Knee pain & mountain biking

Mountain biking has caused me on-going knee problems for several years now. It has caused me to question everything about my biking activities:

• road bike versus mountain bike
• bike fit
• frame size
• saddle height
• saddle position on seat post
• type and softness of the saddle
• style and fit of bike shoe
• type of peddle
• style and fit of bike shorts
• gear ratios
• gear cadence/rpm of peddling
• type of rides- steep, grinding climbs; mild, easier climbs; rolling terrain; cross-country; all downhill.
• how often to ride
• temperatures to ride in
• length of rides

Knee issues have also prompted me to stop mountain biking and road cycling all together for extended periods of time, up to a year. 

My primary frustration in trying to figure out the solution is that my discussions with highly trained Orthopedic Surgeons (my Father was one) has left me almost as confused as attempts at self diagnosis online.

Online research, including internet forums, leaves you with the idea that your knee problems are coming from some sort of short-term bike fit inefficiency or poor training methods. Younger doctors will stray toward this opinion as well. Whereas Old-School Doctors like my Dad would focus on long-term wear and tear over many years. One side has a more popular solution and the other has unpopular reality.

A wise person, as I try to be, will attempt to put the two perspectives together: I have been cycling for many years, which is going to cause long term wear and tear on my knee joints, ligaments, cartilage, and muscles. NO MATTER how properly my bike was fit or how healthy my riding technique. But having said that, it is a fact that bike fit and technique will undoubtedly determine the severity of that wear and tear. Another reality that every aging cyclist needs to accept is that youth masks a whole lot of future cycling problems.

So what is causing your knee problems and how to fix them?

The knee is the most common location for overuse injuries. It's most likely your knee problems are chronic -caused by long-term wear and tear / overuse- . It's unlikely you're going to be able to entirely fix the problem in the long-term, but it's perfectly reasonable to think you can deal with the problem in a way that allows you to continue cycling.

So, as a chronic knee pain sufferer, I offer this opinion: you're not getting any younger so you need to try harder to be a better cyclist:

• Do not carry extra weight. Lose weight.
• Make sure your bike is sized and fit properly. Don't guess. If you can't figure it out get a professional bike fit.
• Go slow at the beginning of the mountain bike / road cycling season. It's gonna take you a month of abbreviated, short, unsatisfying rides and more days off than you like in order to get back in mountain biking shape. 
• Cut back on epic long rides and avoid grinding climbs. If you live in or near a ski town that shuttles bikes up the mountain with chairlifts or has a bus that goes up the mountain take advantage and do more rolling terrain rides starting from the middle or top of the mountain. I swore forever I would never do this, cheat, but I've learned it ain't cheating to do what makes your body work and feel better.
• Be a seasonal cyclist. 
• Lastly, consider finding another sport that makes you happy. There are lots of options that you might like a lot better. Having to quit cycling isn't the worst thing in the World.

To conclude my post, I will offer my strongest opinion: your problems are caused by overuse and your seat is too low...