In early March, I started to ride outdoors in preparation for my cycling team‘s training camp in Southern Illinois. After 2 days of outdoor riding on my road bike, which had been idle all winter, I started developing pain above my kneecap (Quadriceps Tendon). I was a bit surprised because I had not changed my road bike setup, whereas I had been tweaking my TT bike quite a bit. I started to make some of the same adjustments to the road bike as I had to the TT bike but this made the situation worse or at least had not helped it.
In researching Quadriceps Tendonitis and cycling all I found was that it is due to a poor bike fit but no one seemed to state what to adjust. It seems to be well known that if you have knee pain below the kneecap that means your seat is too low and if you have pain anterior (back of) the knee it means your seat is too high.
In my last indoor TT race of the season the tendon really hurt and was no better in my class the next day. This was not looking good for my training camp where we climb 10,000+ ft over the 3 days. Upon advice from several folks I decided to cancel the training camp and stayed off both bikes for over 2 weeks.
When I got back to the bike, I rode the TT bike very lightly, high cadence and low power output. Everything seemed better: I would feel the pain only slightly and for short periods of time. I decided to get a bike fitting and went to the LBS that sponsors our team. Matt worked with me on both bikes, lowering my seat and moving them forward a bit. This did help out quite a bit. I was now at least riding my TT bike w/o any more issues but when I took the road bike out there was still knee pain.
I was still not quite sure if the issue was riding outside or riding the road bike so I had to put the road bike on my trainer and lo and behold I felt some tendon pain. This was at least a breakthrough that the road bike was the source of my pain. I still didn’t understand why this was happening as I had been riding the same bike setup all last year. Time to call in serious help. I looked around for highly recommended bike fitters and contacted Wheel Werks and the University of Wisconsin Madison.
Bob from Wheel Werks called me back and we talked about my situation and set up an appointment. I drove up to Crystal Lake on an early Wednesday morning with bike loaded up and met Bob; he is a very personable guy. He had me fill out a history / survey form covering what issues I have been having, followed by some strength and flexibility moves.
We then looked at the bike and found the derailleur hanger bent again (this happens all the time) probably when I loaded the bike in the car. After fixing the derailleur, we put the bike on the fitting rig. Bob uses the Retul system. I started to pedal to warm up and Bob’s first comment was about how smoothly I pedal. I was a bit (pleasantly) surprised because others had mentioned I need to work on pulling up more. I guess I have been successful in using more of the pedal stroke.
Bob went through and tweaked quite a few different settings. It kinda felt like an eye exam: “Which is better, 1 or 2?” He thought that I was being pushed too far forward due to my extreme downward pitch on my saddle. He also noticed that the angle of my feet were pointed down as I was pedaling. So after a slew of changes we arrived at a setup we both were comfortable with (pun intended). I note the measured angle of my saddle is still out of UCI specs at -11 degrees.
In addition to flatting my saddle angle, Bob pushed the seat forward, lowered the height, put shims under my cleats, moved the left cleat forward a bit (both had been slammed back and outward as much as possible), lowered the handle bar, raised and toed-in the hoods.
Since the bike fitting I have been able to ride (mostly) pain free for hundreds of miles on both my road and TT bikes and I am making up for lost time and miles. I plan on getting a fit for the TT bike but probably at the end if this season. I have spent too much money on the bikes already.
I think the answer to what changes are needed for Quadriceps Tendonitis pain from cycling (and why I am writing this post) for me was to relieve the pressure put on my feet by falling forward. Hopefully this will help others but Y[B]MMV 🙂