Knee Pain - Inner/Medial

[Chubba]

Hi Guys,

Any of you experiencing inner knee pain from your e-bikes. I have had a set up, but on steep climbs in granny gear on Eco (Spesh Levo 25% assist), i get serious knee pain. Just seems like the weight of the bike and cadence is an issue. On a normal cycle i was able to spin at high cadence up big climbs, cant seem to get the same feel on the ebike and i don't want to lose the fitness aspect by increasing assistance?

Example of ride yesterday: 37km/1200m cadence 74rpm

Thanks for the input.

 

[Al Boneta]

Hi Guys,

Any of you experiencing inner knee pain from your e-bikes. I have had a set up, but on steep climbs in granny gear on Eco (Spesh Levo 25% assist), i get serious knee pain. Just seems like the weight of the bike and cadence is an issue. On a normal cycle i was able to spin at high cadence up big climbs, cant seem to get the same feel on the ebike and i don't want to lose the fitness aspect by increasing assistance?

Example of ride yesterday: 37km/1200m cadence 74rpm

Thanks for the input.

I don’t wish to give offense or come off like a prick (just this one time)
Maybe you should consult your General Practitioner or an Orthopedist instead of an Emtb forum full of guys who aren’t those things I mentioned earlier

 

[Chubba]

I don’t wish to give offense or come off like a prick (just this one time)
Maybe you should consult your General Practitioner or an Orthopedist instead of an Emtb forum full of guys who aren’t those things I mentioned earlier

Thanks for that, but this isn't a medical issue, its a bike/physiology mechanics issue. I go to doctors for more important issues.

 

[outerlimits]

You are using your muscles more at a low cadence than at a high cadence. So effectively you are putting more load on your legs. So yeah, it could be a medical condition causing the pain as you loading your legs differently.
I have a tear in my medial miniscus that occasionally gives me grief. Especially when I do longer low cadence up hills. If I’m spinning faster then I don’t have a problem.
The Levo gives the most torque at 80-90 rpm.

 

[mark.ai]

Few things come to mind (useful or not!):
1) Try adjusting position of your saddle slightly forwards/backwards or up/down. It may have been set up by a specialist, but could be different from your previous bike (which your knees were used to). The ideal position is supposed to be: foot on pedal, with crank arm in forward horizontal position, and plumb line from knee will go down through spindle of pedal.
2) When you are going up hill this completely changes the "ideal" position from (1) above due to the angle of the slope ...
3) Higher cadence as mentioned by you and others sounds better and easier on the knees - try switching down to a lower gear until you achieve that.
4) Different pedals, shoes and foot position could make a difference too if they have changed since your previous bike.

 

[KennyB]

STOP
I had this late 90s in my racing days on a practice lap. Stupidly raced and tore the cartilage. A few months to wait for surgery, two pieces of cartilage the size of little finger taken out. Six weeks intense physio later and back to racing.

 

[lumpy]

Check your bike fit. The saddle is probably too low or too far back - or both

 

[Jeff McD]

As a sports medicine doctor I would tell you honestly that before I went to the doctor I would have a friend who is a very knowledgeable cyclist check your set up on the bike. As mentioned, you could be riding with your saddle too low because you feel safer, but this grinds the knee surfaces against your patella or with the saddle too far forward or backwards or even with your saddle too high. One tip would be to try angling the foot of the painful leg outwards slightly duck foot and I mean very slightly at first to see if this eases the pain. This will shift the weight off the medial compartment of the knee and more onto the lateral compartment.
You didn’t tell us how old you are and if you are getting up there in age you could have some arthritis in the medial compartment of the knee Which you could inflame if you’re grinding too big a gear up the hill. 74 RPM is not spinning. You really need to be up closer to 90 RPM when you’re climbing hills in an easier gear to save your knees. If you are already in your easiest gear you need to consider changing your cassette to add another easier gear as I did, changing out the stock 10-42 to the Shimano 11-46. That gave me one easier gear which is perfect for the steep steep hills it was not very expensive .
If you’re riding clipless pedals where are your foot is forced to rotate inwards too much you will tweak the MCL and get that inflamed as well. Riding flats would fix this.
If the pain persists in spite of these things then you just got to get an x-ray at your doctors office and take it from there. Also if you go to a sports medicine physician they’re a little bit more educated at doing a thorough knee exam to pinpoint exactly what structure is involved in the affected knee which can spare you the cost of additional expensive tests sometimes . Good luck with it.

