TTP reader Matt asks the following question:
Hi Keith,
I’ve been enjoying your blog for quite some time, so thank you for providing such a fantastic resource. I eat, workout, etc., in a similar fashion as you and also happen to love riding fixed. But I’ve recently gotten a bit concerned about possible long term knee damage from grinding up hills, bigger gears, and fixed in general (I want to still be sprinting 20 yrs. from now!). Have you read about or explored this at all? Just wanted to get your take. Thanks in advance, I truly appreciate your time.
Best,
Matt
Oh yeah; my God, have I ever heard this one. This “dude, fixie kills your knees” thing kinda falls into the same bro-science department as “full squats will blow-up your knees”….or hack squats, or Zercher squats, or Oly squats, or plyometrics, (or hell, name your poison of choice) will damn your knees to friggin’ hell. The thing is, if there were any merit to any of these arguments, I should be a friggin’ cripple by now, as I’ve been riding fixed for well over a decade, and I’ve been hitting every squat and plyo variation imaginable for — well, I don’t want to sound like a curmudgeonly ol’ dinosaur, but it has been some 30+ years. And before that what was I doing? Riding single-speed bikes, skateboarding (without a helmet and pads!!), jumping off of roofs, climbing ropes, and generally being a little body-bashing hellion. And yeah, at one point I did blow up a knee. But what my ACL and MCL finally gave into was the result of a freak, instantaneous commingling of speed, cleats, natural turf, and force x mass x acceleration delivered at a “perfect” angle and point-of-impact. But hey, that’s another story for another time…
…the point is, I still I have no knee pain at all, and none as a result of any hard-and-heavy fixie riding or squatting, or whatever else, for that matter. Of course, I am an experiment of only one. In all seriousness though, Matt, I have no doubt that some people do experience knee pain that results from huckin’ it fixed and that some people do suffer knee pain from squatting and other “questionable” forms of exercise. What these folks fail to realize, though, is the difference between cause and correlation.
In short, what huckin’ it fixed, squatting, plyometrics and all other “knee destroyers” are actually doing is (1) exposing an underlying muscular weaknesses and/or imbalance, and/or (2) serving as an indicator of crappy/sloppy form. And, if truth be told, in most instance we’re dealing with both — as one condition inevitably leads to the other, in a kind of self-perpetuating death spiral.
Now, this should not be interpreted as me implying that if your are suffering knee pain as a result of these “villainous” activities that you should just suck it up and endeavor to persevere. No, what I’m saying is that the resultant knee pain in these cases is simply a correlate, or indicator of another underlying, root problem. In other words, banning fire engines from responding to fires will do nothing to prevent fires in the first place. Address the underlying weaknesses and imbalances, and practice proper form. Once a solid base of strength has been established in the body’s basic movement patterns (push, pull, squat, deadlift, press overhead), any potential knee problems will be avoided. Know, too, that the “base” level of strength required to inoculate one from knee pain is relative. For pain-free fixie riding, we’re not talking about much; for a 900 lb squat, we’ve got a bit of work to do.
In short, Matt, get strong, stay strong, and huck-on with no fear of wrecking your peg hinges.
And hey, speaking of the ol’ fire/fire truck analogy, there’s this recent Mother Jones article, Death by Hamburger to deal with. I twittered about this yesterday, but this damn thing has the feel to me of — I dunno — Cliff Notes for the China Study? I mean, how many ways can it be said that correlation does not imply causation, that just because fire trucks are frequently seen near raging fires does not imply that they cause those same fires? For every article the mainstream knocks outta the park, we have to endure tenfold of these. Sheesh. And I like Mother Jones, if for no other reason than they force me to think outside of my comfort zone. I appreciate that in a publication. Anyway, good ol’ MJ missed the mark on this one. In fact, in honor of that piece, this is what I had for dinner last night –
That’s a nice porterhouse, brother — with some locally grown, fresh beets. Eatin’ my way to an early grave, no doubt 😉
Theory to Practice 
I have heard this so many times too… The one that gets me are the people who won’t do any form of lunge or other single leg work due to the fear of blowing their knees, but they will sit on a leg extension/leg curl machine all day.
