Knee Pain/Injury

robpiper

Hi All

My apologies but this is a lengthy read. I'm currently training for an End to End Cycle in June where I will ride 100 miles for 9 consecutive days. I'm very much a beginner cyclist (previous longest ride being 40 miles) and my training started in January. For the first two and half months I was able to increase my mileage so that I was doing around 500 miles per month and managed to reach 80 miles as my longest ride. On the whole, other than tight calves and a small Achilles problem, I remained injury free, felt good and was ahead of my training schedule.

Around the 3rd week of March during the final 10 miles of an 80 mile ride I began feeling pain in the lateral part of my left knee, just below the knee cap. I didn't think too much of this and was still able to continue my daily commute to work with no problems. Around the same time I began feel lots of tiredness, exhaustion and lethargy. As a result I took a week off training as I just didn't feel like I had the energy.

Two weeks ago I picked it up again - commuting to work and also did two consecutive 50 mile rides. During the second of these two rides I began feeling the same knee pain where it was hard to push as I was going uphill. However, after the ride I didn't have any pain and was able to walk as normal (stairs, etc).

I decided to see a Physio who said that my Vastus Medialis Oblique (VMO) needs strengthening and also that I am slightly over pronouncing on my feet, causing my knee to be very slightly out of alignment and I require Orhotic Insoles to correct this.

Last week, after meeting with the Physio, I contracted a Gastro Virus, and whilst suffering this my knee pain began during non rides also. When walking down the stairs, trying to squat on one leg or changing gears in the car, I was having pain in the same area of my knee which was even more painful than when riding. I don't understand why this suddenly appeared as it had been 5 days since I last rode the bike.

Essentially, I haven't ridden for two weeks now due to the pain in my knee as I'm worried I will irritate it and make it worse. However, my ride is only 8 weeks away and I'm also worried I won't be fit enough to complete it.

The Physio has been working on my quads and also massaging around my knee area. The pain seems to be easing and getting easier but I was wondering if anyone has any ideas as to whether it is worthwhile or even sensible to try some smaller rides while recovering? I have also began doing a variety of stretches to loosen my lateral muscles as well as strengthening work to strengthen my VMO.

All in all I'm really worried as I'm not sure whether resting is the right option and I'm not entirely sure why the problem materialised after two and half to three months.

If anyone has any suggestions as to how I can still undertake this charity ride (as I have a lot of people and fundraising committed to it) then I will be extremely grateful to hear them. I thought my training was going well and ahead of schedule but I now wonder whether I did too much too soon.

Thank you

Rob

kajjal

I would check with a medical professional like your GP rather than a physio. For my shoulder injury I saw two physio's , one was useless and the second was very good. The first made decisions with no medical tests. The second used the medical test results to design the course of treatment which worked very well.

In general unless you have a pre existing condition cycling should not cause injuries. My left knee is slightly weaker due to injury but I get no pain after hours of cycling on road , except being exhausted ! Have a read up on bike setup as road bikes have to be accurately setup. When I first started road biking my bike gave me knee, back, ankle and saddle pain for rides over an hour. After adjusting the setup myself and getting a proper fitting saddle I now get no pain at all. The longer you ride the more bike setup issues become apparent.

It took me a few weeks of research and adjustment but now I understand bike set up a lot more and it helped me setup my MTB properly as well.

Hope that helps.

sungod

when you pedal, do your knees move up-down in a vertical plane parallel to the frame?

if one/both are moving side-to-side this may well be due to the over pronation that the physio noticed, it can result in knee problems

correcting this typically involves footbeds with increased arch support and/or wedges to adjust foot angle

for mild correction, the specialized bg footbeds are a good option, they also include some wedges and a guide to fitting, try the blue ones (aka ++)

it's also worth getting bit fit checked, if saddle height/position is wrong it can also cause issues

once triggered, problems can recur or just linger until the underlying cause is corrected

Bar Shaker

This sounds very like my IT Band problem.

Walking after a ride was fine but pedalling or climbing stairs was painful.

I think mine was caused by my saddle being too high and resting did not help as the saddle height didn't change.

Fatamorgana

Get a proper bike fitting.
You know it will be £200 very we'll spent.

Two thoughts on your lethargy and knee pain: are you pregnant and are you too close / over your crank arms?
Lastly - replace your cleats.

kajjal

Fatamorgana wrote:

Get a proper bike fitting.
You know it will be £200 very we'll spent.

Normally I would suggest doing your own bike setup but due to the distance you are planning to travel in a few days this is very good advice. Just make sure you research bike setup / fit before you go so you know what riding position etc. you prefer and able to get the most out of the process. The worst thing is to turn up clueless