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  1. #1
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    Knee pain after a difficult climb

    I have developed some knee pain recently after a riding trip I took where there was a rather steep/short hill that took all my effort to over come. I obviously started the climb quickly and with lots of momentum, but the last 10-15 feet was a very slow cadence and ALOT of effort. Had to do this twice.

    After my ride I noticed that the ligaments/muscles below my knee cap have been sore/tender after my rides or spin classes at the gym. This has gone on almost 2 months. Usually the pain comes after the activity not during. I took roughly 2 weeks off of riding anything and the pain went away. I started back again yesterday at the spin class and though not as severe the pain seems to be creeping back in. Should I rest longer? Are there any stretches or therapy I can do to solve this issue? I've NEVER had any knee pain in 3yrs of riding before now. I'm hoping I haven't done permanant damage.

  2. #2
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    It's very likely a seat-height issue. It's either too high or too low. I forget which one. Probably too low. There are lots of threads on adjusting your seat height properly. The one I like is to sit on the bike, put your pedal at the 6 o'clock position, place the heel of your foot on the pedal and adjust the seat height so that your knee is very slightly bent. One eighth or one-quarter of an inch does make a difference, particularly if you are getting older or did not grow up on a bicycle.

    Best wishes.


    Quote Originally Posted by flynbryan19 View Post
    I have developed some knee pain recently after a riding trip I took where there was a rather steep/short hill that took all my effort to over come. I obviously started the climb quickly and with lots of momentum, but the last 10-15 feet was a very slow cadence and ALOT of effort. Had to do this twice.

    After my ride I noticed that the ligaments/muscles below my knee cap have been sore/tender after my rides or spin classes at the gym. This has gone on almost 2 months. Usually the pain comes after the activity not during. I took roughly 2 weeks off of riding anything and the pain went away. I started back again yesterday at the spin class and though not as severe the pain seems to be creeping back in. Should I rest longer? Are there any stretches or therapy I can do to solve this issue? I've NEVER had any knee pain in 3yrs of riding before now. I'm hoping I haven't done permanant damage.
    "You'll thank me when it's all said and done"

  3. #3
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    I would be inclined to think that possible if the problem hadn't have just developed. Again, prior to what I believe was over exertion I've never had knee pain and I haven't adjusted my seat position.

  4. #4
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    I had ACL replacement surgery and torn meniscus repair 9 years ago. Note: I am not a medical professional so don't cut off your toes or anything else drastic because some hack (like me) on MTBR suggests it

    I'd rest longer for starters and then gradually build up intensity to a spin class or masher climbs.

    You didn't mention if you use clipless or flat pedals.

    For either, you should consider the angle of your foot on steep climbs. If your heel is down lower (which is common) you exert more stress on the knee. I focus on "stepping" more than pedaling (particularly when riding single speed) on slow steep climbs if that makes sense...

    If you use clipless pedals, you may want to adjust your cleat position back a few mm further and see if that helps.

    If the pain persists after longer rest and slowly increasing the level of intensity, I'd get it checked out by an orthopedist just to be on the safe side.

  5. #5
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    Quote Originally Posted by edubfromktown View Post
    I had ACL replacement surgery and torn meniscus repair 9 years ago. Note: I am not a medical professional so don't cut off your toes or anything else drastic because some hack (like me) on MTBR suggests it

    I'd rest longer for starters and then gradually build up intensity to a spin class or masher climbs.

    You didn't mention if you use clipless or flat pedals.

    For either, you should consider the angle of your foot on steep climbs. If your heel is down lower (which is common) you exert more stress on the knee. I focus on "stepping" more than pedaling (particularly when riding single speed) on slow steep climbs if that makes sense...

    If you use clipless pedals, you may want to adjust your cleat position back a few mm further and see if that helps.

    If the pain persists after longer rest and slowly increasing the level of intensity, I'd get it checked out by an orthopedist just to be on the safe side.
    Thanks for the response. It just might kill me (lol), but I'll try to take it easy a little longer. I do use clipless pedals and I believe they are closer to the ball of my foot than the toes far as the adjustment is concerned.

  6. #6
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    Muscles imbalances are usually to blame. If you aren't already doing them, try some exercises that hit your legs differently than cycling does.

  7. #7
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    Sounds like some patellar tendonitis. Ice your knee even if it does not swell, 3 times a day till the pain stops. Give yourself a nice 10 day break and ease back in to riding. If you don't rest and ice your knee this injury can get much worse.

