Help ! Knee pain

Brocade

Hi,

After two years of cycling happily in all sorts and manners of bicycle, from road to mountain, including 200km rides like the magnificat, boom, suddenly on Saturday, my knee gave in. I was 75km into a 100km ride around Surrey and my left knee just started to hurt very badly.

Pretty much out of nowhere. The pain is to the right hand side of the knee cap and there is one specific point to the right of the kneecap that hurts when I put my finger on it and press. It was hurting whenever I applied pressure to the knee on the downstroke.

The pain is not on the kneecap, behind the kneecap or behind my knee. It's to the right hand side on my left leg.

So.... I am very worried. I cycled for another 10km and then took a cab home. It wasn't entirely intolerable and I can walk up and down stairs today but I feel a niggle there. It was quite painful those last 10km.

Any thoughts anyone ? Any recommendations ? Anything appreciated. I was supposed to do the Dragonride Sunday... (sounds of crying)

Thanks in advance

softlad

obvious question - had you changed anything on the bike or your kit (ie new shoes, cleats, etc) before this ride....?

Brocade

Changed to Time RXS pedals but that was ages ago... I guess my worry now if there may be any permanent damage, what the issue with my knee might be and how to heal it.

ut_och_cykla

see a physio or sports doctor asap. Could be any number of things and riding without knowing what risks making thinsg worse!!

CometGirl

See a sports physio. Your GP, if they're anything as good as mine, will conduct a conversation something like this:

Me: "Every time I ride more than 100km, I get a sharp pain in my left knee. I really need to sort this out because it's getting in the way of my weekend riding."

Doc: "Oh.

...

...

Er.

Well, don't ride more than 100km then!"

Whereas the sports physio I saw reckoned that it was a combination of being hit by a car (scar tissue inside the knee where there should be mushy stuff) some time ago, combined with only cycling - cycling gives you lovely big strong thigh muscles but little feeble cheestrings for iliotibial band muscles.

When your knee extends, your ITB muscles have to pull the kneecap over into some 'ridges' in order for the kneecap to move smoothly over the top of the bone. If your ITBs surrender too early, then you're forcing the kneecap over the bone without being in the right ridges, which causes extreme pain just to the right of your left kneecap.

When you cycle, you don't extend your leg fully, so you don't use your ITB muscles nearly as much as your thigh muscles, and you end up with this imbalance. So knee pain like this is quite common in cyclists.

See a sports physio and they will give you a number of horridly painful exercises to do to strengthen your ITB muscles, and this should sort it out.

I must go back to the sports physio... :oops:

evilollie

hoffa pad is a common injury in the knee as well its one of the most sensetive sturctures in the knee. It can be obvious with swelling on the medial & lateral sides of the patella tendon

ITB tends to flare up due to weak hip abductors, so working your glutues maximus & medialis help , the medialis help by stopping your femur rotate inwards , when the femur does rotate it causes strain on your ITB

ketsbaia

*watches thread with interest*

My left knee is utterly goosed. It's never been a fan of cold or wet weather (well, ever since I broke my leg above and below the knee), but more recently it's come under some serious strain due to me cycling more and more in preparation for the Marmotte. There's pain right in the middle of the patella as well as a more niggling, nagging sensation underneath. I can almost hear the grind sometimes. Thing is, it only kicks in after around 10 miles and tends to stop being too much of an issue after 20 or so miles once the knee's warmed up. Definitely improves the more miles I put in anyway.

I've recently started riding a new bike with new cleats, shoes, etc., but tbh it was an issue on my old bike as well. Had a proper fitting when I bought the new bike and had the cleats positioned correctly, so it shouldn't be down to that. Legacy injury coming back to haunt me? Or is it something I could get sorted in the next five weeks?

I know, I know, go and see a sports physio.

CometGirl

Oh, are you Marmotting as well?

I'm in France at the moment, I rode up something similar to the Alpe D'Huez today and my knee is telling me that the Marmotte is a Very Bad Plan...

Stretching. I must do stretching. I know what to do, i just never get round to doing it and have only myself to blame. :roll:

ketsbaia

CometGirl wrote:

Oh, are you Marmotting as well?

Assuming my knee doesn't give up the ghost, yes. I've a 'dry-run' at the Dragon Ride next weekend, so if I come through that and the following week's Magnificat, I reckon I should be OK. Might need some severe pain-killers for the day after, though.

paul.k

sounds like a strain to me probably where the connective tissue bonds round the knee ,dont waste time with doctors see sports physio straight away for a correct diagnosis as you wont want to miss out the best part of the cycling season
you need a diagnosis of whats wrong so youre not wasting time resting when you should be working it ,or working it when you should be resting it if you get what i meen.

i had a soft tissue injury in my left knee and waisted 4 months resting and it didnt improve till 3 months after i started cycling again ,physio will tell you best..

Brocade

Many thanks all, this is all useful. I have the same prejudice about what the GP would say so not even thinking of bother to go. Let me find a good physio (if any recommendations near Central London, pls pm me) and see what they say.

AntiShaver

There's an excellent article from bikeradar that has been very helpful in the past and worth a read.

Part 1

Part 2

Brocade

Thanks, will do.