I'm always injuring my left leg, what have I done now?

endurojcb

I always seem to be injuring my left leg, and I don't know what I'm doing wrong.

First I tore a muscle in my groin/top of my left leg while doing a short but very steep climb (it just kind of popped). I then had to have 10 weeks of phyiso on it because the scare tissue healed up really tight so it had to be torn away from the muscle (I don't think I've ever been in so much paid as when the physio was proding her thumb as far into the top of my leg/groin muscle as possible).

Now I seem to have done something to my left knee.

I went out for a ride just over a week ago with a friend for about 3 hours in total, so not too long really. But after two hours of pedalling through the quagmire like bridleways and byways in my area I noticed that my left knee was starting to ache/hurt near the top towards the inside (if you were to look at someone's left knee, the pain would have been at roughly the 10/11 o'clock position of the patella near where I assume one of my quads must connect to my knee). It was only hurting every time I pushed down on the pedal putting a lot of pressure on it (such as going up a moderate climb). I had a feel while pedalling and noticed that there was the feeling of a slight clicking coming from said area every time I pushed down on the pedal. By this stage I was some 7.5m miles from home on the loop we do, so had to push on and deal with it. Anyway, by the time I was home It hurt like hell to pedal on it especially as there is a nice 1/2 mile stretch of road with a steep climb just before the finish.

I did start spinning at the gym twice a week about 3-4 weeks ago. One 45 min session on a Monday and an hour long session on a Thursday, but I hadn’t noticed any problems while doing that.

The area in question continued to hurt/ache for 3 or 4 days after the ride. It was fine to walk on, but if I got up from my desk at work to quickly I'd be reminded of it immediately. It doesn’t hurt any more though, but I'm worried about getting on my bike and doing it all over again now.

So, does anyone know what I have done, and if there's any way of preventing it in the future? And why is it always my left side that I injure, bearing in mind that I'm right handed and as far as footy goes, I'm right legged too?

Dr_Death

Why is it always the left? Bad luck probably.

Sounds like a small quadriceps tendon tear (vastus medialus by the sounds of it). Usual treatment is rest plus mobilisation/stretching and then gentle return to your normal exercise levels....

endurojcb

Thanks Steve, I had thought it might be a cartilage problem or something rather than the tendon, but you're a doctor so you know what you're talking about.

I did a 15 mins at 75-80% max heart rate this evening in the gym with a couple of quick changes of speed/resistence, and it didn't seem hurt at all.

If I do a squat my knee clicks at that 10-11 o'clock position of the patella when straightening the leg (standing up) but doesn't actually hurt!?

Will the clicking go away eventually?

Should I give spinning a miss for a bit longer or give it a go this thursday and see how it goes?

endurojcb

Well, after 5 sessions at the physio doing friction rubbing, ultrasound on the Vastus medialis (VM) tendon and strengthening exercises I have managed 4 weeks of easy riding at the gym doing 30 min sessions with no aches and pains from the tendon and only occasional clicking (but not all the time). Having started my proper training (only cruising alone at 80% of max) last week consisting of the Regular Mountain Biker programme here: http://www.mtb-marathon.co.uk/training/8.php the tendon has started to ache again.

It didn't ache at all during the hour of 80% of max riding I did last night, but started to ache after I got home and while cooking my dinner. It still aches (not hurts) now! If I push down on the offending area in a specific way with my thumb I can feel a crunch and the tendon (I assume that's what it is) moves very slightly. If I then do a squat or just stand up from my work chair my knee doesn't click. If I don't do that with my thumb it clicks when I stand up.

I'm wondering if I should maybe see a specialist about this now!? My physio did mention that my vastus lateralis (VL) is very tight and was causing my knee cap to be almost a cm out of place to the outside of my leg/knee. But I've been doing lots of stretches etc to sort that out and she said it had improved vastly compared to when I first saw her. She mentioned surgery as an option. Something called muscle release or something like that to take some of the tension out of the VL. Don't like the sound of that though! I'm really starting to get annoyed with this problem now!

NikB

I've had a fascial release performed on both of my patellae due to poor tracking within the femoral trochlea. For me it made no difference but your condition sounds slightly different and one persons' results shouldn't put you off. I think an element of the problem could come from the setup on your bike. It's worth getting how you sit on your bike checked out - i.e is the seat at the correct height and distance from the stem. When your foot is at the bottom of the pedal stroke your leg should be at about a 20 degree angle (this can be measured with a goniometer). If your seat height is too low you will be putting a hell of a lot more pressure through your quads which could cause such a problem.

