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Knee pain

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kramdra
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Joined: 28 Oct 2010
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PostPosted: 15:08 - 18 Aug 2020    Post subject: Knee pain Reply with quote

Last year had a running injury* and an MRI suspected Hoffa fat pad impingement in the knee. I can still run but by about 15km I will be in quite a bit of pain, often aborting and walking home then feel like a cripple rest of week, Im not running much any more.
Cycling has been better, and helped me recover if I cycle the next day, while I am aware of it, there was no pain and no limit for distance, until yesterday. I have not cycled or ran for a few days, did 20km cycle shopping and then second half home I was getting pain.

Feels like I need to raise the seat up to extend my knee more, which is the opposite of what anyone will say. Im clipped in with SPD pedals, they appear correctly adjusted. Ive been trying to keep my cadence high which feels easier. Also feels like my left is doing most of the work, burning left quads with the right feeling normal.

Anyone had similar, or knee surgery or any cure? Bupa consultant told me nothing can be done, but he was an arsehole. Google tells me they can keyhole poke at the fat and remove the bad bits Laughing

*I enjoy fast downhill trail running, I am no good at flat city distance. In the local running club I am known for having a variable stride, pace and low cadence, but none can keep up on technical trail, and I can out sprint all but the fastest guy.

TLDR: How to set bike fot a bad knee?
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stinkwheel
Bovine Proctologist



Joined: 12 Jul 2004
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PostPosted: 15:17 - 18 Aug 2020    Post subject: Reply with quote

What about seeing a physio? Would altering your foot balance with insoles help?

Mrs stinkwheel has a knee impingement, but of a different sort. She wears corrective insoles now, including on the bike. We also swapped out her cleats for ones with a load more float in them.
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kramdra
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Joined: 28 Oct 2010
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PostPosted: 17:34 - 18 Aug 2020    Post subject: Reply with quote

Physio wasnt much good other than pointing the ultrasonic prodder at my achillies and referring me on for the MRI. My bupa ends soon and wont be renewed, at 60 quid a time I dont think it would be worth while paying myself.. maybe if there was a better one.

Just been having another look at the mri, I have no idea how to correctly use DroidRender app, or which images are for the bad knee..
https://i.postimg.cc/kgfkQxb1/IMG-20200818-173124.jpg


Last edited by kramdra on 00:16 - 22 Aug 2020; edited 1 time in total
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Irezumi
Renault 5 Driver



Joined: 07 Dec 2019
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PostPosted: 17:45 - 21 Aug 2020    Post subject: Re: Knee pain Reply with quote

kramdra wrote:
I have not cycled or ran for a few days, did 20km cycle shopping and then second half home I was getting pain.

Feels like I need to raise the seat up to extend my knee more, which is the opposite of what anyone will say. Im clipped in with SPD pedals, they appear correctly adjusted. Ive been trying to keep my cadence high which feels easier. Also feels like my left is doing most of the work, burning left quads with the right feeling normal.

First, getting back into cycling and doing that much is a large amount after a lay-off so potentially too much too soon.

You set a saddle height for a good knee the same as for a bad knee, correctly. Many methods to do this but a good start is measure your inside leg length (from groin to floor) and then calculate 88.3% of this. Use this figure to set your height from the centre of the bottom bracket to the top of the saddle.

One side of your quads working overtime suggests something is a miss. If you can set your bike up on a stationary trainer them take a video from the front and back this may indicate a problem with your cycling that you aren't feeling. Look at your cleats as suggested, can you adjust for more float? Also measure the q-factor (centre of pedal to centre of pedal/width) compared to the centre of your hip joints, is it significantly different?

Hoffa's fat pad is inferior and posterior (below and behind) the patella and tendon. Which side is the knee pain on and which side is the quad overworking, is it the same? Also your image isn't showing, are your files as jpegs or Dicom?

Lastly, go and see a bikefit specialist. Not some bikefit in a cycling shop but a proper specialist. May cost a fair bit but how much do you value your knee/health?
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RhynoCZ
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Joined: 09 Mar 2012
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PostPosted: 23:10 - 21 Aug 2020    Post subject: Reply with quote

Without me trying to explain something, see this video first: https://www.youtube.com/watch?v=FVu5Zrktm40 Thumbs Up

Then, if you still feel pain, it's due to higher torque you put in, just use higher ratio gears to reduce the stress. I also use my bicycle computer to limit my input. I don't exceed 30km/h with my human force.

I have bad knees myself. When I feel any pain (too much torque), I get into higher gear (slow down, higher cadence) and pain goes away in a few minutes. Riding alone alowes me to keep the pace I feel alright with, no need to keep up with anyone. Use the gears, all of them.
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