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For the Physio's

Mar 18, 2009
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First, I'm a former client of Dario's and really enjoy the advise on the site. I purchased a custom road bike last year which I had designed after several fittings. I love the bike and I feel very comfortable on it. I have a separate road bike that I use on my trainer. When I train outdoors on the custom bike I feel great. However, when I train indoors on the trainer bike I get hip and knee pain. I've copied the exact dimensions of my custom bike and set up the trainer bike the same (seat height, crank length, ect.) Still, I get the pain when I switch bikes. Am I missing something?

Thanks,
Jason Lane
 
hip and knee pain

Hi,
There are many reasons why you may be getting hip and knee pain on a training bike (with identical dimensions) used on an indoor trainer. The pedal forces (at different stages of rotation) measured on an indoor trainer differ significantly from those measured while out on the road. This load also varies according to the brand and mechanism of resistance (for example air, magnetic, or hydraulic).

With the the information given, it is speculation to come up with one or more contributing factors to your hip and knee pain. However, I can suggest some possible scenarios. I am assuming that pedals, shoes, saddle (and age of saddle), handlebars, BB width etc are identical.

1) Your warm-up on the trainer may be different to that of your road bike. Most people do a shorter, higher intensity warm-up on a trainer relative to the road bike. Try to approximate the same warm-up, and note any changes to your hip or knee pain.

2) If you have a heart rate monitor, compare the intensity and duration of workouts on the trainer relative to the road bike. A power monitor would be ideal but these are less common than heart rate monitors. You may be surprised at the difference. If you do more 'quality' efforts on the trainer, which is usual, you may for instance be exceeding the capacity of your vastus medialis to repeatedly control the movement of your patella during extension (straightening) and therefore develop patello-femoral pain syndrome (or sore knees). Hip pain at higher intensities may be due to aggravation of the sciatic nerve or simply lactic acidosis and failing contraction/ischaemia. As I said before these are just possibilities.

My recomendations would be to see a local physiotherapist who has a passion for cycling, and to try to reproduce the same warm-up on the trainer as you do on the road bike. This would include getting off the bike for a stretch after 15 minutes if this is what you do on the road bike. Remember that out on the road you are often getting out of the saddle for long hills, pot holes, sprints, traffic lights etc, and these regular changes of position alter muscle usage patterns and intensity and reduce fatigue. As a generalisation, indoor training sessions are usually shorter, sharper, and (barring discomfort that you describe) also give you a greater training response for the time allocated.

The fact that you are pain free on the road bike is very reassuring and it is less likely that there are serious issues. It is more likely to be a case of carefully comparing your activity on the bikes.

My qualifications are undergraduate exercise physiology and physiotherapy degrees, masters in pain management, and medical student (and 10 years in bike shops). Raced at track nationals (without merit) and a couple of top ten national road results.
 
Mar 19, 2009
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i'm no physio but...

the engineer in me has some 'fault finding' questions/suggestions in the order I'd try them.:

1. You say the road bike was custom made for you after several fittings- what's custom about it? I would have thought your custom made bike would be different to your training bike - otherwise you wouldn't have had one made up?

2. Do you have the same issues when you take the trainer bike out on the road? If yes - then you can eliminate the trainer and put it down to the bike set-up combo - if no then the trainer plays a part.

3. If yes for 2 then ensure you eliminate all possibly variances between your road bike and your trainer bike set-up/combo? Same shoes/cleats/saddle/clothing (padded shorts the same thickness) (revisit 1 again if need be?)

If you still can't fix it - try getting a bike shop fitting on your trainer bike to see if they pick up something you missed.

4. If 2 gave you a No then try putting your road bike on the trainer - if you have problems then it's most likely how you ride on the trainer (i.e. is it level, warming up correctly, too high a gear, etc etc)

give all that a go and update the forum coz if you still have problems I'm sure the physio's here will have a greater chance of helping you.

Good luck!