting process but I won't bore you with all of the specifics. Needless to say the bike is setup VERY differently now than it was when I walked in. I still need to get a slightly longer stem (120mm), as the 110mm is not long enough with the 11-degree sweep Salsas that I have on the bike now. I am going to ride the bike for a while and work on the strengthening exercises that Russell gave me to see if I can get the pain under control. After that I will look back into getting the knee scoped.

Anyway, thanks a TON for everyone's help here. You all have been so supportive through this ordeal. I do not think that the pain is due only to the singlespeed. I have something going on that is only exacerbated by he SS more than it would be on a geared bike. Russell did mention hat spinning higher rpm in a lower gear is going to be easier than mashing up climbs on an SS, but I think we all already know that!  He mentioned that if nothing is showing on the MRI, then it is probably something very small, and thus an easy fix. I wish I had thought of that! Makes perfect sense.

Well, I think it was a most enjoyable and educational experience. It was expensive ($195) but I feel it was well worth it. I am trying to exhaust every resource at my disposal before resorting to surgery.


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## SS-Rider (Feb 27, 2006)

One thing I've learned from riding my SS is STRETCH before a ride I used to get alot of pain behind my knees, stretching helps with that!


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## cocheese (Jan 12, 2004)

Agreed. Stretching before and after have helped me a lot.


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## cocheese (Jan 12, 2004)

JMac47 said:


> I didn't see anyone mention this. I just built up another SS and had to run a 118 Ultegra bb (112.5 XTR on my other) to get the spiderless crankarms off the chain stays. I have an old cartilidge injury that's come back to haunt more now plus an inside pain to my good one after about 3 hrs into a ride. I have a feeling that the wider spread might be it. I have to admit I sat abit too long in the saddle yesterday on some of the sections I usually stand that probably didn't help much either.
> 
> Maybe mention that to the PT and let us know what he thinks. I'm also thinking on the same lines as you to see a pro and get some proper fitting for my 50 y.o. body, to my bikes, so I can extend some years enjoying this crazy passion of ours.
> 
> Best wishes on your knee rehab.


I thought about the Q factor thing as well. I've got XT cranks on my geared bike and the width on those is like 175mm. The width of the ENO cranks and BB on my singlespeed is about 162mm. I'm not sure what effect that would have on my knees but I might try to put a set of XT cranks on the SS and see if it makes a difference.


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## connie (Mar 16, 2004)

cocheese said:


> Agreed. Stretching before and after have helped me a lot.


Just FYI - the latest studies show that stretching before exercise not only doesn't offer any benefit, but reduces your muscle strength by causing micro-tears in the muscles. You should definitely stretch after exercise though, and warm up thoroughly before exercise. There is defintely a benefit (and reduction in the likelihood of injury if you warm up, vs. starting cold), and a benefit to stretching after exercise though.

I believe the only exception is if you have some sort of situation where you don't have the range of motion to actually perform the activity without stretching. But if that is the case, you should still warm up, then stretch just as much as you need to, then perform the activity, then stretch thoroughly afterwards. Not just get out of your car, stretch cold and ride your bike.

Granted, plenty of people still stretch before exercise, and have done so for years, and are fine. But apparently it is not ideal.

(I've read this in a number of places with different studies referenced, but here is one article: http://www.exrx.net/ExInfo/Stretching.html )


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## monogod (Feb 10, 2006)

cocheese said:


> Agreed. Stretching before and after have helped me a lot.


this is true *ONLY* if pre-activity stretching is done properly. however, if done improperly (as about 98% of people (including pro athletes) do) then connie is absolutely correct that micro tears occur and that it can do more damage than good. improper pre-activity stretching will actually set you up for an injury during activity rather than prevent one.

if you are having problems with muscular tension and cramping, especially in the joints, then begin a yoga program. it is important to do it properly, because improperly performing yoga postures will cause the same micro tears. done properly however, yoga is an incredible holistic strengthener of body and mind.

if any interest is indicated ill be happy to start a new thread with some guidelines on proper stretching and yoga techniques.


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## connie (Mar 16, 2004)

monogod said:


> this is true *ONLY* if pre-activity stretching is done properly. however, if done improperly (as about 98% of people (including pro athletes) do) then connie is absolutely correct that micro tears occur and that it can do more damage than good. improper pre-activity stretching will actually set you up for an injury during activity rather than prevent one.
> 
> if you are having problems with muscular tension and cramping, especially in the joints, then begin a yoga program. it is important to do it properly, because improperly performing yoga postures will cause the same micro tears. done properly however, yoga is an incredible holistic strengthener of body and mind.
> 
> if any interest is indicated ill be happy to start a new thread with some guidelines on proper stretching and yoga techniques.


