What You Need to Know About Knee Pain on A Bicycle – And A Bonus Fancy High-Tech Bike Fit Video!

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Retul

If you're into fitness, trying to get into shape, training to compete in a triathlon, or the average person, you've probably been on a bicycle at some point in your life.

And if you've ridden a bicycle a lot, you may have noticed that it's pretty darn easy to get knee pain on a bike. Over at a website called Cycling Performance Tips, I recently found a quick bullet list that really helps you figure out what part of your bike might be causing your knee pain. Here's a synopsis (don't worry, if you don't understand all the terms here, I've got a video below the list that will let you ask your questions):

Knee Pain Location

One way to classify knee pain (and identify possible solutions) is to look at the location of the knee pain.

Anterior (the front of the knee)

Reasons

patellar tendonitis

patellofemoral syndrome

Causes

pushing BIG gears – cadence too low

saddle too low or too far forward

foot too far forward on the pedal

crank arms too long

leg length discrepancy with seat set for shorter leg

Possible solutions

ride at 75 rpm or higher

raise seat (in small increments of less than 5mm) or move seat back

move cleat forward 1 to 2 mm

shorten crank arms by 2.5 cm

set seat for longer, not shorter, leg with correction for the shorter leg

Posterior (the back of the knee)

Reasons

hamstring/gastrocnemius

neurovacular bundle

Causes

saddle too high or too far back

too much pedal float

leg length discrepancy with no correction for shorter leg

Possible solutions

lower seat (in small increments) or move seat forward

limit float to 6 – 8 degrees

set seat for longer, not shorter, leg with correction for the shorter leg

Medial (inner side of the knee)

Reasons

medial collateral ligament

pes anserenus

Causes

cleat position too wide – foot held externally rotated (toes point out)

excessive knee frontal plane motion

too little pedal float

Possible solutions

narrow foot position by moving cleat towards the outside of the foot (thus your foot moves nearer the bottom bracket)

orthotic or wedge to correct foot alignment

pedal float should be 6 – 8 degrees

Lateral (outer side of the knee)

Reasons

iliotibial band

degenerative lateral meniscus

Causes

cleat position too narrow – foot held internally rotated (toes pointed in)

too little pedal float

excessive knee frontal plane motion

Possible solutions

widen foot position by moving cleat away from the bike

pedal float should be 6 – 8 degrees

orthotic or wedge to correct foot alignment

So what if you can't figure all this out on your own, and you want to get a bike fit? You can easily get a bike fit performed at most local bike shops, and even at some sports medicine facilities. And how about those ‘fancy, high-tech' bike fits? Well, there's one version out there called the “Retul bike fit”, and here's how they describe it on their Retul website:

“Fit data collected in a traditional two-dimensional plane (i.e. video-based systems) is fairly limited because the fitter can only look at one view at a time, and those views stand as independent reference points. In order to make the best fit recommendations, the fitter must realize that the front and side views are actually interdependent reference points. In other words, the front and side views must be viewed simultaneously in three dimensions in order to see how all the applicable movements of the body are working together.  Retul uses a 3D motion sensor to simultaneously gatherdata on multiple angles of the rider.”

Hmm…it sounds pretty complicated, but here's my question:

From a practical standpoint, what can you expect if you show up at one of these fancy triathlon bike fit specialists with your bike, and the simple request to make your bike “fit like a glove”?

I'm going to do just that when I meander into the Retul Bike Fit center in Boulder, Colorado on this Monday morning at 9am PST, and you get to watch LIVE as I ask them to make my bike fit my body *perfectly*, and they do the entire Retul bike fit.

These are the guys that fit the top pro triathletes and cyclists, and you get to see them in action!

Not only do you get to watch live right here but we'll have a chat box open so that you can ask your questions as you watch the entire bike-fitting process.

So just come back here this Monday morning at 9am PST, and you'll get instant access to the live video bike fit below and your opportunity for live chat Q&A during the bike fit.

Watch live video from bengreenfield on Justin.tv

If you have questions or comments leave them below!

Ask Ben a Podcast Question

11 thoughts on “What You Need to Know About Knee Pain on A Bicycle – And A Bonus Fancy High-Tech Bike Fit Video!

