I mentioned in my last post that I’ve come down with knee pain. It seemed to start on my last training ride in January, when I noticed an ache/burning under my right kneecap. I specifically recall feeling it while climbing on my first ride with significant hills this season. For the past month I have only been noticing the pain while riding, and usually towards the end of a ride or when my training volume was highest. I’ve tentatively diagnosed myself with .
Last week I had to stop a workout because of the pain. It still wasn’t excruciating, but I could feel it on every pedal stroke and it was obvious something was wrong. Since I also came down with a mild case of the flu, I took the week completely off. On Sunday I was feeling better and going stir crazy from not riding. I foolishly decided to join a local group and ‘ride how I felt’. My legs felt great and I was raring to go, but my knee slowly made itself known. I finished the ride without thinking I had done anything too extreme, but Monday was the first day I had pain while not riding so I ‘officially’ announced my trouble on the blog.
I haven’t had any major knee problems, injuries, or surgeries. However, I have had various aches and pain in the past. During my first winter after getting a road bike (Age 18) I had on-and-off pain from my right knee, which in hindsight seems similar to my current issue. I kept paper training logs, and I’m sure I would find them useful (and probably hilarious) if I had kept them around, but I threw them away years ago. I remember spending about a month repeatedly taking a few days off and finding myself with pain until it finally went away. I also recall having “movie goer’s sign” (a burning ache that gradually builds while sitting) in my knee during college, and specifically on the flight to Collegiate Nationals in 2001.
More recently, after a big gear hill workout in 2010, I had pain and tenderness just above my right kneecap. This was likely a brush with , although it healed after a few weeks of relative rest. In spring 2011 I had pain in my right hip, a burning sensation just behind the greater trochanter. I had increased my mileage and lowered my stem, and a tight IT band was causing me enough hip pain that I had to stop a workout. I went to the and got a card, but never made an appointment. The pain was bad enough I was concerned it would impact my performance at the Tour of the Gila, but after some rest following the race, it went away.
The first thing that I noticed is that I seem to have recurrent problems in my right leg. It is said that many people have muscular or structural imbalance that can cause an effective difference in leg length. One bit of history I left out earlier is a femur fracture from when I was very young, on my right side. I took a look at my equipment and found some additional evidence of imbalance:
First, my shorts. Sorry for the oversharing, but I noticed a while back that my shorts wear unevenly. The fabric on the right, inner side of my leg wears and pills up over time. In fact, I’ll take the TMI to the next level and mention that the only (minor) saddle sore problems I’ve encountered are in this area. I took a look at my saddle and didn’t notice anything obvious there.
Next, I’ll mention that I’m naturally duck-footed. I stand with my toes pointed outward enough that my wife often trips over them. When I ride, I tend to scuff chainstays with my . On the road I use Time pedals that have what I would consider ‘soft float’, meaning they have float, but the tension slowly increases as your foot deviates from the center until it releases. So yes, there is 5 degrees of float, but also a centerpoint you can feel. I took a look at my cleats and noticed additional uneven wear.
You can see the groove worn by the retention spring is much deeper on the outside of my right cleat. This is likely from ‘pulling’ my heel more inward than the cleat alignment would allow. The wear is unlikely to be from clipping out at intersections, since I usually will only clip out with my left foot. My cleats were very close to identical alignment, but I did notice my right cleat was not quite as ‘duck footed’ as the left.
As you can plainly see from my history, I’m generally not interested in seeing a doctor about my problems. I believe many problems are solved by simply giving the body time and ideal conditions required for it to heal itself.
Although my symptom from a tight IT Band was hip pain last season, I think I may have a new symptom from the same problem. Tight IT Bands can pull the kneecap out of position as the knee bends, causing pain and inflammation. This week I am going to focus on flexibility in my legs, especially on the right side. I will be stretching three times a day, and a solid foam roll session once per day. I will commute short distances by bike only if pain free. Otherwise, I won’t be riding until Saturday.
I already took the initiative to rotate my right cleat so it is equally duck-footed as the left. This is the area where I could possibly use the help of an advanced professional bike fitting. I haven’t made an appointment yet, but I do have the card of a good place if I need it.