Kneecap discomfort - what to do?
Discussion
I did a long (for me) ride on Saturday - 50 miles of towpaths. I was feeling great until the last 5-ish miles when my left knee, around the kneecap, started aching. It's a dull pain - I have obviously overdone my capabilities (I'm in my early 50s). It only hurts on the upswing and isn't a constant pain at all but I can trigger it again when I sit on a chair and bend my leg under. Walking doesn't trigger any pain but climbing or descending stairs forces me to bend my knees just enough that I can feel it is still there.
I had a day off cycling yesterday but having just popped-out for my daily regime, I had to cut-short my usual route because it was getting worse and I'm a little in fear of doing something permanent.
I am very rarely ill, and as such I don't often visit the docs (according to the NHS app I have, I haven't visited since 2004) and if I can be assured that this will go away, I'll not bother them this time. Has anyone got any comforting words of wisdom like "give it a couple of days" or should I take it more seriously?
I had a day off cycling yesterday but having just popped-out for my daily regime, I had to cut-short my usual route because it was getting worse and I'm a little in fear of doing something permanent.
I am very rarely ill, and as such I don't often visit the docs (according to the NHS app I have, I haven't visited since 2004) and if I can be assured that this will go away, I'll not bother them this time. Has anyone got any comforting words of wisdom like "give it a couple of days" or should I take it more seriously?
1) Never ignore or work through pain. Your body is telling you that something is wrong
2) If you're worried, see a physio
3) I'd rest it completely for a week or so. Knees are tricky things at the best of times and it's easy to do serious and lasting damage
4) Knee pain can be associated with low cadence. If you're regularly grinding down at 40 or 50 rpm then drop down a few gears and try to keep it over 70
2) If you're worried, see a physio
3) I'd rest it completely for a week or so. Knees are tricky things at the best of times and it's easy to do serious and lasting damage
4) Knee pain can be associated with low cadence. If you're regularly grinding down at 40 or 50 rpm then drop down a few gears and try to keep it over 70
About 15 years ago I attempted LeJoG on a bike, and had to give up half way because of knee pain despite having done lots of training. I took up marathons. A few years ago I got locking and had cameras in there, but nothing was found. A few months ago the other knee suffered the symptoms you mention, luckily I had private insurance and had an op and had quite a bit of meniscus removed and it is better but not perfect. Aged 52 now, and haven't been able to run for 6 months.
Ice, rest. If pain continues you will need xray and MRI and to see a consultant. At one point with the latest injury any movement out of the ordinary was excruciating, for instance if you got your leg hooked up whilst getting out of a van.
Ice, rest. If pain continues you will need xray and MRI and to see a consultant. At one point with the latest injury any movement out of the ordinary was excruciating, for instance if you got your leg hooked up whilst getting out of a van.
Thanks all.
I am a spinner not a grinder- I don't have the strength for low cadence, so it's not that. I think I literally went too far in one go. I did the whole 50 miles with barely a rest when I'm still only a year into cycling regularly. I think I just overdid it this one time.
The pain feels like "wear". I have, in the past, suffered with tennis elbow which is not actually a pain in the elbow - and I currently have muscular pains in my back which are hard to pinpoint exactly where they are coming from. This knee pain isn't like that - it feels very localised, so I genuinely think it's wear-related.
But the advice above, to rest it, seems sensible. I will call the docs tomorrow morning and see if he can assess it. I'll get him to look at my back problems too while I'm there - I'm sure I'm only firing on 7-cylinders at the moment anyway.
Not cycling while I rest this knee will seriously hurt my mental health so I hope it sorts itself out quickly.
Thanks again.
I am a spinner not a grinder- I don't have the strength for low cadence, so it's not that. I think I literally went too far in one go. I did the whole 50 miles with barely a rest when I'm still only a year into cycling regularly. I think I just overdid it this one time.
The pain feels like "wear". I have, in the past, suffered with tennis elbow which is not actually a pain in the elbow - and I currently have muscular pains in my back which are hard to pinpoint exactly where they are coming from. This knee pain isn't like that - it feels very localised, so I genuinely think it's wear-related.
