# Dull Knee Pain



## r.shoemaker78

Sorry I searched and got conflicting answers about this, I've tried all the usual approaches like playing with cleat position and position on the bike. The pain was far more sever but a majority of the pain has susided since making playing with my position on the bike. The issue I still have is that I can't seem to get the constant dull ache in my knee's to subside. 

One thread I found suggested a little more rest to heal and drink more water. I gave it a couple days and hydraded extensively, the daily ache had completely subsided so I hopped back on the trainer for a nice lil workout. I did a very easy 10 min warm up and everything felt great, then I started to put the power down (what little power I have) and after about 10 more minutes the pain came back...I'd only rate it around a 3-4/10 now but its enough to make me unconfortable and always just my right knee. I have zero pain in the left knee. 

Could this be something more extensive or just require a little more rest??? I've been riding and training a lot since getting back on the bike in January after a few year hiatus (sp) but have felt big improvemens in power and have lost almost 20 lbs. 

Thanks for reading.


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## r.shoemaker78

After rereading my post I realized I should probably give a little more information. First off I'm not a masher, I typically spin 90-110 rpm when training and rarely go below a cadence of 80 even on some of the longer climbs around here. I have also dropped from the low 190's down to 173-174 lbs and this pain really just seemed to come out of nowhere about 3 weeks ago.


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## triathlonandy

Are you icing it? Try icing your knee for 15 minutes a day. Maybe some exercising a little off the bike..

Here's a list of some exercises that might help - Durango Orthopedics - Knee Exercises What I do at physical therapy is put a big fitness ball on my back and lean it against a wall and do very short squats. It's supposed to strengthen and build the parts of the body that connect to the knee.


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## r.shoemaker78

No I havn't tried icing it yet, I will definately give those exercises a go and see if that helps also. Thanks for the tips, my mind is getting ahead of my body and I have to remember to tone it down a notch at times.


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## cyclesport45

Ice, naprocin, rest. oh yeah, and patience.


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## tom_h

If the pain is more to to the outer edge of knee, there's a chance it could also be the "IT Band".

The usual way to treat the ITB (in addition to ice, etc) is roll the entire ITB over a firm, foam roller.

You can find many articles and how-to videos on the web.

For most people , rolling the ITB will be very painful the first few times. Try to get into a routine where you're rolling for a few minutes, before & after the bike ride. It can make a world of difference.


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## BigTex_BMC

Hit it with a hammer and some duck tape, good as new. PM me so I can tell you where to send the check.


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## r.shoemaker78

tom_h said:


> If the pain is more to to the outer edge of knee, there's a chance it could also be the "IT Band".
> 
> The usual way to treat the ITB (in addition to ice, etc) is roll the entire ITB over a firm, foam roller.
> 
> You can find many articles and how-to videos on the web.
> 
> For most people , rolling the ITB will be very painful the first few times. Try to get into a routine where you're rolling for a few minutes, before & after the bike ride. It can make a world of difference.


It definately isn't on the outside edge and from the sounds of it I'm glad it isn't. The best way to describe the location is behind the knee cap.


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## stumiller

Is it possible the seat is too low? Front of knee pain is usually related to seat being too low and behind the knee is seat is too high. maybe some tendonitis if your just starting back into the sport


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## r.shoemaker78

stumiller said:


> Is it possible the seat is too low? Front of knee pain is usually related to seat being too low and behind the knee is seat is too high. maybe some tendonitis if your just starting back into the sport


I did play with seat height quite a bit till I felt like I was in the best position but I may move it up just a mm or two and see if that helps, thanks for the tip.

I'm really just starting to think its tenonitis from getting back into the sport so hard at first and that I should just take a couple extra days off and see how I feel.


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## carlosflanders

Most cyclists get "spring knee" in March. Comes from ramping up the workload early when the knee and surrounding tendons/ligaments/muscles aren't ready for it. As long as your fit is good (big if), patience is the best cure.

Some fish oil and a conservative very gradual warm-up can help as well. That and keeping it in the little ring.


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## Lionvista

It was also pointed out to me (as I am a beginner age 45 male, 215 pounds) to consider that I might have been lowering my heel on the down stroke. I was told to hone my form before it got to be a bad habit. I'm resting mine a few days while it rains. Then I'll be more conscious of my heel position as I try to build a little lung capacity.


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## Nicole Hamilton

Is it possible your crank arm is too long? I've been on 170s for 38 years on my Paramount with never any problems. But when my new Pinarello showed up, it was incorrectly configured with 172.5s. The 172.5s were much harder on my knees than you'd expect, considering it's only 2.5mm difference. By the end of a 30-mile ride, my knees hurt. CC sent replacement 170s and in the two rides since the swap (36 and 35 miles) the problems were gone.

Moral of the story: Small differences in crank arm length can make a big difference to your knees.


