# tendon / LCL / knee pain - help!



## simonkeeton (Jun 22, 2006)

Hate to have another knee post out there, but I couldn't find much that parallels my issue...

Over the past three months, I have noticed progressively more pain at the back outside of my left knee, at the tendon that connects the upper and lower parts of the leg (I belive the lateral collateral ligament). What used to be minor soreness is becoming ever more painful. During the ride it is not so bad, after the ride, especially after a few hours, I can barely walk.

I am resting, icing and taking NSAIDs... but I have no idea what to do to actually correct the fundamental biomechanical issue or where to start... I presume it is a cleat position issue, but not 100% sure. Right now the ball of my foot is pretty well centerline with the pedal axle, and my foot position is neutral. I am not sure if I should try moving my cleats forward / backward, rotate the cleat, or try some of the varus wedges from Specialized... I currently have the Specialized Pro Carbon Comp shoe and use the Sole heat moldable footbeds; still does not solve the problem. I have slight pronation of the foot, but otherwise no issues.

If anyone has suggestions, I am all ears. Thanks in advance...


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## The Flash (May 6, 2002)

I'm having the same problem in my right knee! I know that this leg is a little shorter, and I suspect it is from tight hamstrings, but I won't know for a while until I can get them stretched out.

the Flash


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## Eddie O (Sep 19, 2006)

Get a professional bike fit ASAP. From your description it sounds like you may be over extending through the pedal stroke. Saddle could be too high or too far back, though it could be a cleat position issue as well. Each one of those are a small piece in a big puzzle and it's best to address a fitting from the ground up rather then try to address a single piece.

Eddie O


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## 8art8 (Feb 2, 2007)

my knee pain was diagnosed by a popular sports physician as ITBS (Iliotibial Band Syndrome). The treatment was lots of stretching, ice, massage using a foam roller (really painful) and a really good bike fit. The bike fit included leveling my saddle, raising my stem height, and lemond wedges. I also now use really good insoles that go in all my shoes. My pain was more "side" & "frontal" than what you seem to describe, but my very limited understanding is that the IT band is guilty for lots of knee pain.


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## Doggity (Mar 10, 2006)

I literally feel your pain. ITBS can involve the posterior insertion, as well as the lateral.
What the others have said...if you want this to NOT become chronic (sounds like it's already well on its way), you've gotta get OFF the bike entirely...for like 2-3 weeks. No exercise that involves knee flexion. Get your fit evaluated (in my case, I had the saddle about 5mm too high, and a bit posterior, AND I wasn't wearing my Specialized shoes-stick with those, if they've worked for you in the past), ice and NSAID it, stretch, stretch, and more stretches, massages or physiotherapy to break up the myofascial strictures that form at the site of the friction. I've done all this; I'm now on my 19th day of not riding (pure torture!), but the pain is GONE. I'm a little bit gunshy, afraid it'll come back, so I'm just gonna take an easy spin tomorrow, see what happens.


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## simonkeeton (Jun 22, 2006)

*Thanks to all for the feedback*

Thanks to everyone for the notes. I will heed the advice and rest things for a while, and at the same time recheck my fit... keeping off the bike for 2-3 weeks is going to be very tough :mad2:


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## torrefaction (Jun 25, 2006)

what's nsaid? nothing special anti-inflammatory doodads? seriously, what does NSAID stand for?


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## Doggity (Mar 10, 2006)

torrefaction said:


> what's nsaid? nothing special anti-inflammatory doodads? seriously, what does NSAID stand for?


You're pretty close...it stands for 'nonsteroidal anti inflammatory". You know...aspirin, ibuprofen, and the heavier hitting prescription ones.


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## mattfatlander (Feb 7, 2005)

simonkeeton said:


> Thanks to everyone for the notes. I will heed the advice and rest things for a while, and at the same time recheck my fit... keeping off the bike for 2-3 weeks is going to be very tough :mad2:


+1 gazillion on getting a three-dimensional fit done. Cleat position, arch support (or lack thereof), leg length inequality, and other factors could all serve to create/exacerbate the problem.


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## starstevenson (Dec 29, 2006)

*read page 60 in Andy Pruitt's Complete Medical Guide for cyclist!*

Lower your seat and purchased fixed cleats (red in shimano durace), never ride a fixed gear and vary your terrain.
Star Stevenson Physical Therapist


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## [email protected] (Mar 25, 2007)

starstevenson said:


> Lower your seat and purchased fixed cleats (red in shimano durace), never ride a fixed gear and vary your terrain.
> Star Stevenson Physical Therapist


It's impossible to know what's wrong with your knee from the information listed. Find a professional in your area and have them look at it. Does your seat need to be lower? Impossible to know without seeing your current set-up. Find someone who does a good bike fit and musculoskeletal evaluation. It could be a lot of things with your fit: saddle height, for/aft, saddle tilt, cleats, in-soles/orthotics, or pedal mechanics/stroke, training errors, cadence. Too many variables to determine online. The easy fix is the bike because they are adjustable, but also make sure you see someone who can assess any pathology associated with the injury to make sure your body will heal. I know a lot of people in the industry and would be happy to make recommendations if I know anyone in your area. best of luck,

Russell Cree, DPT, CSCS
www.herriottsportsperformance.com


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## torrefaction (Jun 25, 2006)

starstevenson said:


> Lower your seat and purchased fixed cleats (red in shimano durace), never ride a fixed gear and vary your terrain.
> Star Stevenson Physical Therapist



FYI, the original post is from April... 
Cheers!


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