Knee Pain

Timmy Evens

2010-02-26

I've been biting my tongue too long on this subject.
the idea that knee motion is a consequence of arch collapse is incredibly short sighted. heel lateral motion (causing knee rotation) will happen regardless of whether the arch is supported if hamstring muscle contraction is in poor timing. if a rider has proper motor control the hamstrings will fire evenly holding the foot steady. if there is motor control dysfunction you will see a lateral then subsequent medial heal whipping through the stroke. this is NOT fixed by orthotics. it is fixed by teaching the medial hamstrings to control the knee rotation.

IF YOU HAVE KNEE PAIN SEE A PT THAT SPECIALIZES IN CYCLING.

come to bend and i'll show you what i mean.

tim

--- On Thu, 2/25/10, johnfforbes@comcast.net wrote:

From: johnfforbes@comcast.net
Subject: Re: [OBRA Chat] knee pain
To: "Jennifer Slawta" , obra-bounces@list.obra.org, "Edward Groth" , "Kevin"
Cc: "OBRA"
Date: Thursday, February 25, 2010, 3:57 PM

The reason pedals have float is knee movement; The heel mirrors the knee. That knee movement springs directly from arch collapse. Thus, a crucial aspect of a proper bike fit is correcting that collapse.
Sent from my Verizon Wireless BlackBerry

-----Original Message-----
From: "Jennifer Slawta"
Date: Thu, 25 Feb 2010 15:44:39
To: Edward Groth; Kevin
Cc:
Subject: Re: [OBRA Chat] knee pain

Hi Ed and all,

Sorry to keep chiming in on this, but I actually worked with a PT who felt strongly that less float is best for lateral knee pain. I struggle with that - I tightened up my zero pedals somewhat, but too much drives me nuts. Jenny

>>> Edward Groth 2/25/2010 12:31 PM >>>
Hey Kevin,

I'm no doctor or fit specialist, but I'm inclined to think she's
stressing something from overuse.

When she started training this year, what was her average mileage each
week and what were the longer rides she's been on?  I wonder if she's
just trying to ramp up too fast.

If it were me I would write down the current set up of the bike fit
(saddle height and forward/back location, seat location, handlebars)
and then try moving things around a little at a time to see if the
pain goes away or gets worse.  Then you know the bike setup that's
right for you rather than the one you're "supposed" to use.  Not that
there's anything wrong with getting a bike fitting.

This may be a crazy suggestion, but I've found on longer rides flat
pedals or clips and straps work better for me than cleats since you're
able to move your feet around to avoid hot spots and vary your
posture.

  Ed

On Thu, Feb 25, 2010 at 12:19 PM, Kevin wrote:
> Hello OBRA-ites,
>
>   A friend is a social rider with hopes of doing a 1 day STP this year.
> She's ramping the miles up in anticipation of the big event.  She's not a
> hard core rider but has done full centuries.   She's been experiencing what
> she describes as a burning feeling on the outside of her left knee on longer
> rides.
>
>   Cleat alignment?  Saddle adjustment?  Just ride more and strengthen
> muscles?  Get in for a professional bike fitting?  Sell the bike and go back
> to knitting sweaters for holiday gifts?
>
> All of the above????
>
>
> Kevin
>
> +++++++++++++++++++++++++++++++++++++++++++++++++++++
> What is happening in Kevin's corner of the bike world?
> http://the-whir-of-spokes-in-air.blogspot.com
> +++++++++++++++++++++++++++++++++++++++++++++++++++++
>
>
> _______________________________________________
> OBRA mailing list
> obra@list.obra.org
> http://list.obra.org/mailman/listinfo/obra
> Unsubscribe: obra-unsubscribe@list.obra.org
>
>
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Seth Hosmer

2010-02-26

Lateral knee pain with cycling may be due to bike fit or training habits/overuse, but there could also be an underlying musculoskeletal problem.

If the person has no history of knee problems and it only happens with cycling, I'd suggest looking first at the training program and see if the volume & intensity has been reasonable. If training has been reasonable, then a bike fit is a good next step.