But the advice above, to rest it, seems sensible. I will call the docs tomorrow morning and see if he can assess it. I'll get him to look at my back problems too while I'm there - I'm sure I'm only firing on 7-cylinders at the moment anyway.
Not cycling while I rest this knee will seriously hurt my mental health so I hope it sorts itself out quickly.
Thanks again.
you don't mention in your post, but have you had a bike fit? If not then get one asap. If you have previously had a bike fit then has anything changed, pedals, cleats, saddle height.
I find knee warmers/leg warmers help a lot with my knee pains. Give me just enough support without being obstructive, and keep the knee warm which helps with the pain.
I find knee warmers/leg warmers help a lot with my knee pains. Give me just enough support without being obstructive, and keep the knee warm which helps with the pain.
By co-incidence I was just this afternoon skimming through Vivian Grisogono's ''Running Fitness and Injuries'' which has a chapter on Runner's Knee. In runners, it's commonly triggered by quads imbalance, particularly a weak VMO muscle, which means the kneecap is pulled to one side of its groove.
Not sure how that translates to cycling - except that a saddle too far forward can worsen patella pain, eg if the kneecap moves materially ahead of the pedal spindle. Possibly also cleats that are constraining the knee to move unnaturally during parts of the pedal rotation - I suffer from painful knees and always prefer cleats with a decent degree of 'float'.
Not sure how that translates to cycling - except that a saddle too far forward can worsen patella pain, eg if the kneecap moves materially ahead of the pedal spindle. Possibly also cleats that are constraining the knee to move unnaturally during parts of the pedal rotation - I suffer from painful knees and always prefer cleats with a decent degree of 'float'.
I switched from running on the road to a treadmill in Jan 2020 and after a few days, I woke up in terrible pain. After nursing it for about 18 months (lots of popping, limp etc), a friend who used to run marathons recommended this:
https://www.amazon.com/dp/B07KPNKJX7?psc=1&ref...
I don't usually take supplements but after a while and within a few days, I noticed a huge difference. No idea why or how but I don't feel any ache now and I've recently resumed running. Only 2 miles / day but i'm happy to report that it's not hurting.
https://www.amazon.com/dp/B07KPNKJX7?psc=1&ref...
I don't usually take supplements but after a while and within a few days, I noticed a huge difference. No idea why or how but I don't feel any ache now and I've recently resumed running. Only 2 miles / day but i'm happy to report that it's not hurting.
I think you have answered your own question, a bit too much too soon. Just build gradually. That said, there is a rule of thumb around knee pain on the bike. Anterior pain (like yours), raise the cadence and raise the saddle height. Posterior pain, lower the saddle.
Aim for a cadence of 90+ - a simple bike computer has this, and do try to avoid mashing up hills. As for saddle height, don't whack up the saddle a ton, add 5mm at a time. Bike fitters will aim for a c.135 degree knee angle at full extension, and want to see that when cycling, viewed from behind, your pelvis is not tilting from side to side.
Aim for a cadence of 90+ - a simple bike computer has this, and do try to avoid mashing up hills. As for saddle height, don't whack up the saddle a ton, add 5mm at a time. Bike fitters will aim for a c.135 degree knee angle at full extension, and want to see that when cycling, viewed from behind, your pelvis is not tilting from side to side.
This is 100% bike fit related. I have been riding quite regularly for 13 years or so now (ride between 6,000 and 10,000km per year, on road and off road) and only in the last year or so have I got to the point where I feel like the only discomfort I have at the end of the ride is due to the exertion rather than due to actual bike fit related pain. Physio isn't the answer here at this stage, having some good knee stretches can help, but realistically, the longer you continue to ride your bike in an improper position, this will keep being a problem and causing you issues. Also, pushing a bigger gear at lower rpm is also going to compound the issue.
Knee pain is a very common cycling issue, and there is plenty of literature (good and bad) online which can help you diagnose your issue. Depending on exactly where the pain is can help you to diagnose what the problem is. The more you ride, the worse the pain is. From previous experience, it feels more like a dull ache rather than a sharp pain and this can hang around for quite a while after the ride and is then exacerbated when you ride again.
