Resting is Hard! - A Knee Rehabilitation Odyssey

peat

So, after a long winter of pounding in the cold, wet & dark miles in preparation for a big (hopefully) year ahead, a glimpse of summer arrives and ........................... I'm injured.

I treated myself to a week off having just come home from a training holiday in Mallorca, then went out on the usual club run on Sunday, felt great so carried on solo for the afternoon and did my first 100 miler of the year with a great (for me) average.

I felt on top of the world on Sunday night, brimming with confidence and looking ahead to a week of sunshine.

Wake up Monday morning - Right knee is swollen and the inside is tender to touch. Go to get out of bed and it's painful to bend it past 20 degrees. NOOOOOOOO!

A strict course of R.I.C.E ever since and i'm just about ready to blow my brains out. I have realised how all-consuming cycling has become to me and I feel totally lost as a result. And of course, this is all compounded by the lovely weather down south, seeing the world and his brother frollicing around on bikes everywhere.

The situation is grave - I had to resort to getting pissed and watching football with mates last night. The horror. THE HORROR!

Knee is now painless, but feels a little tight and notchy to move.(not sure how much of that is in my head though) Considering a very light, flat spin this evening but am terrified of going back to square one.

Boy oh boy, this resting lark is tough!

jgsi

So what made your knee flare up after what you say is the large mileage done over winter?
I'd be a lot more worried about not knowing the reason than having enforced off time.

peat

Well yes, that is obviously my worry. I guess I'll find out in time.

I have a slight 'clicking' feeling from the knee when i pedal, it feels muscular rather than bone/cartilage. Almost like the muscle on the top inner edge of the upper knee/thigh is under load then releasing suddenly.

I've been looking at various exersises to strengthen/improve knee movement and one of the tests is to test the amount of float in the kneecap when fully relaxed. It certainly feels alot looser than t'other, but I think I would like it verified by a physio before i go too much further.

Hopefully it's just that. 31 last month, getting old you see.....

kajjal

I would get it checked out so you know where you stand and can have proper targeted treatment. My left knee is weaker after a knee injury but cycling keeps it built up and I have no problems.

peat

Update (for if this ever get's searched):

Physio reckons it's Patellar Tracking Disorder. (wonky knee cap)

Prior to taking up riding (frequently) a few years ago, I was never what you could call athletic so has a pretty poor base to start from.

He says my outer quads are pretty strong but the inner (medialis) is relatively under-developed. Add to that my lack of stretching/complimentary exercise and I have tight quads that pull my knee cap all over the place, stretching the ligaments.

Love and Light.

ai_1

Peat wrote:

Update (for if this ever get's searched):

Physio reckons it's Patellar Tracking Disorder. (wonky knee cap)

Prior to taking up riding (frequently) a few years ago, I was never what you could call athletic so has a pretty poor base to start from.

He says my outer quads are pretty strong but the inner (medialis) is relatively under-developed. Add to that my lack of stretching/complimentary exercise and I have tight quads that pull my knee cap all over the place, stretching the ligaments.

Love and Light.

I've had similar problems (though perhaps less severe) with both knees which made me stop running years ago. That's how I started cycling. When cycling it initially still caused discomfort but but much less so. Once I spent some time strengthening my knees the pain and clicking started appearing less frequently and eventually almost disappeared. I think I really need to do some maintenance knee strength work to maintain the balance of muscles around my knee but being a bit lazy with such things I don't have occasional twinges but nothing that stops me riding, plus I eventually got back running again too.

Enforced rest can be very frustrating but hopefully it doesn't last too long. Maybe keep the rides shorter for a while once you do get back on the bike and up the intensity to compensate. Your issue may vary but in my case duration not intensity was the trigger. Higher intensity sometimes seemed to actually improve my knee, my theory was that the stabilising muscles didn't fatigue at the same rate as the main working muscles and also that I could better feel and subconciously correct any proportionally small off-axis loads when pushing hard thus helping keep my knee better aligned. Just a theory and could well be nonsense!

tangled_metal

I had that. Got told the knee cap moves up a kind of groove and any imbalance results in one side trying to pull it over that way. Can result in it trying to come out of its groove. I think mine was the tight band running up the outside of my thigh that attaches to the knee cap IIRC being too tight. I got the load bearing exercise of leaning against the wall with the knees bent at 120 degrees and the feet about shoulder width apart. Holding that position for some time then relax and repeat. Building up the time in that stress position.

Never did it but found my own exercises instead. Stopped having problems and carried on. The trouble with knee problems I have found is once you start you will keep getting problems. I finally got fed up with just getting fobbed off with a printout from patient.co.uk or the local hospital physio department on knee pain, causes and exercises from the GP (apparently they are being told to not bother the physios but print this info off). I got them to xray and MRI the knee and I am going back shortly to get the results. Once you have a bad knee I think you will keep getting problems (not necessarily the same issues each time)

dilatory

Do you use Speedplays?

ai_1

dilatory wrote:

Do you use Speedplays?

I do. They definitely helped

dilatory

Ai_1 wrote:

dilatory wrote:

Do you use Speedplays?

I do. They definitely helped

Mine were great until suddenly intense knee pain caused by the dreaded rocking from the plastic base wearing. New cleats fixed it but an unpleasant signal that they're worn.

peat

Been using Shimano SPD-SL's since owning a road bike. Never had problems before, what benefit would you say Speedplay offers?

I use MTB SPD's on my MTB & SS and find the knee pain alot less/non existent when riding those.

I went for a small spin on the roady yesterday and my knee got quite irritated within 1hr. I'm beginning to think there is a fit issue on it. Perhaps something has moved??

ai_1

Peat wrote:

Been using Shimano SPD-SL's since owning a road bike. Never had problems before, what benefit would you say Speedplay offers?

I use MTB SPD's on my MTB & SS and find the knee pain alot less/non existent when riding those.

I went for a small spin on the roady yesterday and my knee got quite irritated within 1hr. I'm beginning to think there is a fit issue on it. Perhaps something has moved??

The speedplays have nearly resistance-free float which I found allowed my knee to find the most comfortable position throughout the pedal stroke. I was immediately more comfortable the first time I used them 4 years ago and have done so ever since. They also have a huge range of float (+/-15 degrees IIRC) and it's completely adjustable so you can lock out the float or individually set the amount you want in either direction on each foot. I've reduced float in one direction to about half of maximum so less movement is needed for clip in and out and left the full 15 degrees in the other. Never had any problems.

I'm not certain having not used them but I expect the float on the SPDs will be much lower resistance than the SPD-SLs? If so this may explain the increased pain using the road bike. Can you switch the pedals over and ride the road bike with the MTB pedals and shoes? It would at least rule in/out the pedals and bike fit which could avoid a big wild goose chase if they are not the issue!

peat

That, I shall try.

thiscocks

Search for VMO strengthening exercises.

peat

Yep, and these are being stepped up with immediate effect.

I am not allowed on the bike for 2 weeks.

In the meantime, I have to do a rocky-montage of work on my Vastus Medialis to make them start to make my knee track anything like it's supposed to. The other knee isn't great either, so a chance to effect some positive changes.

The work starts.......after tea.