If a rider is going to get a bike fit done because they are having pain, it would be reasonable for them to look for somebody that is familiar with diagnosing and treating sports injuries, so that the rider can be evaluated for musculoskeletal problems at the same time they are doing their fit. There are a number of good resources for that, as pointed out previously by Russell.

Seth Hosmer, DC, CSCS
hpchiro.com
503.227.2279


johnfforbes@comcast.net

2010-02-25

The reason pedals have float is knee movement; The heel mirrors the knee. That knee movement springs directly from arch collapse. Thus, a crucial aspect of a proper bike fit is correcting that collapse.
Sent from my Verizon Wireless BlackBerry

-----Original Message-----
From: "Jennifer Slawta"
Date: Thu, 25 Feb 2010 15:44:39
To: Edward Groth; Kevin
Cc:
Subject: Re: [OBRA Chat] knee pain

Hi Ed and all,

Sorry to keep chiming in on this, but I actually worked with a PT who felt strongly that less float is best for lateral knee pain. I struggle with that - I tightened up my zero pedals somewhat, but too much drives me nuts. Jenny

>>> Edward Groth 2/25/2010 12:31 PM >>>
Hey Kevin,

I'm no doctor or fit specialist, but I'm inclined to think she's
stressing something from overuse.

When she started training this year, what was her average mileage each
week and what were the longer rides she's been on? I wonder if she's
just trying to ramp up too fast.

If it were me I would write down the current set up of the bike fit
(saddle height and forward/back location, seat location, handlebars)
and then try moving things around a little at a time to see if the
pain goes away or gets worse. Then you know the bike setup that's
right for you rather than the one you're "supposed" to use. Not that
there's anything wrong with getting a bike fitting.

This may be a crazy suggestion, but I've found on longer rides flat
pedals or clips and straps work better for me than cleats since you're
able to move your feet around to avoid hot spots and vary your
posture.

Ed

On Thu, Feb 25, 2010 at 12:19 PM, Kevin wrote:
> Hello OBRA-ites,
>
> A friend is a social rider with hopes of doing a 1 day STP this year.
> She's ramping the miles up in anticipation of the big event. She's not a
> hard core rider but has done full centuries. She's been experiencing what
> she describes as a burning feeling on the outside of her left knee on longer
> rides.
>
> Cleat alignment? Saddle adjustment? Just ride more and strengthen
> muscles? Get in for a professional bike fitting? Sell the bike and go back
> to knitting sweaters for holiday gifts?
>
> All of the above????
>
>
> Kevin
>
> +++++++++++++++++++++++++++++++++++++++++++++++++++++
> What is happening in Kevin's corner of the bike world?
> http://the-whir-of-spokes-in-air.blogspot.com
> +++++++++++++++++++++++++++++++++++++++++++++++++++++
>
>
> _______________________________________________
> OBRA mailing list
> obra@list.obra.org
> http://list.obra.org/mailman/listinfo/obra
> Unsubscribe: obra-unsubscribe@list.obra.org
>
>
_______________________________________________
OBRA mailing list
obra@list.obra.org
http://list.obra.org/mailman/listinfo/obra
Unsubscribe: obra-unsubscribe@list.obra.org

_______________________________________________
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obra@list.obra.org
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Unsubscribe: obra-unsubscribe@list.obra.org


Russell @ Upper Echelon Fitness

2010-02-25

If your knee is a uncomfortable or sore with cycling, consider getting your
bike fit first. If it is in pain, you should see a healthcare
professional. While you *can *find a bike shop willing to look at your knee
and even diagnose the injury, I would be careful with that situation. Many
shops do, however, offer good bike fits at a reasonable price. This is a
good starting point. If you are in Portland, there are several of us who
are healthcare professionals and work with exclusively with cyclists (myself
at Upper Echelon Fitness, or Seth at HPChiro). If in Bend, Timmy Evans is a
PT who focuses on treatment of cyclists. In that case, you could have your
knee evaluated and have your bike fit done in the same visit.

