Diagnosing a knee problem can be difficult, and we certainly don't want you to try to do it yourself. However, Dr. Evans has provided some of the more common problems, which are presented in the sidebars.
You Knee-d Proper Bike FittingOne important area of possible problems is your bike fit, including pedal cleat type and position, plus saddle height and fore/aft position.
"Excessive internal rotation of a rigid cleat or a cleat too far forward can cause ITBS [see sidebar]," says Evans, " and simply switching from a fixed to a floating pedal system or making small adjustments in floating cleat position may be all it takes."
A saddle height that is too high, causing knee extension greater than 150°, or a saddle position that is too far back, which increases pedal reach and over-extension at the knee, can also lead to ITBS. On the other hand, a saddle height that's too low can cause excessive force on the patella resulting in pain in the front of the knee.
As you can see, getting your fit just right can be critical. Many bike shops offer fitting services, but they are not all at the same level. A bike shop "fitting" can range from a shop employee telling you what size frame is right for you, to an hour-long process of measuring and fitting by a trained employee that can cost upwards of $100.
If you have knee problems, try to find the most qualified person--one with a working knowledge of anatomy. Physical therapists, licensed cycling coaches and Serotta-trained shop employees are a good starting place.
"In most cases you don't need a customized bike to minimize your risk of injury as long as the bike is sized and adjusted correctly," adds Evans.
On the Trail to Recovery"The management of a knee injury often includes decreasing mileage, riding on flatter terrains, and lowering workout intensity by pedaling easier at a lower, pain-free resistance," says Evans. He adds that occasionally, the use of a formal physical therapist is indicated to correct strength or flexibility deficiencies and to incorporate additional therapies such as ultrasound, electrical stimulation and friction massage. Also, the use of an anti-inflammatory medication as directed by your doctor is often helpful.
In some cases however, surgical interventions are the best ways to get back to pain-free riding. Surgeons can remove torn pieces of cartilage, replace torn ligaments, re-attach muscle to tendon and smooth rough bone surfaces. Many times surgery only requires two or three small holes in the skin.
But don't worry; most knee problems are minor, even though there may be multiple factors behind the pain. Just remember, the knee is designed to work in an up and down motion, like the piston of a car, and the slightest disturbance of that motion is amplified because with an average pedaling cadence of 80 revolutions per minute, each knee bends an average of nearly 10,000 times in a two-hour ride.
Play it safe, listen to your body, and get checked out if a problem persists. Occasional soreness and aching may be inevitable, but serious problems are not.