Knee Owner's Manual
And, you could have perfect anatomy but poor form, meaning
you mash the pedals instead of pedaling with a smooth cadence, or you
pedal with your knees flaring out to the side. Correcting that can
often help eliminate minor aches and pains.
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 Fitting
One 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
"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
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.