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## Cervelo S-5

r.shoemaker78 said:


> It definately isn't on the outside edge and from the sounds of it I'm glad it isn't. The best way to describe the location is behind the knee cap.


Hello R. Shoemaker I have just read your plight and I can sympathize with your frustration. The advice of Ice, ITB rolling, rest, patience...etc all good stuff. (the hammer thing might be extreme, but it made me laugh). The following was a post I made in another knee pain area in this forum that I think applies to you and may help you out. Try it as it is conservative and will do no harm regardless. Let me know how you make out. Cheers and good luck!! 


"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)

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!


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## Peanya

I had to use shims and inserts to correct mine. And a shorter crank, all with a pro fiting. If your arch falls when you put weight down on it, then you definitely need inserts. If you have someone ride behind you, they should watch your knees to see if they go up and down in a straight line. If your knee swings out on the upstroke, then it's clear that your arch is falling. If you don't have anyone, maybe set up a camera behind you and record yourself on a trainer. Ideally, a good pro-fitting can be a big help. Hey, a $300 fitting is pricey, but it's cheaper than a $2000+ surgery and no cycling.


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## r.shoemaker78

Thanks, you guys have all made some really great suggestions, I'm about to build up my Cervelo in April and was already planning on getting a pro-fit when its completed. Not to mention going down from a 175 mm crank to a 172.5 or even a 170 mm since I'd much rather spin than mash. I honestly think a pro-fit is well worth it since I'm no longer just a casual rider and looking to really improve my form and abilities. 

It's tough getting older, I was such an avid athlete for so long then stepped back to raise my kids and move up at work...now I'm shocked at how hard it is to not only lose weight but to recover from injuries and soreness. Running and Basketball are just too hard on my joints so I intend to make cycling my primary focus, I just hope I can keep my uber competitive nature in check till my body can handle it.


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## Nicole Hamilton

r.shoemaker78 said:


> Thanks, you guys have all made some really great suggestions, I'm about to build up my Cervelo in April and was already planning on getting a pro-fit when its completed.


I liked the Cyfac fit that I got at an LBS, perhaps especially because I was able to use it as guidance to buy a Pinarello instead. When I talked with Eric Sakalowsky, Cyfac's owner, he was really proud of the ergonomic modeling software they'd developed. The way he described it, he had something nobody else could match. I can't judge that claim, but I can say I was impressed by the way the measurements are taken, using some specific props, e.g., magnetic pegs that get moved around as you sit or stand. The measurements were really repeatable, to within maybe a mm or two.

What you get is a 4-page PDF (though I had to ask for the PDF, not just the printout) showing the frame geometry you'll need for either a traditional flat top tube or a sloping tube and a diagram of your position.

It turned out to be pretty much right on the money for me in predicting how I should transition from a 56 cm Paramount using 27x1.25 wheels to a modern bike with 700C wheels. But of course, what it also told me was that, within the obvious (but unstated) margin of error, there was nothing so unusual about me that I actually needed custom to get a good fit. It predicted that the 51.5 Paris would be a pretty good fit and that turned out to be right. And, btw, yes, it predicted that I should not use a crank arm longer than 170 mm and it was right about that, too.


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## velocipedio

r.shoemaker78 said:


> I did play with seat height quite a bit till I felt like I was in the best position but I may move it up just a mm or two and see if that helps, thanks for the tip.
> 
> I'm really just starting to think its tenonitis from getting back into the sport so hard at first and that I should just take a couple extra days off and see how I feel.


How did you set your seat height? Many types of knee pain come from a saddle that is too high, which is the case for many riders.


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## r.shoemaker78

Well its been just over a week since I asked this question, I basically just gave myself a few extra rest days, focused on hydrating and only doing easy stretches each night. My next ride on the trainer was just a 30 min easy pace followed by a 34 mile ride this weekend at a moderate pace, not killing myself. Last night I did my max effort climbing intervals on the trainer and lets just say WOW!! No pain and for a few minutes I thought my bike might come off the trainer, I was pounding out the gears higher and hard than I ever have causing a whole slew of mercy noises from my bike and trainer LOL!!

Thanks for all the input, I really think over training and lacking proper recovery time was the cause. 

On a side note, I had my follow-up physical since my last one in October. At that time I was overweight, had high blood pressure (141/98) and high cholesterol...I'm down almost 25 lbs and near my ideal weight, my blood pressure was 125/80 and my cholesterol is just 5 points over normal. I was elated and I think the good news put a little extra power in my legs haha. Sorry its a lil off topic but hey...I had to share.


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## darkcoal

I am the same boat, with the knee pain, I'm getting a pro-fit this week to see if help with the pain.
And congratulations on you health managing success.


