knees again

From: "DH"
Organization: @Home Benelux
Newsgroups: alt.rec.bicycles.recumbent
Date: Sun, 7 Dec 2003 23:53:15 +0100
Subject: knees again

Could someone, preferably someone with a medical background, please
explain why riding a recumbent causes knee pain. What exactly is going
on? When I feel pain or stiffness, I figure something is damaged or
irritated. I just want to know if I could damage myself. Thanks, DH


I think you should see a doctor, one of the reasons I only ride recumbent is
because my left knee has been reconstructed and riding recumbent is one of
the few things that does not hurt it, if you are getting pain then it sounds
like you have damaged something.

--
Ian

http://www.catrike.co.uk

No I'm not a medical person nor do I portray one, however I do know that if
you push too hard too soon when you are riding a recumbent you probably will
have knee problems. Go easy until you built up the miles. Spinning for
several hundred miles should probably do it. Spinning is a good thing no
matter what you ride. When you've been off the bike for a few weeks it maybe
necessary to get reconditioned.
Newbies often get on a bent and push too hard climbing even small hills.
This puts lots of pressure on the knees, since you are pushing back in the
seat. One of the advantages of a conventional bike, you naturally raise off
the saddle, this relieves the knee pressure.
Almost all of us have gone thru this learning curve.
This being said if you are experiencing extreme knee pain time to take a
rest and see a doc. Recumbents are a great riding experience, but there are
new muscle groups that need to be conditioned. Go easy, learn to spin, get
your bike adjusted to your riding style, and you'll probably do fine.
Denny in Sayre, Pa
"Bent but not Broken"

"DH" wrote in message
...
Could someone, preferably someone with a medical background, please
explain why riding a recumbent causes knee pain. What exactly is going
on? When I feel pain or stiffness, I figure something is damaged or
irritated. I just want to know if I could damage myself. Thanks, DH

"Ian" wrote in message
...

From: "DH"
Organization: @Home Benelux
Newsgroups: alt.rec.bicycles.recumbent
Date: Sun, 7 Dec 2003 23:53:15 +0100
Subject: knees again

Could someone, preferably someone with a medical background, please
explain why riding a recumbent causes knee pain. What exactly is going
on? When I feel pain or stiffness, I figure something is damaged or
irritated. I just want to know if I could damage myself. Thanks, DH


I think you should see a doctor, one of the reasons I only ride recumbent
is
because my left knee has been reconstructed and riding recumbent is one of
the few things that does not hurt it, if you are getting pain then it
sounds
like you have damaged something.

--
Ian

http://www.catrike.co.uk


Are you sure the bike has been properly fitted to you? I get knee pain on
both uprights and recumbents when my leg extension is too short. Even being
off by a small amount causes pain after a certain point. It's the first
thing I check and adding a tad more extension has always cured my knee
pain. Other than that spin don't mash. See a physician with experienced in
this area if the pain continues.

skip

It is either force strain, or repetitive strain injury.

If it is force strain, you are probably pushing too hard and need to
spin.

If it is repetitive strain injury, you are either overextending the
joint or over compressing it and the repetitive motion strains the
tendon.

For the repetitive strain injury, you have to check two parameters on
the recumbent. 1) Leg extension, neither too short nor too long and 2)
the crank length -- too short is okay but you lose power.
If the crank length is too long, even though your seat distance is
correct, and your extended leg is in the proper position, your other
leg, the compressed leg is too compressed.

If the crank is too short, you won't have the repetitive strain injury
problem, you will just not get an effective leverage as a longer
crank.




"DH" wrote in message ...
Could someone, preferably someone with a medical background, please
explain why riding a recumbent causes knee pain. What exactly is going
on? When I feel pain or stiffness, I figure something is damaged or
irritated. I just want to know if I could damage myself. Thanks, DH

No medical advice here, but if the pain goes away after you've been
off the bike, it might just be your "getting used to" period. Someone
gave me that advice when I started on my recumbent and had some slight
discomfort whereas I had none on my DF. In my case I was a "spinner"
on both bikes. Pain went away after awhile.

Good Luck

Joe

"DH" wrote in message ...
Could someone, preferably someone with a medical background, please
explain why riding a recumbent causes knee pain. What exactly is going
on? When I feel pain or stiffness, I figure something is damaged or
irritated. I just want to know if I could damage myself. Thanks, DH

I appreciate all the responses, but am really interested in knowing
(mechanically/biologically) what causes the pain when riding a bit too
hard or a bit too long.

I believe the bike fits me well. I have a slight to moderate break in my
leg when biking and it feels natural.

I really try to use the gears to keep things spinning, but sometimes you
just need that extra burst of power and that's probably the wrong thing
for me to do. I'll take you word for it that things will improve with
time; _and_ if I have severe pain or chronic pain, I will see a doctor.

Edward, thanks for the info. Your answer was closest to the kind of info
I was looking for.

