Knee over-use injury - what to do?

treitz

Dear all,

In short, I am a reacreational cyclist who has spent his first winter on a trainer with power meter. After starting the outdoor cycling season in the beginning of March, not following any structured training plan or periodization of any sorts, I doubled my weekly TSS without rest for basically two months straight. This of course was bound to go very wrong, and I have now been out with an overuse knee injury for the past month.

Now I am finally able to return to some easy cycling. This time around I would like to set up a sensible training plan for coming back from my injury. Does anyone have any tips for me? How easy do I start out (power zones)? When/how fast do I start increasing training load? What types of workouts are most beneficial in recovering from an injury?

Any help is greatly appreciated!

borisface

It is very unlikely that you will have had an over-use injury in the relatively short period you have been cycling. Lots of people do scary miles each week with no side effects. It is more likely that you have injured yourself because there is something amiss with your bike set-up or position which has contributed to, created or developed an imbalance.

My best advice would be

a) See a good sports physio to sort out the immediate problem

b) Get a good bike fit by a reputable and experienced fitter to help ensure that you are doing what you can to avoid it happening again

c) Start back very gently - level 1 rides (i.e. stupidly slow with little resistance) 3-4 times a week maybe an hour max at first increase by 15 mins each week until you feel more confident.

d) Longer term sort out what you are seeking to achieve cycling-wise and work back accordingly.

Mikey23

And work on cadence instead of mashing out big gears!

treitz

Thank you for your replies!

a) My physio has just recommended some strength/weight training (basically squats in different variations) as well as hip external rotator stretches

b) Ironically, I was scheduled for a bike fit just a couple of days after my knee started to hurt. The guy that fitted my bike told me that my right (painful) knee was moving too much from side to side. With some new sole inlays and re-adjusted cleat position it got better, tough it is still not entirely eliminated.

c) Please pardon my inexperience, but is level 1 the same as zone 1? Due to me living in a hilly area, I am struggling going below zone 2 (at least on the climbs). I recently bought rollers (Elite Arion), is that a good alternative?

d) I was going to do a 450km 3-day ride in the beginning of august which was basically my main training target this season, which as it seems right now, is an unrealistic goal...

My average cadence is around 91. Is that too low?

Mikey23

No, that is way above mine which is low 80s... Cadence probably not the issue then!

borisface

Level 1 = zone 1. Rollers would be a perfect rehab device. 90rpm is fine.

Good luck.

craker

Lots of stretching! I'm still getting over a two year old knee ailment. Rest, private physio, 'easy' exercise didn't really achieve anything; the NHS physio got me doing calf stretches



Knee stretch



(the page I got that image from seems quite decent http://www.strongshape.com/exercises-for-knee-pain.html

Hamstring stretch



Of course these may not apply to your injury, in my case regular (twice daily) stretches can really loosen things up.

DeVlaeminck

To be honest one knee injury doesn't necessarily mean you have a big problem. Maybe you just overdid things a bit, too much too soon. Get back on the bike and just build up a bit steadier this time then monitor ow the knee feels.

kajjal

I would look at your bike setup as the longer / harder you ride the more apparent setup issues become. Once I stepped up the distances my bike gave me ankle, knee and seat pain. A new wider saddle in the right position and a stem change means I now ride for hours injury free. Also rest days are important so you get the most fitness gain from your hard work.

treitz

@craker: Ooooh, my calves are super-tight. I am unfortunate enough to be born with absolutely gigantic calf muscles that I never seem to be able to stretch enough. I did yoga a couple of years back, simply for the sake of proper stretching - perhaps I should start again!

@borisface: Thank you!

@DeVlaeminck: Well, that is kind of the problem. I still don't feel that my right knee is completely healed - if I push it slightly, I feel it aching the next day. This way, I feel that I have been on an "easy" training program for more or less 3 weeks, and the progress is marginal.

@Kajjal: Indeed! I did a bike fit recently, got a shorter stem and cleats adjusted. I am however starting to feel unsure that cleats are properly aligned, because I feel my right knee comes much closer to the frame than does the left... Planning on taking it to the store on next occasion to sort it out.