Like you Keith, I have been ‘grinding big gears’ for 30 or so years now – with not an ounce of knee pain. Lucky? Maybe… but in my weight lifting career (close to 20 years now) I have always aimed to keep my hips strong, strong, STRONG!
Invariably, whenever I have looked at someone with knee pain, they have weak glutes, particularly glute med. Fix that, balance the hip joint, keep in mobile = no knee pain.
Invariably, whenever I have looked at someone with knee pain, they have weak glutes, particularly glute med. Fix that, balance the hip joint, keep in mobile = no knee pain.
Yeppers…
You are sooo right. The only time I ever suffer from knee pain is when I miss the gym for a while and thus stop doing squats or leg presses and an old childhood injury in my left leg starts to re-assert itself. Clearly lack of muscle balance is the problem.
Cheers – Mark
Reading this post blew out my knees.
Similar experience for me: It made my osteochondritis dissecans (http://en.wikipedia.org/wiki/Osteochondritis_dissecans#Causes) come back. I thought I had left that knee episode in the past with my early teenage years.
Seriously, though, I work diligently to maintain hamstring strength and flexibility to protect my knees. Skiers know.
Weak ham/glute strength is the usual offender in the muscle imbalance cause of knee pain.
After squatting like a maniac during the off season, I entered summer training for football and pulled a hamstring. Then, after hobbling for nearly 2 weeks recovering, when I did a sprint session about a month after the injury I pulled the other one severely. That imbalance in addition to making you look freakish can really cause injuries.
I try to balance all of my routines (or at least within a time period if doing split routines over a week) with push/pull exercises that complement each other. When I studied up on that, my lifts in my weak areas improved greatly, symmetry improved, and I would imagine I’ve had some injury prevention with this method, too.
Would be interesting to hear how you or Skyler develop your routines regarding posterior/anterior push/pull muscle groups. Or, perhaps, that’s ground that’s already been covered. Maybe a subject of another post for you if taking requests? Too often high quality new points of clarification are found in comments, often overlooked if you don’t enter the comments sections.
Forgot to clarify, that to my detriment, when I concentrated on squats, I very rarely did any hamstring work, sometimes skipping that lift entirely. The glut/ham strength ratio was completely out of whack. Forgot what my trainer told me at the time you should theoretically shoot for, but my hams were spaghetti noodles, and my gluts were granite.
meant to type:
The QUAD/ham strength ratio was completely out of whack. Forgot what my trainer told me at the time you should theoretically shoot for, but my hams were spaghetti noodles, and my QUADS were granite.
Yeah, I’ve heard these ratios tossed about as well. I’m not so sure I’d put much into them, however, as the skeletal lever system and ratios thereof act as the larger determinant in, for instance, squatting and deadlift ability. Technique is also an issue. For instance, Louie Simmons teaches a squat style that is predominantly glute/ham dominant. Very little likeness between this style of squat and, for instance, a high-bar, Oly squat.
In my opinion, it’s very, *very* difficult to overtrain the PC to the point of muscular imbalance with the quads. In fact, I don’t know that I’ve ever seen this. On a personal level, since I do so much biking (which is quad dominant), I don’t do much in the way of quad dominant iron work. And when I do, I ensure to hit a full range of motion (engaging the glutes/hams in the bottom-out position), or I focus on glute/ham dominant box squatting. I also lean toward more unilateral work (lunges, step-ups, RFESS, etc) — again, emphasizing a full range of motion.
Reflecting on these injuries after reading your responses, I think the hamstring pulls may have occurred not because of all of the heavy squatting, but with all of the leg extension work that isolated the quads, unlike the squat that engages other muscles groups, as you note.
That may have been my problem nearly 20 years ago, I wasn’t doing full range of motion exercises. Lower body consisted of just squats and leg extensions, and may hamstrings once a month. I didn’t engage in any heavy sprint sessions over the 6-8 months of lifting in the off season, neither.
I became about as flexible as an oak tree, and my hams just snapped like rubberbands when I did some sprint sessions during the first week of summer training.
I totally agree with your comments that a set ratio of ham to quad strength is probably useless regarding measuring muscle strength w/ isolated ham curls and leg extensions (for example). I would go with your prescription of full range of motion exercises along with squatting.
