What Causes Cycling Knee Pain (with a bike fitting expert)
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- čas přidán 1. 06. 2024
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About Neill Stanbury: neillsbikefit.com.au/
About the RCA: roadcyclingacademy.com/
Cycling knee pain is very common for cyclists and it is commonly brought about by an incorrect fit on a bike. So in this video, bike fitting expert Neill Stanbury will share with us what causes different types of knee pain and the associated bike fitting opportunity.
#cycling #knee #pain
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Most well spoken I've seen anyone talking about knees in the context of riding.
That was the best explanation I’ve heard on what happens with a cyclist knee(s).... Love these types of educational discussions... 🙌🏽🍻
This totally describes the knee pain I've been experiencing in my left knee. Great content Neill and Cam!
Glad you're liking it Mike! - Neill
Yeah I have exactly the same issue as Cam. How did you fix it? A stanse underneath the shoe?
Ah man, I had a really painful left knee issue yesterday. Hoping this helps!
Superb explanation. There are now 1000s if riders saying 'thats me!'.
A professional bike fit is on my list once we can. After 25+ years of riding bikes, still learning. 😎
My right knee gets IT band pain. The only thing that fixed the problem was proper stretching. Stretching at the buttocks area is where i needed to stretch. The I.T. band runs the length of the outside of each leg. Without these stretches i was done.
Stretching saved my riding. There are many vids here on youtube on the stretches needed to perform for i.t band pain. 👍
Such a talented bike fitter/physiotherapist with expertise in cycling, a great resource for all cyclists! Much appreciated the thorough and concise explanation as alwasy!
Thx for sharing your wisdom Neil!!!
This is awesome, very clearly explained and totally makes sense mechanically!
Pretty amazingly clear and Neil really makes it easy to understand. Unbelievable! Thank you!!
This is a fantastic video thank you very much for creating it.
Fantastic information. Really like the way Neil explains all this.
This is epic info! Still helping people 2 years later 😊
Top notch content yet again gents - keep em coming!
Brilliant stuff. Thanks for this!
You’ve completely nailed my left knee pain thank you so much for the clear informative content!
I'm catching up on these videos and loving them. I think Neill might need to do a national bike fitting tour. The way he describes things is brilliant. I'd definitely love to pick his brain and get his opinions in person.
Thank you for this explanation! Was wondering why I get ITB pain on only one side when I cycle. Never had this issue whenever I run. Very informative and helpful content! 👍🏼
Excellent talk! Appreciate the information. I have had knee pain on the inner knee before, fairly consistent when I train a lot. I recently purchased the upgrade to my Assioma Uno pedals, so know I know what both sides are doing. Turns out my first ride/race I was 54% | 46% left dominant. Strange thing is my left knee is the one that flares up sometimes. Going to look at shimming to try some things out. Thanks again for sharing!
Loved the explanation!!!
Genius! Thank you very much (this will never get old!)
Excellent video!
Really explains the concept. Now I have to go get a bike fit for my PF-pain syndrome.
Thanks for the content!
Great explanation. This really helped identify and solve for my knee pain.
This guy is a genius I swear. I have learned so much from him. Ty my guy.
Thank you, very detail explanation if knee pain causes.
Thanks so much for your clear and concise description on what is a complex area for most to explain.
I unfortunately am going through my own knee issues (made more apparent POST bike fit). I'm right leg dominant, and have experienced left medial knee pain. After settling recently (and doing minimal riding 6hours/week) I upped my riding (13 hours/week) but the mild discomfort (2-3/10) continued. Then on changing to new pedals (Keo Classic to Keo 2 Max) the very original pain came back for a week before subsiding somewhat. The pain/discomfort is predominantly when seated.
The fit was completed the one of the UK's leading fitters (not on a rig), and the conclusion is that have been riding (and racing) for years on too low-a-saddle), which is now up by 30mm!
Prior to this I've done fits in part, with tapered shims for overpronation, and custom footbeds to support flat arches (with the same fitter).