I can attest that yoga has really helped keep my IT bands from causing issues with my knees. And I love the days when my gym has yoga scheduled right after spin class - what a perfect way to stretch afterwards.


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## monogod (Feb 10, 2006)

cocheese said:


> I have recently gotten my first SS, a Pereira 29er to be exact. Super bike, love it. Anyway, I injured my knee racing back in 1997 and thought that the injury had fixed itself after a year or so off the bike. Well, I have been singlespeeding lately and it seems the left knee tightness and pain has come right back. Anyone else have this issue when riding singlespeed? If so, what did you do about it?


generally tightness in the knee is caused by the lateral iliotibial band. when it is tight or spasms it mimics knee pain with more serious etiology.

the i.t. band is basically a long group of very tough fibers that run laterally on the leg from the hip to the knee. there are many biomechanical abnormalities that can cause i.t. band irritation, and a previous knee injury and resulting surgery is most def one of them.

in fact, there are thousands of knee surgeries needlessly performed every year because of iliotibial inflammation and the resulting pain and tightness. often times they will even go in and clip the meniscus (NEVER have this done) in an attempt to rectify the pain and tightness of the knee when in fact the cause was i.t. irritation/inflammation. simply lengthening the i.t. band was all that was needed.

below is included a stretch for the i.t. band that will relieve the tightness in your knee. dont be concerned that you dont feel the stretch in the affected area, because you will most likely feel it in your thigh rather than your knee. also, be gentle when you stretch so that you dont cause more harm than effect benefit.

additionally try to avoid anti inflammatory meds as they are VERY hard on the liver. holistic methods take more time and energy, but they return a much more effective and long term relief to the pain. anti inflammatory meds simply address the symptom rather than address etiology. conversely, holistic methods not only provide side-effect free relief from symptoms, but generally will aid in rectifying causality as well. additional treatments for i.t. band inflammation are ice and massage therapy, as well as several herb tinctures and essential oils that will aid in recovery.

move into the position pictured below slowly and make sure you are steadying yourself by holding on to a stationary object with your hands. apply pressure to the i.t. very slowly and progressively by lowering yourself with the opposite leg keeping the extended leg straight. DO NOT apply sudden tension and DO NOT BOUNCE. when you feel tightness hold that position for 15 seconds. release tension for 5 seconds or so by raising slightly then again slowly apply pressure and hold. repeat 5-10 times three times daily initially. once the pain has subsided and flexibility is restored include the stretch in your post ride (or activity) stretching routine. oh, and be SURE to stretch BOTH sides.

if you have any more questions feel free to ask.


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## cocheese (Jan 12, 2004)

Thanks for that monogod. I'll give those stretches a shot. The ortho did mention that he would just go in and see if there was anything wrong with the scope. He said that since the mri was clean, there is a chance that there is nothing wrong with the knee at all. Well, it hurts, so there is something going on...but it may not be meniscal. If I end up going that route I will certainly let him know that I do not want him to trim it if he does not see anything wrong with it. Thanks for the tip.

One thing I wanted to clear up that I may not have in my previous posts. I don't "blame" singlespeeding for the pain at all. I think it exacerbates my particular problem which I feel is structural and was not caused by the SS'ing.

After a few rides on the newly set up bike has made a huge difference in overall comfort. My legs are so much more fresh feeling after a ride. 

I've got to give props to Russel at HSP. The bike fits like an absolute glove. 

This past ride I was on the road for a while and could hear my knee popping at each revolution of the pedal. No real pain but there was a pop that I could feel coming from what seemed to be the center of the knee. When I put my hand on it to see if I could feel where the pop was emanating from, it seemed to be pretty much dead center towards the front.


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## cocheese (Jan 12, 2004)

The I.T band stretches feel very good. I did my first set tonight. I'm going to keep doing them and then try some post ride after my next ride. I feel most of the tightness and pain come on within 2-3 hours after I ride. When I ride there's no realy pain, only some times where I feel like my knee needs to pop. Sometimes it does and sometimes it does not. The more I seem to sit and relax after a ride, the tighter and more painful the knees get. I'm hopefull that doing some of these stretches may help to head it off.


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## OverTheHill (Dec 3, 2004)

I have been SSing for a few years now both on and off road. I find I occasionally get knee pain which in my case is usually caused by over enthusiatic spinning on faster sections rather than mashing up steep climbs.

