General Discussion Triathlon Talk » Medial knee pain when cycling ONLY Rss Feed  
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2012-09-10 6:55 PM

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Subject: Medial knee pain when cycling ONLY

Anyone ever had this? It started a couple of weeks ago. I did a 70 mile ride, which is a typical distance for me these days, but the course was a bit hillier than I thought it would be. A few miles from the end, my left knee started to grumble and by the end, it was downright angry. I figured I'd just overdone it with the hills and maybe was in too hard of a gear.

I've tried taking a few days off from cycling at a time, and it always follows the same progression: for a day after, two days tops, I am very aware of my knee when going up/down stairs or squatting. Then it's fine, totally fine, but the pain returns when I get back on the bike. It's not a debilitating pain, but it's a big annoyance. It's in the bottom of the vastus medialis muscle, right where it bulges over my kneecap. Doesn't seem to get swollen, it just tightens up.

The oddball thing?? NO pain when walking or running. NONE. I can run 12, 13 miles. I can run fast (for me), I can run slow, I can run immediately after cycling. As soon as I'm off the bike my knee is fine. I did a HIM yesterday and my knee hurt a little while on the bike, but I literally forgot about it as soon as I was out of transition.

I just had my bike fit checked a few days before the pain started. They didn't change anything and said it looked fine. I did change my cleat position, as it was farther forward than my right cleat, and I've been riding in an easier gear and avoiding hills, but the pain still seems to re-start after a few miles on the bike.

Anyone else ever had this and any suggestions?



2012-09-11 8:23 AM
in reply to: #4404587

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Subject: RE: Medial knee pain when cycling ONLY
It happens to me when I do a long ride with lots of hills.  It could also be your bike fit or mashing gears up hill rather than spinning.  I say give it another long ride or two and if it still bothers you check your bike fit and see what your bike fitters says and if that doesn't work see a sports doc. 
2012-09-11 9:43 AM
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Subject: RE: Medial knee pain when cycling ONLY
Moving the cleat could be the culprit, give it a few more rides and see if it gets better. If not
check you cleats for wear. When I start having unexplained knee problems on the bike without changing anything it is usually because my cleats are worn out. I use the red cleats (maximum float) with Look pedals. Typically for me, when the cleats are worn out I get less float.
2012-09-11 9:49 AM
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Subject: RE: Medial knee pain when cycling ONLY

Please go to a doc and ask if its a plica issue. I had the exact same thing.  Plica is a little vestigal ligament that can rub and get sore from biking.  Minor surgery to remove, and will be 100% after.  But that is what it sounds like.  I could run without any issues but cycling bothered me.


http://www.fernleyphysicaltherapy.com/Injuries-Conditions/Knee/Knee-Issues/Plica-Syndrome/a~347/article.html



Edited by turtlegirl 2012-09-11 9:51 AM
2012-09-11 11:07 AM
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Subject: RE: Medial knee pain when cycling ONLY
I have a very similar issue, but I have managed to get it under control...  general rule of thumb is if your knee pain is in the front - raise your seat.  I found that moving my seat up just a few mm made a difference.  Before that, I did see a orthopedic doctor and after $300 he said to take advil and ice it.  Because it doesn't bother me off the bike, I tend to forget to tend to it.  But once I started taking an anti inflamatory on a regular basis, whether the knee hurt or not, it started to heal and be less of a problem on the bike.  Now I will take a couple advil before a ride and ice after and it seems to be holding together.  Also, if your cleats are not all the way back, I would consider moving them back a bit.  That also reduces stress on the knee.   
2012-09-12 6:53 AM
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Subject: RE: Medial knee pain when cycling ONLY

Jtiger - 2012-09-11 9:23 AM It happens to me when I do a long ride with lots of hills.  It could also be your bike fit or mashing gears up hill rather than spinning.  I say give it another long ride or two and if it still bothers you check your bike fit and see what your bike fitters says and if that doesn't work see a sports doc. 

That's what it was, and I do think I'm a bit of a masher without realizing it. Trying to be more aware of it. I asked a guy at the LBS who has worked with a lot of triathletes and he agreed that it sounded like a mashing issue.



2012-09-12 6:55 AM
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Subject: RE: Medial knee pain when cycling ONLY

Cajuntriguy - 2012-09-11 10:43 AM Moving the cleat could be the culprit, give it a few more rides and see if it gets better. If not check you cleats for wear. When I start having unexplained knee problems on the bike without changing anything it is usually because my cleats are worn out. I use the red cleats (maximum float) with Look pedals. Typically for me, when the cleats are worn out I get less float.

I moved it after the knee pain started; I checked and realized that cleat was further forward than my other cleat. I think it's gotten BETTER - first time it happened, it was bad enough pain that I would've stopped had the ride not been over anyway.

I have speedplay light action pedals, and I just got them a few months ago, so they shouldn't be worn out and it shouldn't be a float issue, either.

2012-09-12 6:57 AM
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Subject: RE: Medial knee pain when cycling ONLY
turtlegirl - 2012-09-11 10:49 AM

Please go to a doc and ask if its a plica issue. I had the exact same thing.  Plica is a little vestigal ligament that can rub and get sore from biking.  Minor surgery to remove, and will be 100% after.  But that is what it sounds like.  I could run without any issues but cycling bothered me.


http://www.fernleyphysicaltherapy.com/Injuries-Conditions/Knee/Knee-Issues/Plica-Syndrome/a~347/article.html

Thanks for this!! It doesn't SOUND totally right with my symptoms; mine really, really feels like muscle, like it's a ball that I want to just yank out. I'm putting off going to the doctor (I hate them) but if it doesn't get better with other measures, I will go and I'll print this out and take it with me.

I'm 10 weeks out from an IM anyway, so I'd be putting off the surgery until after the IM!!

2012-09-12 7:01 AM
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Subject: RE: Medial knee pain when cycling ONLY

bluebike - 2012-09-11 12:07 PM I have a very similar issue, but I have managed to get it under control...  general rule of thumb is if your knee pain is in the front - raise your seat.  I found that moving my seat up just a few mm made a difference.  Before that, I did see a orthopedic doctor and after $300 he said to take advil and ice it.  Because it doesn't bother me off the bike, I tend to forget to tend to it.  But once I started taking an anti inflamatory on a regular basis, whether the knee hurt or not, it started to heal and be less of a problem on the bike.  Now I will take a couple advil before a ride and ice after and it seems to be holding together.  Also, if your cleats are not all the way back, I would consider moving them back a bit.  That also reduces stress on the knee.   

I'll try raising the seat too. And yep, that's about the best a doc has ever said to me for a soft tissue injury, too...that and "run if you want, don't run if you don't want to" since it's always been a running injury before. Gee, thanks!

I totally forget about mine, too. Before Sunday's race I almost forgot to tape it. (I don't know if the tape made much of a difference or not, but it gave me a pretty funky tan line!) I haven't taken anything for it but I will try taking an anti inflammatory for it. I moved my cleat back, too; it was farther forward than the other one for some reason.

I'm hoping that I can get mine under control as well, so that I can ride without thinking about it so much!! A few hours of "stupid knee, stupid knee" gets old fast.

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