Edward Ing scribed with passion and wit:


If the crank is too short, you won't have the repetitive strain injury
problem, you will just not get an effective leverage as a longer
crank.




"DH" wrote in message
...
Could someone, preferably someone with a medical background, please
explain why riding a recumbent causes knee pain. What exactly is going
on? When I feel pain or stiffness, I figure something is damaged or
irritated. I just want to know if I could damage myself. Thanks, DH

Thinking more on this, there is also the question of "float" if you are
using clipless pedals.

--
Ian

http://www.catrike.co.uk

Dh wrote:
Could someone, preferably someone with a medical background, please
explain why riding a recumbent causes knee pain.



It is fairly easy to incur knee pain on a recumbent. It depends greatly
on how you ride. A pedal masher may find it easy because there is no
real stress on the body as on an upright bike. Thus the legs feel more
confident to hammer the pedals. Some use their seat back to push off of
giving the knees maybe too much confidence.

I would however say that you should contact your primary care physician.



--

"DH" wrote in message ...
I appreciate all the responses, but am really interested in knowing
(mechanically/biologically) what causes the pain when riding a bit too
hard or a bit too long.

I believe the bike fits me well. I have a slight to moderate break in my
leg when biking and it feels natural.

Lawrence Preble, D.C. gave a great analysis on knee pain on this list
in the past. Let me quote it he

Here are a few basic suggestions concerning cycling-related knee
pain
which you may find helpful. I posted something similar to this on this
NG,
some time ago; however, this might be a good time to review some
basics in
assessing and preventing knee injuries. Just a second while I take
off my
helmet and put on my lab coat...There, that's better. The following
information should not be construed as a diagnosis or prescription for
anyone's particular injury and is meant as informational, only. Also,
this
information did not originate with me but is widely available from
multiple
sources.

The knee is the most commonly injured joint in cycling. As injury is
generally a problem of overuse, it is often seen in the cyclist just
beginning a training program or early in the training season when the
temptation is to do too much too fast.
The most common causes a

1.) For a wedgie rider, faulty saddle height or for recumbent
rider,
faulty seat distance.
2.) Pushing excessively high gears
3.) Slow cadence in cold weather
4.) Too much leg work in the gym. (Yes, some of us cyclists
do some
cross-training, and some do way too much. I'm guessing this is not
your
main problem.)


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

Anterior (i.e., front of 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 (back of knee)
Reasons
hamstring/gastrocnemius
neurovascular bundle
Causes
saddle too high or recumbent seat 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)
Reasons
medial collateral ligament
pes anserenus
Causes
cleat position too wide - foot held internally rotated
excessive knee frontal plane motion
too little pedal float
Possible solutions
narrow foot position by moving cleat outwards
orthotic or wedge to correct foot alignment
pedal float should be 6 - 8 degrees

Lateral (outside of knee)
Reasons
iliotibial band
degenerative lateral meniscus
Causes
cleat position too narrow - foot held internally rotated
too little pedal float
excessive knee frontal plane motion
Possible solutions
widen foot position by moving cleat towards the bike
pedal float should be 6 - 8 degrees
orthotic or wedge to correct foot alignment

Treatment
General Issues

These are usually conditions that develop slowly over a number of days
and
are not emergencies. Likewise immediate evaluation by an orthopedic
specialist is overkill. Immediate care is always available at a walk
in
clinics, but it is more productive to see your primary care physician
or a
sports medicine physician as the first step.

Dealing with yourself will be the biggest issue. Competitive athletes
and
overzealous newbies have a "fear of rest" - and rest is probably the
single
most effective treatment. Peer pressure to continue to ride doesn't
help.

First Aid
Ice, elevation, and resting the knee are all helpful.

Rehabilitation
Take a few days off and then begin a limited riding program - cut back
mileage by 20 - 30 % and spin at a high rpm and in a low gear for a
week or
two. And the same goes for leg work in the gym. Remember, if you push
too
hard, you just get to start over again. Mild stretching before and
after the
ride keep the muscles loose, and icing the knee after the ride may be
beneficial as well.

Drugs
Tylenol or NSAIDs such as motrin are a good start. Motrin can be taken
up to
800 mg 3 times a day for a few days, but then drop back to the
recommended
dose on the bottle. If you have a history of ulcer problems or develop
GI
side effects, either switch to tylenol (it helps pain but is not as
good an
antiinflamatory) or see your physician for one of the newer Cox-2
medications (Vioxx, Celebrex) which are much easier on the stomach.


Prevention

a.. Correct biomechanics - follow suggestions above
b.. Consider a complete bike fit
c.. Choose gears that allow a cadence of at least 75 - 80 RPM
d.. Don't make big changes in your training program - increasing
mileage
by more than 10% a week is a risk factor for injury as is over zealous
interval training.
e.. Keep your legs covered in cold temperatures