QUESTION:

During my first ride of the year on an indoor mag trainer, I developed some pretty serious knee pain, only on my right knee - just about where your quad attaches to the insde of your knee (forgive my lack of medical terminology. It started out fairly dull, but has progressed to a sharp pain after several more trainer rides. I spent most of the last year running, but bought a Cannondale R700 several months ago and began riding quite a bit. I never noticed this pain on the road. Any tips? Could it be the fit of my bike? Could I be taking an irregular pedal stroke on the trainer? Help!!

ANSWER

There are several possibilities for what you describe.

• 1. *Unusual or different position on the mag trainer*. Depending upon what type of trainer you have, there may be a discrepancy in wheel height, or excessive side to side rocking (eg. trainer set up on carpeted floor)
• 2.* Cranking the resistance up to 10.* The so-called, "young male, testosterone phenomenon" (no offense to anyone intended). Even with perfect form on the road, too much grinding, too early causes knee pain. I see this every year with some cyclists at Rice University. After a reasonably quiet December and January, they hit the roads and hammer -- and get knee pain. On a resistance trainer, the tendency is to try to get a "quality" workout within the smallest time frame possible, because it is so monotonous. You are better off -- especially early on -- going to a very easy resistance level and just spinning.
• 3. Even with a "perfect" set-up on a resistance trainer, it is never quite the same as road riding. It is easy to forego balance and throw force around on a trainer. This translates into abnormal biomechanics and ultimately, pain.

Recommendations.

• 1. Keep a log of your set-up, resistance, etc...
• 2. Change one variable at a time.
• 3. Pain is your friend. It lets you know when you are doing something wrong. Estimate your pain score (0 - 5), and have some reasonably objective way of quantifying it (eg., 1= slight soreness the day after a workout that goes away after 1 day). By comparing your daily pain score to the other components in your training log you can see if your adjustments are working to cure your problem. The goal is a progressive decline in pain scores to zero. Keep in mind that the pain may lag the resolution of the biomechanical problem.
• 4. Easy spin workouts.
• 5. For base building, approx. 75% of the workouts should in the easy aerobic range. Strength training is very useful for the remainder of the workouts as it prepares the muscles and tendons for the increased loads they will be experiencing later during intensity and interval work. High reps with weight / resistance training, if done correctly, can be a key element to preventing injury.
• 6. If the pain doesn't go away, see your doctor.

Hope this helps. Take care,

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