Medial knee pain while cycling

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2009-09-06 8:28 AM

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Subject: Medial knee pain while cycling
I have been having medial knee pain on the right knee.

I've been nursing this knee pain for a couple weeks now (a few days off completely, lower volume, lower intensity, no hillwork, no speedwork, etc.)

I have been icing, stretching, staying off the knee, yada yada yada.

Knee pain shows up while cycling, no pain while running.  It "lingers" during the day (tingles and it sensitive to the touch).  The only time there is real pain is while cycling, every time I push down with the right leg too hard.  I go to easy gears, keep my cadence high, etc.  Sometimes it just hurts and I have to back off big time (where I feel like I'm not even working anymore).

I was fit to the bike upon purchase... I can't help to think that my fit is off though.  I have been reading that too low of a seat can cause medial knee pain.  I have a fit scheduled tomorrow at a different shop to get a 2nd opinion.  Any other ideas on what this could be?

Edit:  Forgot to say that I am just about 6 feet tall and riding a 2009 54cm P2.  People have said this seems small and I'm starting to think maybe it is, but I feel comfortable overall on the bike besides the knee pain (and saddle numbness)

Edited by tkelsay 2009-09-06 8:31 AM

2009-09-06 8:36 AM
in reply to: #2392101

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Vine Grove, KY
Subject: RE: Medial knee pain while cycling
Is it more in the joint line medially or more up into your medial quad? Or even just medial to your kneecap?

That bike does seem a bit big. I'm 6' as well and started out on a 58cm entry level bike and then proceeded to go down to a 56cm Dual thats about 4-5 years old now and I personally feel it fits me really well, although I have never had a professional fit.
2009-09-06 8:44 AM
in reply to: #2392106

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Subject: RE: Medial knee pain while cycling
I suck at describing where the pain is so bear with me. 

It's medial to my knee cap, I'm pretty sure.  If you were to take ur fingers on the tip of your knee cap and run them over to the medial area about half an inch, that's where the pain is when cycling.

While not in pain (not cycling) the knee has a tingly sensation on the top of the knee cap, closer to the quad, and also sometimes in the front but not often.  The other night while sleeping, I woke up in the middle of the night with short pulsing stabbing pains to the front of the knee, this hasn't happened before and hasn't happened since I have been resting/icing/stretching it appropriately.
2009-09-06 12:31 PM
in reply to: #2392101

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Nor Cal - Bay Area
Subject: RE: Medial knee pain while cycling
The best web site I have seen for bicycle related knee issues is:
http://www.cptips.com/knee.htm

I had a similar problem years ago. I ended up going to a bicycle specific physical therapist. She solved the problem by inserting a shim in the bottom of my right shoe to make up for the difference in leg lengths, as well as adjusting the cleat positions. No problem sense. Her analysis was comprehensive. Video taken to measure mechanics of leg movement during riding, measurement of leg lengths, etc...

Good luck,

John

Edited by johnrsims 2009-09-06 12:31 PM
2009-09-06 12:39 PM
in reply to: #2392101

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Subject: RE: Medial knee pain while cycling
Have you looked thru the threads ( or posted yourself) on the Injuries & Health Issues Forum?  It is a section here on BT  Forum under "Other Resources"

Lots of info
2009-09-06 2:29 PM
in reply to: #2392101

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Subject: RE: Medial knee pain while cycling
the bike does sound small but if you go through another fit and all is well, get a massage. If the pain is right over your VMO (the medial aspect of your quad, right above your kneecap) it can just be an overuse tendonitis kind of thing. I struggled with that while upping my bike miles this summer and it went away after some self massage and a lot of stretching. If you get the right kind of massage (you need myofascial release and a particular technique called skin rolling) it will be painful and feel almost bruised the next day but the pain will be gone after that. keep stretching your quads as well.of course, I can't diagnose you over the computer but I know this happened to me and happens to alot of my friends with increased bike mileage.

2009-09-06 6:52 PM
in reply to: #2392101

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Leesburg, Va
Subject: RE: Medial knee pain while cycling
are your shoes new? What kind of pedals? I had the same thing and was using a very small older shimano pedal. I have since switched to a wider platform type pedal and it has stopped the twisting of my foot when i mash. also, my plastic shoe bottom actually twisted, so my foot was never flat. Now with new shoes and pedals all is well.
2009-09-07 11:18 AM
in reply to: #2392101

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Subject: RE: Medial knee pain while cycling
Thanks for the advice/help everyone.

I went in for the 2nd opinion bike fit this morning and he said everything looks okay with the fit.  He said I tilt my right leg a little, so he added a small spacer on the cleat and also turned the cleat ever so slightly.  He said this should level out my foot and could help to fix the pain.

I'll look into the massage.
2009-09-07 11:35 AM
in reply to: #2392101

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Subject: RE: Medial knee pain while cycling
I believe that your bike is too small. I am 6' (longer legs, shorter torso) and I ride a 60cm. I was having the same sort of pain you are describing to a lesser degree and I raised my seat and it took care of the issue. Why don't you test out some larger bikes and see how it feels?
2009-09-07 4:42 PM
in reply to: #2392101

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Subject: RE: Medial knee pain while cycling
I am experiencing the same exact medial knee pain when cycling, only mine is in my left knee.  I did an 83 mile ride this morning, and it bothered me something awful, for the last 10 miles of my ride.  Like the OP, if I back off on the intensity a bit...it helps, but then I feel as if I'm doing nothing...which sucks and defeats the whole purpose of being out there on the bike in the first place.   I'm using Time RXS Carbon pedals (large platform) with Northwave road shoes, had a professional fit when I bought my bike (Cervelo Soloist Carbon 51cm - I'm 5'6"), so I'm not sure why this is happening. 
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