When I ride my geared road bike I never encounter this problem because I am usually in a gear that cuts out the spinning. This is also supported by the fact that when training I am very often I am mashing up a climb in a big gear but knee problems never seem to result from this (just stronger legs!)

I have no scientific or medical basis for this theory, it is just my personal experience.


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## monogod (Feb 10, 2006)

cocheese said:


> The I.T band stretches feel very good. I did my first set tonight. I'm going to keep doing them and then try some post ride after my next ride. I feel most of the tightness and pain come on within 2-3 hours after I ride. When I ride there's no realy pain, only some times where I feel like my knee needs to pop. Sometimes it does and sometimes it does not. The more I seem to sit and relax after a ride, the tighter and more painful the knees get. I'm hopefull that doing some of these stretches may help to head it off.


if you are experiencing tightness while riding and getting post ride tightness and pain it def sounds like muscular or i.t. etiology as these are textbook symptoms of i.t. band friction syndrome.

me personally, since the mri was clean i wouldnt let them do an invasive procedure but would postpone that and stretch the i.t. band. (but thats just me) yes, there is something going on, and if its not an internal mechanical problem that the mri would have revealed then why go inside and look? two reasons... money and money. if he told you to stretch the i.t. its one office visit and no procedures to bill. actually, sometimes its a third reason... ignorance. i know plenty of p.t.'s (physical therapists) that know far more about kinesiology and etiology than a great deal of the orthos out there.

im very glad youre getting some relief. i.t. band friction syndrome is very common in cyclists (as is guyon's syndrome) , but both are very seldom accurately diagnosed.

while its best to do the stretch sometime in the day before the ride one doesnt necessarily need to do the stretch right before the ride, but should stretch the i.t. post ride for the first couple of weeks at least. to do the stretch bilaterally for a 15 count on both sides takes less than two minutes though, so its not a bad idea for those who have had a history of knee pain to do so post ride. also, if the knee starts to tighten a couple of hours after the ride then gently perform these stretches. often times the i.t. band will spasm post activity.

a friendly reminder to be sure to do them bilaterally and do them correctly, as incorrect stretching can do more harm than good. i know i already said that, but many people think if they do the stretch their own way they can speed up or take a short cut and get more results. that just aint how it works.

if you let them scope the knee and there are some burrs that need to be smoothed, thats ok, but chances are they would have shown up on the mri. if it was me i would NOT let them clip the meniscus. often times they will clip the meniscus to alleviate tightness of the knee when the true etiology is i.t. band friction syndrome. i know i already mentioned this, but it is worth mentioning again because ortho's will often insist upon it insisting they know whats best (physician god complex). what they dont tell you is how many people are permanently hobbled by this procedure. when the meniscus is clipped there is literally nothing holding the patella in place and the entire knee joint is loosened. this CANNOT be undone.

some years ago (before i got into e.r. nursing and sports kinesiology/pathophysiology ) i had tightness and pain in the knee while running and riding, and sometimes after activity my knee would literally "freeze up" and not move at all. after xraying my knee the ortho wanted to go in, de-burr, snip & trim some cartilage, and clip the meniscus. instead i confabbed with a p.t. friend and she immediately diagnosed my problem as i.t. band friction syndrome and instructed me to do this stretch. within about 2 weeks the pain was gone and 100% flexibility was restored and ive had no problems since.

thats WITHOUT surgery (including an exploratory scope) and the accompanying down time, recovery time, and exorbitant cost.

ive encountered many people with knee problems and have turned them onto this stretch and their problems have also been resolved, with a few of them avoiding scheduled "restorative" surgery. i sincerely hope you'll be another!

now for the disclaimer...

this post contains information intended to improve your health and overall wellbeing, and the information presented in this post is offered as-is for informational and educational purposes only. monogod makes no warranty or representation whatsoever regarding the services or products provided through or in connection with the post. use your own discretion when performing these stretches. work at your own level and explore your own limits.

the reader of the information presented by this post assumes all risks from using the information provided herein. monogod, along with this site's operators, authors, owners, and partners disclaim any and all liability from the information provided herein. any medical, financial, legal, health, psychological or other information provided in this post is not intended as a replacement for professional consultations with qualified practitioners. no such information provided by this post is intended to treat or cure any disease or to offer any specific diagnosis to any individual as monogod does not give medical advice, nor does he provide medical or diagnostic services.

monogod is not diagnosing your problem nor dispensing medical advice, but rather is simply relating personal experience, stating some facts, and providing information. how the reader uses that information is entirely up to him/her. the reader assumes full responsibility for acting upon the information received. consult your doctor before initiating any exercise program. results may vary. allow 4-6 weeks for delivery. offer not valid in all areas. an additional handling fee may apply.