 

[steve_sordy]

@Chubba I had knee pain and eventually it forced me onto an emtb. Thank God I made that choice! Now I do longer rides and more frequently, all without knee pain. Stop torturing yourself by refusing to use the higher power modes. Give your knees a rest and maybe they will start to repair themselves, like mine appear to be doing!

PS: Be sure to follow the advice in previous posts about bike set up and cadence etc. If you can't bring yourself to see your GP, go see a physio! You know it makes sense!

 

[Mikerb]

Best bike fit is the one that makes you feel the most comfortable...on a mtb you adopt at least 5 different riding positions anyway and will be ( should be) constantly moving around on the bike, so a bike "fit" is not very useful! There is no need to put any strain on your body doing a climb on an EMTB...that what the motor is for! Save your energy for the downhill fun bit.

 

[Aragaiki]

I suffered severe knee pain when I changed to eMTB, basically the pedal position was too aggressive, due to of the steepest seat angle, 77 degrees, of my Kenevo. I did a bike fit and the conclusion was to change the dropper post to one with 25 mm offset and increase the height of the seat 10 mm more than my regular position. Luckily, after these changes pain disappeared.

 

[Myalteregohamish]

@Chubba I had knee pain and eventually it forced me onto an emtb. Thank God I made that choice! Now I do longer rides and more frequently, all without knee pain. Stop torturing yourself by refusing to use the higher power modes. Give your knees a rest and maybe they will start to repair themselves, like mine appear to be doing!

PS: Be sure to follow the advice in previous posts about bike set up and cadence etc. If you can't bring yourself to see your GP, go see a physio! You know it makes sense!

I completely agree with Steve. I too had knee pain as a result of pushing hard on slow cadence climbs. After switching over to an EMTB, and riding at a higher cadence (80-95rpm) in a lower gear, virtually all pain has disappeared from the knee cap area. It is allowed my knees to fully recover both on and off the bike. An additional benefit is I am able to turn a higher wattage output longer at a higher cadence.

 

[steve_sordy]

I also use Volterol gel 2.32% (it's Diclofenac something or other). Rub a thumbnail sized lump on to the knee joint half an hour before riding. It's expensive but sooooo worth it. A tube lasts for ages because you don't need much. The 2.32% is for joints. They also make a half strength one for muscle pain., which I didn't find much use on the joints.

 

[Mikerb]

Interesting that some should get knee pain specifically from riding an eMTB. The biggest differences from an MTB are likely to be Q factor, and crank length plus a tendency to do more pedalling in a seated position than might be the case on a MTB. The answer to that final factor is to use a higher cadency. Q factor can be changed by using wider pedals, fitting pedal washers or ( in effect) by changing to a wider format of pedal.

 

[Myalteregohamish]

Yeah, I wish I could comment on the Q factor. I don’t know much about it other than what you’ve described above. I will say this, though my knee is starting, but started bothering me about five years ago on aciustic mountain bikes. Because there was no assist when you got super steep, climbs my cadence, would slow down to 60 or so. I think between that and the amount of pressure I was putting on the crank arm was causing the issue. Electric mountain bikes have actually lessen the effect by providing assistance allowing me to use a more comfortable cadence around 90. So for me, with the proper seating position and an electric mountain bike, have actually solved the problem.

 

[Mikerb]

well I am no expert on Q factor either but it strikes me that the same Q factor cannot be right for a range of people all with different hip widths and tendencies for their feet to pronate or not. Maybe some indications can be determined by whether your crank arms are polished clean by the inside of your feet yet that is resolved by using a pedal with greater width? That would suggest the natural position for your feet was indeed in need of more spread.
I recently changed cranks on a bike from 165 to 155........fitted pedal washers and larger platform pedals. I had previously started to get pain on the inner side of my left knee. That disappeared after the change of cranks and pedals ( no science applied and the changes were done for reasons other than the knee pain)