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Over the summer during one particular ride, the Middleton 100, I experienced left-sided knee pain with only 10 km to the finish. 

It was quite intense and made me avoid quadriceps contraction and I was tending to ride using my right leg with some hamstring action on the left.I rested it in the hope of a rapid recovery but after a month, it hasn’t really settled.

 As part of my considerations as to why this had occurred when I’ve ridden thousands of miles I realised that I had just recently changed the cleats on my shoes. The rest of my set up had remained the same over the last couple of years. When I changed my cleats I made the error of not drawing around them with a marker pen so that the new cleats could go on to the shoe in an identical position. 

I put them where I thought they should be and I just wonder retrospectively whether this was the cause of the problem. The position of your cleats has two fundamental variables. How far forward or back the peat is positioned and then at what angle the cleat is positioned with reference to the longitudinal axis of the shoe. 

I therefore spent some time talking to a selection of bike setup experts for their suggestions. A general comment was that a cleat placed too far forward is more likely to create problems than if the cleat were placed further back. It’s also important to recognise that we all have an individual lower limb design and that we have rotations in our lower leg individual to ourselves. Recognising this natural plane of movement is important. 

When you are walking around or sitting with your legs hanging over the side of a table or desk you will notice that your feet either point forward or perhaps more comfortably toe-out. Try and mirror this with your cleat set up. In my work I recognise that the majority of the knees that I see from cyclists are caused by overuse injuries. This is dependent upon the cyclist’s ability, the training intensity and the volume of work they do. We are able to compensate for some mistakes in our set up but getting the cleats just right is essential should the intensity or the volume be greater. 

Unfortunately an element of trial and error is required.  Some cleat systems have different limits to the foot position. As a brand, Mavic tends to put the cleat mounting hole position in the bottom of the shoe quite far forward whereas Specialized and Shimano have the holes further back.  Setting cleats up is easier on a turbo trainer than on the road. Start with the cleat rearward so that much of the foot as possible (given the constraints of the shoe holes) is in front of the cleat to begin with.  

Some cleats have built-in a degree of ‘float’ or play and this allows your heel to move from side to side even when the front is clipped in. Speedplay in particular have this design. I change my cleats in front of every significant distance ride and I found that a small amount of grease helps the screws run smoothly and lock in place. As always however if your problems are ongoing get a professional shoe/cleat fit as an expert will have a much better idea of what set up position would be right for you.

Cape Rouleur 2016  – Part of the HotChillee Global Event Series which includes The London-Paris and Alpine Challenge.

The Cape Rouleur is a 5 day endurance road event that covers 600km and almost 6,000m of climbing. It is a pro style event that has rolling road closures, seeded groups commensurate with ability and full technical, medical, logistic and pro crew support.

Cape Rouleur riders also get the opportunity to gain seeded entry to the Cape Town Cycle Tour, the world’s largest individually timed cycle race followed by VIP finish hospitality. This gives participants a full week of cycling, comprising of a prologue, three stages of the Cape Rouleur, a 112km Festival ride into Cape Town escorted in style by the City traffic police.

Organise your telephone consultation with Wimbledon Clinics, the sports injury specialists. We will help you develop a clear strategy for dealing with your injury and help you get back to your best as soon as possible.