My concern is I've done lasting damage to my knee and any settling is going to cease when I up the load again, but I hope this isn't the case - any positive insight would be appreciated as the fit has now effectively been ruled out. Cheers!
the "extremely high" seat height might also be 15mm. in my case it was somewhere 11-15mm where the pain totally disappeared. But it was not easy to understand, because seat height was set the same as to my old bike - but the geometry of the bike is slightly different - so my body did not like it that much.
Wow. Very impressive explanations.
I so wished I lived in Australia. Would visit Neil in a heartbeat. Fantastic insights. 👌
Thank you for this info. Thought I might just be suffering from an old sports injury or just aging faster than I had hoped. Got Into biking and my mind and heart want to go go go but my left knee has terrible post ride pain on the outer knee. Your explanation brings me hope that it's just a motion change in order to avoid the 2-3 day recovery time. Thanks a lot for the calm explanation
You are the only one of a physiotherapist into bike fitting. I haven’t put this much a thought from anatomical point of view. Thanks for your insight, In USA, bike shops offer bike fitting (and it’s not cheap) but really do nothing much then fancy machine and shining monitors. The only they know is sell the stuff. I have got four saddles and counting. Giving me one more good reason to come back to Oz.😊
Best explanation i ve seen in years
I was two minutes in and instantly knew this was the information I’ve been searching for - presented with enough depth to make sense, yet easy enough for us non medics to understand. My Physio never explained it this well. Thank you!
Very facinating, I tend to get right knee frontal pain, but always thought I was right leg dominant. I need to play with my seat height a little before considering a bike fit (as that's money!)
Aha! Pes ancerinis! This is where I get pain at about 30 miles into almost every ride.. left side only. sore to push on pedal. Very annoying as not tired after that distance but it is painful.and annoying. Must get a bike fit to see what can help. Another great video.
Fantastic content! Straight to the point without skipping the details. It's so rare to have the first video you click be exactly what you want it to be, y'all instantly gained a fan. Keep em coming, cheers from Germany.
Cheers mate 👍
Neil is an asset to the sport.
Thanks for this video. I think my left leg is shorter than my right so what I have been doing was to position the left cleats to where it should be and then move the right cleats backward more towards the middle of the foot. I was hoping that this would compensate for the differences in leg reach.
This is for sure the best content about bike fitting that I found in this platform, althought I´m just seeing this video now(because this problem come to me)... Neil and Cam already helped me in a different problem that I was carrying for much much time. A BIG THANKS GUYS!
Thanks for sharing Joao! Cam
This is gold, thanks for sharing. I have a strong left top knee pain, just 400 meters in cycling, I went to bike mechanic gotyeasurament to the t and still horrible knee pain. Last year I used a different bike and used for a small period a different bike and the pain was gone. Could it be the frame geometry? or more sy could a wider seat prevent knee pain even if my seat doesn't give me any bottom disconfort?
So interesting, really explained well
Neil has such an amazing way of describing incredibly complex things in an understandable manner. Thanks for putting these videos out
Agreed George 👍 Cam
After a year of physio, X-rays etc you are the FIRST person to tell me what’s going wrong with my left knee when I’m cycling!
We're glad we could help!
Happy riding.
-RCA Team
What a joy to listen to! The pes anserinus rotatory whip, how would one approach that? Assuming seat height is correct. Cleat position?
This is fantastic!
Great informative video. I've had knee pain at the top of the left front knee for a few years now, more noticeable on the turbo. I broke my right femur (snapped in half) 30 odd years ago (in my early 20's). Would that make my right leg shorter or longer? my right leg is definitely the more dominant one, certainly more muscular and I've noticed I don't sit sqaurely on the saddle. Any advice on what I can do to rectify this would be much appreciated. Thanks.
Wow this was good. My right it band outside my right knee acted up awefulky starting at 50 miles. I muscled through for a century. And thrn coukd hardly walk that night. Next day was much bettter. My son noticed the saddle seemed to be a bit high as my hips were swaying a bit . Will try a bit lower on the saddle next ride.
I had been making adjustments to combat lateral knee pain, but after he described the back of the knee popliteal pain and movement, I am now curious if that's my issue. Especially considering my left cleat wears faster so it has a lot more movement than the right. The popliteal is tired on one side and where the hamstring connects to my left knee laterally gets inflamed. Usually only when riding hard or long for 2+ hours. Ill definitely try his suggestions from this.