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## carbonframe47

carlosflanders said:


> Most cyclists get "spring knee" in March. Comes from ramping up the workload early when the knee and surrounding tendons/ligaments/muscles aren't ready for it. As long as your fit is good (big if), patience is the best cure.
> 
> Some fish oil and a conservative very gradual warm-up can help as well. That and keeping it in the little ring.


I'm in the same boat with the knee pain and I think this might be my problem. I just got a new Specialized Roubaix, but I was professionally fitted at the Specialized concept store. The crank length is actually shorter than on my old bike. I've been on the indoor spin bike all winter and cranking pretty hard on it so I thought I was ready to rock. Went from 2 to 3 days a week on the spin bike to almost every day for 2 weeks on my new bike. Hammered on the hills hard and tried to do interval training, cranking as hard as I could (in a high gear). I think this has caught up with me fast. I've been limping around for the last week. I've taken this week off and I've been elevating, icing and taking naproxen. Knees feel a little better, I hope I can ride next week.


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## Andrew L

Last year was my first year cycling and I road about 1000 miles (finished Hotter'N Hell last year). In September I started doing shorter but more intense rides and I noticed that my legs were really achey and my knees kind of hurt. I took the winter off, mainly due to a chest issues, and started riding again in March. Sure enough, the knee pain returned after a few weeks but I&#146;ve managed to keep it from getting too bad. I&#146;ve been resting (only riding about once a week), ice, elevation. I&#146;ve also had good luck with using Kinesio tape while riding. Seems to help support my knee and the patella tracking correctly. I also started taking Glucosamine which seems to help as well. We'll see if everything keeps improving.


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## Andrew L

darkcoal said:


> I am the same boat, with the knee pain, I'm getting a pro-fit this week to see if help with the pain.
> And congratulations on you health managing success.


Did the pro bike fitting help? I've been dealing with a dull achey knee for the past several weeks. I sit all day at my job and that really makes both of my legs ache but it's definitely coming from below my patella. I had a bike fitting done so I think the seat height isn't a problem. Any recommendations on cleat placement to fix knee pain? Also, how do I know if it's "Spring Knee" or if something more complex is going on.


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## carbonframe47

Now a week-and-a-half without riding. I've been elevating, icing, and taking naproxen every night. My knees do feel MUCH better. However, now I'm uncertain as to when I can really start riding again. My knees generally feel ok, but every once in a while if I turn just a certain way I can feel a tiny "tinge". I really want to get back at it but I don't want a relapse either. Should I just make a full two weeks off?


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## Chris-X

carbonframe47 said:


> I'm in the same boat with the knee pain and I think this might be my problem. I just got a new Specialized Roubaix, but I was professionally fitted at the Specialized concept store. The crank length is actually shorter than on my old bike. I've been on the indoor spin bike all winter and cranking pretty hard on it so I thought I was ready to rock. Went from 2 to 3 days a week on the spin bike to almost every day for 2 weeks on my new bike. Hammered on the hills hard and tried to do interval training, cranking as hard as I could (in a high gear).* I think this has caught up with me fast. I've been limping around for the last week*. I've taken this week off and I've been elevating, icing and taking naproxen. Knees feel a little better, I hope I can ride next week.


I think you're right!



carbonframe47 said:


> Now a week-and-a-half without riding. I've been elevating, icing, and taking naproxen every night. My knees do feel MUCH better. However, now I'm uncertain as to when I can really start riding again. My knees generally feel ok, but every once in a while if I turn just a certain way I can feel a tiny "tinge". I really want to get back at it but I don't want a *relapse either*. Should I just make a full two weeks off?


More rest won't hurt. Easing into it probably won't hurt either. Listen to your body this time rather than flailing away with wild abandon. Slowly testing your limits while properly "regulating" your training and recovery is what training is all about.

IOW, listen to your body and pay close attention to what it's telling you. No big secret there, nor does one exist.


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## darkcoal

Andrew L said:


> Did the pro bike fitting help? I've been dealing with a dull achey knee for the past several weeks. I sit all day at my job and that really makes both of my legs ache but it's definitely coming from below my patella. I had a bike fitting done so I think the seat height isn't a problem. Any recommendations on cleat placement to fix knee pain? Also, how do I know if it's "Spring Knee" or if something more complex is going on.


It did, I end it buying new shoes, my old ones did not have any more support , he installed pedal extenders and some other little changes,I have only done small fast rides 30-35 miles each time to get used to the new settings, the pain is gone for now.
Well worth the money


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## PoorCyclist

Could be alot of things but have you guys tried to lower your saddle just a little.

Sometimes when setting up bikes I was too ambitious to set the saddle higher and started to get a little bit of aches after riding. I lower it anywhere 2-5mm and it freed up the knee where it isn't so "taut" and no more pain after riding. Give it a try and I would think doesn't really hurt your power, in fact it is more powerful for me than 5mm too high.


