Lower Knee Pain

petemadoc

I seemed to have developed some knee pain over the last few weeks. I first noticed at after doing a 100 mile sportive and thought it was probably just because I wasn't used to doing that kind of distance. But yesterday I did a quick 25 miles and the pain is back.

I'll try and describe it as best I can. The pain seems to be just below my knee caps on both legs and only noticable when walking up stairs or pushing down on the pedals when on the bike.

After the 100 miles I did it kept me off the bike for a week but until yesterday I've been fine.

I've been thinking it could be saddle height, cleat position, and I have played around wih these to try and get things right. Dropping a plump line down from my knee it's about 3cm in front of the pedal axel. Pretty sure my seat height is good.

Has anyone else suffered anything similar and managed to pin it down to something specific?

Duffer65

I had the very same thing some months ago after attacking some hills my right knee became very painful in the way you described. I went to the doctor and he thought it was a torn miniscus and told me to rest my knee and not to ride my bike. After about six weeks, although it had got a little better, he thought it best to refer me to the hospital. I had an x-ray and saw the consultant and he said that I had only strained my knee and to rest for a few more weeks and then start gently riding my bike again..no hills! I did think at one point that my knee would never get better, but it has and I'm now able to ride as normal..well, as normal as I ride.

u05harrisb

yeh i had the same happen to me for pushing to hard up hills doctor told me just to rest up, i had strained the muscle or ligament bits next to the knee cap. apparently its the muscles all around the knee that keep the knee cap in position so my problem was one was strained and was therefor not doing its bit keeping the cap in equilibria if that makes sense

Ben

petemadoc

I thought it could be a simple strain as it only came on after that 100 miler. I've ridden 60-70 miles in the past with no problems but at this sportive I was pushing quite hard to keep up with some fast groups so maybe that's what did it.

Any idea how long these things take to heal properly. I think I agrivated it yesterday after having a 10 mile race with some mates.

RickyG

I had pain below one kneecap very recently that was painful on the downstroke of the pedalling action and at its most painful when the leg was almost straight.

Mine turned out to be something called a 'fat pad impingement' caused by having my left cleat pointed too far in towards the bike. Two weeks of RICE treatment and several ultrasound sessions and it seems back to normal now. Could maybe also be patellar tendonitis if it's below the kneecap?

When I described my symptoms to the physio those were the two things he came up with first.

u05harrisb

not toosure how long it will take, i keep thinking mine is okay then going out and riding and then screwing it over again, its quite frustrating. sofar all in all its been about 3 months mabye a tad more, but if you rest up will then you will be fine im sure!

forward_loop

To OP - if you where pushing hard in the sportive - then ideally you should be knackered. Not have knackered knees.

Supsect its still saddle height fore/aft issues. (and probably saddle too low) Remember if you move the saddle forward in most cases you might need to raise it lightly - andvice versa for moving it back.

if it feels better pretty quickly off the bike then that might also point to the fit.

I dont think its the cleats.

usual caveats apply....

edit - suggest you sort this out before you buy the "best" pedals which in many cases will exacerbate the issues you are facing above.

petemadoc

Forward loop wrote:

To OP - if you where pushing hard in the sportive - then ideally you should be knackered. Not have knackered knees.

Supsect its still saddle height fore/aft issues. (and probably saddle too low) Remember if you move the saddle forward in most cases you might need to raise it lightly - andvice versa for moving it back.

if it feels better pretty quickly off the bike then that might also point to the fit.

I dont think its the cleats.

usual caveats apply....

Yeah I was knackered after the sportive too but the last 20 miles my knees hurt like hell, I just span through the pain which probably was't such good idea. I wouldn't say it feels better quickly off the bike, the 2 hour drive home after the sportive was not goog, every press of the clutch was a struggle. I tried to cycle to work the next day but it was too painful so a week off the bike then I was back to my normal commute and the odd training ride. No problems until yesterday. Another good way to describe the pain is like a bruise inside that you can't see.

I think it must be down to one of two things

A - bike fit

B - overdoing it and straining the muscle. This would be odd though cos I cycle nearly every day, but maybe the 100 miler was too much of a jump in distance

Monty Dog

Sounds like patellar tendon inflammation if under the knee - try RICE and anti-inflammatories and ease-up on the cycling for a bit - easier gears and avoid grinding big gears in the saddle. It's quite a common condition when people ramp-up their training after winter rather than it being a position or bike set-up problem.

petemadoc

2nd time RICE has been mentioned. Do you mean rice that you eat or is this a code I'm missing?

JustinLeeAtkinson

Rice is an acronym. Cant quite remember what it stands for, but it basically involves putting an ice pack on the affected area, and raising it up above your heart level to reduce the blood flow to the area and stop further inflammation. Should be done soon after the injury occurs though I think.

