# knee pain...



## zizi (Dec 25, 2011)

I have read alot bout knee pain issues, but nothing seems to apply to me. 
Recently, I switched my cleats, Look Keo grey to Look Keo Black, and the pain started there! I was experiencing bareable pain on my left knee, and a month later, I was painfree. Not long after that, the pain returned, but this time on the right knee. 

I have tried moving the cleats, but nothing seem to work for me, so I switched back to the previous cleats!

The pain is on the upper side of the knee cap, and slightly to the inner side!

Suggestions, please!

I also switched bikes, from Dogma 60.1 to Dogma 2


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## Cervelo S-5 (Dec 16, 2011)

zizi said:


> I have read alot bout knee pain issues, but nothing seems to apply to me.
> Recently, I switched my cleats, Look Keo grey to Look Keo Black, and the pain started there! I was experiencing bareable pain on my left knee, and a month later, I was painfree. Not long after that, the pain returned, but this time on the right knee.
> 
> I have tried moving the cleats, but nothing seem to work for me, so I switched back to the previous cleats!
> ...



Hi zizi!!:idea:

I don't know for sure if I can offer any help but I will make a suggestion that you can try at home quite easily. Even if it does not help, it should not do you any harm either. 
Assuming that your set up is correct and your pedaling technique is reasonable and smooth; the area of discomfor that you are describing is indicative of a condition known as patella-femoral syndrome. It can bother you on the bike and also if it is bad enough, will be bothersome while sitting to a point where you are looking to straigthen out the affected leg for relief. (like wanting that leg in the aisle at a theatre):cryin:

If you have been riding for some time you will notice that the outside muscles of your quads (vastus lateralis) are probably quite well defined, and if the inside muscles are not as strong, in particular the VMO, (vastus medialis obliquus) it may cause the patella (knee cap) to track incorrectly and move to the outside instead of straight up and down causing pain on movement to the inside upper portion of the patella. 

The fix for this is quite easy. First make sure your set up correct (have someone else check it for you if needed). While sitting on a chair, pull your foot back so your toes are pointed up and extend your leg slowly to full extension. At this point put your hand on the inside of your knee and try to extend your leg a bit more. You should feel a small bit if muscle contract further during the last 5 degrees of extension and that is the VMO. It is important to NOT whip you leg up and jam it into extension as this is not good for the joint. The exercise is known more commonly as quad setting. Do 3 sets of 10 a couple of times per day and ice the knee after for 10-15 minutes. I would also recommend ice after riding for a while as this will be impotrant in reducing the inflammation ion the area. 

Rest may be in order until the pain is under control, but I will leave that up to you to decide. You should see results in about a week or two if this is the condition that I think it is. I would also recommend doing these things (as all exercises) bilaterally although ice on the good leg is likly not necessary.

Do not take flexibility exercise for granted either! Stretch your quads, hams, calves, gluts,hip flexors and ITB's frequently as they all work hard on the bike!

I hope this helps you!

Cheers and ride safely!:thumbsup:


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## Clyde250 (Feb 24, 2007)

Quadracep Tendonitis, Suprapatellar Bursitis, both are in that area. Slap a brace on it and immobilize it for a few days with RICE. Patella-femoral pain syndrome, in my experience, is under the knee cap. Move your seat up.

Send 1000 dollars to me for such awesome medical advice.


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## Cervelo S-5 (Dec 16, 2011)

Clyde250 said:


> Quadracep Tendonitis, Suprapatellar Bursitis, both are in that area. Slap a brace on it and immobilize it for a few days with RICE. Patella-femoral pain syndrome, in my experience, is under the knee cap. Move your seat up.
> 
> Send 1000 dollars to me for such awesome medical advice.


Also both very possible structures to be involved and although retopatellar pain is associated with longer standing P-F syndrome probably as a result of patella alta, I have found that the one of the first symptoms is usually superior/antero-medial patellar pain. Good call on raising the seat for sure!
Check you feet for pronation or flat footedness as well if you get no relief and if this is the case consider orthotics in your shoes.


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## Elpimpo (Jan 16, 2012)

in december i started getting knee pains after three "hard" seasons, so it caught me off guard. I didn't go to ortho, but to a bike shop instead to get re-fit. I measured EVERYTHING on the bike and then took it apart, cleaned it, and went in for the fit. The goal being to see if and what was "changed". When i brang it home i remeasured and compared. the ONLY difference was the seat height. It was about 1- 1.5 cm lower than it was before. So i was riding around for three years on what i thought was a perfect fit. Anyways, the pain went away within a week. After some research i found that the angle of the knee when at the 6 o'clock position can make or break this knee pain in most people. a goniometer is used to measure this and they are cheap but you need someone with basic understanding of anatomy to measure you while on a trainer.

I KNOW thats where my pain came from (saddle height), yours may be a totally different thing. If i was you id get re-fit and tell the person fitting you whats going on (pain, cleats,bike) any reputable fitter should do a full interview/history before the fit anyways.

BTW i know you know this: 
but the black cleats are no-play. that in and of itself may be your issue..
your feet may NEED to move during your stroke. Mine do.
Everyone is different and black cleats aren't for everyone


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## BCP (Nov 3, 2011)

I had a similar issue, except I switched shoes and installed new Keo Gray cleats. Lined them up as best I could in comparison to the old shoes, but started experiencing pain in my left knee, similar spot to your description. Spoke to my LBS about it, and ended up getting them to do a RAD fit which helped a ton. left knee pain went away but I had pain in the right knee. Swapped the right cleat out and installed a red cleat and all is well.


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## zizi (Dec 25, 2011)

wow!

Good to know I am not the only one! Cervelo S5, thanks for the exercise ideas... I will surely try that and keep you all posted for any changes.

Last week I checked with the doctros! After checking and tweeking the knee in every possible way, he told me it wasn't any injury at all, ony inflamation! told me to take it easy for a while!!! in the mean time, when I changed back to the grey cleats, I have done a bike fit and yes the saddle went up a little 3-4mm, and also the cleats were moved a little forward!

Don't know if that will help, since it is cold and dark, can not take the bike for a ride! waiting for the weekend


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## Ricey155 (Feb 17, 2012)

glad i read this post i never realised in the cleats had so much movement

just nipped out and checked mine and my left is in a different position to my right shoe and guess what my left knee has been hurting 

note to self check your dam equipment more often well just check it 

good reading love a good thread that gives me a cure :mad2:


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## zizi (Dec 25, 2011)

I am happy to report that it has been almost 1000 KM since I made the changes and no knee pain whatsoever.

I think it was because I switched back to the grey cleats! I am sure bike fit/cleat fit for ammateurs, like myself, is not taken very seriously! Black cleats require an appropriate technique and appropriate equipment, which most LBS don't have!

Anyhow, I have been happily riding and pushing very hard, just today rode a grup ride of 150 km!


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