Head, shoulders, knee and toes

Head, shoulders, knee and toes. Sound off to you? There is a minefield of possible culprits causing knee pain on the bike. One wrong move, you’ll cause an explosion of further problems. But, take the right approach, and you could be back to pedalling in no time.

The TT. Twang and twinge. Vocabulary that can all too often turn into a more serious TT. The Torn and Tear. Either way, TT’s are classic in the sporting injury descriptions. Luckily, (or unluckily) I’ve elicited the former. A slow and gradual twinge with several twangs of pain forced an early end to my ride. Having sulked, had a tantrum, got on and off the turbo several times over, and checked the bank account, I arrived at a conclusion. A rest and SELF-diagnosis were needed. However, the level of information surrounding the injury was in fact more overwhelming than the price of a physio. We all know typing any symptoms into the internet can result in a somewhat questionable diagnosis. “Side knee pain” in fact means you just have a severe case of thrush. “Itchy vagina” just means your head needs to be amputated. Possibly a slight exaggeration but you get the picture.

Trawling through the unending stream of biomechanical jargon, you can break down knee pain in cycling to just a few factors. To save you a few years of life, here is a condensed version of the information.

Disclaimer: I have no qualifications as a physio, but I have helped treat a few dogs for arthritis and a couple of cat castrations.

The table, although very sparse, did help me to break it all down. Initially, IT band syndrome seemed to be the glaringly obvious culprit. The general gist was that the IT band syndrome came about from poor bike fit or overuse. It would have meant 2 weeks off the bike possibly rising to 4 if the pain didn’t go. Poor bike fit didn’t really add up. Riding for almost a year without an issue then suddenly TWANG. Despite this, I became a fiddler. 30 videos later, a slight angle change there, a touch to the centre here, test on the bike, repeat. It was about as painful as watching Jumbo Visma dropping Sepp Kuss... It went on and on. Finally, it felt “right”. Tentatively setting off down the road, I pulled upwards. No pain. Out of the saddle? No pain. 60km? No pain! Even the monsoon belting down wasn’t enough to rain on my parade.

To those new to cycling, hitting the panic button immediately assuming that full leg amputation is the only viable option for a twang or twinge of the knee, it’s not. It’s not as simple as just buying cleats, clipping in and pedalling. Marginal changes can have drastic consequences. Don’t do what I did and ride for almost a year without so much as a sniff at the bottom of my shoes.

1) Get on YouTube and take your time! It will take a while to get your head around the cleat orientation. It may seem very Australian at first, but it's worth making small changes, testing and repeating. It may be tyresome, but better that than blowing the G Ma’s inheritance on physio bills.

2) Ask a friend or local bike shop to help out, someone who is a bit more clued up on the cycling front.

3) If that still isn’t floating your cleat and you have money to burn, head down to a bike fitter.

All the best and hopefully you’ll never have to remove any plurals from head, shoulders, knees and toes.

References:

1. BikeRadar (2022) Why do my knees hurt? cycling knee pain explained and how to manage it, BikeRadar. Available at:

https://www.bikeradar.com/advice/fitness-and-training/cycling-knee-pain-the-problem- areas/ (Accessed: 21 November 2023).