Anyway, here is my story. I am grateful to the posts from above.

I had left knee pain at the beginning of the year. just started to happen as I was building up my mileage. A professional bike fit, which raised the saddle quite a bit solved the problem in one fell swoop.

So I put loads of miles in bulidng up to a sportive of 100 miles one week ago. I had only done 70 miles in one go leading up to the sportive. All injury free, including some fast and hilly group rides of approx 60 miles with my club,

So, did the sportive, which had a few steep climbs, decent average speed, didn't feel too bad at the end, but since I have had right knee pain almost exactly the same as the pain I had at the beginning of the year in the other knee.

So the only answer seems to be rest. How annoying with such good weather outside, and two more local sportives planeed in the next few weeks! Will I ever be able to ride 100 miles with climbs again??

RickyG

RICE stands for Rest, Ice, Compression e.g. a tubagrip over the affected area, and Elevation.

I think they are most effective as soon as possible after the incident but if something is still inflamed the RICE should still help, it certainly seemed to in my case.

Rich

evilollie

Sounds like patella tendonitis . I have had my share I'd knee probs , snapped ligaments , operations etc , Hoffa pad probs , you think that it will never get better .

Things do improve sometimes it just takes longer than what you envisage .

Duffer65

Mine took around 10 weeks to get back to normal. However, you sound like you are fitter than me so it might not take as long. The best thing to do is see a doctor and get referred to a specialist for x-rays etc. as soon as you can.

I hated the idea of not being able to ride for so long but it was better to lay-off riding for 10 weeks than knacker the knee forever

Duffer65

Mine took around 10 weeks to get back to normal. However, you sound like you are fitter than me so it might not take as long. The best thing to do is see a doctor and get referred to a specialist for x-rays etc. as soon as you can.

I hated the idea of not being able to ride for so long but it was better to lay-off riding for 10 weeks than knacker the knee forever

Monty Dog

FWIW an X-ray isn't going to show up much if it's a chronic inflammation of soft tissue which it probably is due to the lack of acute pain.

petemadoc

I think seeing a doctor would be overkill. Although the pain today is the in exactly the same place as before it's nowhere near on the same scale. I cycled to work and back with minimal problems. Might drive tomorrow tho to give it some rest

So how do I prevent this in the future? Is it just a question of building back up to long rides slowly to strengthen the muscles or could it be the fit of the bike?

velvetytoast

I'm just going through exactly the same caused in exactly the same way - I asked the wife (she being a physio and all) 7-10 days complete rest to reduce any inflamation followed by gentle (think pan flat) riding with no pressure for a couple of weeks. I did my second ride today and sure enough I'm getting there :-) Just got to take it easy and build back up gently I suppose.....

T.C.

Ha, i've a problem with a clicky knee aswell, dull pain, not happy, again a physio wife of a friend checked me out, no serious problem, but get it checked, i did injure the knee in 2005 though

petemadoc

T.C. wrote:

Ha, i've a problem with a clicky knee aswell, dull pain, not happy, again a physio wife of a friend checked me out, no serious problem, but get it checked, i did injure the knee in 2005 though

Yeah it's the having to stay off the bike bit I don't like

T.C.

i did 6 hours yesterday though,not serious enough yet : -)

petemadoc

Cool, where did you go? Once I'm happy my knees are better I want to do a big ride over to Bala and on to Bwlch y Groes then back home. If we can find a date we can both do do you fancy joining me?

T.C.

Aye, i went Bala, Dolgellau, llan yesterday 90 miles, i'm going tomorrow pm, also might be going S Wales Sun, plan after .

petemadoc

Sounds like a similar route. I'm going to be taking it easy for the rest of the week on the MTB

Thelittlesthobo

As i am currently recovering from a completely ruptured patella tendon i feel qualified to comment on the need to protect this tendon. Believe me, it is one of the most horrible situations you will experience if it ever snaps on you. Mine went with a bang (Different sport) and i ended up with a knee cap up my thigh and a crater in the middle of my knee. Oh and you lose all control of your lower limb as it isnt really connected anymore. That tendon takes the equivelant of 18 times your body weight when it is extended so when it goes, it goes with a bang.

Not saying this is going to happen to anyone with patella tendonitus (I have that in both knees) but as my consultant said, its not exactly a healthy tendon to begin with is it.

Oh, i am 3 months into what is deemed to be a 9mth recovery period so dont begrudge any time for healing.

squigs

I did 204 miles last weekend, on the second day my knees were very sore. Started after 20 miles, then went after another 60 miles. 5 days later I did 35 miles and the pain was back all this was on the Roubaix. I went out 2 days ago on the sirrus and it felt fine. After reading the comments on here I checked my saddle height comparison and the Roubaix had gradually slipped over the last year, hadnt even thought to check.