  1. Albert says:

    I was just watching your retul bike fit and right at the end of the first video the fitter was talking about how Lance's knees were in the way of his elbows. What adjustments was the fitter suggesting to remedy this type of issue? Also, did he ever comment on how much hip roll is too much? With an adamo since there is no nose of the saddle a rider has a lot of ability to roll his hips forward but is there a point where enough is enough?

    1. Q: I was just watching your retul bike fit and right at the end of the first video the fitter was talking about how Lance's knees were in the way of his elbows. What adjustments was the fitter suggesting to remedy this type of issue?

      A: In Lance's case, the saddle is the biggest fix for this problem. I'm looking for anterior pelvic rotation, which will rotate the body forward around the bottom bracket…this will allow the rider to extend the bars a slight bit, but bring the shoulder closer to be over the top of the elbow/arm pad (to support the extra weight, skeletally, on the front end.

      Q: Also, did he ever comment on how much hip roll is too much? With an adamo since there is no nose of the saddle a rider has a lot of ability to roll his hips forward but is there a point where enough is enough?

      A: There is no specifics for how much is too much, but there is a point where enough is enough. The adamo is a great tool to help with anterior pelvic rotation and when Lance used this saddle…it was the best I've ever seen him look an a TT bike. There are several factors that would tell me that you are too far forward:

      -You have too much weight on the front end and have a hard time staying in the bars.
      -You feel that you are expending too much energy to keep yourself planted on the seat. (sensation that if you relax, you will fall off the front of the bike).
      -You also need to make sure your front end is lowered to coincide with the forward seat position. With the Retul system, I measure this via back angle. You don't want to ride a very forward position with a high front end.
      -With the Retul system: A knee forward of foot measure above 140mm.

      Ultimately, I'd need to see you, but I would ask you the above questions to start.

      Hope this helps,
      Mat Steinmetz

      1. Thanks for the thorough response, Mat!

  2. Camron Diaz says:

    I have been trying to follow your articles. But they load so slow, I finally have given up. Sorry to say I won't be back here. Bye!

    1. Camron…what was loading slowly for you…the video?

  3. Doug Staudt says:

    Early last summer I won a "professional bike fit" at a benefit auction from the Specialiazed dealer; since I ride the Tarmac Comp, I was stoked.

    As a runner, turned average biker, and now triathlete, I was curious as to the benefits. I spent 2 hours there as they tweaked pedals, cleats, seat position, tribars, brake settings; all tiny tweaks of a millimiter or so.

    The result? I can't say that my times were improved or I became a faster cyclist. BUT, I could absolutely feel a difference. All the little nagging pains, pings, and odd sensations were gone! Yes, my butt still hurts after 30 miles in the saddle … that's not gonna change!

    Also – regarding glucosamine-chondritin comment…HUGE fan here. Used to have knee / hip issues. Started taking it religiosuly several years ago, and no problems since. I have also ramped up my time in the gym with weights, so maybe a two part process. But my 75 year old mother-in-law was nearly confined to the lower level of her home and started taking GC and now nearly bounds up the stairs like a kid – her knees are much better.

  4. April says:

    You asked for feedback on videos we would like to see posted. I would be interested in several things: cooking demonstrations, travel workout routine (for those of us who travel internationally a lot and don't necessarily have access to a gym), run technique (I realize there are several such as Chi, Pose, Evolution…but what is your recommendation for run technique and how can it make us faster). Those are a few ideas off the top of my head. Thanks.

  5. Gary G. says:

    Since it's a given that the standard american diet isn't going to give us the nutrients we need to keep us energized for everyday living, much less, endurance oriented activities, what top ten super whole food supplements would you recommend to maintain excellent health and vitality? Also, what do think of "pine pollen" as a super whole food supplement?

    1. Great question! Could you toss it up on the "Ask Ben" form on any of the podcast shownotes?

  6. Chris Hughes says:

    I tried a lot of these things years ago and still had patellar tendonitis from riding my bike. I found that a Pateller strap did the trick. I know it's fixing a symptom and not the problem, but I could never get the issue resolved through fitting

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