8/22*Turns out the issue was from the right leg being virtually shorter from my hip sitting higher and anteriorly rotated on that side. I tried a 3mm lift but I’m still having lowback mostly QL pain on my left side
Oldddd original post:
I have not seen an improvement in my back or knee pain after adjusting the position of my Look Keo cleats on my Shimano R310S shoes in every possible way.
I am using a 3mm leg length shim on my shorter side, my right leg is virtually shorter because my hip sits higher and anteriorly rotated so it’s not an actual leg length tib/fib femur issue. I took out my 1.5 mm valrus tilt cleats after wondering if they were ever really necessary.
I was curious if anyone has had success with this combo or has any other input regarding cleat positioning, knee pain, and shims vargus/valgus leg length etc.
I have not seen an improvement in my knee pain after adjusting the position of my Look Keo cleats on my Specialized shoes in all possible ways.
Some friends recommended that I look at the shim kits sold on http://bikefit.com and consider trying Speedplay pedals to adjust float. I know too much float can be a power robber and maybe even have an adverse effect on knee health and I’m not even sure float is an issue with the Look Keos. I just want to try the adjustibility of the Speedplays.
I was curious if anyone has had success with this combo or has any other input regarding cleat positioning, knee pain, and shims vargus/valgus leg length etc.
thanks
I’ve never had knee pain from it, but when I had my fitting a little bit ago, he found that my right knee moves in almost a figure 8 pattern. I guess my foot tilts sideways pretty severely on my left foot, so he put in shims under my cleats. Leg tracks straight, and with the fitting and the cleat adjustments, I’ve gained 2-3mph on the same effort on my cycling.
I am an Advanced BG Fitter trained with Dr Andy Pruitt and can speak from personal experience. I have a leg discrepancy in my left tibia due to numerous knee surgeries over the years. I use 4 Lewedges stacked under my SPD-SL cleat to lift up my foot. Having raced for a number of years, I always carried a wrench with me and made saddle adjustments due to my hip rocking. As to the varus/valgus shim issue. Cycling is a forefoot activity in relation to running being heel and midfoot primarily. So by correcting the angle by which you forefoot connects to the pedal this gives a much more stable platform. If you watch your knees when you pedal you either have a perfect straight up and down action or a woodchopper action or an action looking like you are trying to rub the paint off the top tube, adding shims corrects the latter two. Fit is all about aligning the whole body on the bike.
I’ve research Dr. Pruitt’s work extensively and was impressed by the article/video on (velonews? forgot) It’s been a dream of mine to fly out to you guys and get the whole fit package. I am doing what I can on my own though and researching what shims, foot beds, and cleats I can try. The Veterans Affairs health network isn’t the best in the world but the physical therapy has been helping a little. After two years of serious riding and racing it pains me to say that I’m still not comfortable on the saddle, although John Cobb has helped me tremondously in the last week and the sugestions he made regarding my fit have helped at least 40%, I can almost see the light.
Few questions for you is …
Are your specialized shoes new and do they feature the BG thing?
How are you knees tracking?
Where is the pain in the knee?
When did this happen, any changes in equipment?
Were you comfortable and pain free before on a Look pedal?
Posterior lateral aspect of right knee. I’ve demonstrated weaker adduction on the cable machine with my right leg and less flexibility such as placing the lateral aspect of my right ankle on top of my left knee when sitting.
do yourself a favor and invest $200 in a GOOD bike fit. Spend a few weeks to a month researching reputable bike fitters and then pull the trigger. This $200 will repay you for a lifetime of cycling.
Like many others, I have a leg length discrepancy and used to have knee pain until I combined LeWedge w/ a proper bike fitter who got my legs and knees to track straight up and down using the wedges and proper cleat alignment, seat height, and seat fore/aft positioning. Best money I ever spent.
Trust me, it will be the best $$ you ever spend.
Also, other comments about shoe sizing and pedal type are good, but they should be secondary to the bike fit.
How are you knees tracking?
My right knee seems to want to come towards the top tude near the top of the stroke
Where is the pain in the knee?
