What's wrong with my knee?

April 30, 2007 3:21 PM

What's making my knee hurt when I bike?

I started biking to work a few weeks ago (only 1 mile each way) and it was fine the first couple of times. Then one day, on the way back, I felt something strange in my knee. It wasn't painful, but it felt like everytime I moved my knee up (when the pedal on the bike came up) and then down, a ligament or a tendon would "get caught" or click into place. No audible click though.

I didn't think much of it after getting off the bike because my knee felt fine after. Then that night, while moving around in bed, I got this sharp pain in my knee and tried to bend it, which made it worse, so I kept it still and went to sleep.

The next morning, it was fine, but when I got on my bike and started pedaling, the sharp pain returned. The pain doesn't feel like it's on my knee cap, but more inside the knee. And bending it up while pedaling makes it hurt. It also hurt to walk up and down the stairs on that knee but regular walking was painless and normal.

I gave up biking for a few days, the pain went away and walking up and down the stairs was painless. Got on the bike again, went for about 1/4 of a mile before the knee started hurting again. I think it has to do with going up hill, even though I do it on one of the lowest gears with minimal mashing. My bike seat is pretty high, I can *barely* touch the ground with my toe while the bike's leaning and I'm sitting on the seat, so I don't think the knee pain is from low seat.

At first, "research" on the interweb made me paranoid that it was a torn meniscus. But then, considering there was no "pop" that resulted in debilitating pain, I don't think that's it.

I'm going to see the doctor this week for an unrelated thing, but was wondering if anyone else has experienced this before? I think it's definitely "getting better" but it's just annoying that the pain returns whenever I bike.

posted by nakedsushi to health (15 comments total)

I don't know what's wrong with your knee, but regarding the "what's making it hurt" question: What sort of pedals are you using? If you are using clipless pedals, how much float (degrees of free rotation) do they allow? Some pedals are a lot more knee friendly than others. I used to use standard Shimano SPD pedals and they were very unforgiving, and my knees would bother me a lot on longer rides. I switched to fully floating pedals about 18 months ago and my knees are MUCH happier.
posted by mosk at 4:01 PM on April 30, 2007 [1 favorite]

do you use toeclips of any kind? are there hills on your route?

barring any of that information, it's possible that your seat is actually too high. try lowering it a half-inch or so and see if it makes a difference.
posted by rhizome at 4:02 PM on April 30, 2007

If possible, stop in at a bike shop and let them look at you sitting on your bike. They can check if your seat is at the right height and that you're putting your foot in the right place on the pedal. There are bunch of other alignment things they can check, but those are the main ones.

The key thing is that your knee should be slightly bent when you are sitting on the seat with your foot more or less parallel to the ground, at the bottom of your pedal stroke.

Good luck -- it's really worth trying to figure out what's going on so that you can ride your bike.
posted by nnk at 4:02 PM on April 30, 2007

Seconding bike posture. My knee felt weird until I fixed the way I rode.
posted by pantsrobot at 4:04 PM on April 30, 2007

Platform pedals and I tried lowering my seat an inch and that made it worse.
posted by nakedsushi at 4:10 PM on April 30, 2007

Go to a shop that knows what it's doing and ask to be fit on your bike.

Generally speaking, pain in the front of the knee indicates a saddle that's too low. Pain in the back of the knee indicates a saddle that's too high.

That's not a rule, however, and a competent bike fitter should get you squared away.

If you ever decide to go from platform pedals to clipless, and want something with free float as mosk said, I recommend Speedplay, but it's a very individual choice to make.
posted by spikeleemajortomdickandharryconnickjrmints at 5:01 PM on April 30, 2007

The height of your saddle (called seat height) is probably the most important adjustment on your bike. Inches are huge, huge adjustments to make at a time. I'm an experienced cyclist, and I can feel 1 cm differences.

First of all, you're injured. Go to a doctor, heal up first until it doesn't hurt to walk up or down stairs. Don't get back on the bike, you're not going to accomplish anything other than prolonging the pain or increasing the injury.

I injured my knee doing something similar, had to cancel a week-long bike tour that was two states away. Didn't look at the bike for two months.

Then you should do what other people are saying and go to a friend who rides often, or a suitable bike shop, and have them look at your positioning.
posted by meowzilla at 5:24 PM on April 30, 2007

I'd be willing to put money on Iliotibial Band Syndrome (ITBS). The big clue is that when you stop doing what makes it hurt, the pain completely disappears. Also that it only kicks in on hills. It's a fairly common running injury, but it's not exclusively a running injury. Google it and see if you think that's what it is.

I had a bout of it a few months ago from running. It's interesting, because it can be debilitating pain, but the moment you discontinue activity, you're completely back to normal.
posted by AaRdVarK at 5:45 PM on April 30, 2007 [1 favorite]

I'd be willing to put money on Iliotibial Band Syndrome (ITBS)

100% correct. I have this too. Pay the money for a professional bike fitting, and always, always, always stretch before and after riding - and every day, even if you don't ride, if you can.
posted by pdb at 6:13 PM on April 30, 2007

Here's some good stretches. Here's a few more.
posted by pdb at 6:23 PM on April 30, 2007

ITBS generally produces pain on the outside of the knee. Plus it takes a lot of repetitive stress to induce ITBS, I doubt you would have it after only a few weeks of biking.

I'm with the folks who think your seat is too low. The fact that you can barely touch the ground with your feet is irrelevant -- on most bikes you should NOT be able to touch the ground AT ALL while seated. What's important is that your leg should almost be straight (but without locking the knee) at the bottom of the pedal stroke. You will have to get off the seat every time you stop.
posted by randomstriker at 6:46 PM on April 30, 2007

Okay... I used to get knee pain cycling, my knees clicked when I did and they felt like there was a little bit of grinding in there too.

My Osteopath gave me a load of stretching exercises to do because my hamstrings were stupidly tight. Now I can cycle without this knee pain and twanging clicking feeling. The grinding? That's probably a cartlige thing, but it eased off at the same time.
posted by twine42 at 12:26 AM on May 1, 2007

Depending on where you live, if you're willing to say, someone may be able to give you advice on bike fitters. I know of a few in the SF Bay Area (e.g. Terry Shaw) that are definitely worth the money, and a few that are not. A good idea in any case, probably $100 at most (and *maybe* a few parts to swap out if you go that far) .. and that is money well spent.
posted by kcm at 12:37 AM on May 1, 2007

I'm going to echo the stretching as above, BUT -- do it after you've been on the bike for five minutes. As per my trainer, who works in the kinestheseology lab at work: "Warm muscles stretch. Cold muscles tear." Get on the bike and go for about five minutes at as slow a pace as you can manage. Get off and stretch. Then continue your ride home. And stretch again afterwards. (I have the same issue with the exercise bikes at the gym, which is why I asked her.)
posted by SpecialK at 4:25 AM on May 1, 2007

After reading about ITBS, I'm thinking this is exactly my problem. I'll try doing some of the stretches. As for fitting, it's probably be a good idea, but $100 seems like a lot to pay a guy for telling me how to adjust my bike right, but I guess it's worth it for my knee to get better.

I'm also nervous about finding a good fitter. I've never been fitted before, and I don't really know what I'd ask, or what to look for, so any suggestions would be welcomed. I'm in Los Angeles, btw.
posted by nakedsushi at 11:04 AM on May 1, 2007