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## connie (Mar 16, 2004)

I'd be REALLY cautious about that "just a scope" type of thing.

I've had 4 knee surgeries - all from when I either tore an ACL and had no stability and needed it fixed, or had meniscus problems that caused my knee to lock and I needed it fixed because I couldn't move it at all. You couldn't pay me to have another one just to "see what's going on". 

Sure, there are some people who have a knee scoped and return to normal almost immediately and it's no big deal. Others - not so much. Any surgery like that is invasive and usually requires therapy to get back to normal. It causes your muscles around the knee to react - swelling, etc. I've known people who had "nothing but a scope" done to find out there was nothing wrong with their knee, but it was much worse afterwards. Some of them felt better over time, some were never the same.

If you NEED surgery - then by all means. My two meniscus surgeries I could barely walk to get into the hospital and then walked around comfortably straight out of the recovery room. And my knees were unstable without ACLs but now I ski and race DH and everything with the reconstructed ACLs. That's success to me. And if I were in that situation, I'd do it again. But it would have to be something where I really felt it was needed.

Honestly, I'm not a doctor or anything, but yours sounds like a muscular imbalance type of problem that can be fixed with intensive stretching and physical therapy. I'd recommend yoga and physical therapy and REALLY exhaust those options before letting any surgeon talk me into doing a scope. Just because they do surgery all the time doesn't make it a good idea.


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## craig_m (Mar 19, 2006)

Hey Cocheese, please keep us updated on how things work out for you. I've been battling with a very similar issue with one knee for about 2 years now and have all but stopped cycling because of it. I went through the whole PT/ortho/MRIs/massage therapy process back in NC and now in WA as well and nobody can seem to pinpoint the cause of my pain. With my job, it's very difficult to totally take time off, but I try. 
I'm away for a few more months, but I'll definitely check into Herriott Sports when I get back to the Seattle area after hearing your positive experience with them.
Good luck with your knee.


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## cameraboy (Apr 13, 2007)

cocheese-you sound like me. i used to ride skateboards, and the knee pain from it made me switch to single speed mtb. i don't know if that's a good switch, but it doesn't hurt anymore. I tried taking two weeks off my skateboard and then trying again, and that seems to help alot.


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## cocheese (Jan 12, 2004)

OverTheHill said:


> I have been SSing for a few years now both on and off road. I find I occasionally get knee pain which in my case is usually caused by over enthusiatic spinning on faster sections rather than mashing up steep climbs.
> 
> 
> > Thanks OverTheHill. Heck, at this point I'll try just about anything! I went for a good 36 mile ride today on my geared bike and my knee is hurting pretty good right now. It doesn't really hurt when I'm riding but it does feel kind of compromised or weak. I'll try the spinning thing for sure. Thanks for the input.


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## cocheese (Jan 12, 2004)

connie said:


> I'd be REALLY cautious about that "just a scope" type of thing.
> 
> I've had 4 knee surgeries - all from when I either tore an ACL and had no stability and needed it fixed, or had meniscus problems that caused my knee to lock and I needed it fixed because I couldn't move it at all. You couldn't pay me to have another one just to "see what's going on".


Connie, I hear where you are coming from. I don't feel like I am doing it just to find out what is going on. There is definitely something going on in there that is not normal. It has been 10 years, 3 mri's, LOTS of time off (too much actually), as well a few 8 week sessions of PT and nothing. I've tried all of the stretching and icing that I can handle. I seriously wish I knew what the heck was going on in there, but at this point I'm not sure what other avenue I have to go down. I have tried everything non invasive to no avail. I am not one to leap headfirst into surgery as I've waited 10 years already.

Honestly, I would ride every day of the week IF my knee allowed. At this point I ride one to two times a week and hobble around the rest of the time. The aching and pain just has me plain beat down!

I missed the last available scope appt on the 23rd. According to my dr. I must have a consult within 30 days of the actual surgery and I will have to reschedule anyway.