Love the content! I had one sided knee pain caused by my cleat shifting over time. Besides bike fit I would also say perform random systems check from time to time.
what's "random systems check"?
Awesome content again fellas! Simplified breakdown, and helps the average Joe to try to fix their issues themselves to an extent...
Neill, have you thought of doing a week long fitting workshop in a couple capital cities, where people can book you for a fit?
I’d be first in line for Melbourne!!!
Thanks for posting video. How about for us right leg dominant that are having lateral knee pain? My left leg is shorter, so my bike fitter added a shim but I'm still having lateral knee pain on my dominant leg.
I watch these videos over and over again as there are such good information and insights on each one! I've spent so many hours trying to understand bike fit and got 4 bike fits, none of which were specialized enough for my needs (last fitter was an IBFI level 4) . I've had the best results by using a motion tracking software along with the guidance of knowledge from these video series. Much appreciated and looking forward to more in order to understand more!! If I land in AU I'm booking an appt with Neil even if I feel 100% dialed in on my bike. Chapeu!
I do too! While editing. Thanks for sharing on the thread. Cam
Interesting, which motion tracking software do you use?
@@MOVIEKICKS I use BFF elite but there are others that are free
Would you consider doing a video on lower back pain and good cycling posture. It would interesting to see Neil's perspective.
Coming
@@roadcyclingacademy6476 do we have a video haha.
This video should have more views to give it justice. I saw Steve Hogg and neill short right leg 8mm and other stuff going on. Looked like cam but have unilateral tibial varum (greater on left, the longer leg.) so shimming or cleat offsetting will not give a full resolve.
Cleat position video along with this video go hand in hand to explain what a bike can do.
Thanks Cam
Awesome video. This is not only for bikes but also motorcycles. I just bought a new motorcycle and the riding position is very sporty, very low. 2 days riding it and I’m feeling the knee pain exactly as described here. And I know now why. Thank you for sharing. Now I need to find a way to fix it 😂.
That will go on time, all about getting used to it. Lower pegs can help slightly to release a bit of the tension when your in the “sport bike” stance
8:55 hey that's me too! Fighting with a nasty ITB inflammation on my right knee for more than a year, my right leg is 1cm shorter than the left. Been strengthening my glutes and leg muscles with PT, still waiting on my pro bike fit because of covid restrictions. Since January I have seen a lot of improvements because I have adjusted my position on the bicycle with the help of Neil videos and added an 8mm shim on my right shoe. So, thanks for this series, consider making a video for dealing with ITB pain.
Good stuff mate, glad we are helping someone at least! - Neill
what video have u watched because i have the same problem . :(
This is excellent
Neill was some of best money I have spent and his accessibility and follow up awesome. Was also a bonus that my “deformity” caused him so much excitement haha. Tibial torsion I think he called it. Either way he fixed it. Thanks boys.
I have a tibial torsion on only one foot. What did he do to fix it? Cleat and shoe wedges? pedals?? This could help me a lot!
@@onilovni1234 Hi Anthony. Mine is right leg only. I had no leg length difference so no shims or wedges. Because I was always trying to keep foot straight the by product was right knee kicking inwards towards top tube. This caused right hip to drop and I used to sit to side of saddle.Neill put a way longer axle on right side(around 20mm from memory) this allows my knee to track straight up and down and foot stays in its natural kicked out position. It doesn’t make me 100% symmetrical but short of trying to make a twisted bone straight it’s the best solution. Really happy. Just don’t look down at foot sticking out!!
This was exactly my case!! Shorter right leg and left knee pain. Luckily I just had my bike fit session! Thanks for the awesome series of videos!!
How did you fix your issue.?
Amazing explained
Thanks Miriam
So insightful. Keeps coming back to the need for a professional bike fit. Still haven’t done that yet. In the To Do list for sure. Thanks Can and Neil.
Definitely a good one to invest in Nigel. Hopefully there's a good one in your area. Cheers, Cam
@@roadcyclingacademy6476 we will see. Will let you know via RCA.
@@roadcyclingacademy6476 That's the point. I don't think it's easy to find such a knowledgeable bike fitter. At least not in my area.