As for the potential injury itself, it could be many things. ITB is
certainly one of these things. Bike fit can contribute, cleat adjustment is
very important also, and correct training may be a contributing factor.
Thanks and best of luck,

Russell Cree, DPT
www.upperechelonfitness.com

Russell Cree, DPT
Upper Echelon Fitness, LLC
Coaching. Bike Fitting. VO2 + Lactate Testing. Physical Therapy
www.upperechelonfitness.com
Phone: 503.501.8121
Fax: 503.345.0999

On Thu, Feb 25, 2010 at 3:07 PM, Jennifer Slawta wrote:

> Sounds like ITB syndrome to me - you can buy a ITB strap at a running for
> store for less than $20. It can help a lot! Jenny
>
> >>> Timmy Evens 2/25/2010 2:32 PM >>>
> lateral knee pain can be a few things. as a physical therapist who
> specializes in this sort of thing i have to recommend you get your bike fit
> and if that doesn't solve the issue see a PT. in my experience lateral knee
> pain is not just simply a problem with "overuse" but is related to alignment
> on the bike and the manner in which a rider generates force. pedal
> stroke/posture vary hugely from rider to rider and has a tremendous effect
> on the types of injuries that develop with large miles. just buck up and get
> it handled by a professional and take care of the pain before it ruins a
> perfectly good season of riding.
>
>
> tim evens
> Rebound Physical Therapy
> Bend Oregon
>
> --- On Thu, 2/25/10, Kevin wrote:
>
> From: Kevin
> Subject: [OBRA Chat] knee pain
> To: obra@list.obra.org
> Date: Thursday, February 25, 2010, 12:19 PM
>
> Hello OBRA-ites,
>
> A friend is a social rider with hopes of doing a 1 day STP this year.
> She's ramping the miles up in anticipation of the big event. She's not a
> hard core rider but has done full centuries. She's been experiencing what
> she describes as a burning feeling on the outside of her left knee on longer
> rides.
>
> Cleat alignment? Saddle adjustment? Just ride more and strengthen
> muscles? Get in for a professional bike fitting? Sell the bike and go back
> to knitting sweaters for holiday gifts?
>
> All of the above????
>
>
> Kevin
> +++++++++++++++++++++++++++++++++++++++++++++++++++++
> What is happening in Kevin's corner of the bike world?
> http://the-whir-of-spokes-in-air.blogspot.com
> +++++++++++++++++++++++++++++++++++++++++++++++++++++
>
>
>
>
>
>
>
> -----Inline Attachment Follows-----
>
> _______________________________________________
> OBRA mailing list
> obra@list.obra.org
> http://list.obra.org/mailman/listinfo/obra
> Unsubscribe: obra-unsubscribe@list.obra.org
>
>
>
>
>
> _______________________________________________
> OBRA mailing list
> obra@list.obra.org
> http://list.obra.org/mailman/listinfo/obra
> Unsubscribe: obra-unsubscribe@list.obra.org
>


Jennifer Slawta

2010-02-25

Hi Ed and all,

Sorry to keep chiming in on this, but I actually worked with a PT who felt strongly that less float is best for lateral knee pain. I struggle with that - I tightened up my zero pedals somewhat, but too much drives me nuts. Jenny

>>> Edward Groth 2/25/2010 12:31 PM >>>
Hey Kevin,

I'm no doctor or fit specialist, but I'm inclined to think she's
stressing something from overuse.

When she started training this year, what was her average mileage each
week and what were the longer rides she's been on? I wonder if she's
just trying to ramp up too fast.

If it were me I would write down the current set up of the bike fit
(saddle height and forward/back location, seat location, handlebars)
and then try moving things around a little at a time to see if the
pain goes away or gets worse. Then you know the bike setup that's
right for you rather than the one you're "supposed" to use. Not that
there's anything wrong with getting a bike fitting.

This may be a crazy suggestion, but I've found on longer rides flat
pedals or clips and straps work better for me than cleats since you're
able to move your feet around to avoid hot spots and vary your
posture.