Don't worry about feeling a tendon move, they are able to move to some degree. As for the crunching it could be the position of the patella within the trochlear groove causing that.

Matteeboy

Translated - you may have knackered your knee.

endurojcb

Matteeboy wrote:

Translated - you may have knackered your knee.

Oh......great!

NikB

Not permanently. I still have these problems and have little or no problems riding. If you use spd's it's worth looking at the Time ATAC system as there's more float than the Shimano ones which makes life a bit easier on your knees.

endurojcb

Have only just started using SPD's...like a month ago because I thought it might help my knees in so far as keeing my feet in the best position on the pedals and being able to pull up on them too. I've arranged another meeting with my physio next tuesday so I'll see what she says I guess. Luckily I have health insurance so hopefully it'll be all paid for even if I do need to see a specialist.

endurojcb

Update:

The physio couldn't help so I've been referred to a knee specialist. had an MRI scan last week cos he thought there might be a problem with the cartilage between the bones in my knee joint.

Anyway, the MRI scan showed that there was no problem with the cartilage or any other part of my knee and surrounding muscle / tendons, but did however show up a rather large white blob. If you've not seen MRI scan pics before then muscle shows up as dark grey matter, and catilage shows up even darker. I guess the denser the object, the darker it is. So this large white blob according the specialist turns out to be a ganglion cyst. He was as suprised to see it as me!

This would explain why my knee has been feeling tight and been aching for ages!

He's going to speak to a colleague about it to try to work out what the best approach is from here. Option A) Leave it. Option Stick a rudy great big needle in my knee and puncture it and suck the censored out, before injecting a steroid into it afterwards. Or option C) Keyhole it and cut it out!

Eek! Not sure which option I prefer!!

NikB

Ganglions can cause a lot of discomfort but they more commonly occur in the wrist. Removing them is often the way forward but each method does have its pros and cons.

endurojcb

Yer, I've heard people used to whack em with big heavy books to burst them under the skin.

This one is deep in my knee somewhere so you can't see it or feel it with a finger. It only showed up on the MRI scan. But would explain my discomfort.

Apparently there's a 50% chance of it coming back if they lance it, compared to a 5-10% chance if the cut it out!

NikB

At least if they lance it there's still an option to remove it at a later date if it does return. That way there is a chance of you not having to undergo surgery.

endurojcb

Yer true.

Well, they called me earlier on and they're going to lance it and then inject a steroid into it at some point over the next couple of weeks. Can't wait!! :?

Casbar

EnduroJCB

Hi there

I have read your thread and come to the conclusion that I must have something very similar to you. All symtoms etc sound exactly the same

Could you pls give me an update how things have gone for you since the lancing

Btw I'm 47 just in case we are of similar age and that might be a contributor to the problem

Regards

cas

The Northern Monkey

good luck with whatever they decide to put you through

keyhole surgery is fine, had that 3 times on my knee now
My problem is that i have been told i'll more than likely need a knee op by the time i'm 30-35. i buggered my knee playing rugby which tore some of my cartilage, and apparently its quite thin now.
I'm not actually sure whats wrong with my knee, i just trust my doc's to do whats best..all i know is that some days it really hurts, some days its fine... just depends how cold it is/how i slept

endurojcb

Guess I should update you:

Lancing the cyst didn't work, so in early September I had surgery to remove the cyst. it wasn't keyhole in the end, so I have a nice 1.5"-2" scar on the inside of my left knee just above the joint. They removed the cyst, my knee swelled up like a balloon and changed to virtually every single colour of the rainbow. About an hour after I'd woken up from the surgery the physio turned up and said to me "Well, come on, get out of bed, I don't have all day", which made me chuckle in my dozzy post op state! I was on crutches for 5-10 days putting more weight on my knee every day. had to do lots of streching exercises, but the joint still got really stiff, and at one stage I was beginning to wonder what I;d gotten myself into, but over the next 4 weeks it slowley eased up and I regained the full range of movement.

It's all fine now. i can run on it happilly for ages, although I haven't properly tacked cycling again yet. That's for the new year!

One thing that is annoying is that my knee (vastus medialus) still clicks when pushing down on the pedals. That was the whole point in the physio work initially! So I'm still at square one really apart from being minus a cyst! ANd I don't have a clue what to do next because if it still hurts to ride in the new year I might have to consider selling my Spesh!

Casbar

Enduro

Has your problem been solved now ? Are you back on the bike ?