Would you do an episode on leg length discrepancy for us that may have it and not know it please?
Good topic for future videos I reckon Lance - I'll put the idea to Cam for next time. - Neill
Are there any studies using different paired crank lengths instead of shims to compensate leg length discrepancies ( eg. 165 left crank 170 right crank or vice vesra to compensate for the leg length discrepancy)? Probably less expensive to put in shims than offsetting cranks.
@@martinlum7166 I'm not sure if there's a price difference.
Don't riders usually replace the left side crank arm with a power meter anyway ?
Didn’t touch on muscular imbalances in this one. Neill told me once I was one of the more symmetrical riders he’s seen, yet I was unable to shake my lateral knee pain in my left leg.
In my case the left VMO was virtually non existent compared to the right causing the patella to track laterally. Gym work was in order to correct this, which I never did so that was the end of my cycling career. 🙃
@Kneesovertoesguy has started a mini revolution on this subject and more, been super eye opening listening to him and ive put alot of what he says int practice.
So interesting! I think I have pain in my right leg, and I am a left legged person. I think it might be a mild ITB inflammation.
Could limited dorsiflexion (from previous injury) be what’s causing lateral pain in my it band?
interesting and fantastic descriptions of possible issues. one question I would have, although I assume rare, is what could be a resulting issue with knee or tracking if the Q-factor is too wide?? IE some buys a longer axle pedal system or puts their cleats too far in (pushing the shoe out)
Thanks for the question - Neill can't get to all the questions though unfortunately and he would be best equipped to answer. Cheers, Cam
I suffer from all 4 directions of knee pains. My current way to remedy the pain is a hanging routine to stretch the knee ligaments and realign my back.
The quick fix to erase my pain within a day is:
Hang from a chin up bar, first rotate hips 100° left, then right. Then rotate neck the same (while hanging with at least 80% bodyweight off the ground. Combo these 2 each way/opposite directions. Only 2 reps of each is required.
THEN while hanging, lift each knee to your chest straight up. Do each knee twice.
To increase the effect, do a chin up, or as much as you can, while in the chin up lift each leg 1 at a time.
Under 30 seconds to complete this stretch routine, it will realign your whole back, decompress every disc in your back, but most importantly it stretches all your knee ligaments
This video might be the solution to my knee pain though, as preventing it is better than remedying it. I'll have to setup a camera to analyse my pedal technique.
One thing Neill didn't touch on was stand up or sit down pedaling. While sprinting the bike leans over 30° or so, our knees must be combating some extreme deflections.
Those trainers can't replicate real world scenarios. I tested my frame under my weight, the bottom bracket deflects about 5° while still, can't imagine what full load might produce.
Hi, I recently noticed that even the crank arms are not perfectly symmetrical. My FSA Powerbox SC crank has smaller Q factor on left side and bigger on right side. The difference is 3.3 mm (confirmed by FSA). I also found my GRX left crank arm has 2 mm wider Q factor than the right side.
Could this issue be associated with knee pain?
Thanks both , Neil mentioned my issue in that my right leg goes up and down fairly straight but left is following a crazy plane of movement- structurally legs same length but might be functional differences - I Tried shimming the left leg - should I have tried shimming the right one instead ? Any one want to give there 2 cents? - thanks
Hi Neill
I need your help buddy!!
Im terribly worry and i trust your skills !!
I have "clicks" and pain from my right knee. Front side.
The patella feels like it wont sit right in the knee!
My right leg is 2 cm shorter.
Yes i was riding far too high and almost had to fully streight my right leg...
I lower it dramatically now-no more games..
And now i feel like the pedal is too close to the frame. Feels Like i need it to be extended outside few cm..
Can it be my Canyon Ultimate CF road bicycles has problematic Q factor that go to the left and is not symetrical compare to the seating center???
Im so afraid this pain and bad feel with the patella will end my riding! Should i switch bikes??
Should i do few weeks break?
Or maybe ride without cleats?
Im worry and need your advise.
Thank you sir
I found my saddle twisted a bit to the left after 5 or so rides not adjusting and when I straighten it, I realize it was comfortable with the saddle 2 or 3 deg to the left. Cheers!!!
