Can you help me solve this cycling-induced Pain?

(3 discussions)

Off and on all season I have been getting a pain in a location I’ll try to describe with my knee bent: approximately the innermost (most medial) point of the bend of the knee – my impression is that it originates a little down into my calf at the most upper and medial area, maybe extending upward into my VMO as well. It’s really hard to describe without pointing at it.

Anyhow, my massage therapist had posed the possibility of pes anserinus (goose’s foot) tendinitis, but my PT dissed this opinion as too medial for that structure and wrote it off to a calf strain.

It seems to come on when I try to pedal “correctly,” i.e. in circles. I think the pulling back (scraping) motion brings it on. But why? I do overpronate moderately in that (right) foot, so have placed an insert with arch support in my shoes AND added shims to my cleats to counteract the pronation. The pain (until yesterday) seemed to have been helped by these measures, but it really flared up on a long ride yesterday – usually hasn’t hurt DURING a ride, only after. But yesterday . . . OUCH!!

Any ideas? Even my VMO hurts today. Thanks!

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    9 10

    Yes actually

    you should be toed in about 5 degrees when cycling to really avoid aggravating your ITB. Also your symptoms may all be just that symtoms of a problem elsewhere. there is a muscle behind the knee called the popeteal muscle which can be responsible for a number of problems and “vague” comlaints. I think you should visit a really good massage therapist and have him/her feel around to see what structures are involved and form a total picture.

    A client of mine had wicked ITBS which in the end (after I got her to rest long enough for the inflammation to subside) turned out to be related to some scar tissue in her back. Once her PT started treating her for the scar, her symptoms started to truly resolve.

    Good look,

    P.S. Happy Hunting


    9 10


    Thank you for your response. No pain when sitting in “butterfly” position. Also, have speedplay pedals with lots of float. Am conscious of keeping toes straight ahead when riding. Don’t wanna flare my ITBs.

    Have some muscle pain presently in my VMO, also a “cord-like” structure in roughly the area of my VMO, a little more medial.

    This along with some tightness in my medial upper calf area, below knee.

    Any more thoughts?



    9 10

    Hi Leeloo,

    Sounds to me like the insertion of your adductors. Try the butterfly stretch (sit w/ your feet sole to sole and allow your knees to flop) and see if you feel a tug in that spot.

    Ice too.

    You might need to adjust your toe in on your bike cleats. Toes should be internally rotated about 5 degrees OW your adductors have to pull your knees in and can get inflammed.

    Hope that helps,


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