If I’m traveling and in a hotel gym, if the leg press is my only option for a lower body workout I skip it if I can’t do some ham curls. Will incorporate instead going forward some of the exercises you suggested. Thanks.
Since I deal with so few athletes, most of my training setup for laypersons is very hip/ham intensive. Glute activation work, abductor work, ham work all before any compound leg work.
I asked this question ages ago but am going to investigate myself: I’ve heard of being anterior dominant to a fault but I’ve never heard of someone actually achieving the opposite: posterior dominance to a fault. I suspect it could be done but I wouldn’t know who or what type of athlete would be a bad enough dude for the job.
You and I have discussed this prior, though I can’t seem to locate that thread at the moment. I’m not even sure how a PC-dominant-to-a-fault athlete would present. Quad injuries (other than contusions and the like) are pretty rare in my (admittedly small) empirical survey group. Our cultural propensity for sitting, and for *not* walking, of course, only exacerbates PC weakness — even within otherwise “well trained” groups.
You were reading this while squatting, weren’t you? 🙂
Isn’t that what the toilet is for?
*rimshot*
@Skyler….ROFLMAO…love it!
He’s here all week, folks!! 🙂
No doubt hip strength, hip mobility, and ankle mobility will protect the knees. I have seen it in many clients. They complain of knee pain with lunging or squatting or running. Sure enough, with several weeks of training they are doing these activities pain free.
I find myself ‘handling’ awkward landings, cuts, and collisions without knee pain during basketball. I play along guys who are my age with multiple knee surgeries and what can only be described as ankle battle gear. They don’t do any strength training. I couldn’t image playing without staying strong and powerful.
I can relate to both sides of this debate, having injured my knee in a freak accident and then recovered (ultimately winding up in a place where I can run, jump, ride, and squat pretty much pain-free). Several factors were instrumental in my recovery. First, I never gave up on physical activity entirely. Even as an athletic “cripple,” I would walk every chance I got, taking it slow if necessary and stabilizing with my other leg. As time went by and nature did her thing, I got more adventurous, loading the knee with machine exercises first and then transitioning to very light work with full range of movement. As I got stronger, I added more weight and allowed myself more freedom in jumping, running, etc. (including single-leg squats: I really like those!) The final piece of the puzzle was diet: cutting out wheat made the knee feel better than I thought it could (and relieved soreness in all my joints, actually).
On a related note, I am happy to report that after taking Keith’s advice (thanks, by the way), I can front squat bodyweight for reps (a measly 180-190 lbs, but the reps are full-range and represent a significant improvement in structural integrity for me: I expect I could do a lot better if I had a spotter, or if I absolutely had to bend down, get under something, and stand up).
I would point out a couple of things that I am experiencing and have discussed with PTists.
I have a significant leg length difference (mostly in the femur) – I’m talking > 0.5 inch. This has completely whacked out my hips, lower back and yes, my knees. Undoing a life time of compression on one side is a very slow process. (My xrays even show significant bone density in my hips from the diparity in weight carrying). I have no knee pain, but I certainly have a “grindy” knee on my longer leg – it cruches quite a bit.
So yeah, there are things that might exaccerbate your knees if you already have an underlying imbalance. Problem is identifying what the imbalance is and whether its muscular or skeletal. You can fix muscular imbalance – skeletal is a bit harder, and I would advise caution about “working through” to address muscular imbalance – there is a risk. But that’s my n=1, YMMV.
The other thing I noticed is shoes – OMG shoes. BEing all XX chromosomal, I have lots more options, with varying heel heights – different heel configurations will put different stressors on all your joints. To a certain extent – look at lots of the new athetic shoes – they have a significant front to back / heel effect. Make sure you’re using the right shoe for the right activity – running shoes probably not good for tennis, eg…
And if you have structural issues and you buy a shoe that only emphasizes your weakness, you’re asking for stresses and ultimate failures, with the knee being the weakest link as it were, due to how complex a joint it is.
Yeah, skeletal imbalances certainly throw a monkey wrench in the works. You’re most definitely a candidate for exclusively unilateral lower body work. Did you break your your (shorter) as a kid? Does going barefoot make things better or worse?
nope – bones all intact – (I think – never know – little brother broke his arm as a kid, but my parents were so anti-doctor that it was a week before they got tired of him complaining and took him in. Imagine their surprise when the “sprain” they kept telling him it was, was actually a hair line fracture.)
