middle-aged knee pain

Hi everyone,
I am struggling with an aching right knee which seems to be getting
worse. It doesn’t hurt while I’m riding, but it aches quite a bit after I
stop. It feels puffy and swollen when I bend it, even though I can’t see
any swelling. It’s been a little sore for several months, but now it’s bad
enough I’m resting it for a while. It hurts to squat or do any side
movement. It doesn’t particularly hurt going up or down stairs, but more
if I bend it a lot.
For background, I’m a 50-something female Level 1 rider, and I’ve been
riding 6-8 miles three times a week for the last couple of years. I ride
on bike paths which have some bumps, and ride a 24" Miyata with 4" (102mm?)
cranks. I am a very conservative rider, because I hate getting
hurt. Twice in the last year I’ve fallen hard on my chest and
bruised/cracked ribs and had major pain for 4-6 weeks. Because I’m afraid
of getting hurt, I think I’m riding with my seat a little lower than I
should because it gives me a little more control when things are
bumpy. But not grossly low–maybe just an inch. Could this put extra
stress on my knee? I ride on my instep rather than the ball of my foot,
because that feels more secure.
Has anyone else had a chronic knee problem like this? Does anyone have
any suggestions? Scott says I should go to the doctor, which is probably a
good idea. But I thought I would ask here for ideas first.

BTW, I know it’s probably stupid to ride a 24" that far, but I’m a little
person and big wheels are big. I can’t ever imagine having the courage to
freemount one. Scott did give me a 26" for Christmas (shades of Jackie
Foss’ “How to Tell if You are a Unicycling Widow”) and I like how smooth it
is. But it’s not real practical if i can’t freemount it. And I’m really
afraid of falling on it, since it is higher and I’d probably be going faster.

On the positive side, Scott started a unicycling class at our church this
year, and we’ve had a gym to ride in all winter (first time ever!) and have
taught some people to ride. I’ve had a chance to practice on my 20" and
have hopes of getting my Obstacle Course time at NAUCC under 60
seconds. (Don’t laugh–that would be a major improvement.) And maybe I
can even stay on the Forward Slow board…I’m glad there is room in the
unicycling world for cautious and careful riders like me…

Take care,

Jody Arnold in Springfield OR

Hi Jody!

That is great that you are putting in that kind of mileage. The seat height can certainly have an effect on knee pain. Sometimes very small adjustments can make a big difference. Try raising it in 1/4" increments to slowly get used to the change and see if it helps.
Since my knee surgery, I have had a little trouble with patellar pain and I think that is often what people have when they have knee pain not resulting from a specific injury. If that is what you have, the number one thing to relive the pain is massage. Moving the kneecap side to side and massaging the areas around it can work wonders. One visit with a PT and they can show you how to do it. There are also elastic sleeves made specifically to reposition the kneecap to correct patellar tracking problems. The point is, there are non-surgical fixes for some knee problems so go to a good knee doctor and see what they say.

Good luck and keep up the riding if you can!

Say high to Scott for me. Will we see you guys at Santa Barbara this year?

Scott Wallis

It’s not uncommon for “knee pain” to actually result from some other correctable problem.

Foot plant or placement, for example, could cause your knees to hurt. Tight leg muscles can also cause your knees to hurt.

Make sure you are not turning your foot on the pedal for some reason (e.g., to avoid hitting your ankles on the crank). Find a natural foot placement.

Also, make sure you do some stretching of your ankles (sides and achilles), calves, quads and hams – especially the sides of your lower legs and your quads. Tight quads are really hard on your knees. Also, tight iliotibial bands are a common problem. Easy to stretch.

Stretching is that ounce of prevention!

Good luck.

Re: middle-aged knee pain

Knee pain can be due to a lot of different causes. It can be from
overuse, bad form, inherent weekness, previous injury, etc. Or a
combination.

In general, raising the saddle (within limits of reasonability) will
make riding easier on your knees. But it also depends on how you
ride: my knees get sore more easily doing freestyle skills with a high
seat position than when I ride MUni with a much lower seat.

I had good luck recently seeking help from a sports medecine knee
specialist. My pain is due to a tendency to twist my knee inward
when, for example, landing on it or riding one-footed. This forces
the kneecap to move sideways and scrape on a sharp edge of bone that
it shouldn’t be near. The cure is rest (allowing the cartilege to
recover), exercises that help stabilize the knee, and just thinking
about how to keep good form.

Anyway, since your pain probably has a different cause and since
nobody can accurately diagnose something as complicated as knee pain
in a forum like this, I recommend finding the best knee doctor you can
and having the problem checked out. Sometimes you can find out who
treats local sports teams, ballet dancers, etc.

Good luck!

Ken

Re: middle-aged knee pain

Maybe you should try a longer crank; maybe 5" (125mm) or even 6".

This would give you more control which, given the falls you’ve described, I think would be useful.

I’m not sure what direct effect on your knees longer cranks would have- some would argue that the bigger turning circle would result in more knee stress, but my feelings are that longer cranks will mean more control and therefore less sudden (and possibly knee damaging) emergency corrections, plus giving greater leverage and therefore less stress.

Only way to find out is to try with longer cranks.

My 38 year old knees are not perfect, and I occasionally get pain (though not to the extent that you do), and I feel that using 6" cranks on my 29-er is better for my kness than the 5" ones I used to use.