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## cocheese (Jan 12, 2004)

craig_m said:


> Hey Cocheese, please keep us updated on how things work out for you. I've been battling with a very similar issue with one knee for about 2 years now and have all but stopped cycling because of it. I went through the whole PT/ortho/MRIs/massage therapy process back in NC and now in WA as well and nobody can seem to pinpoint the cause of my pain. With my job, it's very difficult to totally take time off, but I try.
> I'm away for a few more months, but I'll definitely check into Herriott Sports when I get back to the Seattle area after hearing your positive experience with them.
> Good luck with your knee.


Craig, I will certainly keepyou updated as things move forward. As I said before, I'm going on 10 years with this injury and I'm just about at my breaking point. I stopped cycling for 8 years and started up a couple of years ago, hoping that time would have healed the injury. It was not so. It does sound like we have a similar situation. The ortho that I saw said that there are times where the mri will be clean as a whistle yet after a scope an obvious issue is found and fixed. Yes, Russell over at HSP helped me out tremendously. While I never expected it to be a magic bullet for the knee, it has changed the way I am able to ride now that I have a bike that fits correctly. They are also capable of TONS more than I will ever need. Good luck with things and I'll check back as things go on.


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## cocheese (Jan 12, 2004)

cameraboy said:


> cocheese-you sound like me. i used to ride skateboards, and the knee pain from it made me switch to single speed mtb. i don't know if that's a good switch, but it doesn't hurt anymore. I tried taking two weeks off my skateboard and then trying again, and that seems to help alot.


Cameraboy, that's the other thing I could do...just not ride so much. I ride a coupe of times a week but I'd like to ride more frequently. It's a bit of a crossroads and with no "smoking gun" on the mri or anything, I'm a bit nervous about scoping it. It may be my last alternative at this point.


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## cocheese (Jan 12, 2004)

Went to the doc in Seattle last week. He prescribed a round of very site-specific physical therapy for me. If that doesn't have any effect, then we're going in.


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## cocheese (Jan 12, 2004)

I'm in PT still and it seems to be making a difference. The knee pain is still there but it seems more manageable than before. I did purchase some Specialized Body Geometry shoes that have seemed to help as well. I ended up selling the SS due to the fact that it just made the pain worse. In the end I don't blame the SS for anything. I think it boils down to my specific physiology. I'd rather ride geared than not at all.


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## PuddleDuck (Feb 14, 2004)

Hi Cocheese,

Here are some of my thoughts regarding knee pain.

A great method of stretching the ITB and the quads is to roll on a roller such as this...

http://www.empind.com.au/html/s13_shopping/view_product.asp?cid=19&id=38

What also works for me is to use a tennis ball, and to roll my butt/hip on it to relieve stress in my glutes and hip.

Do you regularly stretch your calf muscles, both soleus and gastroc? Again, these make a big difference for me.

I assume that you have a pretty serious program that you use to strengthen your core - very important, if your core is wobbling about then all of your lower body muscles will have to work harder.

Make sure that you have a semi regular bike fit to ensure that your fit matches the changes in your body as you do PT, effect of Spec BG shoes / fitting new cleats, etc.

Good luck! :thumbsup:


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## cocheese (Jan 12, 2004)

PuddleDuck said:


> Hi Cocheese,
> 
> Here are some of my thoughts regarding knee pain.
> 
> ...


Are you psychic?!?!?!?!?

I have been working very hard on each of the things that you mention and the results have been dramatic. I have not totally eliminted knee pain, but I am working on it. The pain now (geared only) is what I would call very manageable.

I have been in PT for a few weeks now working 2-3 times a day with the foam roller and stretching as well as some strengthening exercises for my inner thigh area. It seems that I have overdeveloped muscles in my outer legs but weaker muscles on the inner side of my leg.

I honestly do not know what I would do without my foam roller. I don't see how anyone gets by without one. It has seriously allowed me to keep riding. It hurts like hell when I am rolling out my muscles, but afterwards I am able to walk and even ride two days in a row. Yee-haw!!!

I am working on strengthening my core as well, but that is not something that I have a specific workout regime for. At the moment I am doing pushups and crunches. Any other suggestions?

I need to go back in for another fitting, but I have also slid my saddle forward a slight amount and that has relieved even more knee discomfort. I think it had more to do with where I was sitting on the saddle in a static/stoppped state vs. a riding/climbing state.

The BG shoes have made a difference as well. My PT says that I'm probably a good candidate for orthotics due to pronation. He said that it would probably aleviate even more the stress that I may be putting on the knees when I ride.

Anyway, long story short, the PT has made a marked difference in my ability to enjoy riding and not worry about the pain. I am not 100% pain free, but it is manageable and allows me to ride for a few days in a row if I want to. Sometimes, at that point it is a measure of fitness and not knee issues.