Interesting Jose, thanks for sharing.
I‘m pretty sure that I got pain in my right knee’s popliteus. Is it possible that my Q-factor caused this or is it my cleat-positioning since you mentioned a shaking foot while pedaling (I cloud only discover this on my left leg)?
I was told I possibly have a shorter right leg. That explains why I had pain all these years. 😂
Your guy knows his stuff Cam!👏
Ride On Ride Strong!
He certainly does Bobby! I am in your boat too re a shorter right leg. Cheers, Cam
I was optimised before we had power meters . I have changed since with my health , however .
Well I've been having left knee pain at the front. Will be getting this sorted! Anyone in WA I can go to get it done? Never really gone to a doctor before (25), does Medicare cover this stuff?
This is gold
No Wonder My Left Knee Is So Jacked Up! Fascinating
Greetings from the US. First I'd like to say thank you to both Cam and Neil for providing such great/valuable content.
On to my question for Neil. I'm experiencing some right(dominant leg) pain on the inside of the knee. Feels like also under the kneecap where the divot( don't know term ) is. As a cyclist who is bowlegged(lower legs). Could this be causing some of the problem and do you have any specific recommendations for bowlegged cyclists regarding bike setup. Thanks again and keep up the great work.
I'll hopefully get Neill onto the Q shortly mate, Cheers, Cam
@@roadcyclingacademy6476 thanks Cam any recommendations from Neil would be greatly appreciated.
How about patella femur pain following a big block of training load with much low cadance work. High torque work....
Perfect timing! Have knee pain all of a sudden for no apparent reason...although my new bike does have slightly longer cranks so Im thinking that is the issue
Hopefully you can sort it Andy! Cheers, Cam
@@roadcyclingacademy6476 Thanks mate. 165mm cranks + adductor stretching + glutei medius strengthening and all sorted. Hope you survived the school holidays ok :-)
Is there a way I can get in touch with Neil? I’m have been dealing with extensive knee pain for a month and a half now and can’t get it to go away. Would love some guidance
I too was riding slightly off center. Dropping my right hip, left side saddle sores. I added a 3mm shim to the right leg. Rode it for a while and problem solved. 1st thought is always to revert to the old position. My advice for you guys out there is DO NOT revert to the position. You have to allow your body to adapt. With some people it may be quick but It took me over a month to settle in with the shim. At 1st the 3mm felt weird than got massively better with every ride. Now I can't even tell it's there. No doubt Neil and Bike Fit James know their shit!! Many bike fitters are in this only for the buck. These guys do it for that reason but also because they care and are passionate about helping people from hurting themselves.
Having same problems Sam , same leg . Saddle sores on left side only , ive tried with a shoe insole of about 2/3 mm the saddle sore went away but i ride only on flat pedals / mtb. But then my right foot goes numb due to having double insoles 😂
@@18erik Right. That's the issue with adding too much MEAT inside the shoe. Maybe you can try a shorter crank arm on the shorter/problem leg?
@@samuel8590 I was thinking about that but I think that shimano slx which I have now dont make them any shorter than 170mm . Thanks for the advice
@@18erik Try lowering your saddle 3mm. Might help.
@@samuel8590 thanks Once again for your time and help , i think that i have a unique problem 🤣 if I lower the saddle as you mentioned I've tried that one before it even gets worse as i assume that my left leg is longer or there's something wrong with my hip it pushes my left side I would say more towards the back and then I get this chafing or how do you say it on the soft tissue between my thigh only on left side , and sometimes this weird pinching feel under my sit bone ( hearts real bad ). If I adjust the saddle to my leg length formulas all over the net. My left leg pricesly my heel touches the pedal in the most far away position from the saddle , but then my right leg ( stronger) comes short maybe I would say 3/5 mm didnt measure pricesly . Yep I've tried a few different saddles from wtb , 2 from ergon , 1 of which I have now . SQ lab 2 of them also the 611 and the 6ox with no help . The only one I find out of them that I could ride even with this pain is the ergon SM comp.if I lower the saddle I also get front knee pain awful last time it was so painful I couldn't sleep even though as soon as the pain started I stopped and raised the saddle about 5mm and it went away but came back after the ride maybe I've done too much damage . Knee is better now but I just cant seem to find a solution to this problem . Even If i put an extra shoe insole or how do you call it , it then becomes a lot better but then I get sometimes numb right foot , or the same problem chafing on my right side in the same spot almost as when the pain was on the left . Sadly I do not have such great bike fit experts in my area but for shore they would have full hands if I came to one of them 😂 . Cheers my friend, thanks once again and sorry for the long post .