Ed

On Thu, Feb 25, 2010 at 12:19 PM, Kevin wrote:
> Hello OBRA-ites,
>
> A friend is a social rider with hopes of doing a 1 day STP this year.
> She's ramping the miles up in anticipation of the big event. She's not a
> hard core rider but has done full centuries. She's been experiencing what
> she describes as a burning feeling on the outside of her left knee on longer
> rides.
>
> Cleat alignment? Saddle adjustment? Just ride more and strengthen
> muscles? Get in for a professional bike fitting? Sell the bike and go back
> to knitting sweaters for holiday gifts?
>
> All of the above????
>
>
> Kevin
>
> +++++++++++++++++++++++++++++++++++++++++++++++++++++
> What is happening in Kevin's corner of the bike world?
> http://the-whir-of-spokes-in-air.blogspot.com
> +++++++++++++++++++++++++++++++++++++++++++++++++++++
>
>
> _______________________________________________
> OBRA mailing list
> obra@list.obra.org
> http://list.obra.org/mailman/listinfo/obra
> Unsubscribe: obra-unsubscribe@list.obra.org
>
>
_______________________________________________
OBRA mailing list
obra@list.obra.org
http://list.obra.org/mailman/listinfo/obra
Unsubscribe: obra-unsubscribe@list.obra.org


Jennifer Slawta

2010-02-25

Sounds like ITB syndrome to me - you can buy a ITB strap at a running for store for less than $20. It can help a lot! Jenny

>>> Timmy Evens 2/25/2010 2:32 PM >>>
lateral knee pain can be a few things. as a physical therapist who specializes in this sort of thing i have to recommend you get your bike fit and if that doesn't solve the issue see a PT. in my experience lateral knee pain is not just simply a problem with "overuse" but is related to alignment on the bike and the manner in which a rider generates force. pedal stroke/posture vary hugely from rider to rider and has a tremendous effect on the types of injuries that develop with large miles. just buck up and get it handled by a professional and take care of the pain before it ruins a perfectly good season of riding.

tim evens
Rebound Physical Therapy
Bend Oregon

--- On Thu, 2/25/10, Kevin wrote:

From: Kevin
Subject: [OBRA Chat] knee pain
To: obra@list.obra.org
Date: Thursday, February 25, 2010, 12:19 PM

Hello OBRA-ites,

A friend is a social rider with hopes of doing a 1 day STP this year. She's ramping the miles up in anticipation of the big event. She's not a hard core rider but has done full centuries. She's been experiencing what she describes as a burning feeling on the outside of her left knee on longer rides.

Cleat alignment? Saddle adjustment? Just ride more and strengthen muscles? Get in for a professional bike fitting? Sell the bike and go back to knitting sweaters for holiday gifts?

All of the above????

Kevin
+++++++++++++++++++++++++++++++++++++++++++++++++++++
What is happening in Kevin's corner of the bike world?
http://the-whir-of-spokes-in-air.blogspot.com
+++++++++++++++++++++++++++++++++++++++++++++++++++++


-----Inline Attachment Follows-----

_______________________________________________
OBRA mailing list
obra@list.obra.org
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Unsubscribe: obra-unsubscribe@list.obra.org


Timmy Evens

2010-02-25

lateral knee pain can be a few things. as a physical therapist who specializes in this sort of thing i have to recommend you get your bike fit and if that doesn't solve the issue see a PT. in my experience lateral knee pain is not just simply a problem with "overuse" but is related to alignment on the bike and the manner in which a rider generates force. pedal stroke/posture vary hugely from rider to rider and has a tremendous effect on the types of injuries that develop with large miles. just buck up and get it handled by a professional and take care of the pain before it ruins a perfectly good season of riding.

tim evens
Rebound Physical Therapy
Bend Oregon

--- On Thu, 2/25/10, Kevin wrote:

From: Kevin
Subject: [OBRA Chat] knee pain
To: obra@list.obra.org
Date: Thursday, February 25, 2010, 12:19 PM

Hello OBRA-ites,

  A friend is a social rider with hopes of doing a 1 day STP this year. She's ramping the miles up in anticipation of the big event.  She's not a hard core rider but has done full centuries.   She's been experiencing what she describes as a burning feeling on the outside of her left knee on longer rides. 

  Cleat alignment?  Saddle adjustment?  Just ride more and strengthen muscles?  Get in for a professional bike fitting?  Sell the bike and go back to knitting sweaters for holiday gifts?

