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  #1  
Old 10-22-2016, 10:33 AM
Ali1989 Ali1989 is offline
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Always pain on one knee

Hi,

For ages I've been experiencing pain on my left knee and have no idea why. If anyone can spare a few seconds I've attached a couple of videos. I'll look into getting a proper fit done soon but am I missing anything obvious?

Its shown as the right leg on this one https://www.youtube.com/watch?v=RRRBYSWUNy8

https://www.youtube.com/watch?v=_3MF46kvPlk

thanks, for any help its really frustrating.
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  #2  
Old 10-22-2016, 09:01 PM
Steelman Steelman is offline
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Caveat: Not a fit expert, but have experienced similar issues. Nothing seems obvious in your video to me.

Are you sitting on the saddle squarely? If not, you may have functional leg length discrepancy.

I had a case of this which went undiagnosed for decades, despite being fitted by a certified coach and then a "professional" fitter. At first, pedals with float cured the problem, then custom orthotics.

Ultimately, lowering the saddle a few mms, and then moving the left side cleat forward on the shoe solved the problem.

Steve Hogg has information regarding this common problem, on his website.

Hope this helps.
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  #3  
Old 10-22-2016, 09:10 PM
stephenmarklay stephenmarklay is offline
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Hmm a side view might be useful. Why is your left cleat angled such that your toe is pointing outward?
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  #4  
Old 10-23-2016, 12:14 AM
ultraman6970 ultraman6970 is offline
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The reason he has the toes pointing outward is because sure his feet are in the position 1:50 PM Like a penguin (just being descriptive not teasing the op),

I dont see anything apparently wrong at all with this kid, pedaling looks super smooth not high, not low... Knees trailing ok.... just opinion based in experience.

If ankles and hip/leg joint are not bothering then the cleats might be around the right place.

Where is that pain located??? out, in... inside, front? back??? Where?
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  #5  
Old 10-23-2016, 05:40 AM
Ali1989 Ali1989 is offline
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thanks for the replies.

The pain is usually to the front/inside of the knee.

I do sit slightly more to that side but i'm not sure why. I've subsequently tried using an offset cleat position but this seems to have exacerbated the problem, leaving me with the original problem and a niggle on the right knee to boot!

Haha yea penguin feet does sound about right especially for the right side.
this is the side with the pain https://www.youtube.com/watch?v=hQfPSxQWL_M
and the other https://www.youtube.com/watch?v=-BBJSbfOspk
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  #6  
Old 10-23-2016, 04:48 PM
nate2351 nate2351 is offline
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From the back you can see your left hip oscillating. It makes me think that either the saddle is the wrong shape and you're not fully contacting it, or you have something going on functionally with the muscles of your hips/lower back. I think this is manifesting in the knee because of the mobility of that joint.
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  #7  
Old 10-23-2016, 08:08 PM
ultraman6970 ultraman6970 is offline
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As nate said probably is related with the position over the bike.

Just from experience... maybe you are seated too far to the front and in consequence you are a little low. This is what I would do.

- hope you have a seatpost with off set moving around the house... Whats your seat back right now? close to 2 cm?

- Move the saddle up like 5 mm.

Again, just my opinion ok?
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  #8  
Old 10-24-2016, 10:32 AM
benb benb is offline
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I've had this same little issue for many years (essentially always) but I have it on my right leg. My right foot also wants to point out like your left foot apparently does. Most people say my pedal stroke looks really good too (yours looks good to me.)

I haven't been for X-rays, I don't think I really have a huge discrepancy. However I think there are some of the following issues going on, maybe you have some of them. Whatever it is for me it adds up to some level of functional asymmetry.

- I wear orthotics, my right foot is more flexible than my left. That foot seems to want to point out a little bit even walking
- My feet are not equal size
- I have the same thing you're talking about, my right hip moves more on the saddle than the left.
- Sometimes I can feel like I'm sitting with my hips offset to the left side of the bike
- If I'm going to get a saddle sore, it's always on the right side

For me I think my right leg is effectively longer, it could be the foot is bigger or it could be something else. If the saddle is too low one of two things happens:

- Hip stays put, knee hits an excessive angle and you get tendonitis in the knee (what you seem to be having)
- Hip moves to compensate for the leg and you get that side of your pelvis rocking on the saddle and you get saddle sores on that side. (This is also likely to happen if you have too much setback to compensate for the saddle being too low for the long leg)
- Saddle that is too wide can be an issue that contributes to some of this too.. your thighs will hit the saddle and put some forces on your pelvis and you can end up compensating by sitting strangely on the saddle.
- You pedal weird like this and your legs end up using weird ROM and things get stiff/shortened on one side and/or overstretched on the other and that will make it even worse.
- These problems after years can cascade up to your upper body too.. arm/wrist/shoulder issues from using your upper body to compensate for what your lower body is trying to do.
- This problem probably makes it harder for you to ride no hands. It does for me if it's not correctly compensated for.