Just a little kinky. Or a lot, as the doctor seemed to indicate – 15mm is QUITE a bit off the standard…
you should see the lift I wear in my real shoes (can’t wear it with heels…) but oh how a difference it makes – if I am on my feet all day, I no longer have lower back pain, and I can actually stretch out my lower back. used to be a mass of knotted muscles. My rolfer in seattle was the one who first suggested I had this problem based on the way my back muscles were bunched.
A decade and set of x rays later, here I am. It was horseback riding that ultimately made me get it diagnosed – was having issues freeing up my hips and seat to use them effectively… that pony, he has some power over me. (He’s why I went low carb, and omg what a great thing this has been…)
Anyway, barefoot makes it worse unless i deliberately try to lift the short heel and walk more on ball of the foot. which has its own issues. A lift has really been the only recourse – and periodic deep tissue massages and chiro adjustments to try to free up years of compensation.
Two meatless days a week?!? Does it even count as a meal if meat isn’t involved somehow?
Does meatless even equate to a snack?
Another excellent post and dialogue, thanks for covering it!
Riding a bike (fixie or otherwise) is a nonimpact activity and involves no twisting forces; it’s hard for me to see how it could possibly be bad for your knees.
“But what my ACL and MCL finally gave into was the result of a freak, instantaneous commingling of speed, cleats, natural turf, and force x mass x acceleration delivered at a “perfect” angle and point-of-impact.”
Incidentally the EXACT same thing took my knee out. I rehabed it for 3 months and avoided surgery. I’m 90% on day-to-day activities, but I still can’t run or even think about sprinting for probably another 3 months.
It’s the CLEATS man! Those things should come with a warning label. It’s not natural to have THAT much traction, and when you create that extra grip, the foot won’t budge at all. All the force simply travels up the leg to the next joint. Instead of slipping on wet grass and falling down Bugs-Bunny style, I blew out my ACL and MCL. I didn’t even hit another player!! It was a simple rapid deceleration; I tried to slow down from a dead sprint in one step with that planted foot and the knee said no. Cleats = MENACE. Next time (after 3 more months of rehab…) I’ll take the slip and fall.
Preachin’ my sermon, brother. Awesome shirts, btw. We need one with a fixie/paleo theme. I’ve always figured the fixie community (replete as it is, with free-thinkers) would be ripe for an en-mass conversion if the paleo word were ever given a proper hearing.
Testify!
Hi Keith
Love your blog and have been regularly enjoying your posts for some time now. One thing that people always seem to miss when making a link between knee damage and fixed wheel is the fact that once upon a time the freewheel did not exist. Did all the cyclists of that era have creaky knees? I somehow doubt cycling would have had such mass appeal if so.
As an ex track cyclist I often wonder whether you have ever fancied trying your hand at your local velodrome? You’d surely make an excellent 500m/kilo rider.
I always wonder too, when you talk about fixie sprints what sort of things you are up to. Have you ever tried motorpacing or getting “overspeed” by hitting your sprint at the end of a downhill or with a raging tailwind? All good stuff for improving leg speed but better than that, huge fun too.
Simon
I would love to test-out the velodrome scene; sadly, though, that’s non-existent where I live. Hopefully, at some point my travels will take me near one. My interval sprints are set-up by the “natural” urban/sub-urban environment, i.e., stop-light to stop-light, etc., things like that. I have done overspeed downhill work, which is fantastic for developing spin speed — and a bit dicey, too, with no brakes and with being clipped in 🙂
By the way, thanks for the good words about the blog. And, hey, if you’re aware of a track in the southeast USA, by all means clue me in. Maybe Atlanta??
Hi Keith
I understand there is a track in Atlanta, the Dick Lane Velodrome. There is also one called Stone Mountain in GA but how close that would be for you I’m not sure (my US geography is embarassing). You could always have a look at the velodrome database on FixedGearFever.com. Some other interesting stuff on there too.
Simon
Atlanta and Stone Mountain are about 8 hours away via car; maybe a future weekend trip? Thanks for the link!