These are a simple and rough guide, but assuming that you are riding with SPD's then the best way to start and eliminate issues (in my experience) is to start with a neutral cleat position, then sort the saddle height and fore/aft position. Taking notes and measurements is important and speeds up the process and allows you to track where you started from and then enabling you to re-create the position between bikes etc.
I had a bike fit many years ago and it did get me in the right ball park, but every time I change bikes there is an element of fine tuning to get it spot on again. Finding a really well respected bike fitter local to you would be a really good idea or work through a few of the online bike fit tutorials to see how far off the mark you are currently.
Knee pain is a very common cycling issue, and there is plenty of literature (good and bad) online which can help you diagnose your issue. Depending on exactly where the pain is can help you to diagnose what the problem is. The more you ride, the worse the pain is. From previous experience, it feels more like a dull ache rather than a sharp pain and this can hang around for quite a while after the ride and is then exacerbated when you ride again.
These are a simple and rough guide, but assuming that you are riding with SPD's then the best way to start and eliminate issues (in my experience) is to start with a neutral cleat position, then sort the saddle height and fore/aft position. Taking notes and measurements is important and speeds up the process and allows you to track where you started from and then enabling you to re-create the position between bikes etc.
I had a bike fit many years ago and it did get me in the right ball park, but every time I change bikes there is an element of fine tuning to get it spot on again. Finding a really well respected bike fitter local to you would be a really good idea or work through a few of the online bike fit tutorials to see how far off the mark you are currently.
Bike fit? No, I have not had one but I had got up to 2300 miles this year without any problems until I did that ride. I have been riding that bike for over 10 years now, so I'm confident it's not that.
I can still feel it but it's better this morning. I VC'd with the physio consultant this morning (I have an on-line doctor through the brilliant Babylon app, paid for through BUPA membership from work) who agreed that I had simply overdone it, and suggested I stop riding for 3-4 days, chomp a limited number of Ibuprofen - not for pain relief but to genuinely reduce any swelling that might be inside the knee (nothing is visibly wrong at all), perform some exercises he's sent me YouTube links to, and resume riding, in a few days, with shorter distances to begin with.
Seems sensible. Not being able to ride is messing with my head - seriously. I can talk about it but it really screws with my mood and makes me slightly panic in case this persists for longer than I'm prepared for, but I know I need to let it pan-out as described.
Anyway, thanks for the advice to "not ignore it". That's exactly what I needed to hear.
I can still feel it but it's better this morning. I VC'd with the physio consultant this morning (I have an on-line doctor through the brilliant Babylon app, paid for through BUPA membership from work) who agreed that I had simply overdone it, and suggested I stop riding for 3-4 days, chomp a limited number of Ibuprofen - not for pain relief but to genuinely reduce any swelling that might be inside the knee (nothing is visibly wrong at all), perform some exercises he's sent me YouTube links to, and resume riding, in a few days, with shorter distances to begin with.
Seems sensible. Not being able to ride is messing with my head - seriously. I can talk about it but it really screws with my mood and makes me slightly panic in case this persists for longer than I'm prepared for, but I know I need to let it pan-out as described.
Anyway, thanks for the advice to "not ignore it". That's exactly what I needed to hear.
If you're using clipless, that might be worth ruling out. I had the same pain described in my 30's doing big distances, then shorter, then every ride. It was the upswing of pulling (bad technique or otherwise, I couldn't help it) that appeared to cause it.
I was bike fitted and had used clipless for years previously, with correct float/fit etc.
Ditched for flats and pain never came back again - over ten years ago now, although ride less nowadays.
That's my story anyhow!
I was bike fitted and had used clipless for years previously, with correct float/fit etc.
Ditched for flats and pain never came back again - over ten years ago now, although ride less nowadays.
That's my story anyhow!
timnoyce said:
This is 100% bike fit related. I have been riding quite regularly for 13 years or so now (ride between 6,000 and 10,000km per year, on road and off road) and only in the last year or so have I got to the point where I feel like the only discomfort I have at the end of the ride is due to the exertion rather than due to actual bike fit related pain. Physio isn't the answer here at this stage, having some good knee stretches can help, but realistically, the longer you continue to ride your bike in an improper position, this will keep being a problem and causing you issues. Also, pushing a bigger gear at lower rpm is also going to compound the issue.
