The Paceline Wisdom Rules:Knee Pain, Shoe/Cleat Alignment

[jmeloy]

Ok here goes, getting some knee pain in back, outside of left knee. Have two pairs of Specialized shoes, different models, same cleats, same shoe size. When I ride the same bike I only get the discomfort with one of the pairs. That pair is probably has a shade thicker sole. Odd that I tend to have pretty flat feet and walk a little duck footed (toes out). When I look really closely at the cleat alignment, the RIGHT shoe is just a very (!) small "heel out" but almost too little to measure.

So, where do I start? Raise seat a mm to offset for a VERY small difference in sole thickness? Tweak the heel out a touch on the left shoe? Got the Specialized wedges but not thinking that's the direction I need to go.

Appreciate any help gang!

[rustychisel]

You don't say what pedal and cleat system you're using and I suspect that's deliberate.

But if things are as you say and the stack height difference is 1mm it certainly isn't that. I assume you've adjusted the very slight lateral difference you noted?

Story: when I changed cleats on my Look Deltas I never seemed to be able to get the new ones aligned properly, so that on the very first ride I'd get the sort of knee pain you describe... as an ex hockey player my knees are somewhat susceptible. I tried marking the position with a chinograph pencil, all sorts of crap. I guess that's why Look eventually came out with the printed template. By then I'd moved to Keywins and will never go back.

I get the feeling your're going to have to look elsewhere for the source of pain. Do the 2 pairs of shoes differ slightly in sizing, tightness on the feet, cause you to scrunch the toes slightly ...?

[93legendti]

Wouldn't it be easier to find a 2nd pair of the shoes that don't hurt your knee and sell the offending pair?

[cdn_bacon]

Raised my seat just a bit, and I found that my seat was set too far back.

and also moved my heel out just a wee bit. now no issues.

I also stretch that side a little more before I ride just in case.

[cmg]

on the pair that doesn't cause feet pain mark the location of the ball of the foot on the out sole. Measure the the gap between the ball of your foot and the center of the cleat or the part on the cleat that marks the pedal center line (speedplay cleats have a line). Transfer that dimension to the pair that hurt. Next measure from the crank arm to the inside sole of the along pedal center of the shoes that don't hurt. transfer this dimension to the shoes that hurt. Different shoe models will have different cleat locations in relation to your feet (my opinion). once you have done this the period of adjusting can begin. Pain in the back of the knee means the saddle is to low, adjust by 1-2mm. the older you are the more you'll notice incremental saddle movements/adjustments. after all of this you begin reading setup bolgs such as this one from Steve Hogg https://www.stevehoggbikefitting.com/blog/2011/11/knee-pain/

[bluesea]

Foot/shoe interface change can create enough variation to cause pain or other maladies.

[oldpotatoe]

Ok here goes, getting some knee pain in back, outside of left knee. Have two pairs of Specialized shoes, different models, same cleats, same shoe size. When I ride the same bike I only get the discomfort with one of the pairs. That pair is probably has a shade thicker sole. Odd that I tend to have pretty flat feet and walk a little duck footed (toes out). When I look really closely at the cleat alignment, the RIGHT shoe is just a very (!) small "heel out" but almost too little to measure.

So, where do I start? Raise seat a mm to offset for a VERY small difference in sole thickness? Tweak the heel out a touch on the left shoe? Got the Specialized wedges but not thinking that's the direction I need to go.

Appreciate any help gang!

Got a fit person around who can do a fit on you?

[jmeloy]

Gang, sorry, didn't have forum access for a bit. Pedals are new Time iClic2's. thinking the progression should be:
- raise saddle a touch to see if that improves it
- bump the left heel out a small amount as second attempt
- sell the shoes and get a second pair matching the others

[Pyramor]

Take a look at Steve Hogg's website. http://www.stevehoggbikefitting.com/ He has been a fitter for 25 years and has some very novel and apparently effective ideas about bike fit. I subscribe to his theories and have managed to solve several of my problems.

[cdn_bacon]

I put a plank of wood between my knees as straight vertically as I could, kept my knees shoulder width apart and performed a slow squat.(trying not to focus on my knees but just to see how they bent) I found that my left knee touched the plank of wood before my right (being slightly bowlegged my knees will touch when I perform a full squat and not remain shoulder width apart) same happens on my bike. so I pulled my cleat in(which pushes my shoe out). solved my problem.

[jmeloy]

So I started by raising the seat 2 mm and MUCH less knee discomfort. Then kicked the heel out just a touch to match the right foot and ALL discomfort gone!

Thanks to the gang for the great help. I wouldn't have guessed that 2 models from the same shoe company would differ enough to create the issue but it appears it did!

[xeladragon]

I had a similar issue recently. I swapped saddles... replaced a Specialized Romin Evo Expert with a Romin Evo Comp Gel. Same saddle, so no saddle height adjustment needed, right? Wrong. Some knee pain after half an hour or so. Compared the saddles afterwards, and the Comp Gel definitely had more padding. Lowered my seatpost by 2mm, and I'm good now. Two freakin' millimeters...

[Mikej]

You should look into some kind of body work - pt, massage or something to help. One of my techniques is changing out cleats 2 -3 times a year to reduce the change. I have also found extended axles give me much better comfort- the new DA9000 with 4 mm longer axles are magic for me, along with active release massage every month before it starts hurting.