    As mentioned above, move your cleats a bit back.
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  8. #8
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    I had this very thing happen to me. A period of overexertion called attention to the fact that my seat wasn't properly adjusted and that singlespeeding wasn't the best thing for me. I took two weeks off, adjusted my seat and made the wise decision to return to a geared setup. My knee has been fine ever since.

  9. #9
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    Moonshine Willie, which way did you have to adjust your seat?

  10. #10
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    I adjusted the saddle fore and aft so that my knee was properly placed over the spindle and the ball of my foot and also I think I raised it a little bit. I think those things helped a lot because now even if I climb in a harder gear, I don't get the twinges that I used to get.

    Quote Originally Posted by flynbryan19 View Post
    Moonshine Willie, which way did you have to adjust your seat?

  11. #11
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    Pain in the front of the knee means your saddle is too low, pain in your hamstring means your saddle is too high, learnt this early on when I started riding - remember, if you move your saddle forward you generally also have to raise it and if you move it back lower it. I'd say besides the saddle probably being too low that IrishPitbull has it right and you've probably aggravated your tendon by pushing so hard with your saddle too low (assume you remained seated on the climb) and it needs some time off and care like he said - have done this myself and the only thing that will cure it is rest, icing, maybe some anti inflamatories.
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  12. #12
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    Thanks for all the insight guys. When I (believe) I injured it I was standing and "mashing" on the pedals to make it to the top, so I honestly don't believe my seat was to blame. Just me trying to hard and being stubborn instead of just getting off the bike and walking the last 10ft. I have been icing when symptoms come up, staying off the bike aside from my two spin classes (which I have taken it easy on), and using anti-inflamatories only after my classes. Hoping to see some improvements soon!

  13. #13
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    WOW this sounds exactly like me. I'll have to check my seat and cleat placement. Thursday was my last ride and had no problems during the ride it was after that I had a nagging pain just under my knee cap. The following day it felt like it was more of a nagging pain from under the knee to middle of my shin. Last 2 days I've been pain free but I did use lots of ibuprofen and ice'ed it down a few times. Still going to wait at the very least a week to hit the trails again. Glad I found this thread.

  14. #14
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    An update to this... Today I am almost 8wks into this trial and I have some positives and some negatives to take away from it all so far. To start out with I have been diagnosed with Chondromalaysia (or a knee cap tracking issue). I took up PT after my diagnosis and as much as I hated it STOPPED biking. A LOT of PT, ice, and advil later and my left knee feels to be very close to if not 100%. My right knee has been the nagging one and I'd say I'm around 70-75% with that one right now.

    What I also have going on on top of the tracking issue is the fat pad below my knee cap has gotten swollen/inflamed and it is VERY difficult to get rid of. The left one seems to have subsided, but again the right one is taking more time. It does seem to be improving though. As I've read others comment on the MANY threads I've read about this issue, I can't stress enough.... If your having these symptoms STOP RIDING! I know its very difficult for us since we enjoy it so much, but your knee(s) will NOT get better till you give them time to rest and build up your VMO.

    I feel I'm on the slow road to recovery and the end is in sight, but it has been a very tough process. Its important not to give up and don't get discouraged. This can be beat. It just didn't happen over night, so we can't expect it to get better over night.

  15. #15
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    Quote Originally Posted by flynbryan19 View Post
    Thanks for all the insight guys. When I (believe) I injured it I was standing and "mashing" on the pedals to make it to the top, so I honestly don't believe my seat was to blame. Just me trying to hard and being stubborn instead of just getting off the bike and walking the last 10ft. I have been icing when symptoms come up, staying off the bike aside from my two spin classes (which I have taken it easy on), and using anti-inflamatories only after my classes. Hoping to see some improvements soon!
    Happened to me too. Especially when I'm mashing up a hill. I like going uphills and also the occasional sprint. Curiously, it doesn't happen when I use my full suspension bike. Always on the hardtail. I'm using a patella band/patella guard on my left knee whenever I'm biking. At first I just used a make shift garterized velcro strap as suggested by a PT friend. The result is like night and day. I eventually bought a real chopat (Patella strap) and voila...no pain.
    No strap = pain.
    Wearing the strap = no pain.

    Patellar Straps: Are They Effective for Knee Issues? | Breaking Muscle

    Also, riding full suspension helps. No suspension on the bike means your knees are the suspension.
    Last edited by Gundam168; 04-04-2013 at 09:22 AM.

