Knee pain after a difficult climb

[flynbryan19]

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.

[Blister Butt]

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.

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.

[flynbryan19]

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.

[edubfromktown]

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.

[flynbryan19]

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.

[leaftye]

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

[irishpitbull]

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.

[Moonshine Willie]

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.

[flynbryan19]

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

[Moonshine Willie]

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.

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

[LyNx]

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.

[flynbryan19]

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!

[XRaptor]

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.

[flynbryan19]

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.

[Gundam168]

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.

[flynbryan19]

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.....

[Bdabike]

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?

[flynbryan19]

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!

[Stalk]

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.