I still get a click/pop in my left knee at a lot of pedal strokes, but I am hoping that it will go away after I balance the lateral/medial muscular strength in my legs.

Thanks for the help everyone!


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## mgibbons19 (Jun 27, 2005)

Sorry about coming to the party late. I have had both the VMO problem and the IT band problem. I still don't really know how to work the IT band out well enough, but I DO know that if I let up on squats, the VMO problem reasserts itself with a vengence. I really don't have time for those little leg lifts the PTs sometimes suggest. They don't feel like they help at all. But within a week or so of returning to dumbbell squats and ballet squats in my living room a few times a week, I find I can actually squat down to get something out of a low cupboard again.


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## Chiro75 (Sep 23, 2006)

Read the recent research on arthroscopic knee surgery. A study came out a few years ago showing no difference between the surgical group, non-surgical group, and the sham group, which got a scope but no surgery. In fact, if I remember the research correctly, the scope/non-surgical group worsened, which makes sense. Any time you go into a joint you create damage, scar tissue and possibly adhesions. So, sending a camera in to have a look is a bad idea if you aren't pretty confident it is absolutely necessary.


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## springbok (Apr 23, 2004)

Can't say I've ever had knee pain from my SS - ride the thing religiously. I do experience very sore ham strings esp from uphill rides.

I just stand up and start jamming. Poster Nonracerrichie is so right, it really is like doing dead lifts at the gym, not only my hams but I've pinched my back muscle too, I can tell this muscle plays a role when I'm going uphill and going around a bend. 

No Pain No Gain I always say!


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## monogod (Feb 10, 2006)

mgibbons19 said:


> I still don't really know how to work the IT band out well enough


see post #47 of this thread.


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## PuddleDuck (Feb 14, 2004)

cocheese said:


> Are you psychic?!?!?!?!?


I'm not psychic, but for 4-5 years I battled with knee pain, I have an ongoing issues with my back, and over the past 3 years I've had tendonitis of the calf and the hamstring, and I've had ITB friction syndrome recently :madmax: .

I've spent a lot of time and money trying to get on get my body to do what I want it to...

The key for me has been to get each muscle group working properly. Proper bike fit is fundamental to this, as is the way that I hold myself on bike.

It is vital for me to have my glutes working..the seem to want to switch off, which overloads everything else, and causes all sorts of issues. The gluts are power generators as well as stabilisers (glut med)

The best thing that I've done is doing clinical pilates - I'm not sure what is is called in the US, but is when a qualified physiotherapist (PT?) guides me through a tailored set of exercises on a pilates bed. These exercises MAKE the relevant stabilising muscle 'switch on' and do its job. Huge improvement.

I did clinical pilates for 2 periods of 4-5 months. I currently do exercises on the swiss ball - couldn't live without my swiss ball!

So, core stability is fundamental, as is having the appropriate muscle groups 'switched on'

Check out the following link - it has a set of .pdf files (which include exercises) about knee pain, core stability, invoking the butt muscles, amongst other things. Excellent articles. They were written by my physio (who probably treats most other cyclists in Melbourne!). She is the former Australian MTB champion, so she has real world experience. :thumbsup:

http://www.topbike.com.au/physio.htm

Cheers
PD


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## mgibbons19 (Jun 27, 2005)

monogod said:


> see post #47 of this thread.


Yeah my PT had me doing a thing kind of like that, but not nearly so radical. Basically, you crossed your legs, and leaned away from the side you were stretching. There was no way you got stretch like the dude in the graphic.


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## cocheese (Jan 12, 2004)

PuddleDuck said:


> I'm not psychic, but for 4-5 years I battled with knee pain, I have an ongoing issues with my back, and over the past 3 years I've had tendonitis of the calf and the hamstring, and I've had ITB friction syndrome recently :madmax: .
> 
> I've spent a lot of time and money trying to get on get my body to do what I want it to...
> 
> ...


I checked the link and there are some great stretches and exercises in there. I'm already doing about a third of them from my physical therapy, but there are a lot that I am not doing. I also need to work on my core strength as well as my posture on the bike. I've gotten a pro bike fit recently, but it may not hurt to go back and see if he can address some alignment issues that I may have.

I am finding that I would be a tight and painful mess if it weren't for my foam roller. It seems you feel the same about your Swiss ball. My wife has a few. I will try some of the exercises in the link you provided.