  16. #16
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    I have another PT appointment tomorrow and I'm going to be talking to the Dr again. My left knee is 100%, but my right knee just will NOT give up the ghost.... Just walking up and down stairs yesterday and doing 3 sets of squats made it start hurting bad enough that I had to take advil again to get the swelling/pain to go away. I've been fighting with this since mid Nov. and we're now in the beginning of April. I've been off any kind of "real" bicycle since the beginning of Feb. I'm so over this.....

  17. #17
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    Not to heist your thread, but my pain is on the inner side of my right knee. I was doing some trail running and I believe i may have strained my MCL. Didn't go to the dr, but started riding after it felt 100%. It is now bothering me after bike rides. I think doing my pre-ride stretches, I felt a little tinge of pain. During the ride it was fine. After the ride, it is annoying. Do you think my riding is going to damage it any more than it is?

  18. #18
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    Well, after two months of PT for the Chondromalacia I feel that my knee cap tracking issue is resolved. I have for probably about the last month though dealt with pain in my patellar tendon in my right knee. After it screamed at me when I tried to return to squats and lunges I decided to go get a second opinion on the knee. Sure enough..... Tendonitis. Been wearing a "runners knee" strap and and a neoprene brace when just walking around and its getting MUCH better. I also stretch every day and continue to do my leg exercises for both the chondro and the tendonitis 2-3 days a week. I think I'm FINALLY getting this thing licked!

  19. #19
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    What exercises are you doing? Problem with strap is that it would start irritating tendons on the outside of the knee. My solution so far trading power for cadence and no standup sprinting. Taking few month off the biking didn't helped.
    I used to run tubes like you are, but then I got thorn in my wheel.

  20. #20
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    Quote Originally Posted by Stalk View Post
    What exercises are you doing? Problem with strap is that it would start irritating tendons on the outside of the knee. My solution so far trading power for cadence and no standup sprinting. Taking few month off the biking didn't helped.
    Interesting. The strap has made a MAJOR difference for me. On top of the strap, I've also been doing ALOT of icing, stretching, foam rollering my IT bands, and the first exercise in this video. Knee Strengthening Exercises - YouTube The exercise I use starts at 45 seconds. I tried doing the exercise after where you sit down and then stand back up, but that was hurting my tendon. The first one w/ the rubber band seems to be working GREAT!

  21. #21
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    Strap indeed works but after prolonged use I got side effects. I'm trying tape right now, its uses only surface tension and doesn't irritate tendons.
    In video guy seems to train all muscles that will be active with biking anyway. One of friends went through PT and was told to do lateral resistance training, so muscles got more balanced around knee area. Seems helping a bit but not completely solving the issue. That's why I was curious on what training you getting.
    I'm trying to find a way to get rid of strap/tape completely.
    I used to run tubes like you are, but then I got thorn in my wheel.

  22. #22
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    I will say I don't wear the strap constantly. I only wear it when I'm going to be exercising my legs or riding bike. Otherwise I've been wearing a neoprene knee brace. I could see where it would cause issues if you wore a knee strap constant. What kind of taping are you using? Kinesio tape? I've read of people using it w/ good results. I've been reading basically ANYTHING I could find lately about these two issues since I've had some much down time. lol

  23. #23
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    I also have patellar subluxation that can go hand in hand with chondromalacia, which was the result of crashing in a DH race using clipless pedals. I also received two meniscus tears that had to be cleaned up. Oddly, my knee hurts only if I'm off the bike for extended periods. And the best thing I did to get myself back on the bike after surgery was yoga.
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  24. #24
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    KT Tape, but I guess any sport medicine tape will work. I'm applying it for medial knee pain in a way for it to push patella to the inside. One ride on it so far and it felt better.
    Strap was causing irritation while only applied for the bike ride but ride for 4-5 hours is quite a regular event, or whole day on DH runs at resort.
    I used to run tubes like you are, but then I got thorn in my wheel.

  25. #25
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    I see, so it sounds like you have the same combination I had. Knee cap tracking and tendonitis. I also have yet to ride for 4-5hrs so that might make a difference too in the comfort level of that strap. I personally went out and bought my own McConnell tape for my knee cap tracking issues and would address that myself. At first I would leave it on for a couple days at a time and as I built up my muscles (VMO) and stretched out my IT band's and other related muscles I was able to only tape my knee cap when doing exercises. I now don't have to tape the knee cap at all. I'm just working on addressing the tendonitis. I still do my chondromalacia and tendonitis exercises twice a week. Basically your gonna have to just do trial and error to see what works and it sounds like your on your way with that.

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