So I did the MS150 after maybe 2 weeks of riding clipless, and maybe 50 miles into the first day my left knee started hurting. Went from sore to incredibly painful in maybe 20 minutes. It never swelled or looked irritated, but bending it hurt bad enough that I pedaled with one leg and walked up the last couple hills on the first day. After some ice that night and ibuprofen the next day, I rode un-clipped in my lowest gears to the finish line.
So the ride was three weeks ago, and I haven't ridden since. I tried to ride last weekend but after a half hour on the jail trail I got a little sore. Just figure my leg needs more TLC before I get back on two wheels, and I spend 40 hours a week walking on pavement which isn't helping a speedy recovery.
I stab at google says I've got patellofemoral syndrome, possibly from having my cleat mis-aligned. I've never had knee problems before, but I imagine riding 80 miles is a good way to make anything small stand out. The pain is in my left knee, focused entirely on the left side.
So I've got a couple questions for you folks:
Anyone else experience this?
Ways to assure proper alignment of your cleat?
Word has it places like tri-zilla do fancy scientific cleat alignment, tried to stop by today but they've moved to some top secret location. Recommend any other places?
Yes, I've experienced similar problems. It might not be just your cleat alignment -- you might be a little short on one side, or bowlegged. So you might need a little more than just a twist.
Someone from the UPMC sports medicine place on the South Side was at the MS150 pre-ride "clinic", you might give them a call.
Oh, and... you might already know this, but the biggest cause of knee pain for me is pushing too big a gear.
Three points:
(taken from: http://forum.slowtwitch.com/gforum.cgi?post=1163166#1163166)
Step 1: put on your cycling shoes.
Step 2: measure from the ground up to your greater trochanter.
Step 3: take the desired percentage of this number.
Step 4: subtract the length of the crank arm.
Step 5: set your saddle height as measured from the center of the
b.b.
to the lowest point on the saddle to this value.
Step 6: adjust as desired/necessary.
Point two:
Run a pencil thru the midline of the cleat. It should point to the apex of the shoe toe box. I can take a photo if that's not clear.
Point three:
Pro Bikes can do a good fit. Trizilla went out of business (for a good reason).
A picture of point two would be great.
Know where I can host a photo? Or I can email it to you. Still, I'd like the group to see it.
http://tinypic.com/r/10z76uf/5
That's a neutral set up. If you have feet that angle in or out a lot (one of mine does) you can angle the cleat. But the picture shows a good starting point.
On my first point, regarding saddle height; The saddle should end up being 96-100% of your greater trochanter length. Above 100% and your power starts to drop off.
This sounds exactly what hit me during this year's Crush the Commonwealth. What started out as a dull stiffness in my left knee around Somerset escalated to stabbing pain by the time I hit Breezewood. I had actually made up my mind to quit, but I ran in to a fellow rider who was kind enough to give me some extra strength motrin. I managed to finish by cutting back on my pace and fully embracing the granny gear on all of the remaining climbs.
After about ten days off the bike and plenty of ibuprofen, the pain did eventually subside. I did end up moving my cleats back a bit, but what I think also helped was sliding my saddle about 1 cm back. I'm pretty sure that if you're too far forward on the saddle, your knees are unable to bend and flex at a natural angle. I would check out Sheldon Brown's articles on pain and bicycle fit.
wsh6232: Thats a pretty accurate description of whats happened to me. Thanks for the tip, I'll hit up sheldon.
mayhew: thanks for the photo, I'll give that a shot as well.
I was somewhat surprised that neither the cleats nor the shoes had some sort of basic alignment guidelines.
I have PFS, but it's pretty much under control. I didn't get it from bike riding. (Don't try to study ballet and African dancing at the same time. S'all's I'm saying)
Streches are really important - particularly hamstring stretches, and quadricept stretches (pictued in link) and calf stretches.
http://farm4.static.flickr.com/3193/3037069558_c55f221fd2_o.gif
Be careful in the hamstreing stretch to keep you back straight.
For any of the stretches, make sure your legs are well-warmed up before you stretch and you hold each of the streches for about 30 seconds -which will seem like a very long time - and do them a minimum of twice each side.
The three second stretches you see guys do? They hurt and increase the risk of injury. Don't do them.
When I was at my worst, I did 4 streches, 30 seconds per side and six repeats. Lots of time on that.
For me, the quadricepts isomentrics helped alot, too.
These are specific things that worked for me - but I was not a bike rider then. The pattern of strengths, weakness, and imbalances between muscle groups that cause PFS might be way different for a biker.
I'm pretty sure that for 90%+ of dudes with knee or back pain, hamstring stretches are a key treatment, though.
Ice is therapeutic. In my experience. this is to the point where doing a little of the irritating exercise, then icing is dramatically better than rest.
Ibuprofen, should always be taken with food. That stuff (NSAID) kills about 16,000 people per year. Treat it with respect.
That said, NSAIDs not only treat the symptoms, they also help the condition. They can be taken "prophylacticly" - that is, take a small does before you begin the irritating exercise - to good effect.
Try to keep stretching as ahabit after the pain is gone. Joint pain gets worse with age.
If you have insurance, you want to get to a PT - they can give you stretches and exercises specific to your individual problem. PT's, in my experience, really, REALLY like helping people with their exercise programs and suggesting small details that make large differences.
As Mayhew and wsh point out, bicycle fitting and alignment is going to be critical, particularly with cleats. (shrug) That's a "D'uh" AFTER the pain starts.
Cross-training
In the past, I swam for exercise and just used a bike for transportation. This year, I trained for, and did, the Pgh -> DC -> Pgh trip, without doing other fitness stuff. My sense is that without cross-training, biking for fitness leaves one bizarrely imbalanced, vulnerable to injury, and not really all that fit for non-bike activiites. Maybe a small amount of cross-training can remedy this.
Disclaimer: I'm not a doctor, although I played doctor when I was a small child.
Good luck
Mick
I was having similar issues, but oddly enough riding a single speed up hills doesn't seem to aggravate it at all.
I hiked my seat up a bit so my knees had a longer reach and that has taken care of it unless as wsh6232 pointed out I push too hard on too tough a gear.