I know what you mean about the calf. On the outside edge of the calf (say 225 degrees if the shin is 0 degrees) I have some VERY sore and tight issues. The left is worse than the right by far. I foam roll this area to excruciating pain, but it feels better when I am done. It feels like needles really. I guess it's a muscle? It's getting better and each time I'm able to more and more weight on it. I have a similar issue on my inner thigh and that too is getting better with more rolling.

Thanks a ton for the info and the help. What I thought had to be a torn meniscus or something structural, has turned out to be something that is getting vastly better without any kind of invasive procedure. I'm going to keep working on the stretching and strengthening and I'm pretty darn sure that it will work itself out in time. I don't think I'll ever be able to let it go, but the morning, evening, and post-ride ritual of stretching and strengthening, combined with the fact that I can now ride, seems to have helped my sense of well being.

Again, I really appreciate you taking the time to tell us of your experience and to provide helpful information. On your suggestion, I'm going to try the exercises in the link and get on the Swiss ball too. Good stuff!


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## monogod (Feb 10, 2006)

mgibbons19 said:


> Yeah my PT had me doing a thing kind of like that, but not nearly so radical. Basically, you crossed your legs, and leaned away from the side you were stretching. There was no way you got stretch like the dude in the graphic.


it works miracles!

completely alleviated my knee problems :thumbsup:


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## mgibbons19 (Jun 27, 2005)

monogod said:


> it works miracles!
> 
> completely alleviated my knee problems :thumbsup:


Thanks, I'm gonna give it a shot. Because now that my VMO is stronger and I can squat again, I can also feel the IT start rubbing on that little kneebump :madman:


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## PuddleDuck (Feb 14, 2004)

Howdy all. 

Make sure that you drop back in to this thread to give updates and to describe any new technique or therapy that is working well for you...

Cheers


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## cocheese (Jan 12, 2004)

PuddleDuck said:


> Howdy all.
> 
> Make sure that you drop back in to this thread to give updates and to describe any new technique or therapy that is working well for you...
> 
> Cheers


Well, I've just been stretching the quads and rolling the front, side, and back of my upper and lower legs. I've been working on leg lifts with weights on my ankles for my inner thigh muscles and glutes. I have also been trying some of the exercises that puddleduck provided for the ball from topbike.com. Holy shnikeys! Those things will kick your you know what! The core is something that I am going to start focussing on.

In the end, I am now able to ride for a few days in a row without being crippled from the pain and tightness.

I'm going to the PT today for a last visit before I am on my own.

Thanks for all the help here. I really appreciate it. While I am not riding the SS, I am riding the geared bike like crazy and almost 100% pain free. I am happy!


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## drunkle (Nov 11, 2005)

try orthotics. $20 plastic dr scholl ones from the drug store worked for me when i used to run. i dont use them on the bike, however, never had the need. otherwise, shift your riding position around alot when you feel your knee start to twinge. 

anyone ever actually benefit from a "professional" bike fitment? listen to what your own body is telling you. your knees are complaining, something you're doing on the bike is not right. 

cleat angle: ankle too far in or out? will definately grind your knees if so and you should feel it right away.
shoe/foot position: the orthotic will help with supination/pronation issues, but i'd think that'd be more a problem with the achilles on a bike. 
seat height: not enough leg extension on prolonged efforts can grind your knees. too much overextends the hams and back of the knees.
fore/aft saddle positioning: obtuse or acute angles between your upper and lower legs on the power stroke (12 oclock on the cranks) can cause excess stress on the knee. 
crank length: too long crank causes excess movement in the knees, over and under extension (over extension at 6 oclock, cramped/acute angle at 12). too short... dunno, maybe just inefficiency. 

and just plain overuse; mix it up in the saddle, out of the saddle, forward, back, spin, hammer, coast...

is the bike frame too big for you?


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## cocheese (Jan 12, 2004)

*update*

I know that this is an old thread, but I've got some updates to reports on m knee issues. After several months of diligent physical therapy and stretching exercises, I finally decided to have my knee scoped. Even though the MRI was deemed clean, this was my last resort. My left knee was hurting me even with no exercise at all. I had my scope done 2 weeks ago and the surgeon found not just one, but two tears in the meniscus, quite a bit of fraying, and a terribly irritated medial plica, which he removed entirely. The tears were lateral and medail. The lateral tear was trimmed while the medial tear was in the middle of the meniscus, not in a spot good to be fixed. He said that he would have had to cut out a piece and stitch it back together, thereby creating a weak point. Instead he used a process called trephination, which means using a needle to create channels that allow greater blood flow to the injured area to allow it to heal faster/better. I have several needle holes in the medial side of my knee where he poked through to create the channels.