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## carbonframe47

After two weeks off, knees feel good as new. New approach this time: stay in small chainring and lower gears as much as possible, BUT, keep overall cadence higher. Two good rides under my belt and knees holding up.


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## hamsey

Going through this now. No problems last year but man the knee pain this year 8/10. Went to see sports doc and was told to go to physical therapy. Tight muscles. IT band very tight explains the pain on the outside of the knee. Tight quads messing with a alignment of my knee. Pulling on my knee cap and am getting bone on bone. Knee cap was very sensitive.

Doing a bunch of stretching and strengthening. Going to try taping my knee to keep it aligned until things get sorted.


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## Andrew L

hamsey said:


> Going through this now. No problems last year but man the knee pain this year 8/10. Went to see sports doc and was told to go to physical therapy. Tight muscles. IT band very tight explains the pain on the outside of the knee. Tight quads messing with a alignment of my knee. Pulling on my knee cap and am getting bone on bone. Knee cap was very sensitive.
> 
> Doing a bunch of stretching and strengthening. Going to try taping my knee to keep it aligned until things get sorted.


Be patient, sometimes the pain will go away quickly, other times it can take quite awhile...just don't get frustrated. I went through PT a few years ago for my IT band and it took over a year to finally go away. I just went through knee pain due to Patellafemoral pain syndrome and it was only a month but I was able to ride, just had to take it a little slower. I had great success with Kinesiology tape, just make sure you do it right or it won't be as effective. I had my sister, who is a PT, tape it for me the first several times until I learned how to do it.


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## hamsey

Thanks for the info. PT is going through the Kinesiology tape training now. At the moment we are doing it the old way.


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## Sworker

I have had 3 major knee surgeries on my left knee is a constant battle to keep that knee in good shape. I use special formula Gloucasmin that helps alot, but I also finally broke down and purchase a Cho-Pa3

Cho Pat Store | Shop a complete line of quality Chopat Knee Straps, Cho pat Braces, Chopat Supports and More!

I have one and it really does help.


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## hamsey

Shoe,

What about the arch supports in you r shoes? Went for a fitting and put in a higher arch support insole. I believe this is what is causing my knee problems. Just went back to a lower support and did not have any knee pain during or after my ride. Feels good not having to wear my brace afterwards.

Stretching and strengthening helped also. But, I was still having issues before the swap. Worth a try.


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## r.shoemaker78

Just thought I would update and possibly hear more ideas. I ended up having a hard time staying off the bike till the end of May when the pain was getting very bad and constant. I could hardly walk down stairs and even had to call the wife to pick me up once (she was thrilled ). We had a 2 week vacation planned so I decided to just take it easy, started taking glucosamine and fish oils. After coming back from vacation I had 4 weeks till my major ride for the year, the Triple Bypass. 

The first week I just did 2 easy pedal sessions on the trainer and one 30 mile moderate pace ride...no pain, I continued to stretch and focused on recovery. I slowly amped up the rides in both length and intensity and was feeling great, I also discovered that going for a ride with the wife was a great way to keep a slow pace on recovery rides and it was fun.

I rode great on the Triple Bypass but the pain in my right knee returned on the final pass. About half way up the 16 mile climb I considered bailing out it was so bad and sudden. I took a 15 min break and decided I couldn't stop 100 miles into the ride. I figured out that riding out of the saddle took some of the pressure off the point of pain and ended up finishing pretty strong but so much out of saddle riding and favoring my right knee ended up straining my right ankle. 

I took the week off after the big ride and did a nice easy ride ride the following weekend. The dull knee pain was back almost instantly and now joined by much sharper ankle pain. I had already signed up and paid to ride another big ride, the Copper Triangle that was two weeks from that point. I consulted a PT the next week and began using a foam roller and doing more stretches accompanied by some balance and strength exercises. I didn't ride my bike till the event I was very nervous at the start. The Copper Triangle starts up hill with a nice long climb and my nerves quickly calmed as I settled in. There was no pain and I was climbing better than ever!! The first two mountain passes went by fast and I felt great, passing people all the way up and only getting passed by a few very strong climbers that I ended up jumping on the back of for he rest of the ride. The last pass was Vail and about half way up the knee pain came on pretty strong again. I wasn't shocked and eased up for the last half of the climb but was pleased with the progress.

I'm at the end of another two week rest and my PT wants me to wait another two weeks continuing the stretching, foam rolling and strength exercises before easing back onto the bike much slower than before. The ankle still hurts even just walking around so I will just have to be patient and make sure I am fully healed before getting back in the saddle. It is super hard especially after feeling so good on the bike for over 50 miles of mountain climbing and patience has never been a strong virtue of mine.

I will say that I am totally hooked on cycling now and already planning out my rides for next season. I am really hoping to see some big improvements next seasons since I've lost the weight and dropped my blood pressure down, I can focus on improving my vo2 max and sustained power this winter.


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