Have had knee pain for a while. Bit the bullet and had a sizing done with RETUL measuring. Everything look good except found my lateral knee movement was 52mm, right and 39mm left. Trying a bunch of things with fitter was able to reduce to 39mm and 31mm.
It appears this is most likely what is causing my knee issue. I now want to improve this. I first need to see if my sports doc will be able to help with just understanding what the issue is. But I also would like to hear thoughts on the forum on things to improve this issue. I do realize everyone is different and what might help one person might make it worst for someone else. I was looking for:
Is it caused by flexibility? Or something my ART guy could help with?
Muscle weakness? So something that PT can help with?
Any other insight. Can’t imagine I am the only one with this
My fitter tried some different insoles but it seemed to make it worst. We ultimately tried a stiffer sole shoe which did help some. Plus I also tightened my shoe a lot more which also seem to help.
I understand forcing the foot in a certain way can help the knee behave but I would also like to learn more about what can be done to just get the knee to behave properly.
BTW, when just standing the fitter indicated that my knee was fine in its alignment. He used a device that I stood into and a laser to check alignment. He indicated that a lot of triathletes will have running screw this up over time but not an issue for me.
Also curious if anyone has RETUL numbers for this that they are willing to share. I searched the Internet for RETUL reports and the ones I found had Craig Alexander with a later knee movement of 20mm and a couple of other reports without names with numbers from 16 - 24. From this very small sample it would look like my numbers are really out of the norm.
I have terrible knee tracking too (although knock on wood no knee problems). I have found that one-leg drills on the trainer help enormously, I like to do 10x30" alternating. They will also help flatten out your dead spot at 11-1. You could also try wedges - I haven’t but I know of lots who have found they help with tracking and knee issues.
I think the best thing is to try and figure out why the problem is occuring. I had some lack of flexibility in my SI joint that a chiro helped me with. This was years ago, and I don’t know if it’s come back–haven’t been to a fitter in a long time.
Hard to know where the problem starts, I think.
I also use wedges FWIW.
If I understand what external rotation is I think the answer is yes.
Basically when I pedal my knee from an external view tracks in and out. So if you sat in front of me when pedaling on a trainer and put a dot on my skin where my knee cap is and then took looked at the dot when I pedaled the dot would move right and left. Measured on the RETUL it moved a total of 52mm from the most left position to the most right position.
Nothing is conclusive but it would seem that this lateral movement is what is causing my knee pain. So I am working on reducing the amount. I am down to 31mm and 39mm, left leg versus right leg. Which is an improvement but I would like to try to get it down a little more.
My fitter switched me to a carbon sole shoe with a pretty minimal insole which has been the biggest reason for the improvement so far. I also put my shoe on a lot tighter. My existing shoes had a lot of flex.
My right knee was tracking outward a bit when I went in for my fitting at elite. Dave Greenfield did some magic readjustments on me and during fitting tried lots of different positions and wedges in my cycling shoes. It was a 9-5 process and I also have had to work at it also to keep form but it is almost nada now.
Has there been any talk of or attention to your q-factor? Knee tracking is not all that complex. The angle of the foot and the width of the pedals are the usual suspects.
Where do yuo feel pressure on your foot/pedal interface area as you apply force? Outside, inside, equally across the foot? Does it stay constant or does the foot seem to collapse inwards (or outwards)?
Is your knee tracking in as you apply force on the downstroke and coming back out on the upstroke? Or opposite of this?
Sounds like your fitter may be throwing darts in the dark, which is not the way to address knee pain.
Find someone that understands cleat position and wedges to help you. Just because someone uses Retul does not mean that they understand this. As others have said cleat fore and aft, foot width and even wedges can help dial in the knee tracking.
I now use Shimano SPD pedals. I have tried Keywin and Speedplay before did not measure lateral knee with the other pedals. With SpeedPlay I found it really hard to get out of them. But it now seems obvious that the flex in my shoes was causing disengaging dificulty. Because now with the carbon shoes I am disengaging too easily with the SPDs. I will have to adjust them.
The fitter I was using with the RETUL seem to really understand insoles, wedges, etc. But we flew in my 3.5 hour session and still ran out of time to try other things such as other pedals, etc.
Now the issue seems apparent I will need to figure out where I go from here. We did not play with Q-factor at all during RETUL fitting. My KeyWin pedals do have a smaller Q-factor. I brought different pedals with me but all of this stuff really takes time.
I would really like to play more with it on my own.
If you were using Speedplay I would suggest buying some aftermarket pedal extenders and see if that helps. If it does, and you don’t mind going back to Speedplay, you can keep the extenders or get really fancy and buy longer spindles from Speedplay.
But we flew in my 3.5 hour session and still ran out of time to try other things such as other pedals, etc.
Now the issue seems apparent I will need to figure out where I go from here.
It could have been Cobb, Empfield, Steinmetz or Greenfield fitting you, doesn’t really matter. If there is an issue (knee pain) that could potentially cause an injury (yes) and is caused by a common symptom (knee tracking), THAT is the first and perhaps only thing you guys should have been addressing in your fitting. No need to get aero, comfortable or powerful if there is a good chance of a knee injury ending your ability to ride.
#1 - Ride without inury #2 - Everything else
Where to go from here is back to the fitter and have them finish the job. There is no reason for you to be fiddling with this on your own if you just paid for a bike fit.
Dave totally agree. My first and only objective right now is to get my knees to settle down. I really want to get my lateral tracking under 30mm knees or maybe even under 25mm.
Apologize for not answering your questions sooner.
I went through a session on the RETUL last week-end and I did not think about it. It was not until riding one night this week thinking about q-factor it dawned on me. So now I am anxious to have another session to see if I can effect the results by modifying how I pedal.
But I also wanted to be really prepared to make as much progress as possible in as short of a time as possible when I am there. So I will be asking my fitter what I need to bring so we can try different things quickly.
While you were getting fit, were you able to reduce/eliminate the lateral movement by changing the pattern of the movement?
I had a bike fit with Paraic McGlynn this week at the Faster Performance studio in Scottsdale, AZ. I had heard from other people that my knees looked like they were moving around a lot when they were riding behind me. I have had some chronic hip/back problems since getting into the sport in 2009.
With Paraic’s high-speed high-definition cameras turned on, we were able to track my knee movement with hyper detail. We calculated my knees were doing over 23 kilometers of wasted lateral movement over the course of an Ironman distance race!! 23kilometers!!!
We made some drastic changes to my position and my knees are tracking pretty nicely now. We cut knee tracking by about 70% and we hope to cut the rest with custom cycling orthotics, shorter crank, and narrower pedals…