I am currently in physical therapy trying to get the knee and atrophied leg back into shape. Even with the slight swelling and general tightness I feel in the knee right now, I can tell that something is quite different. From the general location of the plica, this is definitely the region that was giving me the most amount of general discomfort. The knee was popping and snapping at the meniscus in the torn areas as well, and now that is gone.

I am hopeful that this will allow me to ride pain free. I am already on the stationary bike doing about 30 minutes a day. The knee feels better already. I now know that there were things wrong with my knee that have and had nothing to do with SS'ing. I had mechanical things wrong with my knee even though the MRI was "clean".

Thanks for the help to you all. This thread was instrumental in my reaching this point.

I know this will come off sounding like a stubborn mule, but I am looking forward to building the knee back up to peak strength and condition and easing back into a SS. I'll listen to my body and all that, but SS'ing is just too much fun not to give it a shot on two good knees!


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## PuddleDuck (Feb 14, 2004)

Way to go! Good luck with the recovery.


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## craig_m (Mar 19, 2006)

*good to hear*

It's great to hear that your surgeon found everything despite the MRI results. My most current MRI is still "clean" and the new ortho docs and PTs gave me a funny look when I told them where and when my knee hurt. I got a cortisone shot on Tuesday as a "let's see if this works" solution. I'm hopeful that it will do the trick, but if not, it's good to hear that those MRI results are not the final answer.
Best of luck for a speedy recovery!

Craig


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## cocheese (Jan 12, 2004)

PuddleDuck said:


> Way to go! Good luck with the recovery.


Thanks PuddleDuck. I've got a PT appointment in 15 minutes!


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## cocheese (Jan 12, 2004)

craig_m said:


> It's great to hear that your surgeon found everything despite the MRI results. My most current MRI is still "clean" and the new ortho docs and PTs gave me a funny look when I told them where and when my knee hurt. I got a cortisone shot on Tuesday as a "let's see if this works" solution. I'm hopeful that it will do the trick, but if not, it's good to hear that those MRI results are not the final answer.
> Best of luck for a speedy recovery!
> 
> Craig


My doctors always told me that it sounded like a classic meniscal issue. One said that a lot of times he does not even order and MRI. He goes straight to the scope. They are not the best at picking up soft tissue. I never had any cortisone shots, thought that may have helped for a little while. My father has sever deterioration in his meniscus and had some sort of pig cartlidge injected into his joint. He runs no problem now?! Wild stuff.

Anyway, best of luck in your recovery. I hope that the shot fixes things for you. I was pretty worried that the surgeon would go into the knee and say that he did not find anything wrong, thus leaving me with this pain and no reason or fix for it. Obviously that was not the case. The doctors told me that there was certainly something wrong in there. In this case they were right.


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## mtbdee (Jan 31, 2005)

Good luck going forward! Like many I've dropped in on this thread from time to time, and I'm glad to see you're getting somewhere. Nagging injuries are the worst, always good to start to get them sorted out..


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## crux (Jan 10, 2004)

Tore out my knee when I was in my late teens early twenties and it hurt like hell to walk on it. Had to quit working in the warehouse at the time and only limp around the bike shop maintaining some income for school. One night brought home a set of rollers and tried to ride in the hall until I quit falling. After I was able to get some movement the knee fixed itself. Next I started SS and my knees felt better after going thru all that. To this day if you have knee issues sort it out on the rollers then adapt to the bike.


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## cocheese (Jan 12, 2004)

mtbdee said:


> Good luck going forward! Like many I've dropped in on this thread from time to time, and I'm glad to see you're getting somewhere. Nagging injuries are the worst, always good to start to get them sorted out..


Thanks! Nagging is right. My knee has been whining for years!


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## cocheese (Jan 12, 2004)

crux said:


> Tore out my knee when I was in my late teens early twenties and it hurt like hell to walk on it. Had to quit working in the warehouse at the time and only limp around the bike shop maintaining some income for school. One night brought home a set of rollers and tried to ride in the hall until I quit falling. After I was able to get some movement the knee fixed itself. Next I started SS and my knees felt better after going thru all that. To this day if you have knee issues sort it out on the rollers then adapt to the bike.


Thanks for the tip crux. It felt good to get on the stationary bike the other day. It turns out it made me knee swell so the PT took the bike away for now.  I'll look into the roller thing,


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