All of the above????

Kevin
 +++++++++++++++++++++++++++++++++++++++++++++++++++++
What is happening in Kevin's corner of the bike world?
http://the-whir-of-spokes-in-air.blogspot.com
+++++++++++++++++++++++++++++++++++++++++++++++++++++


-----Inline Attachment Follows-----

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halfwheelhill@yahoo.com

2010-02-25

I would call a local shop and see what kind of fit they offer. It may be worth spending a few bucks a get fit right, before she does any damage.

Scott
Sent from my Verizon Wireless BlackBerry

-----Original Message-----
From: Edward Groth
Date: Thu, 25 Feb 2010 12:31:52
To: Kevin
Cc:
Subject: Re: [OBRA Chat] knee pain

Hey Kevin,

I'm no doctor or fit specialist, but I'm inclined to think she's
stressing something from overuse.

When she started training this year, what was her average mileage each
week and what were the longer rides she's been on? I wonder if she's
just trying to ramp up too fast.

If it were me I would write down the current set up of the bike fit
(saddle height and forward/back location, seat location, handlebars)
and then try moving things around a little at a time to see if the
pain goes away or gets worse. Then you know the bike setup that's
right for you rather than the one you're "supposed" to use. Not that
there's anything wrong with getting a bike fitting.

This may be a crazy suggestion, but I've found on longer rides flat
pedals or clips and straps work better for me than cleats since you're
able to move your feet around to avoid hot spots and vary your
posture.

Ed

On Thu, Feb 25, 2010 at 12:19 PM, Kevin wrote:
> Hello OBRA-ites,
>
>   A friend is a social rider with hopes of doing a 1 day STP this year.
> She's ramping the miles up in anticipation of the big event.  She's not a
> hard core rider but has done full centuries.   She's been experiencing what
> she describes as a burning feeling on the outside of her left knee on longer
> rides.
>
>   Cleat alignment?  Saddle adjustment?  Just ride more and strengthen
> muscles?  Get in for a professional bike fitting?  Sell the bike and go back
> to knitting sweaters for holiday gifts?
>
> All of the above????
>
>
> Kevin
>
> +++++++++++++++++++++++++++++++++++++++++++++++++++++
> What is happening in Kevin's corner of the bike world?
> http://the-whir-of-spokes-in-air.blogspot.com
> +++++++++++++++++++++++++++++++++++++++++++++++++++++
>
>
>_______________________________________________
> OBRA mailing list
> obra@list.obra.org
> http://list.obra.org/mailman/listinfo/obra
> Unsubscribe: obra-unsubscribe@list.obra.org
>
>
_______________________________________________
OBRA mailing list
obra@list.obra.org
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Unsubscribe: obra-unsubscribe@list.obra.org


Edward Groth

2010-02-25

Hey Kevin,

I'm no doctor or fit specialist, but I'm inclined to think she's
stressing something from overuse.

When she started training this year, what was her average mileage each
week and what were the longer rides she's been on? I wonder if she's
just trying to ramp up too fast.

If it were me I would write down the current set up of the bike fit
(saddle height and forward/back location, seat location, handlebars)
and then try moving things around a little at a time to see if the
pain goes away or gets worse. Then you know the bike setup that's
right for you rather than the one you're "supposed" to use. Not that
there's anything wrong with getting a bike fitting.

This may be a crazy suggestion, but I've found on longer rides flat
pedals or clips and straps work better for me than cleats since you're
able to move your feet around to avoid hot spots and vary your
posture.