i have zero knee pain while on the bike...but soon as i get off the bike and try to run i have terrrible bilateral petellar pain in front of knee....how do i fix this
The issue with the right ITB describes my right outer knee. I've always favored my left leg and suspected it was longer. I'd never considered that it may be the dominant leg because it's longer. I do et ITB pain in both knees but it's worse on the right. You've talked me into getting a fit when I've gotten the vaccine!
Anyone got an idea on how long it can take to fully recover from a really bad case of ITB pain? Pushed myself hard and was riding through the pain for about 15 miles (24km) 2 month ago. The pain still comes back to me if I walk for a few miles now.
Let's assume that I have the same problem explain in the end. I don't seat simmetrically on the saddle and my body, looking the bike from the rider point of view, moves more to the right and the right knee hurts on the medial part. I didn't understand if the solution is putting a spacer under the right or lef knee in this case. I know it's not easy to fix this kind of problem but it's just to understand. Nice video!
I have the same problem to. Did you manage to solve it already?
So, how do you deal with lateral pain? I ride a gravel bike, a mix of off-road and road . After 50-60 kilometers, I start to feel discomfort on the outside of my left knee - not severe pain, but still noticeable. However, after a ride, when I get up from a chair, it really hurts , no problem with walking. I've tried moving my cleat as far inward as possible and adjusting the angle to match my natural angle -useless
Wait is the clip of the rider from the front showing a straight example or one where the knee is going off to a side?
I lowered my saddle for like two stripes wonder how this goes Sunday on a MTB ride
I was seen by multiple physical therapists… All but one told me, my pain was from ITB… The one doctor actually watched me in my bike, told me it was LCL… After working on my peddle stroke, pain is now minimal if I feel any at all…
What is IBT? LCL?
I am getting a inner knee pain for left leg but not right what can be the reason is it the cleats or height...
Did you mention shims ?
How would I set up my pedals for slightly "duck foot" my right foot especially points somewhat outward when I walk.. should I allow that rotation on my cleats or force my foot to track in the correct direction?
Question for Neill, hopefully he will get to it for you shortly.
Is adding a weight program for legs help or hinder the inflammation in an around the knee?
If it targets the specific structure being overloaded by improving its strength and capacity to absorb load, then it will help. If it targets the assymetry and reduces it, things will also improve! - Neill
My right leg is the dominant But my left front kneecap really hurts after 20 km riding. My seat height and position is correct what else can I do?
Great video. Just one question, what is q factor?
Stance. The measure from one foot to the other when standing naturally. Cheers, Cam
Found your channel after searching for causes of my pain. Juat finished a 34km ride and the outsidenof my knees hurt on both legs. From what you have said its called ITB? But you also mentioned its rare to have both knees affected which worries me why both of mine are. What are remedies in cycling and how can I treat it? At the moment , can barely bend both knees without pain
He said either seat dramatically too low or dramatically too high would cause pain in both knees
@@nathanp9449 thank you. My question was a few months ago. Seat height was not the issue. During my rides i would hear rubbing or friction. I brushed it off to chain noise. Found out later that my bottom bracket / crank was loose. My pedalling was off because of this which caused the pain. After getting it tightened properly, been riding since with no pain. Thank you
Any links to how to actually treat bad knees ? I’ve got pain in the middle of both knees whenever I try to stand from a sitting position or run. I thought not riding for a short while would ease the pain but I haven’t ridden in slightly over 1 month and while the pain isn’t as present as before, it always comes back whenever I try to do anything like a squat. Thanks.
Has this resolved.. I have similar issues
I get medial knee pain on right side and I think as u said my knee goes closer to the top tube every stroke ..like it dips and left doesn't.. that is what causes the pain.. how do I rectify that
Band squats… stronger glutes?