Most of what is going on here is some asymmetry. Most of the bike fitters will only really analyze you from one side and they can't see this as it requires looking at the problem side. It's really hard to see without tools anyway. Most fitters I've worked with seem to look at you from the right side more than the left side, which is going to make this harder for you.

Chances are IMO your saddle probably needs to come up to get to a good height for your left leg. Who knows if your setback is wrong, but it could be as well. Once that is done you might need offset cleat positions to keep the short leg happy and have it not pull you to that side on the saddle.

Working with a fitter who has dart fish or retul is really helpful here. Most of this year I was working with a fit from Seven (no advanced tools used) that was also agreed upon by a Specialized fitter. Neither of them could see my hip moving to protect that longer leg's knee and in fact they put the saddle quite a bit too low. (2cm+) I went this fall and got watched on a dart fish setup and they could see my hip moving and were able to adjust the saddle to get rid of that and solve the problem.

You will pick up some power on top of reducing injury if you sort this out. But it won't necessarily be easy.

It's possible when you tried offsetting your cleats you did it wrong.. I had one fitter years ago tell me I had asymmetry and he completely reversed the correction I needed which made the problem way worse. But you have to get the saddle right first anyway. In my case the saddle was always hard to get right but I intuitively figured out the cleat offset myself right way the first year I had clipless pedals without understanding what was going on. It just felt right to offset them that particular way.

Last edited by benb; 10-24-2016 at 10:37 AM.
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  #9  
Old 10-24-2016, 02:33 PM
Ali1989 Ali1989 is offline
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Thanks again for the replies. I'll experiment with shimming the other leg and raising the saddle. Maybe indicative of the problem is my sensitivity to saddle height adjustments without shimming: I use a power meter and have found that a difference of just around a couple of mm is the difference between feeling terrible at threshold power and managing comfortably. I also notice a difference on my town bike when riding in difference shoes with a sole width difference.

Also I'll look again at saddle selection. I hadn't really thought about having a saddle too wide as being a potential problem before as I've only ever come across writing about the opposite problem which I guess is more common. I'm seriously skinny and my sitbones centre to centre using the marks left by the rubbing on my shorts is not much more than 90mm. At the moment I'm using a 143mm saddle.

Last edited by Ali1989; 10-24-2016 at 02:36 PM.
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  #10  
Old 10-24-2016, 03:41 PM
Big Dan Big Dan is offline
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What pedals are you using?
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  #11  
Old 10-24-2016, 03:47 PM
Ali1989 Ali1989 is offline
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Shimano SPD-sl's at the moment. I also tried with looks pedals with the 9 degrees of float and it didn't improve matters.
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  #12  
Old 10-24-2016, 03:56 PM
nate2351 nate2351 is offline
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I'd be careful throwing shims in your cleats if you don't know for sure you have a leg length difference. That could make the problem worse than before. Just a word of caution, be conservative.
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  #13  
Old 10-25-2016, 12:42 AM
ultraman6970 ultraman6970 is offline
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Don't shim yet, as benb said.. you have to get the saddle height right first. Which in the case of some people is really hard to get it right because are more sensitive to changes than others. I have no idea if you have done this... just to see what number you get... use the lemond saddle height formula, that always gives you a +- number to start, it would not surprise me if you are off like 2 to 3 cm off lemond's number.

BTW what's your seat back? did you measure it?
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  #14  
Old 10-25-2016, 08:59 AM
benb benb is offline
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Yah just to add what others said I tried shims. I feel like maybe I can get the same result with shims or offsetting the cleats and the shims are a big PITA compared to just doing an offset. (And they didn't work any better for me)

They make it more difficult to walk, they can interfere with clip-in/clip-out, and they can collect mud and dirt. I'm not sure why they change the feeling of clip-in/out so much but they really did IME. (Both SPD and SPD-SL)
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  #15  
Old 10-29-2016, 10:48 AM
Ali1989 Ali1989 is offline
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Quote:
Originally Posted by ultraman6970 View Post
Don't shim yet, as benb said.. you have to get the saddle height right first. Which in the case of some people is really hard to get it right because are more sensitive to changes than others. I have no idea if you have done this... just to see what number you get... use the lemond saddle height formula, that always gives you a +- number to start, it would not surprise me if you are off like 2 to 3 cm off lemond's number.

BTW what's your seat back? did you measure it?
Saddle setback is the tip of the saddle being 65mm behind the bb centre and the saddle height is 75cm pretty much the same as what I get from the formula.
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