Knee pain from cycling due to poor tracking | The significance of a biomechanical assessment
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- Опубликовано: 11 июл 2024
- A proper bike fit should always start with a biomechanical assessment off the bike to determine the movement patterns of an individual. In this week's case, this athlete was experiencing worsening right knee pain with hiking and cycling. We dwelve into the root cause of his knee pain, and perform a bike fit to help with his cycling mechanics. Changes made to his fit include medial cleat rotation, cleat wedges and a longer stem.
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Keywords: physio burnaby vancouver bike fit physiotherapy assessment physiotherapist dry needling IMS gait assessment biomechanics manual therapy IMS acupuncture exercise prescription rehabilitation
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In this case. I would advice, to mobilise the hip and ankle too. It's a big chance that your one side of the hip is rotated/stiff/tilted and your gastrocnemius muscles are stiff. I would also use lacrosse balls for the feet, because after adjusting your joint's your feet can be oversupinated. Overall, you need to asses other joints. I have done it to myself and it works a lot. Now I can have more straightforward feet. I have antreverted femurs and external tibial torsion (like this patient). Great video, good guide. After some time you can start to gradually narrowe your stance. It will not be perfectly straight but it would lessen the knee pain.
Thanks for your input Arnak! You definitely need to look at the entire kinetic chain.
Thanks for the explanation...
This thing happend to me to..
Now i will try to fix my position on the bike.. 🙏
Glad it helped
Did u used a wedge who is thicker on 1 side ? The thick part you putted onder de big toe side right? I have EXACT te same problem. I worked out my hips mobility and my strength but stïl when im on the bike i get this kneecap outside pain 》》》 Not itb
Plzzzz help me out 🙏🏻🙏🏻🙏🏻
Did you use heel wedges AND cleat wedges? Some bike fitters say to use only the heel, and others say use both.
Hello
How about having internal tibial torsion or foot turning in to have knee be straight. should canting with shims ever be towards the inside?
Thank you
Great video! Thank you. I'm experiencing knee pain when riding. I live in the Toronto area, do you have any recommendations for a cycling fit specific physiotherapist that offers similar services to you in this area? Thanks
Hey Paul, thanks for checking out the channel. Unfortunately, I don't personally know any physios in TO.
Really like all of your videos, you've really helped fine tune my fit. In this particular video, did you shim the shoe varus or vulgas??
Hey Angus, thanks for the support. I'm glad that your fit is dialed in for this upcoming season. The wedges were placed with the thick side on the inside of the shoe.
Hi EC Physio, I have the same problem. When I walk my left foot turns out more then my right does. Probable because of the leg length who is 1.3cm longer then my right. On my bike i use a 6mm shim under my shorter legt to get more symmetry on my hips in the saddle. (I always had a groin who was red frictioned) this problem is gone but now I turned my cleat so my toes point also outwards on my bike BUT.... my right isnt turned out... shoud i strive fot 2 straight feet and could the SHIM solve this problem? I have EXACT the same pattern as the stair video and when my toes point straight the knee also collapse inwards or pointed inwards... please please text me back 🙏🏻🙏🏻🙏🏻🙏🏻🙏🏻🙏🏻🙏🏻
Do you have contacts in U.S., in the D.C. area, that you'd recommend? I'd love to go to you for biomechanical assessment, but Canada is a bit of a hike!
Hey Tony, I don't have any connections to the D.C. region unfortunately. Word of mouth is generally a good way to go about finding a good professional of any trade. I would ask some of the local cycling clubs to see if there are any common names that pop up.
So you moved his cleats away from the bike to get the feet closer? So he got a narrower q-factor?
Hi Martin, I didn't adjust his stance width in this case. I rotated the cleat slightly medially (so his foot sits rotated a bit more lateral) because that's the way he likes to squat, and set up his snowboard.
I have exactly the same characteristics as this rider, and I do mean exactly... same side, same diagnosis and same king of knee pain. What kind of shoe wedge and where did you put them?
Same here. Which wedges are placed? Great video.
I cured my knee problems with this video by assessing the issue with tibial rotation. The complexity in my case was that I never took into account the fact that one of my foot is shorter than the other. It can create a hip rotation if the cleat are in the same position fore/aft, thus rotating one of my knee inside. My advice is simple GET A GOOD BIKE FIT!!
Great discussion here fellas. The thick side of the wedges would be placed facing the bike. This is to prevent the knee from caving inwards while pedaling.
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@@ecphysiotherapy8012 I mostly solved my issues with a staggered cleat placement front/back since my right foot is about 8mm shorter than the left one. As for wedges, I got 1 degree wedges on both cleats to tilts my knees outward. I use Speedplay pedals and I believe they are the best for knee pain, plus the cleats are much easier to set.
Someone recently mentioned to me that my right knee is tracking outwards by a little when cycling. I never had any problems with knee pain, back pain or any other kind of discomfort while riding. Should I just keep it this way or is it better to fix it?
Hey G L,
I would say it depends on your cycling goals. If you're able to ride your bike for the distances/intensities that you wish to without discomfort, then I would probably just leave it. Don't fix what's not broken right?
However, if you want to maximize your potential on the bike, and feel like there's still more efficiency/performance to be gained from a fit then it may be worthwhile trying to dial it in further.
Keep in mind knee tracking will never be perfect, but should be within the ballpark while riding at an 80% effort. It does change as your effort changes, and as you stand/sit.
@@ecphysiotherapy8012 thanks for your reply! Maybe I do have to look into it and get a new bike fit done (last one was 2 years ago). I’m trying to get my elite license this year so every bit of gained efficiency helps.
I do not have the feeling I’m losing a lot but that might be because I’m so used to it.
Hey G L,
Good work on progressing towards your elite license. If it's been 2 years and you've been steadily improving your fitness/flexibility/function on the bike, I think it would be worthwhile to get back in with your bike fitter and attempt to tweak/optimize. There's just much more info from someone who can look at you from another perspective. It'll likely also take some fiddling on your own as well. Good luck! let me know how it goes.