Posterior lateral aspect, kind of a dull then crisp clicking/sliding sensation
When did this happen, any changes in equipment?
I think it happened around the same time I finally bought a mountain bike with shimano shoes and the little spd pedals/cleats.
Were you comfortable and pain free before on a Look pedal?
Pain free yes but never comfortable. Always felt inefficient like knee was being forced into an inefficient position.
I can’t trial and error combos of cleats and pedals $$$
I could go use that proprietary computer system in Oceanside with the booth you stand in and the laser levels or use some local retul guy who doesn’t have video capturing equipment, retul what us statisticians call data diarrhea. I could go to Nytro, Trek, B&L where some of the guys have more than one certification: specialized BG, Serrota, F.I.S.T etc. and each guy in the store would fit me differently and have different opinions about everything.
I’m through playing that game, I’ve been “eyeballed” too many times. I want a sports physiologist, someone who truly understands biomechanics and cycling economy.
At this point it seems like my only choice is to go see Dr. Pruitt or maybe John Howard.
Osteotomy
Osteotomy may be appropriate if you are younger than 60 years, active, or overweight. There must also be uneven damage to the joint, correctable deformity, and no inflammation. The surgeon reshapes the shinbone (tibia) or thighbone (femur) to improve your knee’s alignment. The healthy bone and cartilage is realigned to compensate for the damaged tissue. Knee osteotomy surgically repositions the joint, realigning the mechanical axis of the limb away from the diseased area. This lets your knee glide freely and carry weight evenly on a more normal compartment. Proximal tibial valgus osteotomy treats arthritis of the medial compartment, correcting a knee that angles inward (varus deformity). Distal femoral varus osteotomy treats arthritis of the lateral compartment, correcting a knee that angles outward (valgus deformity).
The doctor may use one of several techniques to hold the joint in place (immobilization with a cast, staples, or internal plate devices).
Osteotomy relieves pain and may delay the progression of osteoarthritis. Cosmetically, the knee may not look symmetrical after osteotomy. There is a chance you will eventually need total knee replacement (arthroplasty), which can be a more technically challenging procedure after you’ve had an osteotomy. Infections and other complications are possible. Depending on how quickly you heal, you will need to walk with crutches for 1 to 3 months. After that rehabilitative leg strengthening and walking exercises are started. You may be able to resume your full activities after 3 to 6 months.
Yea its pretty intense. I’m 45. I had a knee scope December '07. My lateral compartment collapsed training for IMC last summer (did the race anyway.) This caused my slight valgus to increase to around 11%. Now I have the triple wammy - valgus, osteoarthritis and almost no lateral meniscus. In addition to the osteotomy I will have a cadaver meniscus transplant and a cadaver cartilage plug in the same operation. I can ride with relatively little pain but running is out and even swimmming hurts if I kick. Scheduling the surgery for late summer. That will give me time to strengthen my leg (and enjoy the summer and cycle) before the surgery.
I’m going for a professional fitting later today. I will let you know what they do with the valgus.
I’ve been using LeWedges cuz my knees would hit my top tube on the downstroke. I didn’t have problem with my knees, it was my left hip that got sore after about 50 miles.
I had a bike fitter work with me on it the first time. When I changed shoes I bought new shims for them. I set a video camera in front of my bike on a trainer and recorded my pedaling for a few minutes.
When I played the tape back on the TV I put a straight edge along the path my knees took so I could see if they were still wobbling. If they were I added more wedge. I needed the thicker part on the inside (big toe side)
I have used the old Look and Keo pedals on Sidi T1’s and T2.6
I’m using LeWedge’s with Speedplays. No knee issues.
Here is what Dan wrote a bunch of years ago about LeWedge.
This is much bigger than people think., Huge actually. Dan is right. Good fitters spend a considerable amount of time sorting this out. Think about it - This is the power connection to the bike. It’s a critical point of contact that most never really think about. Getting the LeWedges and having them properly set-up if you need them, could be the BEST $20 you ever spent on bike gear!!! Seriously.
I am always surprised that this does not get more coverage.