Ed

On Thu, Feb 25, 2010 at 12:19 PM, Kevin wrote:
> Hello OBRA-ites,
>
>   A friend is a social rider with hopes of doing a 1 day STP this year.
> She's ramping the miles up in anticipation of the big event.  She's not a
> hard core rider but has done full centuries.   She's been experiencing what
> she describes as a burning feeling on the outside of her left knee on longer
> rides.
>
>   Cleat alignment?  Saddle adjustment?  Just ride more and strengthen
> muscles?  Get in for a professional bike fitting?  Sell the bike and go back
> to knitting sweaters for holiday gifts?
>
> All of the above????
>
>
> Kevin
>
> +++++++++++++++++++++++++++++++++++++++++++++++++++++
> What is happening in Kevin's corner of the bike world?
> http://the-whir-of-spokes-in-air.blogspot.com
> +++++++++++++++++++++++++++++++++++++++++++++++++++++
>
>
> _______________________________________________
> OBRA mailing list
> obra@list.obra.org
> http://list.obra.org/mailman/listinfo/obra
> Unsubscribe: obra-unsubscribe@list.obra.org
>
>


Kevin

2010-02-25

Hello OBRA-ites,

A friend is a social rider with hopes of doing a 1 day STP this year. She's ramping the miles up in anticipation of the big event. She's not a hard core rider but has done full centuries. She's been experiencing what she describes as a burning feeling on the outside of her left knee on longer rides.

Cleat alignment? Saddle adjustment? Just ride more and strengthen muscles? Get in for a professional bike fitting? Sell the bike and go back to knitting sweaters for holiday gifts?

All of the above????

Kevin

+++++++++++++++++++++++++++++++++++++++++++++++++++++
What is happening in Kevin's corner of the bike world?
http://the-whir-of-spokes-in-air.blogspot.com
+++++++++++++++++++++++++++++++++++++++++++++++++++++


Dr. Ryan Iverach

2001-12-13

This is a multi-part message in MIME format.



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I agree with the physical therapist, the crunching in the knee really sounds

like chondromalacia patella.



Taping may do the trick, or you may benefit from some other therapies. Have

any of you tried a Glucosamine Sulfate supplement? I highly recommend this

if you haven't already tried it. Many of my marathon and endurance cyclist

patients have used it with great success, and there is a considerable amount

of literature about its effectiveness. Give it a try!



If you have any other questions, feel free to contact me.



Sincerely,



Dr. Ryan Iverach

Chiropractic Physician



Clearwater Chiropractic and Massage

1201 SW 12th Avenue, Suite 205

Portland, Oregon 97205

Phone: 503-279-0205

Fax: 503-279-0206

Email: ry-@clearh2o.org

website: www.clearh2o.org











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charset="iso-8859-1"

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<HTML><HEAD>

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<META content="MSHTML 5.00.2314.1000" name=GENERATOR></HEAD>

<BODY bgColor=#ffffff>





<DIV><FONT face=Arial size=2><SPAN class=510580501-14122001>I agree with the

physical therapist, the crunching in the knee really sounds like chondromalacia

patella.</SPAN></FONT></DIV>

<DIV><FONT face=Arial size=2><SPAN

class=510580501-14122001></SPAN></FONT> </DIV>

<DIV><FONT face=Arial size=2><SPAN class=510580501-14122001>Taping may do the

trick, or you may benefit from some other therapies.  Have any of you tried

a Glucosamine Sulfate supplement?  I highly recommend this if you haven't

already tried it.  Many of my marathon and endurance cyclist patients have

used it with great success, and there is a considerable amount of literature

about its effectiveness.  Give it a try!</SPAN></FONT></DIV>

<DIV><FONT face=Arial size=2><SPAN

class=510580501-14122001></SPAN></FONT> </DIV>

<DIV><FONT face=Arial size=2><SPAN class=510580501-14122001>If you have any

other questions, feel free to contact me.</SPAN></FONT></DIV>

<DIV><FONT face=Arial size=2><SPAN

class=510580501-14122001></SPAN></FONT> </DIV>

<DIV><FONT face=Arial size=2><SPAN

class=510580501-14122001>Sincerely,</SPAN></FONT></DIV>

<DIV> </DIV>

<P><FONT size=2>Dr. Ryan Iverach<BR>Chiropractic Physician<BR><BR>Clearwater

Chiropractic and Massage<BR>1201 SW 12th Avenue, Suite 205<BR>Portland,

Oregon  97205<BR>Phone: 503-279-0205<BR>Fax: 503-279-0206<BR>Email:

ry-@clearh2o.org<BR>website: www.clearh2o.org</FONT> </P>

<DIV> </DIV>







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