Knee pain only while on the trainer and while pushing high cadence

Before I get into detail, I want you to know that I have read most of the topics and I wasn’t able to find an answer that worked for me.

Background: ever since 2017, I started riding more miles indoors than outdoors. I have been doing a lot of riding ranging from long endurance rides to high-intensity workouts on the trainer so I am mentally and physically used to the intensity. Ever since 2019, I am starting to feel more comfortable with low cadence while in zone 2 on the trainer(low as in 70 to 80 RPM on average). I have been using the garmin vector 3 pedals with the look keo cleats for more than a year as of now and haven’t been having any issues with my knee.

The problem: August 2019 was the month where I did not even ride indoors. I decided to experiment with different saddle heights and was able to put in 300-450 km/week(10-14h/week) for almost 4 weeks without experiencing any discomfort on the bike. I then had to take a week off followed by a week of easy riding(on the trainer) due to a shoulder injury(which I am pretty sure has no correlation with my knee pain). After that, I started the century low volume plan. I trained about 10-14 hours per week and when it came to week three of the plan, I felt some knee pain on the right knee only. Below is a photo showing where it hurts:

What have I done so far?

  • I went to the physio who then did an assessment telling me that my inner knee(pointed above) is tight and I needed to stretch it on a regular basis using a foam roller. I was not convinced with the physiotherapist as she didn’t have much knowledge about bikes and I was told to “not push hard” which makes no sense for someone who is training for hard efforts. The pain was bearable but was very annoying and felt like a considerable hindrance.

  • I then went to a professional bike fitter who took my measurements including my knee angle and moved my saddle accordingly and adjusted the saddle height. I was told that my knee was aggravated and I needed to tone down the intensity for a week. Coincidentally, I finished the 3 week load from the century LV plan and was ready to lower the intensity for a week. I did five hours of riding the next week and I didn’t feel any knee pain as I wasn’t pushing hard. The next week, I started feeling some knee pain and I realized that my cleat position was not even looked at. I then played with the cleat position which didn’t help. However, I played with the garmin vector 3s pedal and I am not exactly sure what this thing does but it does make it feel like my leg is fixed:

I just turned it clockwise and felt that there was relatively a less lateral movement on my left knee and it temporarily solved the problem until today where it came back on. I then put on a new cleat and kept experimenting with different positions. That didn’t help either but this is my cleat position as of now:-

To summarize, the pain amplifies when my cadence is higher(approximately >80rpm). What can I do to fix this annoying pain?

to confirm it is a cadence issue, have you compared knee pain at the same power output, say FTP at 90rpm and 70rpm? What you may be attributing to cadence may be more related to force and cadence combined

I haven’t tried any effort close or higher than my FTP longer than approximately 2 minutes at low cadence so can’t say for sure. I stick to a higher cadence when I am closer to my FTP for quite a long time. From a random workout(tallac) which I pulled up from the calendar, the avg cadence during the first sweetspot block was 90rpm. That causes my knee to hurt.

I was playing with my knee today by watching this video https://www.youtube.com/watch?v=CssWqOwhIZw and trying it out. It made the pain worse :frowning:

So it doesn’t hurt if you do lower cadence at sweetspot for extended periods? Or you can’t even hold sweetspot at lower cadences?

I can’t even hold sweetspot at lower cadences is what I am assuming because I haven’t tried doing that.

So that sounds like more of a force/torque issue related to fit than cadence. You are just subjecting your knees to high force more times per min than you are used to. Do not continue pushing it. If you dont have a good idea of what adjustments to make then go get a professional fit before continuing

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