Knee pain is a very common cycling issue, and there is plenty of literature (good and bad) online which can help you diagnose your issue. Depending on exactly where the pain is can help you to diagnose what the problem is. The more you ride, the worse the pain is. From previous experience, it feels more like a dull ache rather than a sharp pain and this can hang around for quite a while after the ride and is then exacerbated when you ride again.
These are a simple and rough guide, but assuming that you are riding with SPD's then the best way to start and eliminate issues (in my experience) is to start with a neutral cleat position, then sort the saddle height and fore/aft position. Taking notes and measurements is important and speeds up the process and allows you to track where you started from and then enabling you to re-create the position between bikes etc.
I had a bike fit many years ago and it did get me in the right ball park, but every time I change bikes there is an element of fine tuning to get it spot on again. Finding a really well respected bike fitter local to you would be a really good idea or work through a few of the online bike fit tutorials to see how far off the mark you are currently.
Thanks for this. One of those items in that table - rapid increase in distance or intensity is almost certainly the reason but there is another item to do with deep leg squats which might also be a contributor. Knee pain is a very common cycling issue, and there is plenty of literature (good and bad) online which can help you diagnose your issue. Depending on exactly where the pain is can help you to diagnose what the problem is. The more you ride, the worse the pain is. From previous experience, it feels more like a dull ache rather than a sharp pain and this can hang around for quite a while after the ride and is then exacerbated when you ride again.
These are a simple and rough guide, but assuming that you are riding with SPD's then the best way to start and eliminate issues (in my experience) is to start with a neutral cleat position, then sort the saddle height and fore/aft position. Taking notes and measurements is important and speeds up the process and allows you to track where you started from and then enabling you to re-create the position between bikes etc.
I had a bike fit many years ago and it did get me in the right ball park, but every time I change bikes there is an element of fine tuning to get it spot on again. Finding a really well respected bike fitter local to you would be a really good idea or work through a few of the online bike fit tutorials to see how far off the mark you are currently.
Doing squats isn't a new thing but since I increased my miles/week earlier in the year, my thigh muscles (top of my thighs, leading to my knees - I don't know biological names) have felt "tight" so I've been squatting ten times, twice a day to stretch them. As I said, it's not a new thing, and I have been doing it gently (I am aware of my age and lack of exercise until the past 12 months) but squats absolutely pull the kneecaps tight, so I've stopped doing that too.
In the future, instead of doing squats from standing where I apply all my weight in the squat (78Kg), I'll do it seated, and gently pull on my feet to pull my legs beyond 90 degrees... gently. But not yet. I've stopped everything for the time being.
Bear-n said:
If you're using clipless, that might be worth ruling out. I had the same pain described in my 30's doing big distances, then shorter, then every ride. It was the upswing of pulling (bad technique or otherwise, I couldn't help it) that appeared to cause it.
I was bike fitted and had used clipless for years previously, with correct float/fit etc.
Ditched for flats and pain never came back again - over ten years ago now, although ride less nowadays.
That's my story anyhow!
It could be this, I'll concede but I feel the smoking gun in this case is more likely the rapid increased distance, and (now I've thought about it) the squats.I was bike fitted and had used clipless for years previously, with correct float/fit etc.
Ditched for flats and pain never came back again - over ten years ago now, although ride less nowadays.
That's my story anyhow!
I will keep this in mind. I'd be gutted to lose SPDs because I really value them but I will keep it in mind. Thanks.
I'd ridden on them since a teenager, and was equally attached 
to them.
My noticing the problem also coincided with a big increase in distance and effort (I was training up for a big ride) - but it appeared that even with lowering distances, it was now a permanent problem with SPDs.
Might not be that of course but I will say that I missed them for a bit, but not as much as I'd thought. Good luck diagnosing the cause.
to them.My noticing the problem also coincided with a big increase in distance and effort (I was training up for a big ride) - but it appeared that even with lowering distances, it was now a permanent problem with SPDs.
Might not be that of course but I will say that I missed them for a bit, but not as much as I'd thought. Good luck diagnosing the cause.
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