Knee pain--want input on toe-out for my clipless.

Skoorb said:

Although I have a history of knee pain (chronic runner's knee) and have researched this matter to great detail over the past couple of years, I want to get people's input on the appropriate toe-out for my clipless (SPD II with some float in the shoe) pedals. I have done all due-diligence with physicians, PT, seat is high, knees are very close to top tube now, etc, so I want to address toe-out.

I am M 5,11" with presumably fairly proportioned features and relatively good pysiology/. I don't think my hips are wide (thin if anything!).

My cleats are currently stock in their position, which results in my heel/big toe being about parallel with the top tube (so, some toe out, but not a heck of a lot). However, I've noticed that when I one-legged squat, if I want my upper leg to be parallel with a line in front of me as my posterior descends, I need pretty massive toe out, otherwise it will collapse inwards on the line. This makes me think that I should have a similar amount of toe-out with my clipless, but it seems like it would be an awful lot!

Apparently a device exists that some use to push their pedal further away from the crank so that they can toe-out even more and avoid their heel brushing the cranks (mine come very close, so to give myself more toe-out right now, I'll need to move the cleats a bit in on the shoe, which I can still do a little). Moving my cleats back (so pushing from the front arch instead of big toe) would also get me more room to encourage toe-out.

So really my main thing is I'm looking for experiences and also if my idea on the one-legged squat determining toe-out is fair. Thanks!

I would be very interested in this also. My right foot points out significantly to the side compared to my left due I believe to the doc not setting my cast correctly when I broke my ankle in 7th grade.

cugrad said:

I would be very interested in this also. My right foot points out significantly to the side compared to my left due I believe to the doc not setting my cast correctly when I broke my ankle in 7th grade.

My feet have always been pointing a bit differently. When I walk, my bad knee (right) points out more than my left but as I run it starts to come more in line and when I really get my pace up, it actually points more ahead. Instead of a leg length discrepancy, PT has pointed it to differential flexbility and strength in both sides, which I'm working on, but without being a pro and having access to trainers, it's always slow going!

Skoorb said:

My feet have always been pointing a bit differently. When I walk, my bad knee (right) points out more than my left but as I run it starts to come more in line and when I really get my pace up, it actually points more ahead. Instead of a leg length discrepancy, PT has pointed it to differential flexbility and strength in both sides, which I'm working on, but without being a pro and having access to trainers, it's always slow going!

Thats interesting. My foot definitely stays out to the side when I run, but I do have a leg length discrepancy also (I put one of those cheap insoles in my right shoe to compensate). Basketball + running + the abnormality have left my right knee pretty beaten up, which is why I'm looking at biking as a form of cardio I can do that will be much easier on it. Squats and deadlifts put enough strain on my knees as it is.

cugrad said:

Squats and deadlifts put enough strain on my knees as it is.

Yep, I stopped squats a long time back. I do one-legged only, and never below 90 degrees. I feel it ensures the alignment of the knee cap is better than with double-legged, in which case the knee doesn't have the best freedom of motion.

Skoorb said:

However, I've noticed that when I one-legged squat, if I want my upper leg to be parallel with a line in front of me as my posterior descends, I need pretty massive toe out, otherwise it will collapse inwards on the line. This makes me think that I should have a similar amount of toe-out with my clipless, but it seems like it would be an awful lot!
!

Your foot alignment while running should be a closer guide to your foot positioning on pedals than a one legged squat. If you're riding resembles one-legged squats more than running, you're probable pushing too much gear.

If you have excessive pronation or supination, you might look into orthotic inserts for the cycle shoes. Also consider shims to adjust the alignment of the shoe on the pedal along the foot's long axis (like cants on a ski boot sole). Greg LeMond markets a set of these--they're screwed on between the shoe sole and the cleat.