Knee issues

cerv52

Since an extremely long ride over the Easter weekend I have had a painful left knee. Its really hard to describe but I will try and explain how I think it came about and what it feels like.

On the third day of my 400 mile challenge, whilst riding the saddle had dropped about 2" without me realising until I had got home, whether this the cause of the pain I am not sure but it could be a factor. The pain is not to do with the muscles surrounding the knee but something beneath the cap to the top right corner (if that makes sense). My knee does not grind or is in no way painful when straightened or put in any still (rested) position. When the leg is bending the pain starts from the same point and it feels like something is pulling inside. When this happened at Easter I hardly rode at all (26 miles the following week and 2 evenings of spinning on the turbo) till yesterday doing a 72 mile sportive where it hurt a little but not too much that it was unbearable. Maybe in hindsight I should have done a shorter distance but once on the bike I find it hard to stop (typical cyclist!). I am not sure how to remedy it.

I have had a Retul bike fit (end of last year) and therefore position is good and I am comfortable on my bike. I have spoken with the fitter and he has suggested I have over worked the joint and not let it adapt to the new position for long enough.

What's the next step, a few weeks/months off cycling altogether, gentle spinning on my turbo trainer a few times a week or gentle rides on the road. Or should I go and see a specialist about it??? :?

alistaird

As one who suffers with knee problems since an op in 1982, my advice would be to Ice it regularly, plenty of stretching and very gently exercise and if it's not improved after a week, seek specialist advice.

Just my 2p based on my experience but yours is probably completely different.

A

cyco2

I think you should listen to that sensible chap inside you and execute it's advice to the letter. Because the 'cyclist' is going to cause you a lot of problems.

I've seen that dropped seat position by a 'cyclist' before on a very hilly ride. I told him he would knock his knees out if he carried on. I also wanted to tell him he looked like a talented circus monkey. But prevailed on that one. His comment after I got him to raise his seat was "do you think it would be better for me then, still I can always drop it when I get home".

phy2sll2

You need a physio, not a bike fitter.

If your injury wasn't sudden, then chances are it's down to a tight IT band or muscle imbalance that'll need appropriate strengthening exercises to correct. Physio will be able to diagnose and prescribe as appropriate. Warning, you may be inducted into the foam roller club.

In the meantime, continue to ice and consider anti-inflammatory gel or pills. Voltarol emulgel is the nuts.

Dezza

This is all sounding very familiar to me. I went a bit OTT during Jan/Feb and was grinding out some elevation based rides, only for my knees to give in. The pain was very similar to the OP's description but in both knees.

I visited a bike fit + physio (Pearson's in East Sheen) who raised my seat and shortened the stem. I was told to increase cadence and take it easy until I sorted out knackered IBT and TFLs. Since then i've had to do 40 mins of leg stretches a day including the horrible foam roller (a real balls ache), reduce my milage and ride mostly in the 34 ring.

One thing I found very useful which you could try? My physio showed me this. Buy some K tape and cut two equal strips about 12-15cm long (rounding the ends). Split the backing in the middle and peel each side back about 50% of the way, now stretch the tape and place diagonally over the knee cap area only. With the other hand, hold this area down and rub down the remaining flappy bits - but don't stretch these parts, they need to remain relaxed. With the second strip do the same making an 'X' over your kneecap, endure the middle section over the cap is tight while the two ends either side of your kneecap are relaxed. This method should help slightly lift your patella away from whatever is swollen/inflamed underneath.

I caveat that this has worked for me, it may not for others. Its also hard to describe with text only.

cerv52

Dezza wrote:

One thing I found very useful which you could try? My physio showed me this. Buy some K tape and cut two equal strips about 12-15cm long (rounding the ends). Split the backing in the middle and peel each side back about 50% of the way, now stretch the tape and place diagonally over the knee cap area only. With the other hand, hold this area down and rub down the remaining flappy bits - but don't stretch these parts, they need to remain relaxed. With the second strip do the same making an 'X' over your kneecap, endure the middle section over the cap is tight while the two ends either side of your kneecap are relaxed. This method should help slightly lift your patella away from whatever is swollen/inflamed underneath.

I caveat that this has worked for me, it may not for others. Its also hard to describe with text only.

Thanks for your help, not sure I quite understand your point above, maybe next time you do this you could take a pic and add it here please for future reference.

I do have some good news, following my ride last Sunday my knee is in much better shape this week. I have taken it easy during the week with no cycling at all, not even spinning on the turbo. I have taken 4 x Volterol 25mg tablets at the times it was most needed, think that was Tuesday and Thursday (2 each day) and now I can honestly say knee is much better. I rode my local 10 mile TT course alone today to see how it went and no problems to report. Time was not brilliant (28mins 28secs) but I have nothing to compare it with as this is my first time doing it.

I bought a foam roller too and did this when I got home today to stretch out the IT band, pretty painful down the left side but not the right, (left knee is (was) the damaged one)). Should I be using the roller every day or is it only after riding?

steve6690

cerv52 wrote:

Dezza wrote:

One thing I found very useful which you could try? My physio showed me this. Buy some K tape and cut two equal strips about 12-15cm long (rounding the ends). Split the backing in the middle and peel each side back about 50% of the way, now stretch the tape and place diagonally over the knee cap area only. With the other hand, hold this area down and rub down the remaining flappy bits - but don't stretch these parts, they need to remain relaxed. With the second strip do the same making an 'X' over your kneecap, endure the middle section over the cap is tight while the two ends either side of your kneecap are relaxed. This method should help slightly lift your patella away from whatever is swollen/inflamed underneath.

I caveat that this has worked for me, it may not for others. Its also hard to describe with text only.

Thanks for your help, not sure I quite understand your point above, maybe next time you do this you could take a pic and add it here please for future reference.

I do have some good news, following my ride last Sunday my knee is in much better shape this week. I have taken it easy during the week with no cycling at all, not even spinning on the turbo. I have taken 4 x Volterol 25mg tablets at the times it was most needed, think that was Tuesday and Thursday (2 each day) and now I can honestly say knee is much better. I rode my local 10 mile TT course alone today to see how it went and no problems to report. Time was not brilliant (28mins 28secs) but I have nothing to compare it with as this is my first time doing it.

I bought a foam roller too and did this when I got home today to stretch out the IT band, pretty painful down the left side but not the right, (left knee is (was) the damaged one)). Should I be using the roller every day or is it only after riding?

I would just stretch after a ride. I use a roller for my tight IT band and was taught that the roller is used before a stretching session. I always warm up, roll, then stretch.

mrbrightside

I've gone from 0 miles to 100 miles a week in two months and had pain in my left knee (no surprise as i've had a knee reconstruction). i must confess i haven't been stretching at all!

However when i started stretching my i.t band it's but gone. i've just had a foam roller delivered and have booked a sports massage for tomorrow at a private physio (£38 bargain) to get those knots out.

DRBB

Proper diagnosis by a sports orientated professional will really help; knee pain can be referred from various structures in and around the knee including the cartilaginous structures (meniscus, surface of the knee cap), ligaments, tendons and joint capsule; it can also be the result of muscular imbalance eg ITB, hip etc.

Foam roller is a good way to go after diagnosis as is correct cleat alignment etc.